BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri. T.Sundara Ramaiah , B.Com B.L., President
And
Sri. M.Krishna Reddy , M.Sc., M.Phil., Male Member
Monday the 05th day of July , 2010
C.C.No.74/09
Between:
S.K.Rahimunnisa, M/o S.K.Habeeb, Ur Rahaman (Late)
H.No.50/348-E-22, Arora Nagar, B-Camp, Kurnool City, Kurnool-518002.
….Complainant
-Vs-
1. M/s. Oriental Insurance Co.,Ltd., Rep.by its Senior Branch Manager,
City Branch office-VIII, 4-9-6, Surya towers, HMT Nagar, Adjacent to NTR Kuteer, NACHARAM Main Road,Hyderabad.(Amended as per orders in I.A.156/09 dated 29-06-2009)
2. Oriental Insurance Co., Ltd., Rep.by its Managing Director, Regd .Office, Oriental House,
P.O.Box.No.7037,A-25/27,Asaf Ali Road, New Delhi-110 002.
3. The Oriental Insurance Co.,Ltd., Bhupal Complex, Kurnool Branch,
H.No.40-383, Ist Floor, Kurnool-518 002.
…Opposite PartieS
This complaint is coming on this day for orders in the presence of Sri. M. Sivaji Rao , Advocate, for complainant , and opposite party No. 1 and 2 called absent set ex-parte and Sri V. V. Augustine , Advocate for opposite party No. 3 and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No.74/09
1. This complaint is filed under section 11 & 12 of the C. P. Act, 1986 praying to direct the Ops
(i) to pay the policy amount with interest @ 24% p.a
(ii) to pay compensation of Rs.25,000/- towards compensation for causing mental agony and hardship
(iii) to pay cost of the complainant
(iv) to award interest @ Rs.180/- p.a from the date of death.
(v) to grant any other relief as the Hon’ble Forum deems fit and proper in the circumstances of the case.
2. The case of the complainant in brief is as follows:- The complainants son S.K. Habeeb, UR. Rahaman obtained a Group Janata Personal Accident Insurance Policy bearing No.431305/ 2003/ 84/ G.P.A/17 from OP.No.1. The policy is for Rs.50,000/- . The policy is valid from 14-08-2002 to 13-08-2006 . The complainant who is the mother of the deceased is the nominee under the policy . While the policy was inforce, the complainants son S.K. Habeeb U.R. Rahaman met with road accident and died with severe injuries in Fujairah U.A.E on 26-01-2005 and the dead body brought to India . After the death of her son the complainant received the baggage of deceased after one year. After tracing the policy the complainant wrote a letter to OP.No.1 claiming the amount. The OP.No.1 wanted clarification as to the delay. The complainant responded for the delay but the Ops did not settle the claim of the complainant . Hence the complaint.
3. Ops 1 & 2 remained ex-parte . OP.No.3 filed written version stating that the complaint is not maintainable. The complainant has to prove that Habeeb UR. Rahaman is a policy holder of the Group Personal Accident Insurance Policy and that the complainants son died on 26-01-2005 at Fujairah U.A.E due to road traffic accident. It is for the complainant to prove that copies of the letters of certificates were sent to Ops 1 and 2 and that the complainant has not received any amount towards compensation . The deceased Habeeb UR. Rahaman was a member of Ganata Personal Insurance Policy along with others . The policy was taken for the benefit of Group of employees by his employer R. Surya Kumar . Habeeb UR. Rahaman left the employment under R. Surya Kumar and joined in new employment in Fujairah U.A.E . The deceased was not under the employment of R. Surya Kumar by the date of his death . Therefore the Ops are not liable to pay any compensation to the complainant . The intimation of the death of the deceased was given much later than the specified period . Hence the Ops are not liable to pay any compensation.
4. On behalf of the complainant Ex. A1 to A7 are marked and sworn affidavit of the complainant is filed. On behalf of OP.No.3 Ex.B1 is marked and sworn affidavit of OP.No.3 is filed.
5. Both parties filed written arguments.
The points that arise for consideration are
(i) whether there is deficiency of service on the part of the Ops ?
(ii) Whether the complainant is entitled to the relief as prayed for?
(iii) To what relief?
6. Points 1 & 2:- Admittedly the deceased Habeeb U.R. Rahaman was a member of Janata Personal Accident Insurance Policy along with several others. Ex.A1 is the Janata Personal Accident Insurance Policy issued by Oriental Insurance Company Limited . OP.No.3 also filed the copy of Ex.B1 which is the copy of the Ex.A1 policy. The said policy is for the period from 14-08-2002 to 13-08-2006 . The deceased S.K. Habeeb U.R. Rahaman is one of the members of the said policy . It is also mentioned in Ex.A1 that K. Rahimunnisa the mother of the deceased is the nominee under the policy. According to the complainant the deceased was working in United Arab Emierates Fujairah Dist by the date of his death and that he died in road accident on 26-01-2005. The complainant filed Ex.A2 death certificate issued by U.A.E ministry of health stating that Rahaman died on 26-01-2005 in a traffic accident. Ex.A4 is also the copy of death certificate issued by Consulate General of India , Dubai (U.A.E) dated 08-02-2005 . In the said death certificate it is also mentioned that Habeeb UR. Rahaman son of the deceased died on 26-01-2005 in Fujairah U.A.E. From the above documents it is very clear that the Rahaman died in a road accident on 26-01-2005 when Ex.A1 policy was inforce.
7. It is the case of the OP.No.3 that the policy was obtained by R.Surya Kumar employer under whom the deceased worked in Hyderabad. Admittedly R.Surya Kumar not a party to the proceedings. Merely because the deceased Habeeb UR. Rahaman left the employment under R. Surya Kumar and joined employment in (UAE) it cannot be said that the complainant is not entitled for the benefits under the policy . After knowing about Ex.A1 policy complainant got issued notices to OP.No.1 claiming compensation under the policy but the Ops did not pay her the amount due. Ex.A5 is the letter addressed by Oriental Insurance Company to the complainant dated 05-11-2008. In the said letter it is admitted that the son of the complainant died on 26-01-2005 in Fujairah U.A.E . Under Ex.A5 the company asked the complainant to explain the delay in submitting the claim form. After receiving Ex.A5 the complainant addressed a letter to OP.No.1. The said letter is Ex.A6 dated 06-12-2008 . In the said letter the complainant explained delay in sending the claim form to OP.No.1. Even after the receipt of the Ex.A6 OP.No.1 did not settle the claim of the complainant . It is also argued by the learned counsel appearing for the OP.No.3 that the claim was not settled as the complainant failed to submit the copy of the FIR and post mortem certificate. No doubt in Ex.A1 policy it is mentioned that in the event of death of member of the Group Janata Personal Accident Insurance Policy the claimant should immediately inform to the office about the death and also submit the copy of the FIR and post mortem certificate . As seen from the evidence available on record it is very clear that the son of the complainant died while working in UAE . It is not know whether the police there registered a case and conducted post mortem examination was conducted over the dead body of the deceased. Ex.A2 is the death certificate issued by UAE , Ministry of Health . It is clearly mentioned in Ex.A2 that the cause of death of Habeeb UR. Rahaman is an account of severe injuries received in the traffic accident. In the light of the documentary evidence available on record have no hesitation to hold that Habeeb UR. Rahaman son of the complainant died due to the severe injuries sustained in the road accident . The deceased is a member under Ex.A1 policy issued by Ops. Inspite of demand notices the Ops did not settle the claim of the complainant . There is deficiency of service on the part of the Ops.
8. Point No: 4 : In the result , the complaint is partly allowed directing the opposite parties jointly and severally to pay policy amount of Rs.50,000/- compensation of Rs.5,000/- for causing mental agony and also Rs.500/- towards costs with interest at 9% p.a from the date of the complaint i.e, 31-03-2009 till the date of payment.
Dictated to the stenographer, transcribed by her , corrected and pronounced by us in the open bench on this the 05th day of July , 2010.
Sd/- Sd/-
MALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nil For the opposite parties :Nil
List of exhibits marked for the complainant:-
Ex.A1 Photo copy of Certificate of confirmation of Insurance.
Ex.A2. Photo copy of Death certificate issued by U.A.E. Ministry of Health dt.02-02-2005.
Ex.A3. Photo copy of Certificate issued by Consulate General of India Dubai U.A.E. dated 08-02-2005.
Ex.A4. Photo copy of Death certificate issued by Cnsulate General of India Dubai U.A.E. dated 08-02-2005.
Ex.A5. Letter dated 05-11-2008 of OP-1.
Ex.A6. Letter from complainant to OP No.1 along with Postal receipt and acknowledgement dated 06-12-2008.
Ex.A7. Letter notice dated 29-10-2008 along with courier receipt and acknowledgement
List of exhibits marked for the opposite parties:
Ex.B1. Confirmation of Insurance. Group Janata Personal accident policy No.431305-2003/84/JPA/17
Sd/- Sd/-
MALE MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the
A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties
Copy was made ready on :
Copy was dispatched on:
