BEFORE THE DISTRICT FORUM:KURNOOL

Present: Sri K.V.H.Prasad, B.A., LL.B., President

and

Smt C.Preethi, M.A., LL.B., Member

Thursday the 28^th day of June, 2007

CC.NO.02/2007

Between

Nandyala Savitramma,

W/o Late Chinna Dastagiri Reddy,

Narasapuram (v), Rudravaram (M),

Kurnool District.                                                  ... COMPLAINANT

Verses

1)       M/s United India Insurance Company Limited,

          Regional Office, 24 Whites Road,

          Chennai-600 014.

2)       M/s United India Insurance Company Limited

          Represented by its Branch Manger,

          Nagulakuntla Road,

          Nandyal.                                                     ... OPPOSITE PARTIES

          This complaint coming on this day for orders in the presence of  Sri.S.V.Krishna Reddy, Advocate, Kurnool for Complainant,  Sri.D.Yella Reddy, Advocate, Kurnool for Opposite Party No. 1 and No.2 upon the perusing the material papers on record the Forum made the following:-

                                     ORDER

(As per Sri. K.V.H. Prasad, President)

               CC.No.02/2007

1. This case of the complainant is filed under section 12 of C.P Act  seeking  directions on the opposite parties to pay her Rs.1,00,000/- towards the claim of Janatha Personal Accident Policy No.051102/47/11/51/56586/98 with interest at 18% P.A. till realization, Rs.25,000/- towards  mental agony and Rs.25,000/- as costs alleging deficiency of service at the conduct of opposite parties in non settlement of the claim ari8sing out of demise of policy hollered complainant husband by the opposite parties insistence for production of number of documents to evade the policy amount to complainant nominee of the deceased policy holder.
2. In pursuance of the receipt of notice of this forum as to this case of the complainant, the opposite parties caused their appearance through their counsel and contested the case filling written version denying any deficiency and their liability to the complainants claim disputing the alleged mode of demise of policy holder due to electrocution on 26-11-2003 and the failure on the part of the complainants to produce postmortem report of deceased, FIR, Panchanama and Report of Electricity Board as to the death of deceased due to electric shock as required in condition No.2 of the policy and the compliant as bard by limitation.

1. In substantiation of the contentions while the complainant side has taken reliance on documentary record in Ex.A1 to Ex.A3 beside to here sworn affidavit in reiteration of complaint and replies to the interrogatories exchanged, the opposite party side has taken reliance on documentary record in Ex.B1 to Ex.B13 besides to sworn affidavit of the opposite party No.2 and replies to the interrogatories exchanged.

1. Hence the point for consideration is whether the complainant has made out any deficiency of service on the part of  the opposite parties  and their liability to the complainants claim .

1. The Ex.A1 is the office copy of the legal notice datedf 20/02/2006 caused to the opposite party no.2 at the instructions of the complainant seeking the payment of amount of Rs.1,00,000/- arising on the demise of policy holder payment N.Chinna Dastagiri Reddy.  It shows enclosure to it the Death Certificate pertaining to the deceased issued by Panchayath Secretary (Ex.B8), Death Certificate issued by the Medical Officer, Government Dispensary, Bassapuram (Ex.B6), Certificate issued by S.I. Police, Rudravaram (EX.A3) and Policy (Ex.B1).

6.                The Ex.B1 is the said policy on the name of the complainants husband assuring an amount of Rs.1,00,000/- for the risks covered in schedule during 19/11/1998 to 18/11/2008.  It shows the complainant as nominee of the said policy holder.

7.                The Ex.A2 is the Xerox of the brochure pertaining to Janatha Personal Accident Insurance Policy in Telugu Language showing the coverage of risks of life to the policy holder occurring on account of any  accident with vehicle, snake and scorpion bite, electric shock, thunder, drowning  or due  to any other unanticipated incidents.

8.                The complainant alleges the demise of policy holder who was the husband of the complainant and to whom she was nominee was due to electric shock occurred at the field of policy holder on 26/11/2003.  The Ex.B2 is an undated application of the complainant addressed to the opposite party no.2 intimating the accidental death of her husband policy holder due to electric shock.  Even though it is an undated one it bares an endorsement as ‘mise-claims” with an initial and date as 16/12/2003. As it was lodged into the case by the opposite party No.2 from its custody, its receipt by opposite party no.2 remains as on 16/12/2003 as the Ex.B3 another undated application of the complainant with seemlier request as in Ex.B2, also bears seemlier endorsement and initial with an another dated of 17/12/2003.

9.                As per the conditions of the Ex.B1 the notice to the company could be given with one calendar month of the event which is giving raise to the claim. From the date of demise said application in Ex.B2 and Ex.B3 by their dates are within a month of the event.  Hence their appears complaints of condition by the complainants side as to giving of notice of the event which is giving raise to the  claim, especial when there is any contention from the opposite party side that the claim was  a belated one.

10.              The Ex.B4 is the office copy of letter addressed to the complainant by the opposite party No.2 requiring the production of original policy bond, Policy Report (FIR), Electricity Board report regarding accident, Death Certificate, Postmortem Report, Legal Heir Certificate, Ration Card, Duly notarized indemnity bond on Non-Judicial Stamp worth Rs.100/-.  As the base an endorsement as the receipt of claim form the said letter appears to have been issued consequent to the receipt of the claim form.

11.              The Ex.B5 filed by the opposite party side being Death Certificate in Forum no.6 issued by Panchayath Secretary, Bassapuer Village on 29/12/2003 and 10/02/2004 as to demise of N.Chinna Dashagiri Reddy on 26/11/2003, the Ex.B7 filed by the opposite party side is Family Member Certificate issued by M.R.O., Rudravaram as to demise of policy holder on 26/11/2003 due to accident of electric shock and the complainant as the one of the major member of the deceased family and the Ex.B9 filed by the opposite party side a notarized legal hair affidavit and the Ex.A3 an attested Xerox filed by the complainant being a certificate issued by A.P.C.P.C.D.C.L., Rudravaram as to receipt of a complaint of death of N.Chinna Dashagiri Reddy due to electric shock and the observation and issual of said certificate as occurred due to short circuit of starter wire and the original policy bond in Ex.B1 being filed by the opposite party No.2 the complainant  appears to have complied as to the production of above documents among the document sought by the opposite party No.2 in Ex.B4 and the complainant appears to have nearly not furnished the residuary documents sought i.e., Policy Report, Postmortem Report and Ration Card.  The accidental death of the policy holder being not an account of any body’s mischief or criminal act of any body or the said demise of policy holder being under any suspicious circumstances involving the indulgence of any culprits their remains any possibility for issual of any FIR as to the said event.  Further when the accidental death of the policy holder due to electric shock is being envisaged in Ex.B5 and Ex.B8 Death Certificate issued by the Panchayath Secretary, Ex.A3 Certificate issued by Electricity Board, Ex.B6 Death Certificate issued by Medical Officer, Government Dispensary, Narasapuram and Ex.B11 Certificate issued by Sub-Inspector of Police, Rudravaram Police Station there  appears any reasonableness in the conduct of the opposite party No.2 in doubting the geneses in the demise of the policy holder N.Chinna Dasthagiri Reddy, due to electric shock and for instating in Ex.B12 for its satisfaction the postmortem report and FIR  which does not arise in the circumstances of the case as laid in 2000 (CONS)-96 by the Honourable A.P.State Consumers Disputes Redressal Commission, Hyderabad in LIC of India, Secunderabad and another –Vs- Banavath Camlee and in its subsequent conduct in Ex.B13 treating the claim as closed.

12.              When the opposite parties are not denying the status of the deceased policy holder and the nominee-ship of the complainant and the documentary record discussed above clearly establishing the event of demise of policy holder due to electric shock and the risks of death of policy holder by electric shock is also being covered under the said policy as per the contents in Ex.A2 and the circumstances of the opposite party No.2 in not settling the claim by insisting for the material which is not required as is amounting to a clear deficiency of service of the opposite party No.2 towards the liability arising out of policy bond in Ex.B1 on the event of accidental demise of its policy holder due to electric shock and in non-payment of the insured amount to the complainant as nominee of the deceased policy holder.

13.              The role, deficient conduct and liability of opposite party No.1 being not spelled out in the record and the material on record shows a privy of opposite party No.2 along the case against opposite party No.1 is dismissed for want of proper cause of action and for want of any notice alleging any deficiency of service on its part.

14.              The opposite party No.2 by improper display of discretion in settlement of the claim committed deficiency of service towards the complainant and ensured mental agony besides to driving the complainant to the Forum for Redressal of her grievances.

15.              Hence the complaint is allowed ordering the opposite party No.2 topay not only the insured amount of Rs.1,00,000/- to the complainant as nominee of the deceased policy holder but also to pay an amount of Rs.10,000/- as compensation for ensued mental agony and Rs.5,000/- as costs of this litigation within a month of the receipt of this order.  In default the opposite party No.2     shall be liable to pay the supra stated award amount with 9% interest Per Annum from the date of said default till realization.

          Dictated to the Computer Operator, transcribed by him, corrected and pronounced in the Open bench this the 28^th day of June, 2007.

              Sd/-                                                                              Sd/-

          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          Xerox office copy of the legal notice dated 20-02-2006.

Ex.A2          Xerox of broacher pertaining to Janata Personal Accident Insurance Policy.

Ex.A3          Attested Xerox copy of Death Electrician Certificate issued by the A.P.C.D.L., Dated nill.

List of exhibits marked for the opposite parties :

Ex.B1          Janatha Personal Accident Insurance Policy along with conditions.

Ex.B2          Letter dated nill of complainant addressed to opposite party No.2.

Ex.B3          Letter dated nil of complainant addressed to Divisional Manager, United India Insurance, Kurnool.

Ex.B4          Copy of reply letter dated 29-12-2003 addressed to complainant.

Ex.B5          Death Certificate.

Ex.B6          Death Certificate issued by Medical Officer, Government Dispensary Narasapuram, Kurnool District.

Ex.B7          Family Member Certificate issud by M.R.O., Rudravaram.

Ex.B8          Certificate issued by Pancharath Secretary, Narasapuram Village, Rudravaram Mandal.

Ex.B9          Legal Hair Notary Affidavit.

Ex.B10        Claim Forum.

Ex.B11        Certificate issued by Sub-Inspector of Policy, Rudravaram Policy Station, Kurnool District.

Ex.B12        Letter dated 09-06-2004 of opposite party No.2 to the complainant.

Ex.B13        Letter dated 15-02-2005 of opposite party  to the complainant.

                Sd/-                                                                               Sd/-

          MEMBER                                                                       PRESIDENT        

Copy to:-

1. Sri.S.V.Krishna Reddy, Advocate, Kurnool.

2. Sri.D.Yella Reddy, Advocate, Kurnool.

Copy was made ready on:

Copy was dispatched on:

Copy was delivered to parties: