This case is coming for final hearing on 01-05-2014 in the presence of M.Maheswara Rao, Advocate for complainant and of M/s D.V.Subba Rao, Advocates for Opposite Party No.1 & B.G.Chandra Sekhar Advocate for Opposite party No.2 and having stood over till this date, the Forum delivered the following.                                  

: O R D E R :

(As per Sri V.V.L.Narasimha Rao, Member on behalf of the Bench)

1.       The Complainant filed the present Complaint under Section-12 of Consumer Protection Act against the Opposite parties 1 & 2 and requested the Forum to direct the Opposite party No.1

a) to pay an amount of Rs.1,00,000/- i.e., the Policy claim amount along with interest at 24% p.a. from 12.11.2008 till realization.

b) to pay the compensation of Rs.25,000/- towards damages for deficiency of service.

c) to pay costs of Rs.10,000/- towards legal expenditure. 

d) to pass any other relief or reliefs as this Forum deems fit and proper as per the circumstances of the case.

2.       The brief facts are as follows:

          The Complainant submits that the 1^st opposite party Visakhapatnam Port Trust is the employer of the deceased V.Srinivasa Rao (who is the husband of the complainant).  The husband of the Complainant is worked as Mazdoor with 1^st opposite party and he died in an accident on 06.09.2007 while travelling on motor cycle bearing No.AP33A 9750. The Complainant’s husband obtained accident insurance policy No. 550704/42/06/820000086 from 2^nd opposite party by paying premium from his salary through 1^st opposite party.  After the death of the complainant’s husband she intimated the same to the 1^st opposite party and the same was intimated to the 2^nd opposite party on 12.11.2008 for settlement of insurance claim. The 1^st opposite party employees did not clear the insurance claim with one or other reason and dragged the issue. Thereafter, as the issue is still pending she addressed a letter dated 09.07.2010 to the 1^st opposite party to submit the appropriate information under RTI Act with regarding to the claim of accident policy obtained by her husband.  The 1^st opposite party after receiving the letter from the complainant, issued a letter dated 18.08.2010 along with the details with regarding to the insurance policy which was send to the 1^st opposite party for clearance.  Even after that also, the claim of the complainant is not cleared by the 2^nd opposite party.  As the premium of the insurance policy was collected from the 1^st opposite party by the 2^nd opposite party, alleging deficiency of service for not clearing the claim amount within time, the complainant has filed the present complaint seeking reliefs.

3.       Notice sent to the opposite parties. 

The 1^st opposite party filed counter and stated as follows: The Complainant’s husband i.e., the deceased V.Srinivas was an employee at Dock labour board which is merged into Visakhapatnam Port Trust as per the Government of India Orders. He died while in service, as he met with an accident while he was travelling on a motor cycle.  While the Complainant’s husband was working as Mazdoor in Dock Labour Board, the 2^nd opposite party issued a policy with detailed terms and conditions which are binding on the subscriber beneficiaries as well as insurer i.e., 2^nd opposite party.  The complainant’s husband has subscribed to the above policy scheme with the 2^nd opposite party. On receipt of the claim of the complainant after the death of her husband, the same has been forwarded to the 2^nd opposite party for appropriate action vide letter dated 12.11.2008.  It is the outlook of the 2^nd opposite party to examine and to settle the claim against the policy.  The premium which has been paid to the 2^nd opposite party is paid from the wagers/salary of the participating employees, in the similar manner the premium was collected from the complainant’s husband’s salary and the same was paid to the 2^nd opposite party.  The complainant is alleging the 1^st opposite party with false allegations.  The complainant sought information under RTI Act on 09.07.2010 from the 1^st opposite party.  The complainant failed to show the reason why the matter was not followed up to 20 months with either of the parties. Even after that also as the 1^st opposite party received the request letter along with the required documents for clearing the insurance claim the same was forwarded to the 2^nd  opposite party for clearing the same.  With regarding to the cause of action the accident was occurred to the complainant’s husband on 21.08.2007 and he died on 06.09.2007. The complainant filed the present complaint in the month of March, 2011 even after considering the 75 days also there is a delay on the part of the complainant and on this particular fact, the complaint is liable to be rejected as it is barred by limitation.  Hence, as there is no deficiency of service on the part of the 1^st opposite party, the complaint is liable to be dismissed. 

4.       The 2^nd opposite party filed counter denying the averments of the complainant and stated as follows:

          The Complainant’s husband i.e., deceased V.Srinivas is the employee of the 1^st opposite party who is working as Mazdoor died on 06.09.2007 after he met with an accident on 21.08.2007 near Naval Dockyard, Visakhapatnam, for that the complainant has to prove the same.  The 1^st opposite party has taken a Group Personal Accident Policy with the 2^nd opposite party vide policy No. 550704/42/06/820000086.  The intimation with regarding to the claim of the accident policy was not informed to the 2^nd opposite party.  The Complainant might have approached the 2^nd opposite party for settlement of the claim within time with her father Appalakonda who is a retired employee as the Complainant is an illiterate.  After submitting the letter dated 09.07.2009 to the 1^st opposite party under RTI Act.

5.       The 1^st opposite party officials gave the entire details with regarding to the policy claim vide letter dated 18.08.2010 to the Complainant.  The Complainant has invented the false allegations against the 2^nd opposite party after receiving letter from complainant.  She has never approached the 2^nd opposite party’s office at any point of time.  The Complainant never submitted any claim or any particulars to the 1^st and 2^nd opposite parties, unless the proper documents were received, the 2^nd opposite party cannot consider the claim.  Moreover, the claim of the complainant under accident policy must be made within time. Hence, as there is no deficiency of service on the part of the opposite party, the claim is dismissed. 

6.       The Complainant filed evidence affidavit reiterating the entire averments of the complaint and filed the relevant documents which were marked as Exhibits A1 to A4. On behalf of 1^st opposite party G.R.V.Prasada Rao filed evidence affidavit in the capacity of personal officer of Visakhapatnam Port Trust and on behalf of the 1^st opposite party Exhibit B1 to B10 were marked.  The 2^nd opposite party has not filed evidence affidavit even after giving opportunity. 

7.       On perusal of the pleadings above, the Forum framed the following points for consideration:

          i) Whether the complaint is filed within limitation period?

          ii) Whether there is deficiency of service on the part of opposite parties 1 & 2?

          iii) To what relief complainant is entitled?

8.       The Complainant and 1^st opposite party filed written arguments and also submitted oral arguments. 

9.       Point No.i : The Complainant has filed the present complaint for claiming the accident insurance policy as her husband V.Srinivas who is working as Mazdoor Emp. No.6531/100604 died in an accident on 06.09.2007, as the 2^nd opposite party has not settled the insurance claim even after receiving the documents she has filed the present complaint.

10.     As from Ex.A1 (Bunch of documents) i.e., Inquest report, FIR, Death Certificate issued by GVMC, Visakhapatnam and letter dated 12.11.2008 issued by the 1^st opposite party to the 2^nd opposite party for submission of the claim, reveals that the complainant’s husband met with an accident on 21.08.2007 while taking treatment at Seven Hills Hospital and he expired on 06.09.2007.  The inquest report reveals that the complainant’s husband met with an accident while he was travelling on a motor cycle.  The Complainant submitted letter to the 2^nd opposite party on 12.05.2010 for clearance of insurance policy bearing No. 550704/42/06/820000086.  As per Ex.A3 dt:09.07.2010 the complainant has made a request to the 1^st opposite party under RTI Act for submitting the relevant documents for clearing the accident insurance policy i.e., group insurance policy.

11.     Though the 1^st opposite party is alleging that the complaint is time barred as per para No.9 of the counter, observing the Ex.A1 to A4 along with Ex.B6 dt:19.01.2012 and Ex.B7 dt:31.01.2012 it reveals that the settlement of the complainant’s claim was till under process as on 31.03.2012. That too 2^nd opposite party has not filed any documents with regarding to time limit and also in para-8 of counter 2^nd opposite party stated that proper documents for clearing the claims were not received.  As seen from Ex.B7 the documents were received by opposite party No.2.  Hence complaint is not time barred, as cause of action is continuous. Accordingly, point No.i is answered. 

12.     Point No.ii & iii : With regarding to the deficiency of service on the part of opposite parties observing the Ex.A1  and Ex.B7 dated 31.01.2012 issued by the 1^st opposite party to the 2^nd opposite party for settlement of the claim by enclosing the original death certificate of the complainant’s husband, FIR, Panchanama and Postmortem report and Ex.B1 Renewal of Policy along with Ex.B8, B9 still as on today the issue is pending for want of some papers.  But as seen from Ex.B7 all the papers related to settlement of claim were submitted by 2^nd opposite party on 31.01.2012 to 1^st opposite party.  As per Ex.A4 documents i.e., letter dated 22.03.2007 issued by the 1^st opposite party shows that the 1^st opposite party has invited the quotations from the four Government Insurance Companies including the National Company, Kolkatta which the 2^nd opposite party as per the said quotations the sum assured for the accident policy is Rs.1,00,000/- per head.  The premium amount collected is Rs.112/- per head as per clause-3 of letter dated 22.03.2007 the said premium amount of Rs.112/- shall be deducted from the salaries of the employees of the 1^st opposite party Visakhapatnam Port Trust in one lump sum from the salary of March 2007.  In Ex.A4 1^st opposite party is admitting that they have collected Rs.112/- from the officers, employees and workers numbering 1322 are totally amounted to Rs.1,48,064/- and the same was sent to the 2^nd opposite party office vide cheque bearing No.131619 dated 23.04.2007. 

13.     Observing Ex.A4 document, Ex.A3 i.e., letter submitted by the complainant to the 1^st opposite party under RTI Act along with Ex.A1 bunch of documents (i.e., Letter dated 12.11.2008) it reveals that the 1^st opposite party has collected Rs.112/- for the accident insurance policy from the Complainant’s husband i.e., deceased V.Srinivas from his salary.  Thereafter, 2^nd opposite party was directed to clear the claim of the complainant at the earliest.  When the 2^nd opposite party has received the letter dated 12.11.2008 from the 1^st opposite part for clearance of the settlement of the claim they cannot deny that they have not received any letter from the complainant or from the 1^st opposite party at any point of time. 

14.     Hence, the action of 2^nd opposite party for non-clearance of the insurance claim amount even after receiving the documents through the 1^st opposite party vide letter dated 12.11.2008 amounts to deficiency of service.  In this matter, the 1^st opposite party has twice responded in proper manner and sent letter to the 2^nd opposite party for settlement of the claim. But the 2^nd opposite party alleging the complainant for not approaching within time, with out any documentary proof shows that there is negligence on the part of the 2^nd opposite party for not settling the claim.  The Ex.B6 confronts that 2^nd opposite party sent letter to opposite party No.1 for sending required documents pertaining to the settlement of claim. 

15.     Hence, observing Ex.A1 and Ex.B7 the complaint against 1^st opposite party is dismissed and the 2^nd opposite party is held for deficiency of service for not clearing the insurance amount even after receiving the necessary documents through the 1^st opposite party.

16.     In the light of the facts and documents of both sides, as the 2^nd opposite party has not cleared the insurance claim vide accident policy bearing No.550704/42/06/820000086 pertaining to complainant’s husband V.Srinivas, the 2^nd opposite party is directed to pay Rs.1,00,000/- to the complainant along with the interest at the rate of 9% p.a. from 19.01.2012 (i.e., date of Ex.B6) till the date of realization. As the interest is awarded to the complainant compensation has not been granted and she is entitled only for legal expenses of Rs.3000/- to be paid by the 2^nd opposite party to the complainant.  Accordingly, the point Nos.2 & 3 are answered. 

17.     In the result, the Complaint is allowed in part.  The Complaint against 1^st opposite party is dismissed.  The 2^nd opposite party is directed to pay Rs.1,00,000/- to the Complainant along with 9% p.a. interest from 19.01.2012 till realization.  The 2^nd opposite party is also directed to pay an amount of Rs.3,000/- to the complainant towards legal expenses.  Time for compliance is 30 days from the date of receipt of this order. 

Dictated to the Shorthand Writer, transcribed by her, corrected and pronounced by us in the open Forum on this the 30^th day of May, 2014.

APPENDIX OF EVIDENCE

Exhibits Marked for the Complainant:

Consumer Complaint No 91/2012

Exhibits Marked for the Opposite Parties