BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT BIDAR::
C.C.No 01/2015.
Date of filing : 17/01/2015.
Date of disposal : 22/11/2016.
P R E S E N T:- (1) Shri. Jagannath Prasad Udgata,
B.A., LL.B.,
President.
(2) Shri. Shankrappa (Halipurgi),
B.A.LL.B.,
Member.
COMPLAINANT/S: 1. Baswaraj S/o Karbasappa Kotgi,
Age 50 years, Occ: Agriculture,
R/o Meenakera,
Tq: Humnabad, Dist: Bidar.
2. Chandrashekhar S/o Baswaraj Kotgi,
Age: 22 years, Occ: Student,
R/o Village Minkeera,
Tq: Humnabad, Dist: Bidar.
(By Shri. Rajkumar .K., Advocate )
VERSUS
OPPONENT/S :- 1. The Oreintal Insurance Company Ltd.,
Branch Office Shivram Chambers
11th Foolr Opp. Zopendi Canteen
Ninteen Ningur Manmad Roadsaveri
Ahmad Nagar.
2. Manager of Oriental Insurance company
Limited, Add. Near Central
Bus Stand Bidar.
3. The Manager Life Line Life Care Ltd.
No.3 Rainbow House Saveri road
Ahmadnagar-414003.
(By O.P.No.1 and O.P.No.2, Sri.Rajkumar. S.Gotta,
Advocate R3. Inperson)
:: J UD G M E N T : :
By Shri. Jagannath Prasad Udgata, President.
Vide this complaint, the husband and son duo of a deceased policy holder are before us alleging deficiency of service in the part of the opponents u/s 12 of the C.P. Act, 1986, avering as follows:
2. That, one deceased Punyawathi W/o of the First complainant and mother of the second complainant was an insured for a sum of Rs.1,00,000/- in respect of J.P. A. Policy No.76033/165/166/167- coverage Period 5/4/2010 to4/4/2014 issued by the opponents No. 1 & 2 through their medium ( facilitator ) O.P.No.3 ( EX.p2). The husband of the deceased and her son were co- insured in the said policy. It appears, the late insured had nominated the complainant No.2 to avail the usufructs of the policy in the case of untimely death. Regular Premiums were paid.
3. As it appears the insured Punyawathi died due to snake bite while removing grass(s) in the family field in village- Meenakera, Tq: Humnabad, Dist: Bidar on 28.04.2010 and a claim was raised by the complainant No.1 to settle the insured amount. The claim was raised with theO.P.No.3, the medium/ facilitator of the other opponents on 06.09.2010, who had primarily raised certain objections in the manner the claim was raised. (Ex.P1). The anomalies were rectified and resubmitted. As per the say of the facilitator, O.P. No.3, in Ex.P-7, the claim was despatched to the insurers in due time.
4. It further appears that, a Police case was instituted with the jurisdictional Mannakhella Police Station Dist: Bidar vide U.D.R. No.06/2010 u/s 174 of the Cr. P.c. in which a detail inquest was held vide Ex.P4 and the body being subjected to Post-mortem vide Ex.P5, the cause of death has been attributed as “Cardio respiratory failure as result of snake bite”.
5. It further appears that, the complainant No.1 the husband of the viction, had raised the primary claim, and on the failure of the opponents to settle it , had got issued a legal notice on date: 18.11.2014, (Ex.P6 together with postal receipts), to which the O.P.No.3 had replied on 24.11.2014, (Ex.P7), claiming that, they had processed the claim to the original insurers i.e., O.Ps. No.1 and 2. The O.P.No.3 further claims that, it was only a medium/ facilitator of the other opponents and the claim has to be settled by the Insurance Company. The O.P.No.3 further claims that, the earlier arrangement has been discontinued it is no more the franchisee of the Insurance Company. The O.P.No.3 has never spelled out as to whether the proposal for policy was struck at Ahmednagar in Maharastra or Bidar District in Karnataka State. Hence, we are constrained to infer that, the deal was struck in Bidar District of Karnataka, where in the O.P. No.3, an agent of O.P. Nos.1 and 2 was operating with express authority of its principals i.e., O.P.No.1 and2. Further (Ex.P.3) money receipt, executed at Bidar clinches the issue in entirety.
6. Be it whatsoever may, the opponents Nos.1 and 2 entering into defence by filing versions have raised the following grounds for the consideration of the forum:-
a. The compliant is time barred.
b. This forum lacks the jurisdiction as the deal was
concluded at Ahmednagar of Maharastra State.
c. That one Chandrasekhar (son of the deceased) was the
nominee of the Insured and not the complainant No.1.
7. The objections of the O.P.Nos.1 and 2 can be considered as Point No.1, to be adjudicated in the case, followed by point No.2 as to whether any deficiency of service has occurred in the part of the O.Ps.
8. We propose to answer both the points mentioned above combinedly.
9. As discussed earlier, the O.P.No.3, who was procuring Insurance business for and on behalf of the other opponents in its Communication vide Ex.P7, has no where whispered that, the deal was struck at Ahmednagar. Hence we have inferred that, the proposal of Insurance was accepted in Bidar District, which is clear from Ex.P.3, money receipt executed at Bidar, and hence this Forum is competent to try this case.
10. As far as the assertions of the Insurance Company that, the claim was raised after four years of death appears to be a blatant lie. From Ex.P7 it is evident that, O.P.No.3, the agent of O.Ps.No.1 and 2 had received the claim on 26.08.2010 and since there was deficiency in filling up the claim form, the same was returned to the claimant. Ultimately, the O.P.No.3 received the rectified claim on 28.09.2010 and has submitted the same to M/s oriental Insurance Company on the same day, as is read at 2nd page of Ex.P.7. This fact proves that, the assertions of M/s Oriental is self serving and false.
11. Truly to the averments of the Insurance Company one Chandrasekhar was the nominee of the deceased policy holder and not her husband by name Basawaraj. As the case proceeded further, the complainants side filing application has got included the name of Chandrasekhar as complainant No.2, a co-claimant within full view of the opponents and hence there in no impediment to settle the Insurance claim in favour of said Chandrasekhar. The case laws II (2009) CPJ (NC) and II (2008) CPJ 296 (AP) quoted by the complainant clinches the issue.
12. All the discussions above are singly pointing out that, there has been a massive deficiency of service in not settling the claim for which we proceed to pass the following:
ORDER
- Complaint is allowed in part in favour of complainant No.2.
- The opponent No.1 and 2 are jointly and severally directed to pay to complainant the insured amount of Rs.1,00,000/- together with interest @ 12% p.a. calculated from the date of death of Smt. Punyawathi i.e., 28.04.2010 till the date of realisation to the complainant No.2.
- The opponents No.1 and 2 are further directed to pay a compensation of Rs.5000/- and litigation expenses of Rs.5000/- to the same complainant.
- Complaint against the O.P.No.3 and in favour of complainant No.1 is dismissed.
e) Four weeks time is granted to comply this order.
(Typed to our dictation then corrected, signed by us and then pronounced in the open Forum on this 22nd day of November-2016 )
Sd/- Sd/-
Sri. Shankrappa H., Sri. Jagannath Prasad,
Member. President.
Documents produced by the complainant
- Ex.P.1- J.P.A claim form.
- Ex.P.2- Copy of J.P.A. Policy No.163305/47/2011/29.
- Ex.P.3- Copy of money receipt granted by O.P.No.3 at Bidar.
- Ex.P.4- Copy of U.d.R. records u/s 174 Cr.P.C.
- Ex.P.5- Copy of P.M. report.
- Ex.P.6- Legal notice to the opponents date:18.11.2014 with postal
receipts. - Ex.P.7- Reply of O.P.NO.3 to the legal notice date: 24.11.2014.
- Ex.P.8-Letter of O.P>NO.3 to complainant NO.1 date: 26.08.2010.
- Ex.P.9- Intra office letter date:21.06.2012 among the opponents.
Documents produced by the Opponent NO.3 (alone).
- Ex.R1- Copy of letter by O.P.No.3 to complainant date.26.08.2010
(Replica of Ex.P.8)
- Ex.R2- Reply of O.P.No.3 date. 23.09.2011 to complainant
counsel.
- Ex.R3- Reply of O.P.No.3 date. 23.09.2011 (Replica of Ex.P7).
- Ex.R4- Intra office letter date:21.06.2012 among the
opponents(replica of Ex.P9).
Sd/- Sd/-
Sri. Shankrappa H., Sri. Jagannath Prasad,
Member. President.
Sb.
