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
Wednesday the 29th day of August, 2007
C.D. No.142/2003
1. G. Venkata Rami Reddy,
S/o. G.Vengal Reddy,
Agriculturist,
R/o. Adullapuram Village,
Velgode Mandal,
Kurnool District.
2. G. Hymavathi
D/o. G.Venkata Rami Reddy.
3. G. Venkateswaramma,
D/o. G.Venkata Rami Reddy.
4. G.Mohan Reddy,
S/o. G.Venkara Rami Reddy.
1 to 4 R/o. Abdullapuram (V),
Velgode,(M),
Kurnool District. COMPLAINANTS .
Verses
1. Oriental Insurance Company Limited,
By its Divisional Manager,
Divisional Office,
Bhupal Complex,
Park Road,
Kurnool.
2. Secretary,
Primary Agriculture Co-operative Society,
Abdullapuram Village,
Velgode Mandal,
Kurnool District. OPPOSITE PARTIES
This complaint coming on this day for orders in the presence of Sri. B. Nagalakshmi Reddy, Advocate, kurnool for complainant, and Sri. D. Srinivasulu, Advocate, Kurnool for opposite party No.1 and Sri.G. Narayana Swamy , Advocate, Kurnool for opposite party No.2 and upon persuing the material papers on record, the Forum made the following:-
ORDER
(As per Sri.K.V.H.Prasad, President)
C.D.No.142/2003
1. This case of the complainant’s is filed U/S 12 of C.P.Act seeking direction on the opposite party 1 to pay compensation of Rs.4,00,000/- with future interest and cost of the Complainant and of any such other reliefs which the Complainant is entitled in the circumstances of the case, alleging that G.Pullamma the wife of the Complainant No.1 and mother of Complainants number 2 to 4 was a member of group Insurance Scheme of opposite party No.1 through opposite party No.2 for an assured Insurance amount of Rs.1,00,000/- on her life and she met with a fire accident on 22.12.2001 and died due to burn injuries on 29.12.2001 and an inquest was held on her by Grampanchayat, Adulapuram Village and the claim was made to opposite party No.1 through opposite party No.2 enclosing therewith necessary documents and the said claim was registered as 37/2002 but the claim was not settled inspite of legal notice dated 2.1.2003 and the said conduct of opposite party No.1 is amounting deficiency of service .
2. In pursuance of the notice of this Forum as to this case of the Complainant the opposite party No.1 while appeared through its counsel, the opposite party No.2 made a personal appearance and contested the matters by their denial written versions as to their liability to the Complainant’s claim.
3. The written version of the opposite party No.2 alleges the settlement of Complainant’s claim is for the Opposite Party No.1 and it is nothing to do and so the case against it a misjoinder, even though it admits the deceased Pullamma as its member to Group Insurance Scheme of the Opposite Party No.1 and her demise in fire accident and the death intimation of her to opposite party No.1 and on its turn delivering claim form received from Opposite Party No.1 to the Complainant’s for further necessary disposal and so no deficiency on its part .
4. The written version of Opposite Party No.1 even though admits the intimation by Opposite Party No.2 of death of Pullamma by telegram on dated 31.12.2001 and allege the furnishing of the claim form to the Opposite Party No.2 vide its letter dated 1.2.2002 with a request to get it filled and submit along with necessary documents within 15 days but there was no response either from the opposite party No.2 or from Complainant. Hence it addressed a letter dated 15.3.2002 to Opposite Party No.2 requesting the submission of claim form and required documents within 15 days and in case of non compliance by 26.3.2002 the file will be closed treating as no claim. It was also not responded. Hence the claim was closed as no claim on 28.3.2002. The legal notice of the Complainant suitably replied. Hence there is any deficiency on its part.
5. In substantiation of the contentions while the Complainant’s side has relied upon documentary record in Ex.A1 to A.10 besides to his sworn affidavit and of two third parties, the opposite party side has relied upon the documentary record in Ex.B1 to B4 besides to the sworn affidavit of opposite party No.2.
6. In appreciation of material on record this forum vide its order dated 14.7.2004 dismissed the complaint holding any deficiency on the opposite parties. But on appeal from said order the Honourable A.P.State Consumer Redressal Commission vide its order in F.A.No.76/2004 dated 16.1.2007 set aside the order dated 14.7.2004 passed by this forum in this case remitting back the case file to this District Forum for conducting denovo enquiry with direction to the second opposite party to take effective steps along with the Complainant’s to fill up the form and submit the same to the first Opposite Party and there on the first Opposite Party to consider the claim of the Complainant’s on merits. The said direction was given by Honourable State Commission as it felt that Complainants should not suffer on account of the lathes on the part of the second Opposite Party.
7. In pursuance of said order of Honourable A.P.State Commission the case was taken up for denovo enquiry by ordering notices to both sides on 28.4.2007, Posting the matter to 16.5.2007. Inspite of adjournments on 16.5.2007, 9.7.2007, 12.7.2007, 17.7.2007, 20.7.2007, 23.7.2007, 31.7.2007, 7.8.2007, 17.8.2007, 20.8.2007, 22.8.2007 the Compliance of the directions of the order of State Commission was not reported by the second opposite party and Complainant. Instead an I.A. No.269/2007 is filed with a request to direct the Insurance Company to deliver the claim form to it for enabling it to comply the order of Honourble State Commission. The said I.A was dismissed on 23.7.2007 as the order of the Honourable State Commision is casting on obligation on the opposite party No.2 of getting duly filled the claim form by the Complainant rather than any obligation on the opposite party No.1 to furnish any claim form afresh especially when the opposite party No.2 in the main case admits the receipt of the said claim form for the needful.
8. In the above state of circumstances as there is any compliance of the order of the Honourable State Commission by the Opposite Party No.2 in getting duly filled the claim form by the complainants and its submission to the Opposite Party No.1 for its necessary disposal on merits, there appears any claim form of the Complainant pending for disposal with the Opposite Party No.1 to find any deficiency of the Opposite Party No.1. Therefore there appears any liability of the Opposite Party No.1 to the claim of the Complainant. So the case against the opposite party No.1 is dismissed.
9. The deceased Pullamma was admittedly a member of the opposite party No.2 society and by virtue of it she was covered under Group Insurance Policy issued by Opposite Party No.1 to the opposite party No.2 as its master policy holder. As such it is obligatory on the part of Opposite Party No.2 to make a claim properly for its member processing all the required as is warranted for claiming the insured amount of its member beneficiary. The Opposite Party No.2 did not place any such cogent material as to discharged of his obligations as master policy holder to its member beneficiary. But on the other hand bent upon taking in consistent pleas and vexatious petitions in order to shurk its obligations to the determent of its member beneficiary interest. So there appears every deficiency of service on the part of the second opposite party with a supine indifference in depriving the benefit of Group Insurance to the claimants of deceased Pullamma – its member beneficiary.
10. The amount of Insurance covering the member of the Opposite Party No.2 society being one lakh Rupees the fact of which was not denied on record and the Opposite Party No.2 by its deficient conduct deprived the said benefit of the deceased member to her claimants the Opposite Party No.2 has to make good of the same.
11. The demise of Pullamma has not been denied by to the Opposite Parties the material in Ex A1 to A3, A5 and A6.which enunciates the demise of said Pullamma does require any further appreciation. The Ex.A4 legal heir Certificate issued by M.R.O. Velgodu, shows the Complainants herein as left behind heirs of the deceased Pullamma and by that they are remaining entitled as legal heirs of the deceased Pullamma for the benefits derived through her. In the circumstances which are not establishing the deficiency of Opposite Party No.1 the Ex.A7 to A.10 warrants any appreciation against the Opposite Party No.1.
12. Consequently in the light of above discussion as the deficient conduct of the Opposite Party No.2 is found in the deprival of the benefits of Insurance Policy of deceased to the Complainants, the complaint is allowed directing the Opposite Party No.2 to pay Rs.1,00,000/- (assured amount under policy to the member of Opposite Party No.2 society) along with an amount of Rs.10,000/- as compensation of mental agony at non settlement of the claim, and Rs.2,000/- as costs of this case within a month of receipt of this order. In default the Opposite Party No.2 to pay the supra award amount within 9% interest till realization.
Dictated to the stenographer, transcribed by her, corrected and pronounced in the open bench this day 29th August, 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. Statement of G. Pullamma true copy.
Ex.A2. Certificate issued by Civil Surgeon Specialist R.M.O
District Hospital, Nandyal.
Ex.A3. Death Certificate of G.Pullamma issued by M.R.O.
Velogode.
Ex.A4. Legal heir certificate dated 22.06.2002 issued by M.R.O
Velgode.
Ex.A45. Prescribed form issued by medical health and family
Welfare department.
Ex.A6. Inquest Report done by Village Surpanch, Abdullapuram,
Velgode.
Ex.A7. Legal notice dated 2.1.2003 issued by complainants
Counsel to the opposite party No.1 and marked copy to
Opposite party No.2.
Ex.A8. Postal acknowledgement of opposite party No.1
Along with receipt.
Ex.A9. Postal acknowledgement of opposite party No.2
Along with receipt.
Ex.10. Reply dated 10.1.2003 given by opposite party No.1
Through their counsel.
List of exhibits marked for the opposite parties;
Ex. B1. Office copy of letter dated 01.02.2002 addressed by
Opposite party No.1 to the opposite party No.2
Ex.B2. Office copy of letter dated 15.03.200 addressed by
Opposite party No.1 to the opposite party No.2.
Ex.B3. Telegram given by opposite party No.2 to the
Opposite party No.1.
Ex.B4. True copy of policy along with terms and conditions.
Sd/- Sd/-
MEMBER PRESIDENT
Copy to:-
1. Sri. B. Nagalakshmi Reddy, Advocate, Kurnool.
2. Sri. D. Srinivasulu, Advocate, Kurnool.
3. Sri. G. Narayana Swamy, Advocate, Kurnool.
Copy was made ready on:
Copy was dispatched on:
Copy was delivered to parties
