Date of filing: 31.7.2012.
Date of Dispotal:21.12.2012
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM - II:
VIJAYAWADA, KRISHNA DISTRICT
Present: SRI A. M. L. NARASIMHA RAO, B.SC., B. L., PRESIDENT
SMT N. TRIPURA SUNDARI, B. COM., B. L., MEMBER
FRIDAY, THE 21ST DAY OF DECEMBER, 2012.
C. C. No.131 OF 2012
Between:
Udugula Rejeswari, W/o Late Prabhu Kumar, Hindu, 29 years, House wife, R/o D.No.30-24-19/7, Bodepudi Vari Street, Durga Agraharam, Vijayawada – 2.
….. Complainant.
And
1. P. Ramesh, S/o Hamameaulla, Hindu, 36 years, Owner of Ambulance Bearing No.AP 16 TB 1573, R/o D.No.32-15/4-1, Maruthi Street, Karmika Puram Vijayawada – 520 004.
2. The Branch Manager, New India Assurance Company Ltd., D.No.27-6-189, Prakasam Road, Governor Pet, Vijayawada – 520 002
.….. Opposite Parties.
This complaint is coming before us for final hearing on 7.12.2012 in the presence of Sri M.Adinarayana Rao, Counsel for complainant and of Sri K.Rajasekhar, Counsel for Opposite Party No.1 and Sri V.V.S.Saibabu, Counsel for opposite party No.2 and upon perusing the material available on record, this Forum delivers the following:
ORDER
(Delivered by Hon’ble Member Smt N.Tripura Sundari)
This complaint is filed under Section 12 of the Consumer Protection Act, 1986.
1. The averments of the complaint are in brief:
The husband of the complainant, worked as a driver on the ambulance bearing Registration No.AP 16 TB 1573 belongs to the 1st opposite party. The 1st opposite party insured the ambulance with the 2nd opposite party under policy No.62070131110100001261 valid from 25.4.2011 to 24.4.2012. While so on 23.9.2011 one patient engaged the ambulance of the 1st opposite party to go to Khammam from Vijayawada. The 1st opposite party engaged the said work to his driver, who is the husband of the complainant. While he was going to Khammam, one car coming from opposite direction dashed the ambulance and in the said accident the driver of the ambulance i.e., the complainant’s husband sustained grievous injuries and died during the course of treatment on 23/24.9.2011. The inmates of the amblance also received injuries. The accident vehicle was insured with the 2nd opposite party and the insured i.e., the 1st opposite party paid premium towards own damages, basic liability to third parties and compulsory personal accident cover. In view of the same the complainant submitted claim form along with all necessary documents. But the 2nd opposite party did not settle the matter. The complainant issued a legal notice demanding the 2nd opposite party to settle her claim. On receipt of the same the 2nd opposite party issued a rely dated 17.5.2012 stating that they are unable to entertain the claim as the claim is closed for the reason, no coverage to driver under personal accident. The 2nd opposite party collected premium under the head of compulsory P.A. cover for owner driver, LL to paid driver. As such the repudiation made by the 2nd opposite party is illegal, arbitrary and baselss and also amounts to deficiency in service. Hence the complainant is constrained to file this complaint, praying the Forum to direct the opposite parties to pay personal accident claim amount of Rs.2,00,000/- with interest at the rate of 24% per annum from the date of claim i.e., 24.2.2012 till the date of realization, to pay Rs.1,00,000/- towards compensation for delay in payment of claim and mental agony and to pay Rs.50,000/- towards costs. 2. The opposite parties 1 and 2 filed their versions. The version of the 1st opposite party is in brief: The 1st opposite party denied all the allegations of the complaint and submitted that the complainant along with her minor children already filed W.C.No.4/12 on the file of the Hon’ble Asst., commissioner of Labour, Vijayawada and the same is pending for disposal before the said authorities. The complainant again filed this present complaint in this Forum who is not the consumer of this 1st opposite party. The vehicle of the 1st opposite party was insured with the 2nd opposite party and the 2nd opposite party is liable to pay compensation to the complainant in the above said W.C. which is before the Asst., Commissioner of Labour Vijayawada. Therefore the 1st opposite party prays to dismiss the complaint with costs. The version of the 2nd opposite party is in brief: Te 2nd opposite party denied all the allegations of the complaint and submitted that as per the policy, the 1st opposite party has not paid any additional premium to cover the personal accidental risk to the driver of the insured vehicle. The policy was issued to the 1st opposite party only to cover personal accident to owner driver, but not to the paid driver. The complainant is having children and in-laws as per the claim filed in W.C.Court, the other legal heirs of the deceased are the necessary and proper parties in these proceedings. Immediately after receiving the claim forms from the complainant, the 2nd opposite party intimated that the policy issued to the 1st opposite party is not covered personal accidental death of the driver of the insured vehicle and hence, the claim of the complainant is repudiated. The complainant got issued a legal notice on 10.5.2012 and the 2nd opposite party gave a reply on 17.5.2012. The Hon’ble Forum may be read the reply as part and parcel of this claim along with the documents filed by this opposite party. The complainant is not entitled for Rs.2,00,000/- towards personal accident claim and Rs.1,00,000/- towards mental agony as no additional premium is paid by the 1st opposite party. Therefore, the 2nd opposite party prayed to dismiss the complaint with costs.
3. On behalf of the complainant she gave her affidavit and got marked Ex.A.1 to
Ex.A.14 and on behalf of the opposite parties the 1st opposite party filed his affidavit and no documents were marked. On behalf of the 2nd opposite party Sri N.Prabhakar Rao, Manager filed his affidavit and got marked Ex.B.1.
4. Heard and perused.
5. Now the points that arise for consideration in this complaint are:
1. Whether there is any deficiency in service on the part of the opposite parties
towards the complainant in accepting her claim or not?
2. If so is the complainant entitled for any relief?
3. To what relief the complainant is entitled?
POINT 1 AND 2:-
6. On perusing the documents and on hearing the parties we, the Forum came to know that the husband of the complainant worked as a driver to the ambulance of the 1st opposite party and it was insured with the 2nd opposite party under Ex.A.7 and the valid period for the same is 25.4.2011 to 24.4.2012. On 23.9.2011 the husband of the complainant was engaged to the said ambulance to go to Khammam from Vijayawada.
While the ambulance is going to Khammam one car came in opposite direction and dashed the ambulance and the husband of the complainant sustained grievous injuries and died during the course of treatment. The information was given by the 1st opposite party to the police authorities. Ex.A.1 FIR, Ex.A.2 inquest report and Ex.A.3 post mortem report and Ex.A.4 accident reports confirmed the death of the complainant’s husband. At the time of accident the driver of the ambulance i.e., the husband of the complainant had valid driving license under Ex.A.5 and the said vehicle was registered with the transport authority under Ex.A.6. Ex.A.8 is house hold ration card of the deceased issued by Govt., of Andhra Pradesh. The 1st opposite party paid premium towards own damages, basic liability to third parties and compulsory personal accident cover. In view of the same the complainant submitted claim form under Ex.A.12 to the 2nd opposite party along with necessary documents. But the 2nd opposite party did not settle the matter. Then she got issued a legal notice Ex.A.11 dated 22.2.2012 demanding the 2nd opposite party to settle the matter. On receipt of the same the 2nd opposite party issued a reply notice Ex.A.14 dated 10.5.2012 stating that they are unable to entertain the claim as the claim is closed for the reason, no coverage to driver under personal accident. The 2nd opposite party collected premium under the head of compulsory P.A. cover for owner driver, L.L. to paid driver. Ex.A.9 is W.C.4/12 filed by the complainant and other legal heirs of the deceased in the court of the Assistance Commissioner of Labour at Vijayawada. Ex.A.10 is affidavit of deceased parents stating that they agreed to give the death compensation of the deceased to his wife and children. 7. The defence of the 1st opposite party that the complainant already filed W.C.4/12 in the Court of Assistant Commissioner of Labour, Vijayawada and the same is pending. The 1st opposite party insured his vehicle with the 2nd opposite party and the 2nd opposite party is liabel to pay compensation to the complainant in the above saidW.C.4/12 and he is not liable to pay compensation to the complainant in the above said W.C.4/12 and he is not liable to pay anything to the complainant. The 2nd opposite party says that as per the policy Ex.B.1 the 1st opposite party has not paid any additional premium to cover the personal accidental risk to the driver of the insured vehicle. The policy was issued to the 1st opposite party only to cover personal accident to ownerdriver but not to the paid driver. The complainant already filed a claim under W.C.4/12 in the Assistant Labour Commissioner Court and it is pending. 8. On hearing both parties counsel and perusing Ex.B.1, we, the Forum noticed that there is compulsory P.A. cover for owner driver only. We also noticed in legal liability and P.A. Cover schedule in question column that “do you wish to include P.A. cover paid drivers, cleaners, conductor, the answer is “No”. So the insurance does not cover to paid driver. But in Ex.B.1 there is mentioned legal liability to paid driver. The 2nd opposite party is liable to pay the compensation to the complainant under legal liability to paid driver as workman compensation in the court of Assistant Commissioner of Labour. The 2nd opposite party has no liability to pay any compensation to the paid driver under compulsory P.A. cover as he is not the owner of the vehicle. That would cover only to the owner-driver who is the registered owner of the vehicle cum driver. Therefore there is no deficiency in service on the part of opposite parties towards the complainant and she is not entitled to receive any claim amount under compulsory P.A. cover for owner-driver. Accordingly these points are answered
POINT No.3:- 9. In the result, the complaint is dismissed without costs.
Typewritten by Stenographer K.Sivaram Prasad, corrected by me and pronounced by us in the open Forum on this 21st day of December, 2012.
PRESIDENT MEMBER
Appendix of Evidence
Witness Examined
On behalf of the Complainant: On behalf of the Opp. Parties:
None None
Documents Marked
On behalf of the Complainant:
Ex.A.1 24.09.2011 Photocopy of First Information Report.
Ex.A.2 . . Photocopy of Inquest report.
Ex.A.3 . . Photocopy of Post Mortem Report.
Ex.A.4 28.10.2011 Photocopy of Accident Information Report.
Ex.A.5 09.06.2010 Photocopy of Driving License.
Ex.A.6 11.05.2009 Photocopy of Certificate of Registration.
Ex.A.7 . . Photocopy of Policy Schedule cum Certificate of Insurance
Commercial Vehicle package policy.
Ex.A.8 01.08.2005 Photocopy of Ration Card.
Ex.A.9 07.12.2011 Copy of Application filed W.C.No.4 of 2012 on behalf of the
Applicants under Section 20 and 22 of Work Men’s Compensation Act before the Authority of the Assistant
Commissioner of Labour at Vijayawada.
Ex.A.10 18.02.2012 Photocopy of Affidavit.
Ex.A.11 22.02.2012 Photocopy of Letter from the complainant to the 2nd opposite
party.
Ex.A.12 22.02.2012 Photocopy of Personal Accident Insurance Claim Form.
Ex.A.13 10.05.2012 Office copy of legal notice.
Ex.A.14 17.05.2012 Photocopy of letter from the 2nd opposite party to the counsel
for complainant.
On behalf of the Opposite Parties:
Ex.B.1 . . Photocopy of Policy Schedule cum Certificate of Insurance
Commercial Vehicle package policy.
PRESIDENT
