O R D E R
Per Sri A. Hazarath Rao, President:-
The complainants filed this complaint u/s 12 of the Consumer Protection Act seeking assured amount of Rs.1,00,000/- together with interest from the date of death of the insured besides claiming compensation of Rs.50,000/- and costs.
2. In brief averments of the complaint are hereunder:
The complainants 2&3 are children of the 1st complainant and one Thota Srinivas @ Srinivasarao. The said Srinivasarao was a member and Kissan Credit Card holder of the 1st opposite party. The said Srinivasarao was also a member of 1st opposite party’s credit society. The 1st opposite party obtained a policy for its member under kissan credit card holder scheme with the 2nd opposite party covering the risk of farmers to an extent of Rs100000/-each. The said Srinivasarao injured in road accident on 21-09-10 and succumbed to injuries while under going treatment in G.G.H Guntur. The S.H.O., Sattenapalli rural PS registered the said accident as Cr.No.71/10 against the driver of the vehicle AP-07/W-7630. Immediately the complainants approached the 1st opposite party. The complainants on 19-04-11 handed over relevant documents to the 1st opposite party who in turn transmitted them to the 2nd opposite party on 09-05-11. The 2nd opposite party even after receiving all relevant papers i.e., F.I.R, Postmortem report, inquest, death certificate and also family member certificate did not choose to settle the claim. The complainant learnt through the 1st opposite party that the settlement of claim is under process. The opposite party though received notice neither gave reply or settled the claim and committed deficiency of service. The complaint therefore be allowed.
3. The contention of the 1st opposite parties in brief is here under:
The deceased Thota Srinu @ Srinivasarao was a member of the 1st opposite party society and Kissan Credit Card holder. The said Srinivasarao obtained a loan under loan No.102 with general membership number 24089. The said Srinivasarao was covered under J.P.A. benefit scheme issued by the 2nd opposite party vide policy No.1803303015000000. The said policy covered risk of farmers from 24-04-10 to 23-04-11 for a sum of Rs.1,00,000/- each. The death of the said Srinivasarao was within the coverage of the said insurance policy. The 1st opposite party submitted relevant papers like F.I.R, postmortem certificate and inquest and every required information to the 2nd opposite party in time. The 1st opposite party did not commit any deficiency of service. The complaint therefore may be dismissed.
4. The contention of the 2nd opposite parties in brief is here under:
The complainants have not given any information under which policy the complainant was covered. Without policy number and copy of policy the 2nd opposite party is not in a position to settle the claim. JPA/GPA policies are open policies given to institutions with un-named persons. Even at this stage also the 2nd opposite party is ready to process the claim as per terms and conditions of the policy if policy number was given. The complainants have not informed the loss within 24 hours or maximum 48 hours of the event occurred and the documents have to be submitted within 25 days from the date of loss. Due to paucity of information the 2nd opposite party could not process the claim. The complaint therefore be dismissed.
5. Exs.A-1 to A-11 on behalf of complainant and Exs. B-1 to B-3 on behalf of 1st opposite party were marked. No documents were marked on behalf of 2nd opposite party.
6. Now the points that arose for consideration in this case are these:
1. Whether the opposite parties committed deficiency of service
and if so committed by whom?
2. Whether the complainants are entitled to compensation and if so
to what amount?
3. To what relief?
7. POINT No.1:- The version as well as the affidavit of the 2nd opposite party revealed that JPA/GPA policies are open policies and will be given to institutions with un-named persons. It can therefore be inferred that such institutions have to submit names of the persons covered by such policy.
8. In Ex.A-9 notice dated 10-12-12 the complainants did not mention policy number. Likewise in their complaint also. But the 1st complainant in her affidavit mentioned the policy No. as 1803303015000000. The said policy number tallied with the policy number mentioned by the 1st opposite party in its version as well as affidavit. The 1st opposite party in its version and affidavit categorically mentioned that the deceased Thota Srinivasarao was covered by the said policy. About 5760 members in Pakalapadu village of Sattenapally Branch (1st opposite party) were covered under the said policy as seen from Ex B2. Ex.B-1 is the copy of list wherein name of the deceased was shown. It can therefore be inferred that the deceased Srinivasarao was covered under the policy issued by the 2nd opposite party bearing No.1803303015000000.
9. The said Srinivasarao died in road accident as seen from Exs.A-1 & A-2 on 21-09-10. The complainants did not file any document to show that they have sent all relevant papers to the 1st opposite party on 19-04-11. The contention of the 2nd opposite party is that neither the complainants nor the 1st opposite party sent relevant documents to it in order to process claim is well corroborated by Ex.A-9 notice i.e. for want of absence the date on which the complainants sent relevant documents to the 1st opposite party.
10. The contention of the 2nd opposite party that it cannot process the claim for want of policy number is amply corroborated as the 1st opposite party also did not file any proof to show that it sent relevant documents after receiving from the complainants.
11. The opposite parties did not raise the aspect of limitation for the reasons best known to them. The aspect of limitation can be gone into by this Forum at any time if not substantiated. Therefore the contention of the complainants that this forum cannot raise the aspect of limitation at the time of arguments is devoid of merit.
12. The Registry did not raise the aspect of limitation as the complainants specifically mentioned in para 3 of the complaint (neat copy filed on 01-03-13) that the 1st opposite party sent documents along on 09-05-11 along with claim form to the 2nd opposite party as this Forum cannot traverse into the merits of complaint while numbering.
13. Relying on the judgment of Supreme Court rendered in Kandimalla Raghavaiah and company vs. National Insurance Company Limited 2009 CTJ 950 (SC) the National Consumer Disputes Redressal Commission in Lakshmi Bhai and others vs. ICICI Lombard General Insurance Company Limited and others 2011 (4) CPR 64 held
“The cases where such payment is not made, would fall in one of the following categories—
1). Where no claim is made either with nodal officer or the Insurance Company, within 2 years of date of death such claims shall be barred by limitation.
2). Cases where claim is made to nodal officer or nodal officer has forwarded the claim to Insurance Company or claim has been directly filed with Insurance Company within 2 years of the death and the claim has remained undecided. In such a case the cause of action will continue till the day the Respondent/insurance Company pays or rejects the claim.
3). In a case where the Respondent/insurance company rejects the claim, the cause of action arises again from the date of such rejection.
In the absence of any proof either from the complainant or the 1st opposite party evidencing submission of all relevant documents it cannot be said that the opposite parties committed deficiency of service. Therefore we answer this point against the complainants.
14. POINTS No.2:- In view of above findings the complainants are not entitled to any compensation much less the compensation claimed. We therefore answered the point against the complainants.
15. POINT NO.3:- The 2nd opposite party in its version and affidavit contended as detailed infra:
“If the policy was submitted to us even at this stage we are ready to process the claim as per the terms and conditions of the policy”
16. In view of such categorical admission made by the 2nd opposite party disposing off the complaint with a direction to the complainants to submit all relevant papers with policy number to the 2nd opposite party through the 1st opposite party under acknowledgment within two weeks from the date of receipt of this order and in turn directing the 2nd opposite party to process the claim within four weeks there after will meet ends of justice.
17. In the result the complaint is disposed off with the following directions:
1) The complainant is directed to submit all relevant papers to the 2nd opposite party with policy number through the 1st opposite party under acknowledgement within a period of two weeks from the date of receipt of this order.
2) The 2nd opposite party is directed to process the claim within four weeks there after.
3) There is no order as to costs.
Dictated to Junior Steno, transcribed by him corrected by me and pronounced in the open Forum dated this the 5th day of July, 2013.
Sd/-XXX Sd/-XXX
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
DOCUMENTS MARKED
For Complainants:
Ex.Nos. |
DATE |
DESCRIPTION OF DOCUMENTS |
A1 |
21-09-10 |
Copy of first information report and inquest report. |
A2 |
11-10-10 |
Copy of death certificate. |
A3 |
11-02-11 |
Family member certificate (original) |
A4 |
|
Copy of Kissan Credit Card & Pass book. |
A5 |
|
Copy of List of Credit Card holders showing the name of the deceased. |
A6 |
22-09-10 |
Copy of paper publication. |
A7 |
09-05-11 |
Copy of Letter from 1st opposite party to 2nd opposite party. |
A8 |
19-04-11 |
Copy of Janata Personal Accident Insurance Claim Form. |
A9 |
10-12-12 |
O/c. of the Regd.Legal notice got issued by the complainant to the opposite parties. |
A10 |
18-12-12 |
Postal acknowledgement of 1st opposite party |
A11 |
21-12-12 |
Postal acknowledgement of 2nd opposite party |
For 1st opposite party:-
Ex.Nos. |
DATE |
DESCRIPTION OF DOCUMENTS |
B1 |
|
Copies of List of Credit Card holders and Kissan Credit Card pass book |
B2 |
|
Copy of Branch wise PACS wise list for the year 2010-11. |
B3 |
24-04-10 |
Copy of Reliance Janatha Personal Accident Policy issued by 2nd opposite party. |
For 2nd opposite party:- NIL
Sd/-XXX
PRESIDENT
