BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri.K.V.H. Prasad, B.A., LL.B President
And
Smt. C.Preethi, M.A.LL.B., Lady Member
Friday the 22nd day of May, 2009
C.C.No. 164/08
Between:
A.Manoharamma, W/o. Late A.Jaya Sree Raju,
R/o. D.No.51/15-A/18-19, Vinoba Bave Nagar, Kurnool.
… Complainant
Versus
1. Regional Manager,Oriental Insurance Company Ltd.,
D.No.1-1-180/17, Hotal Jhansi, Ist floor,Upstairs of Syndicate Bank,
Near RTC X Road, Hederabad.
2. Divisional Manager,Oriental Insurance Company Ltd.,
R/o.40/383, Bhupal Complex,Kurnool-518001.
… Opposite parties
This complaint is coming on this day for orders in the presence of Sri. CH.Jogarao, Advocate, for the complainant, and opposite party No.1 set exparte and Sri. N.Isaiah, Advocate, for the opposite party No.2, upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. K.V.H.Prasad, President)
CC.164/2008
1. This case of the complainant is filed U/Sec.11&12 of C.PAct seeking an award on the opposite parties to pay to the complainant Rs.2 lakhs with 12%, Rs.25,000/- as compensation and the cost of the case alleging deficiency of service on the part of the opposite parties in not responding to claim of the complainant preferred on the standard Janata personal accident policy No.431103/ZPA/7010/98 of her deceased husband consequent to is accidental death occrued on 22.6.2007 and not even responding to the legal notice dated.4.7.2008 and there by ensuing considerable mental agony and costs of the
case.
2. In pursuance to the receipt of the notice of this Forum as to this case of the complainant , while the Opposite Party No.1- the office which issued the said policy in favour of the deceased husband of the complainant – remained absent and there by was set exparte to the case proceedings, the Opposite Party No.2 – a branch office of Oriental Insurance company Limited in Kurnool – contested the case filing a written version denying any of its liability to the complainant’s claim and seeking dismissal of the complaint with exemplary costs.
3. The written version of the Opposite Party No.2 deny issual of alleged policy to the complainant‘s husband collecting any premium, but alleges to said policy as group policy covering for a period of 12 years from 20-2-1998 to 15-2-2011 for an assured sum of Rs.2 lakhs and the said policy was cancelled by Opposite Party No.1 by a paper publication in a vernacular News paper and under a written intimation dated. 30-3-2002 addressed to Inspector General of Police of A.P.Special Police, Road No.10, Jubilee Hills, Hyderabad seeking surrender of said policy for refund of the premium collected under said policy which is covering thousands of Employees of said police organization as beneficiaries and so there being any privy of contract under said policy consequent to there on, denies any of its liability to complainant‘s claim and bonafidies in the cause of action of the complainant‘s case.
4. In substantiation of the contentions while the complainant side has taken reliance on documentary record in Ex.A1 to A4, besides to its sworn affidavit, the opposite party side has taken reliance on documentary record in Ex.B1 to B3 and sworn affidavit of Opposite Party No.2.
5. Hence, the point for consideration is whether the alleged deficiency of the opposite parties is made out by the complainant exposing the liability of the opposite parties for complainant‘s claim.
6. The policy in Ex.A1 styled as Janata Personal Accident insurance policy, group No.431103/JPA/7010/98 endorsement No.5/98 was issued by the Opposite Party No.1 in favour of the deceased Jayasree Raju to whom the complainant is said to be nominee.
7. No material is placed by the contesting opposite party to the effect that a master policy of said group insurance was issued to the employer to the deceased policy holder and deceased as the employee of said police organization is covered under said master insurance policy as one of its beneficiary.
8. When the said limited scope of deceased under said policy as any beneficiary is made out with any cogent record, the so called cancellation of said group insurance policy alleged by the opposite party taking reference to the Ex.B2-communication addressed to Inspector General Of Police , A.P.Special Police, Road No.10, Jubilee Hills, Hyderabad by Senior Manager, Oriental Insurance, Hyderabad Region stands with any relevancy effecting the status, rights and privy of the deceased policy holder under Ex.A1 policy as insured.
9. When such is the binding nature of the said communication in Ex.B2 and the said cancellation being an unilateral and arbitrary act of the insurer- the Opposite Party No.1 – with any notice and deliberations with effected parties such as the deceased policy holder – leaves any adverse bearing on the rights of insured and his nominee under the said policy in Ex.A1.
10. Even though the Opposite Party No.2 appears to have played any role in the issual of the Ex.A1 to the deceased policy holder and any thing to do with the settlement of the claim made under the Ex.A.1, but as places the Ex.B1 to B3 – the custody of which is expected with Opposite Party No.1 being they are transacted in between Opposite Party No.1 and the Andhra Pradesh Police Battalions – the Opposite Party No.2 appear to be a branch of Opposite Party No.1 in acquaintance with the said material in Ex.B1 to B3. Further as the contingency for the claim being arising in the territorial jurisdiction of this forum as the accidental death of deceased policy holder occured in Kurnool as per the Ex.A4 death certificate, there appears a jurisdiction to this Forum under Section 11 of C.P Act for entertaining this complaint.
11. As the acts of the Opposite Party No.1 as to alleged cancellation to said policy scheme and refund of premium being with any notice and deliberations with effected insured under said Insurance Policy, nor any said general paper publication was filed to infer a constructive notice of said cancellation to the deceased policy holder nor there being any reply by the opposite party to the Ex.A3 legal notice of the complainant with the facts taken in defense, there appears every deficiency on the part of the Opposite Party No.1 in depriving the insured under the said policy especially the complainant who is claiming under the said Ex.A1 as nominee and there by the Opposite Party No.1 is remaining accountable under said policy to complainant ‘s claim.
12. In the circumstances there being any material to constitute any role of the Opposite Party No.2 in the grievances of the complainant there appears any deficiency of service on the part of the Opposite Party No.2 and there by any liability of the opposite party No.2 for the complainant‘s claim. Consequently, the case of the complainant against opposite party No.2 is dismissed.
13. In the result of the above discussion, the deficiency of service of the Opposite Party No.1 in non settlement of the claim of the complainant made under Ex.A1 is made out, the Opposite Party No.1 is not only remaining liable for the payment of the assured amount but also to compensate the mental agony and costs of the complainant for being driven this complainant to the Forum for redressal.
14. Consequently, the case of the complainant is allowed against the Opposite Party No.1 only directing it to pay to the complainant not only the assured amount under Ex.A1 policy but also Rs.5,000/- as compensation for mental agony and Rs.2,000/- as costs of this case within a month of the receipt of this order. In default the Opposite Party No.1 shall be liable to pay to the supra stated award amount with 12% p.a from the date of default till realization.
Typed to dictation corrected and pronounced on this 22nd day of May, 2009.
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. Certificate of Insurance Sl.No.521.
Ex.A2. Office copy of legal notice dt.25-07-2007.
Ex.A3. Office copy of legal notice dt. 4-7-2008 along with postal
Receipt & ack.
Ex.A4. Death Certificate.
List of exhibits marked for the opposite parties:
Ex.B1. Attested Xerox Copy Fax letter dt.2-12-2008 addressed to OP No.2.
Ex.B2. Attested Fax copy of letter dt.14-3-2002 addressed by OP NO.2.
Ex.B3. Another letter dt.27-3-2002 of OP NO.2.
Sd/- Sd/-
MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties
Copy was made ready on :
Copy was dispatched on :
