IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM MYSORE.<br /> <br /> Dated this 6th day of October 2010<br /> <br /> Complaint No. 504/2010<br /> <br /> Present: 1) Sri. T.H. Narayangowda, President.<br /> 2) Smt. Y.V. Uma Shenoi, Member.<br /> 3) Sri. Shivakumar .J, Member.<br /> <br /> Complainant: Smt. K.C. Pushpa W/o late K. Raghavendra<br /> # 3200, 4th cross, Labour colony, Mandya.<br /> <br /> (By Sri. K.V.S, Advocate).<br /> <br /> Vs.<br /> <br /> Opponents: The Manager, Reliance General Insurance<br /> Co. Ltd., Branch Office, 1st stair, Mysore <br /> Trade Center, L 36/D, Opposite to KSRTC<br /> Bus stand, Bangalore-Neelgiri road, Mysore.<br /> (By Sri. K.L.S, Advocate)<br /> <br /> (Order dictated by Sri. T.H.Narayana Gowda, President)<br /> <br /> ORDER<br /> <br /> This is a complaint filed by the complainant u/s. 12 of the C.P. Act 1986 against the opponent for directing him to pay the Insurance Policy amount of Rs.1,25,000/- along with interest at the rate of 18% P.A, compensation of Rs.50,000/- towards mental agony and cost of the complaint etc.,. <br /> <br /> <br /> 2) The case of the complainant in brief as set out in the complaint is as follows:-<br /> <br /> That the complainant’s husband namely Sri. K. Raghavendra was residing at house No.939, 12th cross, Janatha Nagar, T.K. layout, Mysore and he was working as field Sales Officer Associate in H.R. Services Private Limited, Mysore belonging to Reliance Group of company. Her husband had taken the Insurance Policy No. 1403782913001720 dated 08.09.2008 from the opponent for Rs.1,25,000/- and the same was in force for the period from 08.09.2008 to 07.09.2009. Subsequently, during the said period of policy her husband returned to the house after finishing the office duty on 20.02.2009 and in the midnight about 1’ O’ clock her husband had suffered the heart attack due to the accidental fall near the bath room and died on the same night. After the death of her husband, the complainant shifted her residence to Mandya. Thereafter on 27.06.2009, the complainant has sent the application to the opponent by RPAD with a request to settle the policy amount of Rs.1,25,000/- and the same was received by the opponent on 29.06.2009. The complainant personally visited the office of the opponent and submitted the duly filled claim form to the opponent through Fly King courier services. In spite of the same, the opponent did not take any steps to settle the policy amount. Hence, the complainant has got issued the legal notice dated 08.09.2009 to the opponent demanding the opponent to settle the policy amount and the same was duly served on the opponent on 09.09.2009 itself. In spite of the same, the opponent has failed to comply with the said notice. Thus the opponent has deliberately avoided to settle the policy amount without any reason and thus caused mental agony to the complainant and thereby committed the deficiency in service. Hence, the opponent is also liable to pay the compensation of Rs.50,000/- towards mental agony apart from paying the policy amount. Hence, this complaint is filed against the opponent for directing him to pay the said amount along with interest and cost of the complaint.<br /> <br /> 3) In pursuance of the notice of the complaint issued by RPAD, the opponent appeared before the Forum through his counsel and registered the complaint by filing his version. In the said version, the opponent has admitted the policy taken by the deceased husband of the complainant and the claim made by the complainant for the settlement of the policy amount. But the opponent has specifically denied the deficiency in service alleged by the complainant and the fact of accidental death of the insured as false and further contended that the policy taken by the complainant’s husband was a personal accident policy and her husband died due to heart attack and not due to any accident. The said policy covered only the accidental death or permanent injury to the insured and does not cover any natural death due to heart attack or any other disease. Therefore the complainant is not entitled for the policy amount and accordingly the opponent has rightly repudiated the claim of the complainant as per the terms of the policy and the same does not amount to deficiency in service. In spite of the same, the complainant has filed this complaint on false and concocted story and therefore the complaint is not maintainable in law or on facts and the same is liable to be dismissed with cost. Mainly, on these grounds, the opponent has urged for the dismissal of the complaint with cost.<br /> <br /> 4) After filing of objections, the case was posted for evidence. Thereupon the complainant has filed her affidavit and the affidavit of one witness in lieu of evidence and relied upon several documents in support of her case and closed her evidence. Thereafter, the opponent has filed the affidavit in lieu of evidence and relied upon several documents in support of her case and closed her evidence. Thereafter, complainant’s counsel filed the written arguments and also heard the arguments of both sides and then posted the case for orders.<br /> <br /> <br /> 5) In view of the aforesaid contentions taken by both the parties and the arguments submitted by their learned advocates, the points that would arise for our consideration are as follows:-<br /> <br /> 1) Whether the complainant is entitled for any of the reliefs sought for in the complaint?<br /> 2) What Order?<br /> <br /> 6) Our findings on the aforesaid points are as follows:-<br /> <br /> Point No.1:- In the negative. <br /> Point No.2:- As per final order for the following, <br /> <br /> REASONS<br /> <br /> 7) Point No.1:- As already stated above, in order to establish her case, the complainant has filed her affidavit and also the affidavit of one witness in lieu of evidence and relied upon several documents. On the other hand, in order to establish his defence, the opponent has filed his affidavit in lieu of evidence and relied upon several documents. In her affidavit, the complainant has duly sworn on oath in respect of all the averments of her case made out in the complaint. Her witness who is an Auto driver also duly sworn on oath to the effect that by the time of taking the husband of the complainant to the hospital for treatment, her husband died and therefore the dead body of her husband was taken back to their house. But in the evidence of the complainant and her witness, there is absolutely no material to say that the death of the complainant’s husband was solely due to any accident occurred as a result of external force. On the other hand, as per the averments of the complainant and the affidavit of the complainant and her witness clearly disclose that the death of the complainant’s husband was due to heart attack and thus the death of the complainant’s husband is natural and not due to any accident occurred due the external force. Admittedly deceased husband of the complainant taken the personal accident policy and therefore the complainant is not entitled for the policy amount in view of the death of her husband due to chest pain or heart attack. Therefore the repudiation of the claim made by the opponent is justified under the facts and the circumstances of the case. Thus the complainant has failed to prove her case made out in the complaint and therefore she is not entitled for any of the reliefs sought for in the complaint. Accordingly, we answer the point No.1 in the negative.<br /> <br /> 8) Point No.2:- In view of the reasons and the finding recorded on the point No.1, we hold that the complaint is liable to be dismissed in the ends of justice with a direction to both the parties to bear their own cost. Hence in the final result, we proceed to pass the following,<br /> <br /> :: O R D E R ::<br /> <br /> The complaint is hereby dismissed.<br /> Both the parties are directed to bear their own cost.<br /> <br /> <br /> (Order dictated, corrected and then pronounced in the open Forum on this 6th day of October 2010)<br /> <br /> <br /> Member. Member. President.<br /> <br /> <br /> <br /> <br /> <br /> <br />