BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM ::
KADAPA Y.S.R DISTRICT
PRESENT SRI V.C. GUNNAIAH, B.Com., M.L., PRESIDENT
SMT. K. SIREESHA, B.L., LADY MEMBER
M.V.R. SHARMA, B.A. MEMBER
Monday, 20th April 2015
CONSUMER COMPLAIN]T No. 126/ 2012
Paidimarri Narayana, S/o Govindaiah,
Hindu, age … years, Hindu, residing at Old age home,
Near Govt. Hospital, Proddatur, Kadapa District. ….. Complainant.
Vs.
1. Road Safety Club Pvt. Ltd., Rep. by its
Manager, No.1 Sambandam Street,
G.N. Chetty Street, T. Nagar, Chennai.
2. Shriram Chits Pvt. Ltd., Rep. by its
Branch Manager, 19/102, S.V.K. Complex,
Madras Road, Kadapa.
3. The Bajaj Allianz Life Insurance Co. Ltd.,
EG Plaza, Airport Road, Yerawada, Pune.
(R3 added as per the orders in
I.A. No. 28/2013, dt. 12-3-2014). ….. Respondents.
This complaint coming on this day for final hearing on 10-4-2015 in the presence of Sri P.V. Ramana Reddy, Advocate for complainant and Sri G.S. Murthy , Advocate for respondent No.1 and Sri M. Sudhakar babjee, Advocate for Respondent No.2 and Sri D.V.S. Prasad, Advocate for respondent No.3 and upon perusing the material papers on record, this Forum made the following:-
O R D E R
(Per V.C. Gunnaiah, President),
1. The complainant filed this complaint under section 12 of Consumer Protection Act 1986 (for short herein after called as C.P. Act) praying this forum to direct the Respondents to pay Rs. 2,15,000/- jointly and severally, which includes Rs. 2,00,000/- towards insurance amount and Rs. 10,000/- towards mental agony and Rs. 5,000/- towards costs.
2. The averments of the complaint in brevity are that the deceased P. Venkata Subbamma is the wife of complainant. The said P. Venkata Subbamma joined as Member in respondent No.1’s Road Safety Club Programme and obtained enrolment Nos. 199678 to 199681 on 10-9-2007 and obtained 4 membership certificates by paying Rs. 3,300/- for enrolment Nos. 199678 and 199679 and Rs. 5,500/- for enrolment Nos. 199680 and 199681 and insured respondent No.1 the deceased P. Venkata Subbamma for Rs. 50,000/- each with respondent No. 3 insurance office for 36 months and 60 months respectively. The complainant was shown as nominee by the deceased. While so on 4-1-2010 P. Venkata Subbamma died. The complainant in the capacity of nominee of the deceased requested the respondents several times to settle the claim on the respective four certificates of insurance covered under the group policy RCN 0000131 and pay the amount. He has furnished all relevant documents to R1 and inturn respondent No. 1, forwarded the relevant documents to respondent No.3. But the respondents did not properly responded. The respondents have to pay the amount to the nominee in the event of death of holder of the certificate as per terms and conditions. The complainant issued legal notice on 18-2-2012 that they have not settled the claim. Hence, the complaint for the above reliefs.
3. Respondent No.1 filed counter and the same was adopted respondent No. 2 by filing memo. Respondent No. 1 admitted that the deceased P. venkata Subbamma was a member but denied its liability to pay insurance claim as the same is in between respondent No. 3 and complainant. It is further contended that in the terms and conditions of the Road Safety club service it was mentioned and the members specifically acknowledges that this respondent is not liable any manner whatsoever, for the insurance coverage. The documents submitted by the complainant was forwarded to the insurance company. Thus there is no deficiency of service on the part of this respondent. The respondent No. 3 issued certificate of insurance specifically mentioning the name of each member to cover the risk for the period. So this respondent is no way liable to pay insurance claim by the complainant. The complaint is also not maintainable as there is clause in Road Safety Club Programme terms and conditions that any dispute is to be referred to arbitration. Hence, there is no cause of action and the complaint is liable to be dismissed.
4. Respondent No. 3 filed counter denying the allegations in the complaint and called upon the complainant to prove all of them. It is further averred that the complaint is misconceived and contrary contract between the parties. Therefore, the complaint is not maintainable. The respondent No.1 being master policy holder bearing RCN 0000131 has insured the member under group term life voluntary plan with respondent No.3 for the period of one year only i.e. from 9-12-2007 to 8-12-2008 and certificate of insurance was issued for that period of one year only by this respondent to cover the risk for the member. But P. Venkata Subbamma died on 4-1-2010. So respondent No. 3 has no contractual relationship with respondents 1 & 2 or with Pidimarry Venkata Subbamma, no certificate of insurance was issued by respondent No. 3 in favour of P. Venkata Subbamma subsequently. So the complainant claiming death benefit for the policies 2007 to 2008 not sustainable and the complainant is not entitled for the claim and this respondent is not liable to pay the amounts claimed and complaint is liable to be dismissed.
5. On the basis of the above pleadings the following points are settled for determination.
- Whether there is insurance coverage on the date of death of deceased i.e. 4-1-2010 with respondent No.3?
- Whether there is any deficiency of service on the part of the respondents?
- Whether the complainant is entitled for the reliefs claimed against the respondents?
- To what relief?
6. No oral evidence has been let in by the parties. But on behalf of the complainant Exs. A1 to A13 documents are marked and on behalf of respondent No.1 Exs. B1 to B20 documents are marked by consent.
7. Heard arguments on both sides.
8. Point Nos.1 to 3. Learned counsel for complainant submitted that the respondent No. 1 issued Exs. A1 to A4 membership certificates and respondent No. 3 issued Exs. A5 to A9 insurance certificates and Ex. A9 shows the member, under Exs. A1 to A4 died on 4-1-2010. Therefore, the respondents are liable to pay the death risk under Exs. A5 to A8 to the complainant, who is the nominee of the deceased member. Per contra learned counsel for respondent No. 1, contended that Exs. A1 to A4 were issued by respondent No. 1 but the risk to cover insurance is to be paid by the insurance company only for the period certificate issued by them and as per Exs. B1 to B4 terms and conditions, membership certificates issued by respondent No.1 the member acknowledged that respondent No. 1 has no liable to pay the amount and if any dispute arose he has to proceed against the insurance company. He also contended that Exs. B5 to B16 letters addressed by R1’s shows that there was no negligence or deficiency of service on the part of respondent No.1 to address the grievances if any of complainant. So R1 is not liable to pay any amount to the complainant.
9. Learned counsel for respondent No. 3 insurance company contended that the insured member P. Venkata Subbamma was a Group Term Life Voluntary Plan Member under Exs. A5 to A8 for an amount of Rs. 50,000/- each and the same were issued covering for the period from 9-12-2007 to 8-12-2008 but the deceased died 4-1-2010 for which period there was no premium paid nor coverage was extended under group policy. Therefore, the R3 is not liable to pay the claim and the complaint is liable to be dismissed.
10. There is considerable force in the contention of learned counsel for respondents. No doubt as per Exs. A1 to A4 the deceased P. Venkata Subbamma was a member, when respondent No.1’s club and respondent No. 3 issued certificate of insurance under Exs. A5 to A8. But a perusal of Exs. A5 to A8 clearly goes to shows that the group term life voluntarily plan of deceased covers from 9-12-2007 to 8-12-2008 only. There is no evidence placed by the complainant that the deceased / insured member P. Venkata Subbamma paid premium beyond 8-12-2008 and respondent No. 3 issued certificate of insurance covering the risk under Group Term Life Voluntary Plan. As per Ex. A9 the deceased member died on 4-1-2010. By that date, though the deceased was a member with respondent No. 1 there is no iota of evidence to show that the premium was paid to R3 company either by the member or by the respondent No.1. No insurance certificate whatsoever, has been field by the complainant to prove that beyond 8-12-2008 there is insurance coverage to the deceased P. Venkata Subbamma. Further a perusal of Ex. B1 shows that under the terms and conditions of R1, there is no liability to R1 for discrepancy or defect in the claim of insurance. The member acknowledged the same under Ex. B1 to that effect. The complainant in this case also failed to produce the group policy No. RCN0000131 or Group Term Life Voluntary Plan said to have been extended to him by respondent No.1. Therefore, there is no evidence placed by the complainant to shows by the date of death of her wife P. Venkata Subbamma, she had insurance coverage with R3 or she paid premium to R3 company or R1 club paid premium under Group Insurance policy to R3 covering the personal accident insurance of the member. Therefore, it cannot be said that the R3 insurance company neglected to settle the claim. The correspondence under Exs. B5 to B19 addressed by R1 shows that it acted promptly to address the grievance if any of the complainant. Therefore, there is no deficiency of service on the part of the respondent No.1. There is no evidence placed by complainant how R2 is liable to pay the amount to him. It appears the R2 is wrongly impleaded in this case. By going through the entire material on record we hold that there was no insurance coverage of deceased member from respondent No.3 company on the date of death of deceased i.e. 4-1-2010 and that there is no deficiency of service on the part of the respondents and respondents are not liable to pay amounts as claimed by the complainant and the complaint is liable to be dismissed. Accordingly, the points 1 to 3 are answered against the complainant.
11. Point No. 4 In the result, the complaint is dismissed but in the circumstances no costs.
Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open forum, this the 20th April 2015
MEMBER MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant : Nil For Respondents : NIL
Exhibits marked for Complainant : -
Ex.A1 Photocopy of Membership Certificate No.1999678 for Rs.50,000/-
for a period of 36 months.
Ex.A2 Photocopy of Membership Certificate No.1999679 for Rs.50,000/-
for a period of 36 months.
Ex.A3 Photocopy of Membership Certificate No.1999680 for Rs.50,000/-
for a period of 60 months.
Ex.A4 Photocopy of Membership Certificate No.1999681 for Rs.50,000/-
for a period of 60 months.
Ex.A5 Photocopy of Certificate of Insurance for enrolment No.199678.
Ex.A6 Photocopy of Certificate of Insurance for enrolment No.199679.
Ex.A7 Photocopy of Certificate of Insurance for enrolment No.199680.
Ex.A8 Photocopy of Certificate of Insurance for enrolment No.199681.
Ex.A9 Copy of death certificate of the deceased Venkata Subbamma.
Ex.A10 Reminders issued by Ist Respondent 7 in nos.
Ex.A11 Notice issued by the complainant Dt. 7-7-2010 postal receipt
and acknowledgement card.
Ex.A12 Office copy of Legal Notice Dt. 18-2-2012 along with postal receipts.
Ex.A13 Acknowledgement Card.
Exhibits marked on behalf of the Respondents : -
Ex.B1 Photocopy of Certificate of Insurance for enrolment No.199678.
Ex.B2 Photocopy of Certificate of Insurance for enrolment No.199679.
Ex.B3 Photocopy of Certificate of Insurance for enrolment No.199680.
Ex.B4 Photocopy of Certificate of Insurance for enrolment No.199681.
Ex.B5 Letter addressed by Road Safety Club to the Petitioner, Dt. 15-1-10.
Ex.B6 Letter addressed by Road Safety Club to the Petitioner, Dt. 22-2-10.
Ex.B7 Letter addressed by Road Safety Club to the Petitioner, Dt. 17-3-10.
Ex.B8 Letter addressed by Road Safety Club to the Petitioner, Dt. 25-6-10.
Ex.B9 Letter addressed by Road Safety Club to the Petitioner, Dt. 08-7-10.
Ex.B10 Letter addressed by Road Safety Club to the Petitioner, Dt. 19-2-11.
Ex.B11 Letter addressed by Road Safety Club to the Petitioner, Dt. 6-2-12
Ex.B12 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 22-2-2010.
Ex.B13 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 17-3-2010
Ex.B14 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 25-6-2010.
Ex.B15 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 8-7-2010.
Ex.B16 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 19-7-2010.
Ex.B17 Intimation letter.
Ex.B18 Stamped Receipt of Bajaj Allianz Life Insurance Co., Ltd.,
Ex.B19 Letter addressed by Road Safety Club to Bajaj Allianz Life Insurance
Co., Ltd., 8-3-2011.
Ex.B20 Notary Affidavit of P. Narayana along with family members.
Co., Ltd., 17-3-2010.
MEMBER MEMBER PRESIDENT
Copy to :-
- Sri P.V. Ramana Reddy, Advocate for complainant.
- Sri G.S. Murthy, Advocate for Respondent No. 1.
- Sri M. Sudhakar Babjee, Advocate for respondent No.2.
- Sri D.V.S. Prasad, Advocate for respondent No.3.
B.V.P.
