BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri.T. Sundara Ramaiah , B.Com B.L., President
And
Sri. M. Krishna Reddy , M.Sc., M.Phil., Male Member
Friday the 06th day of August, 2010
C.C. No.130/09
Between:
J.B.Nagamallaiah, S/o. Late J.B. Veera Nagaiah,
H.No.LIG II 139, B.Camp Post, Kurnool-518 002. …..Complainant
-Vs-
1. Senior Divisional Manager, National Insurance Company Limited,
Division III, 8, India Exchange Place (Gr.Floor), Kolkatta-700 001.
2. Managing Director, Golden Multi Service Club Limited,
S.B.Mansion, 16, R.N.Mukherjee Road, Kolkatta-700 001.
3. Branch Incharge, Golden Multi Service3s Club Limited,
40-384/1, Ucon Plaza, 3rd Floor, Park Road, Kurnool-518 001. …Opposite PartieS
This complaint is coming on this day for orders in the presence of P.Siva Sudharshan, Advocate, for complainant, and Sri.L.Hari Hara Natha Reddy, Advocate for opposite party No. 1 and opposite party No. 2 is called absent set ex-parte and Sri.M.Azmathulla , Advocate for opposite party No.3 and upon perusing the material papers on record the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No.130/09
1. This complaint is filed under section 11 & 12 of C. P. Act, 1986 praying to direct the Ops
(a) to pay the policy claim amount of Rs.1,00,000/- to the complainant with interest at 24% p.a from 20-12-2007 to till the date of realization along with other benefits.
(b) to grant a sum of Rs.10,000/- towards mental agony .
( c) to grant a sum of Rs.5,000/- towards cost of the complaint.
(d) and grant any other relief or reliefs as the Hon’ble Forum may deems fit and proper under the circumstances of the case.
- The case of the complainant in brief is as follows:- The complainant is the brother of the deceased B. Siva Prasad . Sri. B. Siva Prasad took Janatha Personal Accident Policy from OP.No.1 through Ops 2 and 3 for Rs.1,00,000/- . The period of the policy is from 08-09-2004 to 08-09-2014. In case of the death of the insured his nominee is entitled for an amount of Rs.1,00,000/- . The insured B. Siva Prasad died in road accident on 21-12-2007. Ulindakonda police registered a case in Cr.No.121/2007 U/S 304 (A) IPC. The death of the insured was informed to OP.No.1 through OP.No.2. The complainant submitted the claim form to OP.No.1 through Ops 2 and 3 along with relevant documents. OP.No.2 sent the said documents to OP.No.1 through a letter dated 08-04-2008. OP.No.1 repudiated the claim of the complainant on the ground that the intimation of claim was received after 90 days from the date of accident. Hence the complaint.
3. OP.No.2 remained ex-parte. OP.No.1 filed written version stating that the complaint is not maintainable in law. The complainant not intimated about the death of his brother within 30 days. As per the terms and conditions of the policy the claim in respect of the death of the assured must be made within 90 days . The complainant did not send the claim form within 90 days. There is violation of terms and conditions of the policy and hence the claim of the complainant is treated as ‘No claim’. There is no deficiency of service on the part of OP.No.1. The claims arising out of the policy is subject to Kolkatta territorial jurisdiction only. The complainant has to approach the Civil Court for claiming the amount . The claim is bared by limitation.
OP.No.3 filed written version stating that the complaint is not maintainable. On 02-04-2004 OP.No.2 and 1 entered into memorandum of understanding . As per the said understanding OP.No.1 agreed to extend insurance coverage to the members of Ops 2 and 3. On 22-03-2008 the complainant approached OP.No3 and requested for claim form. On 24-03-2008 the complainant submitted the claim form to OP.No.3 along with documents . OP.No.3 forwarded the said claim forms to OP.No.2 and OP.No.2 submitted the same to OP.No.1 by its letter dated 08-04-2008. There is no deficiency of service on the part of the part of OP.No.3. There is no cause of action against OP.No.3. The complaint is liable to be dismissed.
4. On behalf of the complainant Ex. A1 to A7 are marked and the sworn affidavit of the complainant is filed. On behalf of the opposite party Ex.B1 to Ex.B7 are marked and sworn affidavit of OP.No.1 is filed.
5. Complainant and Ops 1 and 3 filed written arguments.
6. The points that arise for consideration are
(i) whether there is deficiency of service on the part of OPs ?
(ii) whether the complainant is entitled to any relief ?
- whether this forum has got jurisdiction to entertain the complaint.
- To what relief?
7. Points No.1 & 2 :- It is the case of the complainant that his brother B. Siva Prasad took Janatha Personal Accident Policy from OP.No.1 for Rs.1,00,000/- . The complainant in his sworn affidavit stated that his brother took the insurance policy Ex.A1=B1 from OP.No.1. It is mentioned in the said policy that the complainant is the nominee. It is the specific case of the complainant that his brother died in a motor accident on 21-12-2007. To prove the same the complainant filed Ex.A3 to A5 . Ex.A5 is the copy of FIR . As seen from Ex.A5 it is very clear that Ulindakonda police registered a case in Cr.No.121/07 on the basis of the statement of P. Sreenivasulu. It is mentioned s in Ex.A5 that on 20-12-2007 B.Siva Prasad met with motor accident and that he was admitted in Government Hospital, Kurnool. Ex.A3 is the post mortem certificate of Siva Prasad. It is mentioned that Ex.A3 that Siva Prasad died due to the head injury. In Ex.A4 inquest report also it is mentioned that Siva Prasad met with road accident on 20-12-2007 and he died on 21-12-2007 while under going treatment in Government Hospital, Kurnool. From the evidence available on record it is very clear that Siva Prasad met with an accident and died on 21-12-2007. Admittedly after the death of Siva Prasad the complainant who is his brother submitted claim form to OP.No.1 through Ops 2 and 3. The claim of the complainant was repudiated on the ground that it was not submitted within 90 days from the date of the accident. It is also the case of OP.No.1 that intimation regarding the death of Siva Prasad was not given within 30 days of his death. In Ex.B1 policy it is mentioned that the claim intimation should be given within 30 days by the claimant and the claim form along with necessary supporting documents should be submitted within 90 days from the date of the accident. In the present case the complainant filed Ex.A2 claim form dated 24-03-2008. As seen form Ex.A2 it is very clear that the claim form was not submitted to OP.No.1 within 90 days from the date of death of the insured. It is submitted by the learned counsel appearing for the complainant that the terms and conditions mentioned on the reverse side of Ex.B1 are not binding and that the OP.No.1 cannot repudiated the claim on the mere ground that the claim form was not submitted within 90 days . The learned counsel appearing for the complainant also submitted that the requirement of submitting the claim form within 90 days of the death of the insured is not mandatory and it is only directory. Merely because the complainant submitted the claim form shortly after the expiry of 90 days. OP.No.1 cannot repudiate the claim of the complainant . As seen from the evidence available on record it is very clear that the insured died due to the injuries received in a motor accident that took place on 20-12-2007 . Ex.A1 policy is for Rs.1,00,000/-. The complainant is the nominee under the policy. The repudiation of the claim by OP.No.1 is not just and reasonable. There is deficiency of service on the part of OP.NO.1 in not settling the claim of the complainant within the time.
8. It is the specific case of the Ops 2 and 3 that there is no contract between them and the complainant , that they simply forwarded the claim of the complainant to OP.No.1 and that they are not liable to pay any amount. Admittedly the contract of insurance is in between the complainant and OP.No.1. The Ops 2 and3 acted as agents of OP.No.1 for collection of premiums and submitting the claim forms etc., As there is no binding contract between the complainant and Ops 2 and 3 , Ops 2 and3 cannot be made liable . OP.No.3 received the claim form and submitted the same to OP.No.2 who in turn submitted to OP.No.1 . There is no deficiency of service on the part of Ops 2 and 3 and hence they cannot be made liable to pay the amount to the complainant .
9. Point No.:-3 It is the case of the OP.No.1 that all the claims arising out of the policy issued by OP.No.1 are subject to Kolkatta Territorial Jurisdiction only and that the District Forum , Kurnool has no jurisdiction to entertain the case . In Ex.B1 policy it is mentioned that all disputes between the parties , the beneficiary there under shall be filed within the territorial jurisdiction of Kolkatta. It is argued by the learned counsel appearing for the complainant that the said condition in Ex.B1 is not binding on the complainant and it is open to the complainant to file the complaint in District Forum , Kolkatta , or District Forum , Kurnool. The learned counsel appearing for the complainant relied on a decision reported in II (2005) CPJ 587 where in the Karnataka State Commission held that any agreement entered into between the parties restricting jurisdiction to a particular Court constituted under General / Common Law cannot be extended to the District Forum, State Commission and National Commission as the District Forum or State Commission Or National Commission are not the Courts constituted under the Civil Procedure Code and they are only the quasi judicial authorities” . In the light of the observation made in the above said decision it is very clear that the restriction regarding the jurisdiction mentioned in Ex.B1 is not binding on the complaint. As the application to obtaining the insurance policy was forwarded through OP.No.3, this forum has jurisdiction to entertain the present case.
10. Point No.:-4 In the result, the complaint is partly allowed directing the OP.No.1 to pay policy amount of Rs.1,00,000/- with benefits and costs of Rs.500/- with interest at 9% from the date of the repudiation of the claim i.,e 11-04-2008 till the date of payment. The claim against OP.No.2 and 3 dismissed.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 06th day of August, 2010.
Sd/- Sd/-
MALE 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 Photo copy of policy No.100300/42//04/8200012,
dt.8-9-2004.
Ex.A2. Photo copy of claim form, dt.24-03-2008.
Ex.A3. Photo copy of Postmortem report of Jangam Busi Siva Prasad.
Ex.A4. Photo copy of Inquest report.
Ex.A5. Photo copy of FIR report in Cr.NO.121/07of Ulindakonda, P.S.
Ex.A6. Letter dt.08-04-2008 of OP2 to OP1.
Ex.A7. Repudiation letter dt.11-04-2008.
List of exhibits marked for the opposite parties:
Ex.B1. Photo copy of insurance policy No.100300/42//04/8200012, dt.08-09-2004
Ex.B2. Photo copy of claim from, dt.11-04-2008.
Ex.B3. Photo copy of Memorandum of under standing
dt. 02-04-2004.
Ex.B4. Photo copy of Letter dt. 17-07-2001.
EX.B5. Photo copy of Letter dt.22-03-2008
Ex.B6. Photo copy of Claim form submitted by the complainant.
Ex.B7. Photo copy of Letter dt. 08-04-2008 received copy of OP No.1
Sd/- Sd/-
MALE 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 :
