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
Thursday the 6th day of November, 2008
C.C.No. 15/08
Between:
A.Hemalatha, W/o. Late A. Naga Raju Subramanya Gupta Alies Nagaraju Gupta,
R/o.K.V.S.Colony, Dhone, Kurnool District. Now presently R/o. Thadakanapalli Village, Ulinda Konda Mandal, Kurnool District. … Complainant
Versus
1. Shiram Direct to Home Private Limited, Road Safety Club Private Limited, Represented by its Chief Executive Officer,
2A, Prakash Road, T.Nagar, Chennai-600 017. Tamilnadu State.
2. TATA, A.I.G.General Insurance Company Limited, Represented by its Divisional Manager,
Raheja Towers, 9th Floor, Betawing 177, Annasalai, Chennai-600 002.
Tamilnadu State.
3. Shirama Chits Private Limited, Represented by its Divisional Manager,
2nd Floor U-Con Plaza, Kurnool .
… Opposite parties
This complaint is coming on this day for orders in the presence of Sri.D.Siva Sankara Reddy, Advocate, for the complainant, and Sri.P.Siva Sudharshan, Advocate, for the opposite party No.1 and Sri.P.Ramanjaneyulu, Advocate for opposite party No.2 and opposite party No.3 is called absent set exparte and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. K.V.H.Prasad, President )
C.C.No.15/08
1 . This case of the complainant is filed U/S 12 of C.P.Act seeking direction on the opposite parties to pay to the complainant Rs.3 lakhs each under each of the two policies with interest at 24% p.a from the date of accident , Rs.50,000/- as compensation for mental agony and Rs.25,000/- as cost alleging that the complainants husband – Nagaraju Subramanya Gupta @ Nagaraju Gupta was holder of membership certificates Nos.390390 and 390438 of opposite party No.1 through opposite party No.3 on 25-05-2005 and on 04-06-2005 each for a period of 96 months was issued of certificates of insurance bearing No.ACL / P000003158 and ACL / PC000003169 by opposite party No.2 under master policy No. 0000486 covering the period of insurance from 25-05-2005 to 24-05-2006 and 04-06-2005 to 03-6-2006 respectively covering the risk of the member for an assured sum of Rs. 3 lakhs under each and during subsistence of said policies the said member died on 16-6-2005 in a road accident at the village limits of Mone while traveling in the vehicle bearing No.AP 21 V 8073 and succumbed to the accident injuries and the police registered a case in Cr.No.140/2005 U/S 297 , 337 , 336 and 304 (A) IPC and the claim submitted by the complainant along with all relevant documents under said two policies of the insurance not settled by the opposite parties inspite of several approaches and legal notice dated 24-10-2007.
2. In pursuance of the receipt of the notice of this forum as to this case of the complainant , while the opposite party No.3 remained ex-parte to the case proceedings by his absence , the opposite parties 1 and 2 caused their appearance through their counsel and contested the case denying their liability filling their written version seeking dismissal of the complaint.
3. The written version of the opposite party No.1 even though admits the status and privy of the complainant’s husband to it as member and the issual of certificate of insurance of opposite party No.2 to him covering the risk as alleged by the complainant , disowns any of its deficiency and their by any liability to the complainants case as the liability under said certificate of insurance is of the opposite party No.2 , as the opposite party No.1 has done its duty of processing and the submission of claim of the complainant to the opposite party No.2 .
4. The written version of the opposite party No.2 alleges that the certificate of insurance under which the complainant is resting her claim , as a false document created at the connivance of opposite parties 1 and 2 with the complainant and any premium for said insurance was paid either by the complainants husband or by opposite parties 1 and 3 under whose master policy the said certificates of insurance were said to have been issued. Its obligation under any certificate of insurance to the member of opposite party No.1 shall be only on receipt of premium of the member through its master policy holder . It has brought to the notice of the opposite parties 1 and 3 as to the said certificate of insurance and real facts relating to it when the claim was submitted by complainant and the opposite parties 1 and 3 kept silent and so there is any deficiency on the part of the opposite party No.2 in not settling the claim and the liability if any under those certificate of insurance shall be on opposite parties 1 and 3 only and the said certificates of insurance were fake and so not actionable .
5. In substantiation of the contentions while the complainant side has taken reliance on documentary record in Ex.A1 to A8 and the sworn affidavit of the complainant , the opposite party side has taken reliance on documentary record in Ex.B1 to B3 and sworn affidavits of opposite parties 1 and 2.
6. Hence the point for consideration is whether the complainant has made out any deficiency of the opposite parties to hold their liability to complainants claim.
7. The Ex.A1 and A2 are the membership certificate issued by opposite party No.1 in favour of A. Nagaraju Gupta admitting him as the member of their Road Safety Club for a period of 96 months from 25-5-2005 and 4-6-2005 respectively . They acknowledge the receipt of Rs.3,000/- as membership fees of said opposite party No.1 Road Safety Club . They envisage in its terms and conditions printed on their overleaf of that the member therein will be arranged insurance cover in three weeks from the date of enrollment of the membership or from the expiry of the existing insurance which ever is latter and the insurance benefit that could be arranged to the member is of two types while the first one was silver card covering the insurance benefit to one two wheeler and the second one was a classic card providing personal accident insurance of the member . Hence the Ex.A1 and A2 by they themselves not providing any insurance expect a provision for arranging the same to the member .
8. The Ex.A3 and A4 are certificates of insurance of member covered in Ex.A1 and A2 covering the risk for the period envisaged in Ex.A1 and A2 and were said to have been issued under master policy No.GPA0000486 . As per the opposite party No.1 and complainant the Ex.A3 and A4 were issued by opposite party No.2 on payment of the premium to opposite party No.2 through opposite party No.1. But the opposite party No.2 alleges that no premium was paid by opposite party No.1 covering the risk to the member alleged in Ex.A1 and A2 and the Ex.A3 and A4 were fabricated at the collusion of the opposite parties 1 and 3 with the complainant . It further submits that the liability for a claim of member under any master policy shall be only on receipt of premium for covering the risk of said member under said master policy . The opposite party No.1 except alleging that the certificates of insurance in Ex.A3 and A4 to its member in Ex.A1 and A2 was on payment of due premium by it , did not place any such record substantiating the said contention to discredit the value of the Ex.B3 – list of 1047 members covered under master policy No.GPAR000486 issued to opposite party No.1 vide Ex.B2 which is not containing the name of the members mentioned inEx.A1 and A4 nor the complainant as nominee . Further the certificate of insurance in Ex.A3 and A4 said to be concerning to the master policy No.GPA0000486 and not of the master policy NO.GPAR 000486 envisaged in Ex.B2 . In the absence of any proof as to the existence of master policy No.GPAR 0000486 infavour of the opposite party No.1 and in the absence of any cogent material evidencing the payment of premium of insurance for the member covered in Ex.A1 and A2 is placed either by the member concerned in Ex.A1 and A2 or by the opposite party No.1 – master policy holder for providing the insurance coverage to its member concerned in Ex.A1 and A2 , there appears ample doubt on the bonafidees of the Ex.A3 and A4 creating any liability of the opposite party No.2 for complainants claim especially when the Ex.B1 letter dated 16-11-2005 addressed by opposite party No.2 to opposite party No.1 also alleges the claim of A.Nagaraju Gupta is not processed as his name is not appearing in the annexure of the policy (Ex.B3) and the request to the opposite party NO.1 for providing any further details with its to proceed further was not responded by the opposite party No.1 with any such endeavour of providing any further details as to said claim if which is a bonafide and genuine one would have been made.
9. When any concern of the member in Ex.A1 and A2 in reference in Ex.A3 and A4 is making out any valid liability on the opposite party No.2 for the complainants insurance claim , the documents in Ex.A5 , A6, and A8 as to demise of A.Nagaraju Gupta in road accident finds any relevancy of their appreciation in this case.
10. As the complainant is remaining failed , under above state of circumstances , in establishing the bonafidees of Ex.A3 and A4 and any valid liability of the opposite party No.2 there under for the insurance claim of the complainant , there appears any material to hold any deficiency of the opposite parties nonetheless of the opposite party No.2 in not entertaining claim of the complainant .
11. Consequently, there being any merit and force in the case of the complaint it is dismissed with cost against the opposite parties.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 6th day of November, 2008.
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. Membership certificate issued by OP.No.1 dated 25-05-2005.
Ex.A2. Membership certificate issued by OP.No.1 dated 04-06-2005.
Ex.A3. Certificate of insurance of member policy No.GPA 00000486
(Xerox) showing Naga RAju Gupta 25-05-2005 to 24-05-2006.
Ex.A4. Certificate of insurance of member policy No.GPA0000486
(Xerox) showing Naga Raju Gupta 04-06-2005 to 03-06-2006.
Ex.A5. Death certificate attested Xerox issued by Grampanchayat
Karyalay, Loni Bk, Tal Rahata, District, A Nagar dated 07-07-2005.
Ex.A6. Office copy of legal notice dated 24-10-2007 along with
Postal receipt and acknowledgement.
Ex.A7. Reply of Op.NO.1 dated 30-10-2007.
Ex.A8. Certified coy of the complaint along with English translation.
List of exhibits marked for the opposite parties:
Ex.B1. Letter dated 16-11-2005 addressed to OP.No.1 along
with attested letter.
Ex.B2. Group Personal accident policy GPAR 000486 along with
Certificate of Insurance No.009.
Ex.B3. List of Insurance personal in Annexure – A showing page 22.
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 :
