BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: AT HYDERABAD.

F.A.No.450/2012 against C.C.No.23/2011 District Forum, Nizamabad

Between

The Bajaj Allianz General

Insurance Company Limited,

Rep. by its Branch Manager,

Branch Office, GE Plaza,

Airport Road, Yerrawada,

Pune-411006, Maharashtra State.                                       Appellant/

                                                                                      O.P.

And

Smt.M.Sujatha W/o.late Madhu

Reddy, aged 26 years,

Occ: Household, R/o.H.No.4-4,

Sunket village, Morthad Mandal,

Nizamabad District.                                                               Respondent/

                                                                                                Complainant                                                      

Counsel for the Appellant      :  Mr Naresh Byrapaneni

Counsel for the Respondent:  M/s M.Goutham Reddy

QUORUM:  SMT.M.SHREESHA, HON’BLE Incharge President

AND

SRI S.BHUJANGA RAO, HON’BLE MEMBER.

THURSDAY, THE TWENTY SEVENTH DAY OF JUNE

TWO THOUSAND THIRTEEN

Order (Per Smt.M.Shreesha, Hon’ble Incharge President)

***

Aggrieved by the order of C.C.No.23/2011 on the file of District Forum,  Nizamabad, the opposite party preferred this appeal.

        The brief facts as set out in the complaint are that the complainant is the wife of the insured Sri Madhu Reddy who took an insurance policy valid from 25-1-2010 till 17-01-2015 for an amount of Rs.10,00,000/- with accidental benefits by paying a premium of Rs.        4,231/-.  While so on 21-3-2010 the insured died in a motor vehicle accident and the complainant made  a claim with the opposite party which was repudiated on the ground that the insured was driving the said motor vehicle under the influence of alcohol.  The complainant got issued a legal notice on 09-5-2011 which was replied by the opposite party that their repudiation is justified.  Hence the complaint seeking direction to the opposite party to pay the policy amount of Rs.10,00,000/- with interest, compensation and costs.

        Opposite party filed their written version admitting the issuance of policy covering the period from 28/1/2010 to 17/1/2015 and also admit the reply given by them to the legal notice and submit that as per the post mortem report the insured died due to head injury and intra cranial bleed under Ethyl Alcohol intoxication and as the death is under the influence of alcohol, they have rightly repudiated it.  The FCL report also proves that he was under the influence of alcohol and therefore there is no deficiency in service on their behalf.

        The District Forum based on the evidence adduced i.e. Exs.A1 to A10 and B1 to B5 and the pleadings put forward, allowed the complaint in part

directing the opposite party to deposit Rs.10,00,000/- with interest @ 9% p.a. from the date of repudiation i.e. from 07-7-2010 till the date of realization and the opposite party is further directed to pay Rs.20,000/- otwards compensation for deficiency of service and negligence on the part of the opposite party and to pay Rs.2,000/- towards costs within one month.

        Aggrieved by the said order, the opposite party preferred this appeal.

        The brief point that falls for consideration is whether there is any deficiency in service on behalf of the opposite parties and if the complainant is entitled to the relief claimed for in the complaint?

The facts not in dispute are that the complainant is the wife of insured, Sri Madhu Reddy, who died on 21-3-2010 in a motor vehicle accident evidenced under Ex.A1, FIR.  Exs.A2 and A3 are the copies of the statements of the nominee and other witnesses in the FIR and Ex.A4 is the panchanama and Ex.A5 is the post mortem report dated 21-3-2010.  The main point that falls for consideration herein is whether the insured was under the influence of alcohol at the time of the accident?  The learned counsel for the appellant drew our attention to Ex.A5, which is the post mortem examination report, which shows in the stomach contents, that there is a smell of alcohol and a black colour liquid which was sent for FSL examination.  A brief perusal of the final report (Ex.B2)  of the Police states as follows:

“The viscera of the deceased, (D1) sent to RSFL, Kamareddy and the expert has opined that items 1 and 2 are analysed and ethyl alcohol is present in both of them.  Further the medical officer, Dr.M.Srikanth Reddy CAS has issued final opinion stating that the cause of death of the deceased is due to “Head injury and intra cranial bleed, (RTA) under ethyl alcohol intoxication”.

Ex.B4 is the opinion given by A.P. Forensic Science Laboratory where in it is clearly stated that ethyl alcohol is present in the sample of the stomach contents of the life assured M.Madhu.  Clause B 1 (b) of the insurance policy states that the amount will not be paid, if the death is due to accidental bodily injury while under the influence of liquor or drugs.  Keeping in view this clause and also that the opposite party has established by documentary evidence that the life assured died in an accident but under the influence of alcohol, which is excluded in their policy, we are of the considered view that the opposite party has rightly repudiated the claim and hence there is no deficiency in service on their behalf. 

        In the result this appeal is allowed and the order of the District Forum is set aside and consequently the complaint is dismissed.  No costs.

                                                                INCHARGE PRESIDENT.

                                                                MEMBER.

JM                                                             Dt.27-6-2013.