BEFORE THE DISTRICT CONSUMER FORUM AT NALGONDA
PRESENT: SRI MAMIDI CHRISTOPHER,
PRESIDENT.
SMT.S.SANDHYA RANI,
FEMALE MEMBER.
. . .
TUESDAY, THE TWENTY EIGHTH DAY OF JANUARY, 2020
CONSUMER COMPLAINT No. 21 OF 2017
Between:
1. Smt.Anthati Mallamma W/o Late Swamy, Age: 50 years,
Occ: House wife,
2. Anthati Sathaiah S/o Late Swamy, Age: 32 years, Occ: Farmer,
3. Smt. Anthati @ Cheruku Kalamma D/o Late Swamy,
W/o Linga Swamy, Age: 30 years, Occ: Housewife,
R/o Lingojigudem Village, Choutuppal Mandal of Yadadri-Bhongir
District.
4. Anthati Naresh S/o Late Swamy, Age: 28 years, Occ: Farmer,
Complainants No.1,2, and 4 are R/o Veliminedu Village of
Chityal Mandal of Nalgonda District
5. Smt Anthati @ Mettu Mangamma D/o Late Swamy, 27 years ,
Occ: Housewife R/o Bandlaguda, Nagole area, Hyderabad City,
Telangana State.
…COMPLAINANTS.
AND
- The A.P. Grameena Vikas Bank, Veliminedu Branch, Veliminedu Village, Chityal Post and Mandal, Nalgonda District-508114,
Telangana State. Represented by its Branch Manager.
- Bajai Allianz General Insurance Company Ltd., Ground floor, Ashoka Plaza, 32/2, Nagar Road, Viman Nagar, Pune-411014.
Represented by its Authorized Person/Claim Manager.
…OPPOSITE PARTIES.
This complaint coming on before us for final hearing, in the presence of Sri G.Krishna Reddy, Advocate for the Complainants, and Sri P.Srinivas Reddy, Advocate for the Opposite Party No.1, and Sri T.Rajashekhar, Advocate for the Opposite Party No.2, and on perusing the material papers on record, and having stood over for consideration till this day, the Forum passed the following:
ORDER OF THE FORUM DELIVERED
BY SMT.S.SANDHYA RANI, FEMALE MEMBER
1. The Complainant filed this complaint Under Section 12 of Consumer Protection Act, 1986 to direct the Opposite Parties to pay the insured amount of Rs.5,00,000/- under GPA Policy with accidental
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death benefit and interest @ 24% per annum from the date of death of Savings Bank account holder Anthati Swamy, i.e. 23/07/2015 till the date of realization and costs.
2. The facts leading to the filing of this complaint are as follows:
The husband of Complainant No.1 Anthati Swamy S/o late Buchaiah, had opened Savings Bank Account by depositing Rs.50,000/-, vide bearing S.B.Account No.7305615462-4 with Opposite Party No.1, and transactions took place in the said account continuously by maintaining sufficient balance in it till the date of his death in the road traffic accident, i.e. 23/07/2015. The Opposite Party No.1 debited an amount of Rs.100/- from Complainant No.1’s husband SB account. The husband of the Complainant No.1 had Group Personal Accident Policy to his personal S.B.Account towards GPA Policy amount. The Opposite Party No.1 debited the premium of Rs.100/- from the SB account of the husband of Complainant No.1 on 22/09/2014 and the same was credited into Opposite Party No.2 who offered Group Personal Accident Policy to the account holders of A.P.Grameena Vikas Bank, Veliminedu Branch. In turn, the Opposite Party No.2 had issued Group Personal Accident Policy to all the S.B.Account Holders of Opposite Party No.1, vide Policy No.OG-14-1701-6401-00026956 and the insurance period starts from 22/09/2014 to 21/09/2015. As per the terms and conditions of GPA Policy of S.B.Account Holders, if a person dies in natural, the person would get Rs.5,00,000/- and if a person dies in Road Traffic Accident, his nominee or his legal heirs would get Rs.10,00,000/-. The deceased Anthati Swamy who is having S.B.Account with Opposite Party No.1 unfortunately met with Road Traffic Accident on
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23/07/2015 and died on the spot and the date of accident falls in the said insurance coverage period. The husband of Complainant No.1 died in the Road Traffic Accident on 23/07/2015 at Koramandal Factory, Veliminedu Village of Chityal Mandal, Nalgonda District at 9-30 a.m. The Police, Chityal has registered a case in Cr.No.138/2015 U/S 304-A of IPC. against the crime vehicle. The Complainants submitted claim application form on 18/09/2015 with all relevant papers like F.I.R., Inquest, PME Report, Chargesheet and Death Certificate to prove their case that the insured policy and account holder Anthati Swamy died in the Road Traffic Accident on 23/07/2015. The Opposite Party No.1 received the said documents, but kept silent. The Complainants are legally entitled the claim amounts under GPA Policy No.OG-14-1701-6401-00026956 of S.B.Account of APGVB vide Account No.7305615462-4 and the Opposite Parties are jointly and severally liable to pay the claim amount. The Complainant No.1 is the wife and nominee and the Complainants No.2 to 5 are sons and daughters of the deceased Anthati Swamy. The Complainants have no objection to give awarded amounts to the nominee who is Complainant No.1. The Complainant No.1 made representations to the Opposite Party No.1, but the Opposite Party No.1 did not pay the claim amount in SB Savings Account of Rs.5,00,000/- with accidental death benefits to the Complainants or his nominee, i.e. Complainant No.1. The Opposite Party No.1 postponed the same on one reason or the other. The Complainants sent legal notice through their Advocate Sri G.Krishna Reddy to the Opposite Parties on 22/03/2017. The Opposite Parties No.1 and 2 received the notices on 24/03/2017 and 29/03/2017 respectively, but they did not choose to pay legally entitled amounts,
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neither reply to their legal notice nor repudiate their claim till the date of filing of the complaint. As such, the Opposite Parties are jointly and severally liable to pay the insured amount under GPA Policy. The Complainants suffered mentally and physically due to the attitude of the Opposite Parties. There is deficiency of service on the part of the Opposite Parties. Hence, the Complainants filed this complaint.
3. The Opposite Party No.1 filed written version denying all the averments of the complaint and submitted that the policy issued by the Opposite Party No.2 is accidental policy and the nominee or legal heirs are entitled for Rs.5,00,000/- only, but not Rs.10,00,000/- as pleaded by the Complainants. The Complainants are not entitled for double accidental death benefit. The Claim Form submitted by the Complainants were sent to Opposite Party No.2 along with the criminal record and the same were received by Opposite Party No.2 on 24/10/2015. On 26/10/2015 the Opposite Party No.2 sent email stating that the policy bearing No.OG-14-1701-6401-00026956 was expired on 20/12/2014. The said policy was renewed as the said Swamy paid premium amount of Rs.100/- on 23/09/2014 and the same was remitted to No.OG-14-1701-6401-00026952 on 25/09/2014 and, therefore, the policy was in force as on the date of accident, i.e. 23/07/2015. The period of coverage under the said policy is from 21/12/2014 to 20/12/2015. The Opposite Party No.1 submitted that the role of Opposite Party No.1 is only to the extent of debiting the amount from the account of the deceased and crediting the same to the account of Opposite Party No.2. The Opposite Party No.1 accordingly performed its duty and no liability is fastened to the Opposite Party No.1. The liability if any, would be on the Opposite
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Party No.2 and as such there is no joint or several liability to Opposite Party No.1. The Opposite Party No.1 forwarded the claim forms of the Complainants to the Opposite Party No.2 through APGVB Financial Inclusion Cell (FIC) for settlement of claim. The Opposite Party No.1 never assured the Complainants to arrange the amounts, and that the contract is in between the deceased and the Opposite Party No.2 and the Opposite Party No.1 has no role in settlement of the claim. The Opposite Party No.1 received legal notice from the Complainants and did its duty in forwarding the claim forms to the Opposite Party No.2 for settlement, but the Opposite Party No.1 did not give any reply to the legal notice. There is no deficiency of service on the part of the Opposite Party No.1 and it cannot be held responsible for any deficiency of service on the part of Opposite Party No.2. Hence, the complaint against Opposite Party No.1 is to be dismissed.
4. The Opposite Party No.2 filed written version denying all the
averments of the complaint and submitted that the insurance policy is a contract and both the parties are under obligation to obey and fulfill all the terms and conditions and that the claim arrived is also processed within the precincts of the policy only. The policy mentioned in the complaint and in the legal notice, dated 22/03/2017 issued by Sri G.Krishna Reddy, Advocate is not pertaining to the deceased Anthati Swamy and the said policy was expired on 20/12/2014 whereas the deceased died on 23/07/2015. Therefore, as on the date of the accident the said policy was not in force and as such the Claimants/Petitioners/Complainants are not entitled for any compensation from the Opposite Parties and there is no cause of action for filing the present complaint and there is no deficiency of
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service on the part of the Opposite Party No.2. The Opposite Party No.2 requested the Complainants and the Opposite Party No.1 to supply the copy of the policy pertaining to the deceased Anthati Swamy S/o Buchaiah and his bank account statement from the date of opening of account till the date of death of death and other records for processing the claim of the deceased and settlement subject to terms , conditions, liabilities and limitations etc. As per the averments of the Opposite Party No.1, the policy was renewed and the deceased Swamy paid premium of Rs.100/- towards personal accident policy on 23/09/2014, is false and the same was denied by Opposite Party No.2. It is also false that the policy covering the period from 22/09/2014 to 21/09/2015. The Opposite Party No.2 is not aware whether the deceased Anthati Swamy S/o Late Buchaiah died in the road accident on 23/07/2015 and that the Complainants are the legal heirs of the deceased. The contents of the complaint are false and the Complainants are not entitled for any amount of compensation and damages as claimed by them. The Complainants failed to prove their claim as per the Consumer Protection Act. Hence, the complaint against Opposite Party No.2 is to be dismissed.
5. The Complainant No.1 filed her proof affidavit and marked Exs.A-1 to A-10. The Opposite Party No.1 filed his affidavit and marked Exs.B-1 to B-4 and B-7. The Opposite Party No.2 filed his affidavit and marked Exs.B-5 and B-6.
6. The points for consideration are:
1) Whether there was deficiency in service on the part of the
Opposite Parties No.1 to 3?
2) Whether the Complainant is entitled for the claim and
compensation as prayed for?
3) If so, to what extent?
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7. POINT No.1:
The Complainant No.1’s husband Anthati Swamy S/o late Buchaiah, had opened Savings Bank Account by depositing Rs.50,000/-, vide bearing S.B.Account No.7305615462-4 with Opposite Party No.1, and he maintains sufficient balance in his account till his death in the road traffic accident, i.e. 23/07/2015. Ex.A-1 is the Bank Pass-Book of the deceased Anthati Swamy S/o Late Buchaiah, R/o Veliminedu Village of Chityal Mandal, Nalgonda District. The Opposite Party No.1 debited an amount of Rs.100/- from Complainant No.1’s husband SB account towards Group Personal Accident Policy on 22/09/2014 and the same was credited into Opposite Party No.2 who offered Group Personal Accident Policy to the account holders of A.P.Grameena Vikas Bank, Veliminedu Branch. The Opposite Party No.2 had issued Group Personal Accident Policy to all the S.B.Account Holders of Opposite Party No.1, vide Policy No.OG-14-1701-6401-00026956 and the insurance period starts from 22/09/2014 to 21/09/2015. As per the terms and conditions of GPA Policy of S.B.Account Holders, if a person dies in natural, the person would get Rs.5,00,000/- and if a person dies in Road Traffic Accident, his nominee or his legal heirs would get Rs.5,00,000/-, vide Ex.B-6. The period of insurance is from 21/12/2013 midnight to 20/12/2014 midnight, but not 22/09/2014 as contended by the Complainants in the complaint. The husband of the Complainant No.1 Anthati Swamy died in the Road Traffic Accident on 23/07/2015 at Koramandal Factory, Veliminedu Village of Chityal Mandal, Nalgonda District at 9-30 a.m. and died on the spot. The Police, Chityal has registered a case in Cr.No.138/2015 U/S 304-A of IPC. against the crime vehicle, vide Ex.A-2. Ex.A-3 is the Inquest Report, wherein it was stated that
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the deceased died in the road traffic accident on 23/07/2015. Ex.A-4 is the Post Mortem Examination Report, wherein it was stated that the deceased died due to Heammarhagic Shock due to multiple injury. Ex.A-5 is the Death Certificate of the deceased. Ex.A-6 the Claim Form received from the Complainants by Opposite Party No.1. Ex.A-7 is the legal notice issued by the counsel for the Complainants to the Opposite Parties. Ex.A-8 is the Postal Receipts, Ex.A-9 is the Postal Acknowledgement and Ex.A-10 is the Postal Track Consignment. The Complainant No.1 is the wife, Complainants no.2 and 4 are the sons and Complainants No.3 and5 are the daughters of the deceased Anthati Swamy, who are the legal heirs of the deceased Anthati Swamy. The citation filed by the counsel for the Complainants reported in I (1994) CPJ 179 (NC) is not applicable to the present complaint.
8. The deceased Anthati Swamy was the Savings Bank account holder and the Opposite Party No.1 debited premium amount of Rs.100/- towards GPA Policy. As per Ex.B-1, if a person dies in natural, the person would get Rs.5,00,000/- and if a person dies in Road Traffic Accident, his nominee or his legal heirs would get Rs.5,00,000/-. An amount of Rs.100/- was debited from the account of the deceased on 22/09/2014 and credited into the account of Opposite Party No.2 to cover the Personal Accident and the period of insurance starts from 21/12/2013 midnight to 20/12/2014 midnight, but as per Ex.B-6 the said policy expired on 20/12/2014 midnight. The Opposite Party No.1 remitted an amount of Rs.100/- from the account of the deceased as the cover of insurance is from 21/12/2013 to 20/12/2014. The deceased died on 23/07/2015 which does not fall
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within the period of policy coverage. There is no policy coverage by Opposite Party No.1 and the policy being renewed by Opposite Party No.1. Ex.B-1 filed by Opposite Party No.1 reveals that the policy was expired on 20/12/2014 itself. As per Ex.B-3, the premium was remitted on 25/09/2014, but there is no proof of renewal of the policy nor coverage of policy by the Complainants. If Opposite Party No.1 had debited an amount of Rs.100/- after 20/12/2014 then the policy would have covered the period from 21/12/2014 to 20/12/2015. The Opposite Party No.1 failed to credit the amount towards premium to the Opposite Party No.2 and as such there is no policy coverage under GPA Policy to the deceased Anthati Swamy, as contended by Opposite Party No.1 in the written version, the period of coverage of GPA Policy is from 21/12/2014 to 20/12/2015. The amount was debited by the Opposite Party No.1 on 25/09/2014 which cover the policy up to December, 2014 only and not beyond that period as it is the policy insurance coverage period, as per Ex.B-5. As per Ex.B-6 terms and conditions of the policy in Sl.No.29, the period between and including the start and end dates shown in the schedule, i.e. 21/12/2013 midnight to 20/12/2014 midnight. There is no document to show that the amount of Rs.100/- remitted was received by Opposite Party No.2. There is no document filed by the Opposite Parties No.1 and 2 to show that the Complainants are entitled for the claim covered under GPA Policy to claim Rs.5,00,000/- as per Ex.B-5 and Ex.B-6. The Opposite Party No.1 has not paid Rs.100/- towards the premium of PA Policy to Opposite Party No.2 after 20/12/2014 to cover the next year policy till December, 2015, and Ex.B-7 is the letter of intimation for renewal of the policy from Opposite Party No.2 to Opposite Party No.1, so that the deceased Anthati Swamy would have been covered under GPA
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Policy and the Complainants would claim Rs.5,00,000/- under the said policy. The Opposite Party No.1 failed to remit Rs.100/- for the renewal of the policy with Opposite Party No.2 Therefore, there is deficiency of service on the part of the Opposite Party No.1 for not debiting the premium amount of Rs.100/- and not credited the same to the Opposite Party No.2 to cover the GPA Policy to the deceased S.B.Account holder of the Opposite Party No.1 as it is the duty of the Opposite Party No.1. The Opposite Party No.2 failed to renew the policy of the husband of the Complainant No.1 Anthati Swamy for the period from December, 2014. As such, there is negligence and deficiency of service on the part of the Opposite Parties No.1 and 2 in rendering service to the Complainants and in not remitting the amount for coverage of GPA Policy. As such, the Point No.1 is answered in favour of the Complainants.
9. POINTS No.2 & 3:
In the light of the findings under Point No.1, the Complainants are entitled for an amount of Rs.5,00,000/- (Rupees Five Lakhs only) towards accidental death benefit covered under G.P.A. Policy with interest at the rate of 9% per annum from the date of the complaint till realization, Rs.15,000/- (Rupees Fifteen Thousand only) towards compensation for mental agony and Rs.2,000/- (Rupees Two Thousand only)towards costs. It is stated in the complaint that the Complainants No.2 to 5 have no objection to give the entire awarded amount to the Complainant No.1, who is the wife and nominee of the deceased Anthati Swamy.
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In the result, the complaint is allowed in part, directing the Opposite Parties No.1 and 2 to pay to the Complainants jointly and severally, a sum of Rs.5,00,000/- (Rupees Five Lakhs only) towards accidental death benefit covered under GPA Policy with interest at the rate of 9% per annum from the date of the complaint, i.e. 16/06/2017 till realization, Rs.15,000/- (Rupees Fifteen Thousand only) towards compensation for mental agony and Rs.2,000/- (Rupees Two Thousand only) towards costs, within one month from the date of receipt of this order. The entire awarded amounts shall be paid to the Complainant No.1 who is the wife and nominee of the deceased Anthati Swamy.
Dictated to Steno-Typist, transcribed by him, corrected and pronounced by us in the open Forum on this 28th day of January, 2020.
FEMALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
For Complainants: For Opposite Parties:
Affidavit of Complainant No.1. Affidavit of Opp.Parties No.1&2.
EXHIBITS MARKED
For Complainants:
Ex.A-1: Dt.06/08/2013 Original Bank Pass-Book of the deceased.
Ex.A-2: Dt.23/07/2015 Xerox copy of F.I.R. in Cr.No.138/2015 of
PS.Chityal.
Ex.A-3 Dt.23/07/2015 Xerox copy of Inquest Report.
Ex.A-4 Dt.23/07/2015 Xerox copy of P.M.E. Report.
Ex.A-5 Dt.30/07/2015 Xerox copy of Death Certificate.
Ex.A-6 Dt.18/09/2015 Xerox copy of Claim Form.
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Ex.A-7 Dt.22/03/2017 O/c of legal notice issued by the counsel for
the Complainants to the Opposite Parties.
Ex.A-8 Dt.22/03/2017 Postal Receipts (2 Nos.).
Ex.A-9 Dt.24/03/2017 Postal Acknowledgement Card of OP.No.1.
Ex.A-10 Dt.29/03/2017 Postal Track Consignment of OP.No.2.
For Opposite Party No.1:
Ex.B-1 Dt.26/10/2015 Mail copy of Opposite Party No.2 sent to
Opposite Party No.1.
Ex.B-2 Mail copy of Opposite Party No.1 sent to
Opposite Party No.2.
Ex.B-3 Dt.24/09/2014 Statement of Account for Bajaj Insurance.
Ex.B-4 Bunch of E-mail copies.
Ex.B-7 Dt.16/10/2014 Xerox copy of Renewal Intimation Letter.
For Opposite Party No.2:
Ex.B-5 Dt.26/10/2015 Mail copy of Opposite Party No.2 sent to
Opposite Party No.1.
Ex.B-6 Dt.30/12/2013 Copy of Group Personal Accident Policy
along with terms and conditions.
PRESIDENT
DISTRICT CONSUMER FORUM
NALGONDA
