Complaint is filed on 30-07-2009
Compliant disposed on 25-11-2009
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM::AT:: KARIMNAGAR
PRESENT: HON’BLE S.M. RAFEE, B.Sc., B.L.,CHAIRMAN, L.R.A.T.-cum-III ADDL.DIST & SESSIONS JUDGE &
PRESIDENT (F.A.C.)
HON’BLE SMT. E. LAXMI, M.A.LL.B., MEMBER
WEDNESDAY, THE TWENTYFIVE DAY OF NOVEMBER,TWO THOUSAND NINE
CONSUMER COMPLAINT NO. 118 OF 2009
Between:
Smt. Gannu Pushpalatha, W/o. Gannu Narasimha Reddy, Age 47 years, Occ: Household, R/o. Abbapur (v) mandal Dharmaram via Eligaid, district Karimnagar.
…Complainant
AND
Oriental Insurance Co. Ltd., Rep. by its Branch Manager, Branch Office, P.B. No.5, Opp: Collectorate complex, Karimnagar – 505 001.
…Opposite Party
This complaint is coming up before us for hearing on 18-11-2009, in the presence of Sri. M. Rajesham and P. Mahender Reddy and Ch. Devender, Advocates for the complainant and opposite party remained exparte, and on perusing the material papers on record, and having stood over for consideration till this day, the Forum passed the following
::ORDER::
1. This complaint is filed under Section 12 of C.P. Act, 1986 seeking direction to the opposite party to pay Rs.1,00,000/- towards sum assured together with interest and costs.
2. The brief averments of the complaint are that the son of the complainant by name Gannu Narendar Reddy @ Gannu Nagaraju died on 6.11.2007 in a motor vehicle accident which occurred near Mugdumpur village of Karimnagar Mandal. During his life time the said Narendar Reddy obtained Personal Accident Insurance Policy from the opposite party for Rs.1,00,000/- on 26.7.2007. As per the terms of the said policy the opposite party undertook to pay Rs.80,000/- towards Personal Accident Benefit Coverage and Rs.20,000/- towards hospitalization charges during the period of policy i.e. from 27.7.2007 to 26.7.2008. He has nominated his mother (complainant) as nominee to receive the sum assured under the policy. It is submitted that after the death of policy holder, the complainant filed death claim before the opposite party by submitting all the necessary documents showing death of the policy holder in an accident. But the opposite party sent a letter Dt: 8.12.2008 to the complainant informing her that her claim is rejected on the ground that the name of the policy holder is not tallying with the policy and death records. It is submitted by the complainant that her son is called as Gannu Nagaraju and also Gannu Narendar Reddy and she has also produced Death Certificate issued by Gram Panchayat and Family Members Certificate issued by Thahsildar, Dharmaram showing that her son Gannu Nagaraju is also called as Gannu Narendar Reddy. Having issued the policy promising to pay sum assured in case of death of the policy holder, the opposite party is bound to pay the same and non-payment constitutes deficiency of service. Therefore, the complainant prayed for an order.
3. The complainant filed Proof Affidavit reiterating the contents of the complaint and filed the documents which are marked as Ex.A1 to A9. The complainant got filed the III Party Affidavit of Gannu Laxman.
4. Ex.A1 is the attested copy of F.I.R. Dt: 6.11.2009. Ex.A2 is the attested copy of Inquest Report Dt: 6.11.2007. Ex.A3 is the attested copy of Postmortem Report Dt: 6.11.2007. Ex.A4 is the attested copy of Crime Details Form Dt: 6.11.2007. Ex.A5 is the attested copy of Final Result Dt: 30.5.2008. Ex.A6 is the Xerox copy of Death Certificate Dt: 22.12.2007. Ex.A7 is the Xerox copy of Family Members Certificate Dt: 29.12.2007. Ex.A8 is the Xerox copy of Insurance Policy Dt: 27.7.2007. Ex.A9 is the Repudiation Letter Dt: 08.12.2008.
5. The opposite party remained exparte and they did not choose to file any counter.
6. The points for consideration are:
- Whether there is any deficiency of service on the part of opposite party?
- If so, to what relief the complainant is entitled?
7. The case of the complainant is that her son Gannu Narendar Reddy @ Gannu Nagaraju obtained Personal Accident Insurance Policy under Ex.A8 from the opposite party under which the opposite party assured to pay Rs.80,000/- towards Personal Accident and Rs.20,000/- towards hospitalization charges. The said policy is in force for a period of one year commencing from 27.7.2007 to 26.7.2008. The complainant is the nominee under the said policy. The policy holder died on 6.11.2007 in a Motor Vehicle Accident which occurred near Mugdumpur village of Karimnagar Mandal and the Police, Karimnagar Rural registered a case in Crime No.259 of 2007 for his death. A perusal of criminal case records under Ex.A1 to A5 discloses that Gannu Nagaraju son of Gannu Narasimha Reddy died on account of the injuries sustained in the accident. After his death the complainant submitted claim to the opposite party for payment of sum assured under the policy, but the opposite party rejected the claim and sent a letter under Ex.A9 informing the complainant that as there is variation in the name of the policy holder between the policy and criminal case records, the claim is rejected.
8. To prove that the deceased policy holder Gannu Nagaraju is also called as Gannu Narendar Reddy, the complainant filed Third-Party Affidavit of one Gannu Laxman and also the Death Certificate under Ex.A7. A perusal of the said documents discloses that the said Gannu Nagaraju is also called as Narendar Reddy. The father’s name is tallying with all the records and it is clearly established that the policy holder Gannu Narendar Reddy is also called as Gannu Nagaraju. Having issued the policy the opposite party ought to have honoured the same by paying the sum assured. There is no record produced by the opposite party that they caused investigation to ascertain the correct name of policy holder. Further, the opposite party remained exparte and did not choose to file any counter to deny the claim made by the complainant. Non-payment of the sum assured constitutes deficiency of service on the part of the opposite party as they issued policy under Ex.A8 promising to pay assured sum. A perusal of the policy under Ex.A8 discloses that the opposite party undertook to pay assured sum of Rs.80,000/- under Personal Accident Benefit Coverage and Rs.20,000/- towards hospitalization. Though the complainant claimed an order for Rs.1,00,000/- she is entitled to receive Rs.80,000/- only as there is no amount spent for hospitalization. The complainant established her claim for payment of Rs.80,000/-.
9. For the foregoing reasons, we hold, that the opposite party is liable to pay Rs.80,000/- to the complainant together with interest @ 7.5% P.A. and Rs.1,000/- towards costs.
10. In the result the complaint is partly allowed directing the opposite party to pay Rs.80,000/- towards sum assured with interest @ 7.5% P.A. from the date of filing the petition i.e. 31.7.2009 till the date of realization together with Rs.1,000/- towards costs of the proceedings within one month from the date of receipt of this order.
Typed to my dictation by Stenographer, after correction the orders pronounced by us in the open Court this the 25th day of November, 2009.
Sd/- Sd/-
MEMBER PRESIDENT
NO ORAL EVIDENCE HAS BEEN ADDUCED ON EITHER SIDE FOR COMPLAINANT:
Ex.A1 is the attested copy of F.I.R. Dt: 6.11.2009.
Ex.A2 is the attested copy of Inquest Report Dt: 6.11.2007.
Ex.A3 is the attested copy of Postmortem Report Dt: 6.11.2007.
Ex.A4 is the attested copy of Crime Details Form Dt: 6.11.2007.
Ex.A5 is the attested copy of Final Result Dt: 30.5.2008.
Ex.A6 is the Xerox copy of Death Certificate Dt: 22.12.2007.
Ex.A7 is the Xerox copy of Family Members Certificate Dt: 29.12.2007.
Ex.A8 is the Xerox copy of Insurance Policy Dt: 27.7.2007.
Ex.A9 is the Repudiation Letter Dt: 08.12.2008.
FOR OPPOSITE PARTIES: -NIL-
Sd/- Sd/-
MEMBER PRESIDENT
