BEFORE THE DISTRICT FORUM:KURNOOL

Present: Sri.P.V.Nageswara Rao,M.A.,LL.M., President(FAC)

And

Smt. C.Preethi,  M.A.LL.B., Lady Member

And

Sri. M.Krishna Reddy, M.Sc.,M.Phil., Male Member

Thursday  the 24^th day of September, 2009

C.C. 52/09

Between:

M. Aruna Kumari, W/o.Late Mesa David Diwakar Babu,

R/o.H.No.26-605 B-15, Venkatachalam Colony, Nandyal, Kurnool District.                                    Complainant

-Vs- 

1.  The Branch In-charge, M/s.Bajaj Allianz General Insurance Company Limited,

     Shop No. 10, 11, 13, Alankar Plaza, D.No.40/356/A, 3^rd Floor, Kurnool-518 002.

2.  M/s.Bajaj Allianz General Insurance Company Limited, Represented by its Deputy Manager for T.P.Claims,

     Peejay Plaza, D.No.10-1-44/9, 3^rd Floor, VI Road, CBM Compound, Visakhapatnam-530016.             …Opposite PartieS

                        This complaint is coming on this day for orders in the presence of A.Rama Subba Reddy, Advocate, for the complainant, and Sri. A.V.Subramanyam, Advocate for opposite parties and upon perusing the material papers on record, the Forum made the following.

ORDER

(As per Smt. C.Preethi , Lady Member)

C.C.No.52/09

1.     This consumer complaint  of the complainant is filed U/S  12 of C.P.Act, 1986, seeking a direction on opposite parties to pay the policy amount  of Rs. 5 lakhs  and interest at Rs.1,80,000/- and Rs.20,000 /- as compensation  , further interest at 18 percent interest p.a ,  cost of the compliant and any other relief or reliefs which the complainant is entitled in the circumstances of the case.

2.     The brief facts of the complainants case is that the complainant is the wife of  Late . Mesa Devid  Divakar Babu , who was a member of M/s. Mithri Services of Ongole and the said services collected premium from its member for covering the risk of life of its members and paid the said premium to opposite parties and who issued a master policy bearing No. 0G/ 06/ 1804/ 9960/ 00000001 and a certificate No. 0G/06/1804/9961/00001981 for Rs.5,00,000/- was issued to the  complainant and the said certificate commenced from 15-09-2006  to 14-09-11  and the nominated the complainant  as his nominee . On 14-02-2007  the said Divakar Babu while going  in his motor cycle , an auto bearing No. AP 21 W  6545 came from behind and hit  the complainants husband motor cycle and he fell down and died. The death intimation was given to opposite party No. 2  and M/s. Mithri Services  on 03-04-2007 and  also  submitted  death  certificate on 09-07-2007 and all required  documents were sent for settling the claim. But the opposite parties did not settle the claim and purposely  delaying the claim  and hence the complainant resorted to the forum for reliefs.

3..    In support of her case the complainant relied on the following documents viz., (1) Xerox of courier receipt dt:09-05-2007 addressed to Bajaj Allianz Visakapatnam , (2) Xerox of courier receipt dt: 09-05-2007 addressed to Mythri Services , (3) Xerox copy of  courier receipt  dated 03-04-2007  peejay plaza , Visakapatnam , (4) Xerox of courier receipt dated 03-04-2007 addressed to Mithri Services , (5) Individual certificate of insurance issued to the complainant’s husband , (6) Xerox copy of FIR of Nandyal traffic (PS) (7) inquest report ,(8) PM report , (9) death certificate , besides to the sworn affidavit of the complainant  in reiteration of her complaint averments and the above documents are marked  as Ex.A1 and A9 for its appreciation in this case and replies to the interrogatories exchanged.

4.     In pursuance to the notice of this forum as to this case of the complainant , the opposite parties 1 and 2  appeared through their standing  counsel and contested the case . The opposite party No. 2 filed written version  and opposite party No. 1 adopted the written version of opposite party No. 2.

5.     The written version of opposite parties denies the complaint  as not maintainable either in law or on facts  and submits  that the complaint filed  by the complainant does not come within the purview of consumer dispute  and forum  has no jurisdiction to entertain the complaint . It further submits that the complainant added opposite party No. 1 as party to the proceedings only to get jurisdiction  and admittedly M/s. Mithri Services is situated to Ongole and the premium was paid by the said firm to opposite party No. 2  at Vishakapatnam  and hence the cause of action for the complainant aroused at Ongole  and Vishakapatnam  and hence this  forum has no jurisdiction  to try and entertain the complainant . Even other wise the complaint is barred by limitation  as the date of death was on 14-02-2007 and this compliant filed after the expiry of limitation and hence the complaint is liable to be dismissed for want of limitation  . It also submits  that as per the complainant  claim form was submitted  on 09-07-2007  and where as accident  to  place on 14-02-2007 and the courier receipt  confirm  that she has given intimation  only on 03-04-2007  i.e, after one and half month and as per conditions  of policy immediate intimation is to be given to the  insurance company  and in the present case  the intimation  was deliberately  delayed and no opportunity  was given to the insurance company to elicite  the real facts and hence the complainant  failed to give intimation  within time limit and hence the complainant   is not remaining entitled  to any  of the reliefs  as there is no deficiency  of service on part of opposite parties  and seeks for the dismissal of complaint with costs.

6.     In support of their case the opposite parties relied on the following document viz, (1) Xerox copy of Bajaj Alliance General Insurance Policy No.04-07-1804-996100001981 , besides to the  sworn affidavit of opposite party No.2 in reiteration of his written version averments and the above document is  marked as Ex.B1 for its appreciation in this case and replies to the interrogatories exchanged. 

7.     Hence , the point for consideration is to what relief the complainant is entitled  alleging deficiency of service ?

8.     There is no dispute as to the deceased Mesa Devid Divakar Babu covered under the Group Personal Accident Insurance Policy issued by opposite parties  vide Ex.B5 and nominated the complainant as his nominee. There is no dispute as to the death of the policy holder. On 14-02-2007 in an accident . The complainant submits that the death intimation  was  given  to  opposite   parties  through  Ex.A3  dated 03-04-2007 . The only allegation of the opposite party is with regard to delay in intimating the death of the policy holder to opposite parties. The counsel  for complainant submitted that all relevant documents   are  submitted  to  opposite  party  vide Ex.A1  dated   09-05-2009 and being a woman  the complainant  unaware of the fact of informing the opposite parties within stipulated time could not intimate before , but on the other hand the opposite parties submits  that  belatedness of the complainant in informing  the opposite parties about  the death of the policy holder within one month from the date of accident  is clear violation  of policy  conditions.

9.     The complainant in support of her case relied on the decision of Uttar Pradesh State Commission  between LIC of India Vs Rajendra Singh Gaur reported in ( IV) 2004 CPJ Pg 531, where in it was held that  repudiation  of claim by LIC,  on the ground that intimation  of death was delayed , the complainant  contended that he  was 80 years  and not able to intimate earlier and he completed all formalities , hence held repudiation of claim unjustified  and illegal.

10.    To sum up following the above cited decision in the present case  the policy holder died on 14-02-2007 and the same was  intimated on 03-04-2007 and submitted  all documents on 09-05-2009  and being a woman unaware of  the fact of  informing the opposite parties  within stipulated  time, as such the complainant  is showing a  reasonable  cause  for delay in intimating  the death of policy holder  as such there appears  no fraudulent  suspicion  on the face in violation of any policy terms and conditions .

11.    The other contention of opposite parties is that  this forum has no jurisdiction to entertain the complaint of the complainant as the M/s Mythri Services  is situated in Ongole  and the policy is issued by Visakapatnam  branch S 11 2(a) of C.P.Act  says the opposite party or each of the  opposite parties  where there  are more than  one, at the time of the institution  of the complaint , actually and voluntarily  resides or carries  on business or has a branch office , personally works for gain. The OP.No. 2 issued the policy to the policy holder  and OP.No. 2 is having a branch office within the jurisdiction  of this forum , as required in S-11 2 (a) therefore  this forum has jurisdiction to entertain the complaint of the complainant .

12.    To conclude from the above  and following the afore mentioned  decision  the complainant  except delay in intimation the opposite parties  and in all  other aspects certainly remaining entitled  to the accident  benefit under the policy vide Ex.B5 covering  the life risk of her husband and opposite parties 1 and 2 are liable to pay the assured amount of Rs.5,00,000/- without interest to the complainant  and no order for costs and compensation.

13.    In the result , the complaint is allowed directing the opposite parties 1 and 2 jointly and severally  to pay to the complainant the assured amount of Rs.5,00,000/- without interest. The opposite parties 1 and 2 shall pay the award amount within two months from the date of receipt of  this order. No costs and compensation ordered.

Dictated to the stenographer , transcribed by her, corrected and pronounced by us in the open bench on this the  24^th day of September, 2009.

        Sd/-                                  Sd/-                          Sd/-

LADY MEMBER                      PRESIDENT(FAC)     MALE MEMBER

APPENDIX OF EVIDENCE

Witnesses Examined

For the complainant :  Nil           For the opposite parties :Nil

List of exhibits marked for the complainant:-

List  of exhibits marked for the opposite parties: 

             Sd/-                              Sd/-                                        Sd/-

LADY MEMBER               PRESIDENT (FAC)               MALE MEMBER           

// 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      

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