THE DISTRICT CONSUMER’S FORUM: KURNOOL
Present: Sri.Y.Reddappa Reddy, M.A., L.L.M., President,
And
Smt.S.Nazeerunnisa, B.A., B.L., Lady Member
Tuesday the 3rd day of February, 2015
C.C.No.08/2012
Between:
V.Lakshmi Devi,
W/o Late V.Samba Siva Reddy,
Aged 40 Years, Hindu,, House Wife,
R/o Besides Hanuman Temple,
Saidapuram Village, Kadiri Mandal,
Anantapur District,
Presently residing at D.No.3-133, Main Road,
A.Kodur Post, Nandyal-518 502,
Kurnool District. …Complainant
-Vs-
1. The Branch Manager,
M/s Bajaj Allianz General Insurance Company Limited,
Represented by its Branch Manager,
Shop No.10, 11, 13, Alankar Plaza,
D.No.40/356/A, 3rd Floor,
Kurnool-58 002.
2. The Regional Manager,
M/s Bajaj Allianz General Insurance Company Limited,
D.No.G1-F2, Bombay Pune Road,
Akrudi, Pune-411 035.
3. M/s Bajaj Allianz General Insurance Company Limited,
Represented by its Regional Manager,
Regional Office, Macmet Building,
10-B, O.C. Ganguly Sarani,
Kolkata-700 020.
4) M/s Road Safety Club Private Limited,
No.1 First Floor, Sambhandam Street,
G.N. Chetty Road,
T.Nagar, Chennai-600 017. …OPPOSITE PARties
(Amended as per Order in IA.No.55/2012 dated 12-07-2012)
This complaint is coming on this day for orders in the presence of Sri.A.Prabhakar Reddy, Advocate for complainant and Sri.A.V.Subramanyam, Advocate for opposite parties 1 to 3 and Sri.P.Siva Sudarshan, Advocate for opposite party No.4 and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri.Y.Reddappa Reddy, President,)
C.C. No.08/2012
1. This complaint is filed under section 12 of Consumer Protection Act, 1986 praying:-
(a)To directing the opposite parties to pay Rs.3,00,000/- payable under Certificate bearing No.CLS/HA0000070545 and compensation of Rs.10,000/- to the complainant.
(b)To grant interest at the rate of 24% per annum from the date of death.
(c)To grant costs of the complaint.
(d)To grant such other reliefs as the Honourable Forum may deem fit and proper.
2. The facts of the complaint in brief run as follows:- The complainant is the wife of the deceased V.Samba Siva Reddy. He was a member of Road Safety Club Private Limited. The Road Safety Club Private Limited used to collect premium and membership fee from its members and insured accidental risks of its members with the opposite parties. Late.V.Samba Siva Reddy was issued membership certificate bearing No.58694 dated 11-09-2002 and another membership certificate bearing No.102844 dated 12-10-2002. The Road Safety Club Private Limited obtained Group Personal Accident Master Policy bearing No.OG-06-1-501996000000005 for covering the accidental risks of its members. In the said process the risks of Late.V.Samba Siva Reddy was covered under certificate No.CLS/HA000065723 for the period from 31-08-2008 to 30-08-2009 and another certificate No.CLS/HA000070545 for the period from 23-09-2008 to 22-09-2009. The husband of the complainant paid premium as a member of Road Safety Club Private Limited for covering the accidental risks under both certificates mentioned above. Each certificate will cover the risks for Rs.3,00,000/-.
On 25-04-2009 at 9.30 A.M. Late.V.Samba Siva Reddy was murdered unexpectedly in Kadiri Town. Since it was accidental death the complainant sent all required material for claiming accidental benefits of Rs.3,00,000/- under each policy. The opposite parties settled the claim relating to the certificate bearing No.CLS/HA000065723 on 30-03-2010 by sending cheque dated 13-01-2010. But they failed to settle the claim under certificate bearing No.CLS/HA000070545. The complainant approached the opposite parties for settlement of the remaining claim. But the opposite parties have been postponing to pay the amounts on some pretext or other.
The opposite parties are expected to settle the claim within three months. But they are purposely delaying the claim. The opposite parties practiced unfair trade practice in delaying the settlement and that there is deficiency of service. Hence she prays to pass an order in favour of the complainant and against the opposite parties by directing them to pay Rs.3,00,000/- to the complainant under certificate No.CLS/HA000070545 with interest at 24% per annum from the date of death of her husband and Rs.10,000/- towards compensation for causing mental agony and also costs of this CC.
3. On service of notices opposite parties 1 to 3 engaged counsel written version filed on behalf of opposite party No.2 which was adopted by opposite parties 1 and 3. The contents of written version filed on behalf of the opposite party No.2 in brief run as follows. The complainant has to strictly prove all the allegations made in the complaint which are not specifically admitted herein. The complainant is not a consumer as defined under section 2 (d) of the Consumer Protection Act and the complaint filed by the complainant does not come under purview of Consumer dispute as envisaged under section 2 (e) of the Act. Hence this Forum has no jurisdiction to entertain the complaint.
The Road Safety Club is a necessary party to the case, as the discrepancy has been created by the said party. The insurance company had ended their contract with the said club and thus the insurance company is not liable to pay any compensation and the complaint is liable to be dismissed on this ground alone.
They admitted deceased V.Samba Siva Reddy was member of Road Safety Club Private Limited and said Road Safety Club Private Limited insured its member’s lives under Group Personal Accidental Master Policy with this opposite party company under policy bearing No.OG-06-1-51996000000005 covering the risks of its members. The said policy vide bearing No.OG-09-1501-6401-00190930 was issued from 31-08-2008 to 30-08-2009. It is false to state that the complainant’s husband was covered under two certificates bearing Nos.CLS/HA000064723 and CLS/HA000070545 for covering the periods from 31-08-2008 to 30-08-2009 and 23-09-2008 to 22-09-2009 respectively, for Rs.3,00,000/- each. The complainant is put to strict proof of the same.
This opposite party has never issued the certificate No.CLS/HA000070545 by covering the risk from 23-09-2008 to 22-09-2009 as it has ended its tie up with the Road Safety Club Private Limited in September, 2008 and since then this opposite party has not issued any such policies. The policy might have been issued by the Road safety Club as stated by them in the letter that they have erroneously issued the certificate of insurance even after the termination of the arrangement and SKI shall be taking the liability for the said policies which were erroneously issued. As the above certificate is also issued erroneously the Road Safety Club shall be liable for any compensation if any to be paid to the complainant and as such the Road Safety Club is proper and necessary party to the proceedings. Hence the complaint filed by the complainant is bad for nonjoinder of necessary party. This opposite party settled the claim of the certificate issued by them for which period the risks of members of Road Safety Club paid premium.
The complainant has to strictly prove about the murder of her husband at Kadiri on 25-04-2009 at 9.30 A.M. It is not correct to say that the complainant has been approaching the opposite party to settle the claim under certificate No.CLS/HA000070545. The averments of para 3 and 4 of the complaint are false. Hence he prays to dismiss the complaint with costs.
Subsequently the complainant had taken steps to implead the Road Safety Club as party to the proceedings. The said club has been added as opposite party No.4, as per orders made in IA.No.55/2012 dated 12-07-2012. Opposite party No.4 engaged the counsel and filed the detailed counter, the contents of which in brief run as follows. They have admitted about their coordinating with the Insurance Company for providing policies to their members. Therefore opposite party No.4 cannot be made liable for claim. The Group Personal Accident Master Policy No.OG-06-1-501996000000005 provided by the Bajaj Allianz General Insurance Company for the period from 23-09-2008 to 22-09-2009 is subject to the terms and condition of the policy and Bajaj Allianz General Insurance Company is liable to satisfy the claim. The certificate No.CLS/HA000070545 is nothing to do with the claim of the complainant.
The role of this opposite party is only to bring awareness among the public with regard to Road Safety and there by educate them and made them as members of the club so as to enable them to get insurance cover from Insurance Company. Once the Insurance Company provides insurance cover, the role of this opposite party ends. In this case, already the Insurance Company provided the policy and therefore a contract is formed between the V.Samba Siva Reddy and the concerned Insurance Company. There is no deficiency of service on the part of this opposite party is concerned. If the Insurance Company does not Act, remedy for the complainant is to proceed against the Insurance Company but not against this opposite party.
This opposite party forwarded the claim forms submitted by the complainant to Bajaj Allianz General Insurance Company for settlement. As this opposite party did its act with utmost care, there is no deficiency of service on the part of this opposite party is concerned. In view of the terms and conditions laid down in the membership certificates in the application, this opposite party is not proper and necessary party to the proceedings.
It is clearly manifested from the terms and conditions that any dispute in relation to this will be subject to jurisdiction of Chennai Courts. As such this Forum is not having jurisdiction to entertain this opposite party. Hence he prays to dismiss the opposite party with costs.
4. In support of the case of the complainant she filed sworn affidavit and marked as Ex.A1 to Ex.A7. Amtul Baseer Quadri, Senior Legal Executive of opposite party No.2 field sworn affidavit in support of their contention and marked Ex.B1 to Ex.B4. Authorized Signatory of Road Safety Club Private Limited by name N.Mani field sworn affidavit in support of the contention of opposite party No.4. Ex.A1 is the photo copy of Policy Certificate No.CLS/HA000070545, Ex.A2 is the photo copy of Letter addressed to complainant by Road Safety Club Limited dated 30-03-2010 along with Bank Cheque, Ex.A3 is the photo copy of Personal Accident Insurance Claim Form dated 22-10-2009, Ex.A4 is the photo copy of Death Certificate dated 16-05-2009 of Late.V.Samba Siva Reddy, Ex.A5 is the photo copy of F.I.R., in Crime No.104/2009 of Kadiri Police Station, Ex.A6 is the photo copy of Post Mortem relating to the V.Samba Siva Reddy, Ex.A7 is the Policy Certificate No.CLS/HA000065723.
Ex.B1 is the photo copy of Letter dated 26-02-2011 sent to Road Safety Club along with Cheque, Ex.B2 is the Letter dated 14-07-2008 issued by the Road Safety Club, Ex.B3 is the photo copy of Ombudusman Order, complainant No.I.O.(HYD) G-11.11.346.2010-11, Ex.B4 is the Personal Accident Insurance Claim Form dated 22-10-2009.
5. After conclusion of evidence on behalf of the both parties written arguments submitted by the both parties. The counsel for complainant and opposite parties 2 and 4 submitted oral arguments in support of their respective contentions.
6. Now the points that arise for consideration are:
- Whether there is deficiency of service on the part of opposite parties 1 to 4 in settling the claim of the complainant?
- If so? To what relief the complainant is entitled?
7. POINT No.i:- According to the complainant her husband was a member of Road Safety Club Private Limited. It provided Insurance Policy covering risks of its members. One such policy was issued in favour of her husband by the opposite parties under certificate No.CLS/HA000070545. The period of insurance coverage was from 23-09-2008 to 22-09-2009. The Group Personal Accident Master Policy No.OG-06-1-501996000000005 mentioned in the certificate. The policy issued by opposite parties is marked as Ex.A1. The complainant produced, the cheque issued by the opposite parties towards full and final settlement of the claim made by her relating to another certificate No.CLS/HA000065723 which is marked as Ex.A2 along with covering letter under which the cheque was dispatched on 13-01-2010. The Death Certificate of V.Samba Siva Reddy and F.I.R., relating to his murder are marked as Ex.A4 and Ex.A5 respectively. To substantiate their defence opposite parties are relaying on Ex.B1 to Ex.B4. Ex.B1 is the letter addressed to Bajaj Allianz General Insurance Company Limited by Road Safety Club Private Limited. Ex.B2 is a copy of the letter alleged to have been addressed to the members of Road Safety Club Private Limited by its Authorized Signatory. Ex.B3 is an award copy passed by insurance ombudusman in Complaint No.I.O.(HYD)G-11.11.346.2010-11. Ex.B4 is the Claim Form of the complainant. The opposite parties are very much relying on Ex.B2 and Ex.B3 to substantiate their defence. On perusal of Ex.B2 it is clear this is only a printed form, it does not contain the signature of Authorized signatory and also not mentioned to whom it was addressed. Hence basing on the contents of Ex.B2 it is not possible to come to a conclusion that the MOU entered between the Road Safety Club Private Limited, Chennai and the opposite parties 1 to 3 was ended at any time, if so from which date on wards it was cancelled. The order passed by insurance ombudusman cannot be taken in to consideration to establish the defences of the opposite parties in this CC. This award does not contain any appendix of evidence. It is not known basing on which documentary evidence, the insurance ombudusman came to a conclusion that contract between opposite parties 1 to 3 and opposite party No.4 was ended w.e.f. 01-09-2008. As per Ex.A1 the Road Safety Club Private Limited issued the policy by covering the risk of its member Mr.V.Samba Siva Reddy from 23-09-2008 to 22-09-2009. The said document contains the signatures of Authorized Signatory of opposite parties 1 to 3 and opposite party No.4 respectively. The said document was issued on 08-09-2008. If really the MOU between the opposite parties 1 to 3 on one side and the opposite party No.4 on the other, was cancelled with effect from 01-09-2008 onwards, there was no scope for opposite party No.4 to issue the policy in favour of complainant’s husband on 08-09-2008 that too with the signatures of both parties. Opposite parties 1 to 3 and opposite party No.4 are the public institutions. If at all memorandum of understanding between them was revoked or cancelled it shall be born out by record. None of the opposite parties are coming forwarded to produce any such documentary evidence to establish the MOU between the opposite parties 1 to 3 on one side and the opposite party No.4 on the other, was cancelled with effect from any particular date. The sole document on which they are relying is Ex.B2 which is of no use for any purpose as it does not contain the signature of any person either opposite parties 1 to 3 or opposite party No.4 as the case may be. Opposite parties 1 to 3 and 4 have taken different defences in their written versions by throwing blame against each other. When opposite parties 1 to 3 are saying opposite party No.4 alone is liable for claim amount, opposite party No.4 is saying opposite parties 1 to 3 are liable for the same as they issued policy. But Ex.A1 contains the signatures, authorized signatories of both parties. This policy was issued under Group Personal Accident Master Policy No.OG-06-1-501996000000005. The said Group Personal Accident Master Policy shall be with the opposite parties 1 to 4. For the reasons best known to them, none of the opposite parties choose to produce the said document before this Forum. If that document placed before this Forum truth might have come out.
As the Road Safety Club Private Limited issued compulsory insurance coverage to its members, as one of the policy issued by them relating to the deceased V.Samba Siva Reddy was honoured and settled by the opposite parties and as the opposite parties failed to establish the MOU entered between them by covering the risks of the members of Road Safety Club Private Limited, Chennai, was not in force and as policy issued by them contains signatures of the authorized signatories of both opposite parties, both of them are negligent in discharging their duties and there is clear cut deficiency of service on the part of all the opposite parties. Hence we hold this point in favour of the complainant and against the opposite parties.
8. POINT No.ii:- While Answering point No1, we have also made it clear that there is deficiency of service on the part of all the opposite parties. The quantum of amount covered under Ex.A1 is not in dispute. Hence we hold all the opposite parties are jointly and severally liable to pay the amount covered under Ex.A1 i.e., Rs.3,00,000/- to the complainant with interest at 9% per annum from the date of claim till the date of realization. We also direct them to pay a sum of Rs.5,000/- by way of compensation towards mental agony and Rs.1,000/- towards costs of this CC.
10. In the result, the complaint filed by the complainant is partly allowed, an order is passed by directing opposite parties 1 to 4 to pay
1. A sum of Rs.3,00,000/- with interest at 9% per annum from the date of claim i.e., 22-10-2009 till the date payment.
2. A sum of Rs.5,000/- by way of compensation for the sufferance of mental agony and Rs.1,000/- towards costs of this CC.
We direct all opposite parties to pay the claim amounts as directed above within one month from today failing which the complainant is at liberty to execute this order and realize the same by proceeding against opposite parties 1 to 4 according to law .
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 3rd day of February, 2015.
Sd/- Sd/-
LADY MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainants:- Nil For the opposite parties:- Nil
List of exhibits marked for the complainants:-
Ex.A1 Photo copy of Policy Certificate No.CLS/HA000070545.
Ex.A2 Photo copy of Letter addressed to complainant by Road Safety
Club Limited dated 30-03-2010 along with Bank Cheque.
Ex.A3 Photo copy of Personal Accident Insurance Claim Form dated
22-10-2009.
Ex.A4 Photo copy of Death Certificate dated 16-05-2009 of
Late.V.Samba Siva Reddy.
Ex.A5 Photo copy of F.I.R., in Crime No.104/2009 of Kadiri Police
Station.
Ex.A6 Photo copy of Post Mortem relating to the V.Samba Siva Reddy.
Ex.A7 Policy Certificate No.CLS/HA000065723.
List of exhibits marked for the opposite parties:-
Ex.B1 Photo copy of Letter dated 26-02-2011 sent to Road Safety Club
along with Cheque.
Ex.B2 Letter dated 14-07-2008 issued by the Road Safety Club.
Ex.B3 Photo copy of Ombudusman Order, complainant
No.I.O.(HYD) G-11.11.346.2010-11.
Ex.B4 Personal Accident Insurance Claim Form dated 22-10-2009.
Sd/- Sd/-
LADY 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 :
