Before the District Forum:Kurnool
Present: Sri K.V.H. Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B.Com., LL.B., Member
Tuesday the 16th day of November, 2004
CD No.01/2004
Smt Sugali Chakramma Alies Shankaramma,
W/o Late Sugali Teja Naik,
R/o Seethamma Thanda,
Peapully Mandal,
Kurnool Dist. ……Complainant represented by his counsel
Sri.Madanna.
-Vs-
- The Branch Manager,
Represented by its New India Assurance Company Limited,
19/91, Madras Road,
Cuddapah. …Opposite party
- The Divisional Manager,
New India Assurance Company Limited,
HDCT Complex,
Kurnool District. …Opposite party No.2 represented by his
Counsel Sri.Mohammed Ishaq.
O R D E R
(As per Sri.R.Ramachandre Reddy, Member)
CC.No.01/2004
1. This consumer dispute case of the complainant is filed under section 12 to 14 of the C.P. Act, seeking a direction on the opposite parties1 and 2 for the payment of Rs.1,00,000/- towards the insurance covered under the Janatha Personal Accident Policy of her minor son Sugali Hanumanthu Naik, who died on 31-05-2001 due to snake bite with 24 % interest per annum from the date of the death of the insured i.e., 31-05-2001 Rs.15,000/- towards compensation and Rs.5,000/- towards costs.
2. The case of the complainant is that the deceased Sugali Hanumanthu Naik, aged about 15 years who is the complainants minor son died accidentally on 31-05-2001 in his Village Sithamma Thanda due to Snake bite, while he was on deep sleep on the pial which is in front of his house along with mother, brother and sister. At about 2.00 A.M. i.e., early house of 31-05-2001 complainants son who was insured with the opposite party No.1 for coverage of accidental death under Janatha Personal Accident Policy No.4761120105695, which covers risk period from 08-01-1999 to 07-01-2009 for Rs.1,00,000/- suddenly raised heavy cry due to snake bite which is caused on his right foot, mean while all the family members were woke up along with neighbourers and searched for bitten snake around the place and killed the same, subsequently at about 3.30 A.M. the insured i.e., complainants sons was died on the way while he was shifting to the Government Hospital, Dhone due to severances of the said snake bite. In this, to the accidental death a case has been registered by the Sub Inspector of Police, N.Racharla Police Station in Crime No.13/2001 under section 174 Cr.P.C (death due to snake bite) on the same day on the strength of the complainant given by the deceased Grand-Father by name Sugali Somla Naik, later the police have conducted inquest Panchanama over the dead body of the complainants sons and the same to the postmortem examination. As per the terms and conditions of the said policy, the insurer i.e., opposite parties have to pay the accidental death benefit amount of Rs.1,00,000/- to the nominee i.e., who is the father of the deceased who was also died on 05-04-2000 i.e., prior to the death of the insured (complainants sons), now the complainant who is the mother is the legal heir of the deceased (insured).
3. Immediately after the death of the insured the complainant has informed to the opposite party No.1 through the phone call and submitted all the required documents which are needful by the opposite party No.1 along with the claim form. Thereafter the complainant approached to the office of the opposite party No.1 personally on several occasions all the way from her village to Cuddapah and also to Kurnool as this office is situated in Kurnool. The opposite party No.1 is working, doing business under the control of the opposite party No.2. even after the several approachments and oral demands made by the complainant to the opposite parties regarding to the insured death benefit policy amount, the opposite parties 1 and 2 did not respond and not pay the amount, postponed the claim matter without giving any reasons. Finally the complainant vexed to the acts and the attitude of the opposite parties in the claim and got issued a legal notice through her advocate on 05-03-2003 by demanding her son death benefit policy amount. Both are received the notice copies and the opposite party No.1 has given reply with all baseless objections and not maintainable in the eye of law. Without verifying the relevant documents i.e., F.I.R., Inquest report and postmortem certificate of S.Hanumanthu Naik (Insured), FSL Report in the crime case etc., they issued reply notice without applying legal mind and decided not to pay the insured death benefit policy amount to the complainant. The insured death is purely accidental and the final opinion of the postmortem Doctor is also confirmed that the cause of the death is due to snake bite.
4. Since for the last one and half year the complainant has suffered lot of mental agony during the time of the process of the claim and the attitude of the opposite parties 1 and 2 further she spend the money for traveling and all other expenses all the way from the village of the opposite parties offices (Cuddapah and Kurnool) on several occasions. Thus the opposite parties 1 and 2 failed in their duties to take correct measurer insetting her claim under the said scheme and their fraudulent acts caused loss to her, hence the opposite parties 1 and 2 are jointly and severally liable to pay the said policy amount to the complainant along with the interest, Rs.15,000/- towards compensation and Rs.5,000/- towards costs.
5. The complainant in support of her case encloses to the complaint the documents and they are marked as Ex.A1 to Ex.A7 and PW1 doctor who performed the postmortem was examined on behalf of the complainant and depositing of the same filed for their appreciation. The sworn affidavit of the complainant re-iterates the complainant’s case and the above documents.
6. While the opposite party No.1 remained absent without participating in the proceedings in this case and filing any written version and set exparte.
7. The objection statement of the opposite party No.2 besides questioning the justness and maintainability of the complaint in facts and law and denied all the allegations mentioned in the complaint of the complainant, except the risk coverage of the complainants son under the said Insured Policy and further informed that soon after the intimation of the death of the S.Hanumanthu Naik this opposite parties verified the facts and as the Authenticated Chemical Analysis and report of the forensic laboratory with regard the Viscera of the deceased showed that the said viscera did not contain as the poisness substance was found. This fact satisfies the claimants version that the deceased Hanumanthu Naik died due to snake bite. Therefore, the opposite party No.2 applied its mind repudiated the claim and intimated the same to S.Theja Naik, the nominee under he registered post with acknowledgement due on 28-05-2002. The same was intimated to the District Rural Economic Development Society, Cuddapah, thus this has been no deficiency of service on the part of the opposite parties and the claimant is not entitled to claim any amount from the opposite parties and seeks the dismissal of the complaint with costs.
8. The chief examination and the additional chief examination affidavits were filed on 09-03-2004 and 14-05-2004 respectively by the opposite party No.2 re-iterating the objection statement averments and in support of his case encloses the documents and they are marked as ex.B1 to Ex.B4 for their appreciation.
9. Hence, the point for consideration is whether the complainant is entitled to the reliefs sought for.
10. The Ex.A1 is the Xerox copy of the F.I.R. in Crime No.13/2001 under section 174 dated 31-05-2001 of the Police Station, Racherla, which was attested by the Station House Officer, Racherla Police Station, which reveals that the complainants sons died due to snake bite which was caused on his right foot at about 2.00 A.M. on 31-05-2001 i.e., early hours of 31-05-2001 and subsequently died on 31-05-2001 at about 3.00 A.M. The same was reported by the complainants sons Grand Father S.Somla Naik at 10.00 A.M. on 31-05-2001. The Ex.A2 is the Xerox copy of Inquest Report, which was also attested by the Station House Officer, Racherla Police Station which re-iterates the complaint of F.I.R. and after the inquest of the dead body of the complainants son the same was sent for the postmortem at about 1.30 P.M. to the Government Hospital, Dhone with the requisition letter of the Sub Inspector Police Station, Racherla. Ex.A3 is an attested Xerox copy of the final opinion of the doctor dated 03-09-201 which envisages that the complainants son died due to hemorrhage and intravascular haemolysis and the cause for the death as snake bite and cannot be ruled out. Ex.A4 is the Policy No.4761120105695 of the complainants son i.e., the deceased Sugali Hanumanthu Naik, S/o S.Theja Naik which covers from 08-01-1999 to 07-01-2009 and the nominee was the complainants sons father S.Theja Naik. The Ex.A5 is the Death Certificate dated 20-07-2001 of Sugali Hanumanthu Naik (complainants Son) issued by the M.R.O. Peapully and Ex.A6 is the Death Certificate dated 01-07-2000 of Sugali Theja Naik , S/o Somla Naik who wa the complainants father and nominee of the said policy issued by the M.R.O., Peapully, as per this record the date of the death was 05-04-2000. This clearly shows that the complainants son father died before the death of the complainants son and the question of the claim amount under the said policy does not arise by the insured father i.e., nominee. The Ex.A7 is the legal notice dated 05-02-2003 issued by the complainant counsel to the opposite party No.2 along with the postal receipt and the postal acknowledgement. The complainant filed a petition and got examined the doctor who performed the postmortem as PW1. The said doctor in the Chief examination by the complainants counsel on 28-09-2004 admitted that after holding postmortem examination issued postmortem certificate incorporating therein the observations made during the said autopsy and viscera that sent for chemical analysis and he has reserved his opinion as to the cause of the death of the said persons, subsequent there on receipt of the said chemical analysis report from the forensic lab, Hyderabad with the observation as to the non-existence of any poiso-ness substance therein, he has issued on 03-09-2001 the final opinion report which was marked as Ex.A3. The opposite party No.2 counsel cross examined the said doctor. The said doctor said that during the postmortem of the said person, he observed two sting marks (Snake bite marks) on right dorsum of foot and observed hemorrhages in brain, pericardium hear, and inner wall of the stomach, this could be possible in snake bite due to the failure of coagulation system. The Ex.A3 and PW1 deposition clearly establishes that the complainants son died due to snake bite.
11. As per the Lenor of the Chief examination and the additional Chief Examination affidavits dated 09-03-2004 and 14-05-2004 respectively of the opposite party No.2, the cause of eh repudiating the claim is that the chemical analysis report of A.P. Forensic Laboratory shows that the viscera of late Hanumanthu Naik did not contain any poisoness substance. To appreciate the said fact the opposite party No.2 relied on the Ex.B3 which was an attested Xerox copy. The Ex.B1 is the Xerox copy of the Group Janatha Personal Accident Insurance Certificate with its enclosures of eh deceased, where as the complainant field original policy which was marked as Ex.A4. The Ex.B2 is the returned registered postal cover with acknowledgement due with an endorsement stating that since the addressee died, the cover returned. The addressee is nothing but the father of the deceased (nominee), who died on 5.4.2000 (Ex.A.6 i.e., prior to the death of the insured. The Ex.B.4 is the letter dated 5.3.2004 of the M.R.O. Peapully to the Divisional Manager, New India Assurance Company Limited, Kurnool enclosing the Ex.B.3, which was chemical analysis report of viscera belonging to S.Hanumanthu Naik in crime No.13/2001 of N.Racheral Police Station. The O.P.No.2 reliance on the Ex.B.3 will not suffice or overcome or justifies the deligency of the O.P.No.2 in repudiating the complainants claim, in the light of the P.W.No.1 deposition, the doctor who performed the postmortem on the deceased and the contents of the final opinion report of the said doctor (Ex.A3). It is not out of place to cite the ruling of the Honorable A.P. State Commission 2000 ALD part-II page No.96, it was held that when the cause of the death is snake bite, but not a suspicious one obtaining F.I.R and the other documents does not arise. Even though the circumstances are alike the complainant filed F.I.R, P.M. Report and other relevant document in substantiation of her case.
12. To conclude from the above discussions and following the above said decision, the reasonable time frame within the nationalized Insurance Companies must settle or repudiate the insured claims would normally by a period of 6 months. Any delay beyond the would perse odium of deficiency of service, unless the same is cogently explained by the insurance companies and the burden must necessarily rest on them. In the above said circumstances and the cogent material placed by the complainant, the repudiation of the claim of the complainant basing on Ex.B3 by the opposite party No.2 could not escape his liability and it is improper under the above said policy, is amounting to deficiency of service.
13. In the result, in view of the discussions made above, this complainant petition is allowed directing the opposite parties 1 and 2 jointly and severally to pay the insured insurance death benefit policy amount of Rs.1,00,000/- to the complainant with interest at 9% per annum from the date of the death of the insured, S.Hanumanthu Naik i.e., from 31-05-2001, Rs.10,000/- towards compensation and Rs.2,000/- as costs within a month of the receipt of this order.
Dictated to the Stenographer, typed to the dictation, corrected by us, and pronounced in the Open Court this the 16th day of November, 2004.
PRESIDENT
MEMBER MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant :Nil For the opposite parties :Nil
List of exhibits marked for the complainant:-
Ex.A1 FIR No.13/2001 dated 31-05-2001 under P.S. Racherla attested copy issued by S.H.O. Racherla P.S.
Ex.A2 Inquest report held over the dead daby of the deceased Sugali D.Hanumanthu Naik, S/o Late Thaja Naik under Crime No.13/2001 (attested copy).
Ex.A3 Attested copy of the final opinion of the Doctor.
Ex.A4 Policy No.4761120105695 of deceased Hanumanthu Naik.
Ex.A5 Death Certificate Hanumanthu Naik issued by MRO Peapully dated
26-04-2001.
Ex.A6 Death Certificate of Thaja Naik issued by MRO Peapully dated
01-07-2000.
Ex.A7 Legal Notice dated 05-02-2003 issued by complainants counsel to
opposite party No.2 along with postal receipt and postal
acknowledgement.
List of Exhibits Marked for the opposite parties :-
Ex.B1 Xerox copy of policy No.4761120305415 along with proposal form
enclosed.
Ex.B2 Returned Registered postal cover with acknowledgement due.
Ex.B3 Analasis report dated 04-08-2001 given by A.P. Forensic Science Laboratories, Hyderabad, (Attested Copy).
Ex.B4 Letter dated 05-05-2004 of MRO Peapully to the Divisional Manager New India Assurance Company Limited, Kurnool.
PRESIDENT
MEMBER MEMBER
