This is a complaint filed U/s. 12 of Consumer Protection Act by the complainant Kumari Shilpa against two Respondents- (1) Branch Manager Tungabhadra Gramina Bank now re-named as Pragathi Gramina Bank Branch Raichur, and (2) Divisional Manager United India Insurance Company Ltd., Divisional Office Raichur. The brief facts of the complaint are as under:-<br /> The brother of the complainant by name K.Ramesh S/o. late Krishna kumar was an employee in the City Municipal Council, Raichur on daily wages and he died on 26-04-05 at NIMHANS Hospital Bangalore, while under treatment. He was un-married and aged about (30) years at the time of his death. OP.NO-1 which is a schedule bank and OP.No-2 which is a Insurance Company have jointly sponsored a scheme namely “BELLI-HABBA JEEVA NIDHI’ Yojanegalu” by calling upon the customers at large to deposit a sum of Rs. 500/- Rs. 1,000/- & Rs. 2,000/- and to get the benefit of Rs. 25,000/- Rs. 50,000/- & Rs. 1,00,000/- respectively in the event of death of depositor during the said period and the accident-cum-death benefit will be given to the nominee of the depositor under the scheme.<br /> <br /> The brother of the complainant had deposited a sum of Rs. 2,500/- with OP.No-1 under SB /IND/Account No. PSJ-II-20027, on 10-02-05/16-02-05. In the said account he had nominated his sister i.e, complainant as his nominee. On 23-04-05 her brother K.Ramesh had been to Bangalore on his work on 24-04-05 and he fell-down in the Railway 1st platform. Immediately he was shifted to Railway Hospital at Bangalore and thereafter shifted to Victoria Hospital and subsequently to Nimhans Hospital Bangalore where he undergone operations and he died on 26-04-05 at about 7-25 during treatment. The Railway Police Bangalore have registered a case under UDR No. 61/05 U/s. 174 Cr.P.C. and issued FIR. Post Mortem Examination was conducted by the doctor at NIMHANS Hospital.<br /> <br /> The complainant has informed about the death of her brother to the OP.No-1 but the then Branch Manager has dragged the matter. After his transfer the New Branch Manager has asked the complainant to produce relevant documents. The complainant has collected almost all relevant documents namely FIR, Final Charge-sheet, Inquest panchanama, PME Report, Death Certificate etc., and submitted the same with a letter to OP.No-1 on 19-01-06. The OP.No-1 neither replied nor denied the claim of the complainant. So there is deficiency in service by Ops. Therefore the complainant has filed his complaint and sought for direction to OP.No-1 & 2 to pay the complainant a sum of Rs. 1,00,000/- with interest there on and also to award compensation with costs.<br /> <br /> 2. In-response to service of notice OP No-1 & 2 appeared through their respective counsel and filed separate written statement/version. In the written version the OP.No-1 has denied all contentions of the complaint except regarding deceased K.Ramesh was having account PSJ-II/20027 with OP Bank. The complainant with malice intention has disclosed half truth but not the whole truth so as to suit her complaint. The true facts of the case are that the deceased K.Ramesh was suffering from Epilepsy since many years and was taking treatment. On 23-04-05, Railway Official saw him lying un-conscious in the Railway Station, Bangalore they admitted in the Railway Hospital and then shifted to Nimhans Hospital, Bangalore where he died on 26-04-05. The cause of his death is “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage (Medical/Natural cause of death).” The document filed by the complainant revel all these facts. It is false to say that the claim is lodged by the complainant to claim the amount under the scheme of PSJND and the Branch Manager dragged the matter etc., The complainant when approached the bank for information all information were given immediately and she was asked to produce relevant documents which she submitted on 19-01-06 only. The OP.No-1 immediately sent the claim of the complainant with all documents to OP.No-2 on 04-02-06 for further action. OP.No-2 after verifying claim refused the claim as per the letter dt. 14-02-06 addressed to OP.No-1 as the death of Account holder was not due to accident and within few days the matter was informed to the complainant and letter of OP.No-2 dt. 14-02-06 was given to the brother of the complainant. When the OP.No-1 promptly denied the claim of the complainant, there is no deficiency of service on the part of this Ops.<br /> <br /> As per PSJND scheme the bank has entered into an agreement to United India Insurance Company- OP.No-2 to provide Accident Insurance Cover to Accounts holder who will get sum assured in case of his permanent disablement of any part of his body in an accident and in case of death due to accident, the nominee of the account holder will get sum assured. Intimation of accident giving rise to claims shall be given immediately but not later than (15) days of accident. Apart from this there are other conditions also to settle the claim more details of which are mentioned in the Bank Circular No. 54/2005-06 and earlier circulars. In this case the death of the Account holder K. Ramesh is not due to accident or accidental injuries. But it was due to “Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage ( Medical/Natural cause of death).” Haemoerrhage was not due to accidental injuries but due to some other reason. So it is crystal clear that the death of K.Ramesh does not come within the scheme of PSJND and complainant is not entitled to any claim. Intimation of accident i.e., the alleged accident with the stiulated time of (15) days of the incident. Belated intimation deprived the Ops from investigating into the matter. The claim of the complainant is being vexatious should be curbed by imposing exemplary costs of Rs. 5,000/-.<br /> <br /> 3. OP.No-2 has filed written version specifically contending that the OP.No-2 has no knowledge about the contents of Para-1 regarding the relationship between the complainant and deceased Accounts holder K.Ramesh. The Final report U/s. 174 of Cr.P.C. submitted by the Railway Police Bangalore shows that the complainant brother K.Ramesh S/o. late Krishnakumar was suffering from “Fits” ( i.e. Murche Roga) and fell down on the platform of Bangalore Railway Station and was admitted to Hospital and during the course of treatment the said K.Ramesh died and the Post Mortem Report shows that K.Ramesh died due to “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage (Medical/Natural cause of death).” The fact regarding the deceased K. Ramesh was suffering from “Fits” is revealed by his brother one K.Naresh and he has given statement to the Police to this effect. The “B” Final Report is crystal clear that the brother of the complainant died due to natural causes and not due to accident as such and this OP is not liable to pay any policy amount or any compensation.<br /> <br /> After receiving the letter dt. 04-02-06 from OP.No-1 regarding death of K.Ramesh and this OP.No-2 came to know regarding the death of the said K.Ramesh and has replied to the said letter vide letter dt. 14-02-06 stating that the death of said K.Ramesh was not due to accident and as such they are liable to pay any policy amount and so there is no deficiency in service. Hence for all these reasons the OP.No-2 has prayed for dismissal of the complaint with heavy cost.<br /> <br /> 4. During the course of enquiry the complainant Kumari Shilpa has filed her sworn-affidavit by way of chief-examination as PW-1 and has got produced affidavit-evidence of her brother Naresh as PW-2 and this Naresh PW-2 has been cross-examined by OP.No-2. In-rebuttal OP.NO-1 Pragathi Gramina Bank has filed affidavit-evidence of its Manager and OP.No-2 United Insurance Company Ltd., has filed affidavit-evidence of its Divisional Manager as evidence and have not been cross-examined by the complainant. (8) documents have been got marked for the complainant at Ex.P-1 to P-8. On behalf of OP.NO-2 one document at Ex.R-1 has been got marked during cross-examination of PW-2 which is a portion of final report at Ex.P-6 and further got marked (6) documents at Ex.R-2 to R-6. The OP.No-1 has not produced and got marked any documents.<br /> <br /> 5. Heard the arguments of both sides and perused the records. The following points arise for our consideration and determination:-<br /> 1.Whether the complainant- Smt. Shilpa is nominee of <br /> Accounts holder late K.Ramesh S/o. Krishnakumar to claim accident cum death benefit, as alleged ?<br /> <br /> 2 Whether the complainant proves deficiency in service by the Respondents, as alleged?<br /> <br /> 3.Whether the complainant is entitled for the reliefs <br /> sought for?<br /> <br /> 6.Our finding on the above points are as under:-<br /> <br /> 1. In the negative. <br /> <br /> 2. In the negative.<br /> <br /> 3. As per final order for the following<br /> <br /> REASONS<br /> <br /> POINT NO.1:-<br /> <br /> 7. It is the specific case of the complainant as averred in Para- 1 to 3 of her complaint that late K.Ramesh S/o. K. Krishnakumar was her brother and was an employee in the City Municipal Council, Raichur on daily wages and her late brother K.Ramesh had deposited a sum of Rs. 2,000/- with OP.No-1 Bank under the scheme namely “BELLI-HABBA JEEVA NIDHI’ Yojanegalu” sponsored jointly by OP.No- 1 & 2 and her late brother was account holder of PSJ-II-20027, on 10-02-05/16-02-05 and in the said account her late brother was as his nominated her as his nominee being his sister. Both the OPs have disputed the relationship of the complainant with late K.Ramesh. The complainant has produced (8) documents at Ex.P-1 to P-8 out of which Ex.P-1 is the Copy of Pamphlet/hand-bill regarding “BELLI-HABBA JEEVA NIDHI’ Yojanegalu” published by OP.No-1 Bank. Ex.P-2 is the Xerox Copy of Pass Book A/c.No. PSJ-II-20027 of OP.No-1 Bank. A perusal of Ex.P-1 it states that in the event of death of the account holder in the accident, compensation will be paid. In the instant case there is no dispute that late K.Ramesh S/o. Krishna kumar was an account holder under the scheme SB/IND/Account No. PSJ-II-20027. The complainant has produced Xerox copy of the Pass Book at Ex.P-2. A close perusal of this we do not find mention of name of the present complainant as nominee of the late account holder. Of course on the back side of 1st page of this Ex.P-2 we find hand- writings by ball pen showing “ sister shilpa D/o. R.Earanna, R/o. Rcr”. As stated earlier this Pass Book at Ex.P-2 is Xerox copy but we find handwritings showing “Sister Shilpa D/o. R. Earanna”. Except this bare hand- written name of Shilpa D/o. R. Earanna there is no whisper in the entire pass book at Ex.P-2 showing the complainant as nominee of late account holder. Even the complainant has not produced the original Pass Book or has not called-for the original Pass Book if she had given to the Ops or even she has not called-for any papers from the Ops to substantiate the hand-written mention of her name on the back side of 1st page of Xerox copy of Pass Book at Ex.P-2. No explanation is coming forth regarding the hand writings written by “Ball Pen” showing her name on the back side of page No-1 of this Xerox copy of Pass Book at Ex.P-2. Even we do not find signature of any Bank Authority pertaining to this mention of handwritings by “Ball Pen”. This handwritings on the back side of page No-1 of Pass Book is now here by marked in the Green Ink Pen by this Forum so as to avoid further such writings. <br /> <br /> 8. Further more the cause title in the complaint shows the particulars of the complainant as Kumari Shilpa D/o. R.Earanna R/o. H.No. 4-2-78/1 Mangalwarpeth Raichur. The opening sentence in Para-1 of her complaint shows the name of late K.Ramesh S/o. late K. Krishna Kumar. This means father’s name of late K.Ramesh is late Krishna kumar and the father’s name of complainant is R. Earnna. So there is no whisper in the entire complaint to show as to how this late K.Ramesh is the brother of complainant Shilpa. The affidavit-evidence of PW-2 filed in this case shows the name of PW-2 as Naresh and his father name has been written as “Earanna” after stricking out the typed name as late Krishna Kumar. So it shows that PW-2 Naresh is the own brother of complainant-Shilpa. This Naresh PW-2 in his affidavit-evidence has stated that the complainant and deceased K.Ramesh are related to him as brother and sister. Except this oral evidence the complainant has not produced any piece of the paper to show as to how late K.Ramesh S/o. late Krishna Kumar is related to her as brother. So it follows that the complainant has miserably failed to satisfy that she is the nominee of account holder late K.Ramesh. Hence this Point No-1 is answered in the negative.<br /> <br /> POINT NO.2 <br /> <br /> 9. In view of our finding on Point NO-1 the consideration of Point No-2 does not arise, but however assuming for a while that complainant is nominee of K.Ramesh-Account-holder, we have to see whether she has proved deficiency of service by the Ops 1 & 2, as alleged. <br /> As discussed above the complainant has produced the Pamphlet of the sponsored scheme by OPs at Ex.P-1. The OP.NO-2 Insurance Company has produced copy of Group Personal Accident Policy Agreement at Ex.R-3 and Pamphlet with Banner at Ex.R-4. From a perusal of the pamphlet at Ex.P-1 and the Group Personal Accident Policy Agreement at Ex.R-2 and Pamphlet at Ex.R-4, it manifest that the sponsored scheme under JEEVA NIDHI is linked with Insurance covering risk as seen in Para-III of Ex.R-3. It states that “if any time during the currency of policy the insured person shall sustain any bodily injury resulting solely directly from accident caused by external violent and visible means the company shall pay to the insured the sum as detailed in clause (a) to (f) of para-III”. It also shows that the payment of insured sum is subject to Exclusion clause as specified in sub paras 1 to 7. Para-VIII of this Agreement states procedure of claims. Sub para (a) of this para states that “No separate nomination form is required to be submitted it may be incorporated in savings bank Account opening form itself of the bank. The claim amount shall be paid to the Bank who shall pay to the Nominee”. Sub para (b) states that Intimation of Accident giving rise to claims shall be given within (15) days from the date of accident. Sub para (c) Pertains to the documents enclosed in case of death-claims. <br /> <br /> 10. From Ex.P-1, Ex.R-3 & Ex.R-4 it is crystal clear that in case of accident caused by external violent and visible means compensation is awarded to the insured person or in case of his death to his/her nominee. It is the case of the complainant that late K.Ramesh (said to be) her brother had been to Bangalore on his work on 24-04-05 and he fell down in the Railway 1st platform and immediately he was shifted to Railway Hospital at Bangalore & thereafter he was shifted to Victoria Hospital & again shifted to Nimhans Hospital Bangalore where he undergone operations and he died on 26-04-05 during treatment. In this regard the complainant has produced Xerox copy of Death certificate of late K.Ramesh at Ex.P-4, Xerox copy of UDR No. 61/05 U/s. 174 Cr.P.C. issued by Railway Police Bangalore at Ex.P-5 and Xerox copy of “B” Final Report in the said UDR. at Ex.P-6. Column. No. 17 of “B” Final Report at Ex.P-6 states the brief facts of the case that on 24-04-05 Station Manager of SW-Railway, Bangalore noticed a person lying un-conscious near “Pay & Use Tiolet” and sent information to the Railway PS, then immediately they admitted the said person to the Railway Hospital and thereafter they shifted him to Nimhans Hospital Bangalore for further treatment where he died on 26-04-05 while undergoing treatment. Thereafter they conducted Inquest Panchanama and at that time one Naresh S/o. Krishna Kumar younger brother of the deceased was present and his statement was recorded who stated that deceased K.Ramesh was suffering from “Fits” earlier and for which he had taken treatment. The said Ramesh had come to Bangalore from Raichur and he might have been attacked by “Fits” and fallen un-conscious and died and there is no any suspicion in the death of the deceased. This Final Report further shows that the dead body of the deceased was subjected to Post Mortem Examination by the Medical Officer Nimhans Hospital and the Medical Officer has opined that the cause of death of deceased is due to “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage ( Medical/Natural cause of death).” <br /> <br /> The Post Mortem Examination Report at Ex.P-8 also shows that the probable cause of death of deceased is “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage (Medical/Natural cause of death).” So from the Final Report of Railway Police Bangalore in UDR NO. 61/05 U/s. 174 of Cr.P.C. coupled with the Post Mortem Examination Report conducted by Medical Officer at Nimhans Hospital, Bangalore shows that the death of the deceased was due to “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage ( Medical/Natural cause of death).”<br /> <br /> 11. PW-2 Naresh in his affidavit-evidence has stated that on 24-04-05 on the information from Railway Police Bangalore that his brother K.Ramesh has been admitted in Nimhans Hospital Bangalore he immediately went to Nimhans Hospital at Bangalore where his brother K. Ramesh died on 26-04-05 at about 7-25 PM. during the treatment He has specifically stated that the Railway Police have not recorded his statement and that he has not given statement stating that his brother K.Ramesh was suffering from “Fits” disease. In his cross-examination by the counsel for the OP.No-2 he has denied that he has stated before Railway Police Station that his brother K.Ramesh was suffering from “Fits” and might have died due to “Fits” as seen in the UDR Report the relevant portion of which marked as Ex.R-1. Except this denial statement of this PW-2 Naresh, there is absolutely nothing on record to substantiate that the deceased K.Ramesh was hail and healthy and was not suffering from “Fits” disease and that he has died due to accident. The Post Mortem Report of Nimhans Hospital Bangalore at Ex.P-8 clearly shows that death of the deceased was due to “ Subarachroid haemoerrhage of the left middle cerebral artery and left side beamistem haemoerrhage (Medical/Natural cause of death).” This opinion supports the contention of the Ops and the statement of Naresh before the police that the deceased Ramesh was suffering from Epilepsy and his death is not accidental one. Hence it follows that the complainant has failed to prove that the death of K.Ramesh was due to accident caused by external violent and visible means has defined in Ex.R-2. If this is so how can there be deficiency of service by the Ops in not settling her claim. Hence Point NO-2 is answered in the negative.<br /> <br /> POINT NO.3:-<br /> <br /> 14. In view of our foregoing discussion and finding on Point No-1 & 2 we hold that the complainant is not entitled for the reliefs fought for . In the result we pass the following order:<br /> <br /> ORDER<br /> <br /> The complaint of the complainant is being devoid of merits is hereby dismissed. No order as to cost.<br /> <br /> (Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 30-11-06.) <br /> <br /> Sd/-<br /> Sri. N.H. Savalagi<br /> President<br /> Dist.Consumer Forum-Raichur.<br /> <br /> Sd/-<br /> Sri.Pampannagouda <br /> Member.<br /> Dist.Consumer Forum-Raichur.<br /> <br /> On leave <br /> Smt.Kavita Patil <br /> Member.<br /> Dist.Consumer Forum-Raichur.<br /> <br />