Per Sri A. Hazarath Rao,  President:-

        The complainant filed this complaint under section 12 of Consumer Protection Act seeking award for Rs.1,00,000/- being the insured amount; Rs.50,000/- sum assured under Chaitanya Credit Card; Rs.10,000/- each towards mental agony, compensation and legal expenses.

2.   In brief the averments of the complaint are these:

        One Enumala Rama Rao was having Nirbhaya Gold account bearing No.50712 with the 1^st opposite party.   The 1^st opposite party duly insured accidental risk to its account holders for Rs.1,00,000/- each with the 2^nd opposite party.   Under the said scheme the account holder is also entitled to Rs.50,000/- under Kisan Credit Card account.   The 1^st opposite party duly collected the premium and promised to send it to the 2^nd opposite party.   The 1^st opposite party collected the premium for the year 2005-06.   The said Rama Rao died on 07-08-05 in Ganneruvagu of Kamepalli village due to floods.   The complainant submitted relevant documents including death certificate, legal heir certificate, FIR, PM report, inquest report, paper clippings along with claim form to the 2^nd opposite party through the 1^st opposite party.   The 2^nd opposite party on 07-02-06 repudiated the claim contending that the date of accident was not covered by the insurance policy.   The 1^st opposite party served the repudiation letter to the complainant on 22-12-09.   The opposite parties without reasonable cause repudiated the claim and it amounted to deficiency of service.   The contractual obligation in between the opposite parties is not binding on the complainant.   The complaint therefore be allowed.

3.     The contention of the 1^st opposite party in brief is hereunder:

             The claim is barred by limitation.   Husband of the complainant was having account with the 1^st opposite party bearing No.50712 and it was in force till his death on 07-08-05.   The complainant is nominee under the account. The 1^st opposite party insured its customers against personal accident and used to deduct the premium from its account holders and remit the same to the 2^nd opposite party within time.  The policy was in force as on the date of death of husband of the complainant. The 1^st opposite party acted promptly and transmitted all the documents received by it to the 2^nd opposite party for settling the claim. It is the 2^nd opposite party who has to settle complainant’s claim. The 1^st opposite party did not commit any deficiency of service. 

4.    The contention of the 2^nd opposite party in brief is hereunder:

        The claim is barred by limitation as the 2^nd opposite party repudiated the claim on 07-02-06.   The 1^st opposite party did not contend that it served repudiation letter on the complainant on                                22-12-09.  The complainant coined the same for limitation.  The entire correspondence among the complainant, the 1^st opposite party and   2^nd opposite party was for accidental insurance of Rs.1,00,000/- under Nirbhaya Gold account. The opposite parties entered into an agreement on 29-08-01 for a period of three years i.e., 28-08-04.   The insurance coverage per each account holder is Rs.1,00,000/- in case of accidental death.  The premium payable per each account holder was Rs.38/-.   The 1^st opposite party collects Rs.50/- from each account holder and pays Rs.38/- to the 2^nd opposite party and credit the balance amount of Rs.12/- to its profit and loss account.   The 1^st opposite party has to submit monthly statement showing particulars of account holders who has opened/renewed the account during that particular month along with particulars of premium payable on or before the last working day of succeeding month.   The complainant through the 1^st opposite party submitted documents.  The 2^nd opposite party came to a conclusion that the claim is not admissible as the 1^st opposite party did not send any further premium to give further insurance coverage to account holders after 31-07-05 and therefore repudiated the claim on 07-02-06 and informed the same to the 1^st opposite party.   The repudiation by the 2^nd opposite party is legal, justified and valid.   Rest of the allegations contra mentioned in the complaint are invented by the complainant to suit her claim.   The complaint therefore be dismissed.

5.   Exs.A-1 to A-11 on behalf of the complainant and Exs.B-1 to B-15 on behalf of the 1^st opposite party and Exs.B-16 to B-18 on behalf of the 2^nd opposite party were marked.

6.   Now the points that arose for consideration in this complaint are: 

1. Whether the complaint is barred by limitation?
2. What is the period of insurance coverage?
3. Whether the repudiation by the 2^nd opposite party is proper?
4. Whether the complainant is entitled to Rs.50,000/-being the sum assured under Kisan Credit Card Scheme?
5. Whether the complainants are entitled to compensation and if so to what amount and from whom?
6. To what relief?

7.    Admitted facts in this case are these:

1. Husband of the complainant namely Enumala Rama Rao was an account holder of Nirbhaya Gold scheme with the 1^st opposite party (Ex.A-9=B-1).
2. The said Enumala Rama Rao died on 07-08-05 due to drowning (Exs.A-3,    A5 to A-8)
3. The complainant submitted relevant documents as mentioned in Ex.A-2 to the 2^nd opposite party through the 1^st opposite party (Ex.A-2).
4. The 2^nd opposite party repudiated the claim on 07-02-06 (Ex.B-18).

8.   POINT No.1:-    The registry at the time of numbering the petition itself took objection on the aspect of limitation.   In para 3 (g) of her complaint the complainant mentioned that OP1 served the repudiation letter to the complainant on 22-12-09.   The complainant for the reasons best known to her did not file repudiation letter before this Forum. On the other hand the complainant on 13-08-10 represented the complaint with the following endorsement:

                “No repudiation letter was served to the complainant and repudiation letter was communicated between the opposite parties only.   Hence the complainant has not possessed the same and he could not file the same.   Hence it may be filed by the opposite party only at the time of hearing.   Hence it may be numbered”.

Basing on such representation the complaint was numbered as CC 49 of 2011 on 21-02-11. 

9.   Both the opposite parties are contending that the complaint is barred by time.   The 1^st opposite party took the insurance policy for benefit of its customers.   The 1^st opposite party in its version and affidavit did not mention when it served copy of repudiation letter to the complainant.    When 2^nd opposite party received claim form and other relevant documents it can be presumed that address of complainant is available with it.   In Ex.B-18 repudiation letter dated 02-11-07 addressed to the 1^st opposite party it was mentioned that the claim was already repudiated on 07-02-06.   Ex.B-5 is copy of letter dated 07-02-06 addressed by the 2^nd opposite party to the 1^st opposite party on 07-02-06 and it reads as follows:

                “We refer to your correspondence on the above wherein you forwarded the claim papers to us for death of Mr. E. Rama Rao on 07-08-05 claiming Rs.1,00,000/-.

                We are returning the papers as the loss period falls beyond the coverage of the policy.  The agreement with our company expired on 31-08-04 and no further premium has been paid after that date.  You may observe that as per the agreement, the coverage had been provided for the expiring month renewal and new accounts by way of deposit premium.   The premium is payable by the end of next of month as facilitated by us.  The last premium paid by you head office is in the month of September, 2004 i.e., for the period of 01-08-04 to 31-07-05 only.   A copy of the last policy is enclosed which is for the period upto 31-07-05.   Hence the coverage is not available after 31-07-05 and further renewals were not made with our company.  You may approach your head office for the policies issued after 01-09-05 onwards”.

10.   The 2^nd opposite party did not file such copy of letter into Forum.   Nowhere in Ex.B-5 it was mentioned that the claim was repudiated.   The recitals in Ex.B-5 leads us to draw an inference that it advised the 1^st opposite party to address their head office for the policies issued after 01-09-05.   Ex.B-5 in our considered opinion cannot be termed as repudiation.   Ex.B-5 was not marked to the complainant.  Likewise Ex.B-18 also.    Therefore the contention of the opposite parties that complainant’s claim was repudiated on 07-02-06 itself cannot be accepted. 

11.   It is not the 1^st opposite party who can initiate legal proceedings on repudiation.    When such is the case a responsibility is cast on the 2^nd opposite party to inform the repudiation by addressing a copy either directly to the complainant or through the 1^st opposite party under acknowledgment.   It is quite apt to make a mention here that citizens are living in a period of confrontation.   Therefore it has to be inferred that the claim is pending and as such the claim is in time.   We therefore answer this point against the opposite parties.

12.   POINTS 2&3:-    The complainant served a memo on the 1^st opposite party to produce the concerned insurance policy.   In its reply the 1^st opposite party mentioned that the said policy could not be traced inspite of diligent searches.    Ex.B-8 is the copy of agreement dated 29-08-01 between the opposite parties.    The said agreement remained in force for a period of 3 years from 29-08-01 to 28-08-04 as per clause-4.   The 1^st opposite party remitted Rs.1,07,616/- as premium for August, 2004 covering the risk of 2,832 account holders. 

13.   The 2^nd opposite party filed copy of policy (Ex.B-16) bearing No.550500/47/04/9600089.    There was a correction in the dates covering the risk of the policy as seen from Ex.B-16 and after correction it reads the policy period as from 01-08-04 to 31-07-05.  The 2^nd opposite party failed to explain the correction occurring in Ex.B-16.  Under Ex.B-5 the policy period was from 29-08-01 to                   28-08-04. Under those circumstances, the risk of customers of the 1^st opposite party in our considered opinion could be from 01-09-04 to 31-08-05 and therefore the said alteration as mentioned in Ex.B-16 had no meaning.   Since the account holder died on 07-08-05 in our considered opinion he was covered by the policy.  Therefore the contention of the 2^nd opposite party that husband of the complainant not covered by the policy did not hold good.   We therefore hold that the husband of the complainant is covered by the policy in question and answer this point in favour of the complainant.  

14.   POINT No.4:-    The complainant claimed Rs.50,000/- towards Chaitanya Kisan Credit card (Ex.A-9).  In Ex.A-9 the loan limit was mentioned as Rs.50,000/-.  The complainant misunderstood the said amount also as insured amount.   The claim of the complainant therefore in respect of Rs.50,000/- is not maintainable.

15.  POINT No.5:-     The 1^st opposite party did not take further steps on Ex.B-5.  Both the parties did not communicate copy of Ex.B-5 or        B-18 to the complainant under acknowledgement as expected from that of a prudent person and thereby they are denying the beneficiaries to approach the Forum in time.   On this count both the parties are guilty of deficiency of service.    Under those circumstances awarding a sum of Rs.5,000/- each will meet ends of justice.   This point is therefore answered accordingly.

16.  POINT No.6:-   In view of above findings in the result the complaint is partly allowed as indicated below:

1. The 2^nd opposite party is directed to pay Rs.1,00,000/- together with interest @9% p.a., from the date of filing the complaint i.e., 10-06-10 till payment.
2. The opposite parties are directed to pay Rs.5,000/- each towards compensation.
3. The opposite parties are directed to pay Rs.1000/- towards costs.
4. The amounts ordered above shall be paid within a period of six weeks from the date of receipt of the copy of the order.

        Typed to my dictation by Junior Stenographer, corrected by me and pronounced in the open Forum dated this the 23^rd day of November, 2011.

          MEMBER                                                                 PRESIDENT

APPENDIX OF EVIDENCE

DOCUMENTS MARKED

For Complainant:

For 1^st opposite party:

For 2^nd opposite party:

PRESIDENT