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 22nd day of February, 2005
C.D.No. 63/2004
O.Vishalakshamamma,
W/o Late O.Sreenivasa Reddy,
D.No. 6-6B, R.S.Road,
Kothapeta, Dhone. . . . Complainant represented by his cousel
Sri C.Ramana Reddy. Advocate.
-Vs-
1. The Branch Manager,
LIC of India,
Dhone.
2. The Divisional Manager,
Divisional Office,
LIC of India,
College Road,
Cadapa. . . . Opposite parties 1 and 2 represented by their
Counsel Sri P.Sivaprasada Reddy.Advocate.
O R D E R
(As per Smt C. Preethi, Hon’ble Lady Member)
1. This CD complaint of the complainant is filed under section 12 of C.P. Act, 1986, seeking a direction on the opposite parties to pay accidental benefit amount of Rs.50,000/- with all benefits and interest @ of 18% per annum from the date of death of deceased, Rs.10,000/- as compensation for mental agony, costs of this petition and any such other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainant’s case is that the complainant’s husband O.Sreenivasa Reddy has taken a policy bearing No. 651078825 dt 28.12.1991 from opposite party No.1 for assured sum of Rs.50,000/- with accidental benefit. In case of accidental death of the policy holder the opposite parties have to pay double the assured amount with profits. The policy holder died in train accident on 29.2.2004, on the claim preferred by the complainant the opposite party settled for Rs.71,879/- on 25.3.2004 towards assured amount and bonus and opposite party No.2 sent a letter dt 3.6.2004 repudiating the accidental benefit under the above said policy, as they have indisputable proof to show that the policy holder was not in sound mind for last 2 or 3 years and met with accident and died, therefore the accident benefit is rejected. But the complainant submits that the deceased policy holder has never suffered with unsound mind for last 2 or 3 years, hence, the repudiation of claim by the opposite parties is untenable and amounts to deficiency of service.
- In substantiation of its case the complainant filed the following document Viz (1) repudiation letter of opposite party No.2 addressed to the complainant dt 3.6.2004, besides to the sworn affidavit of the complainant in reiteration of its complaint avernemtns and the above document is marked as Ex A.1 for its appreciation in this
case. The complainant also relied on the three third party affidavits of S.Sudhakar Reddy, V. Muralidhar Reddy and B. Jaya Ranga Reddy and the three third parties suitably replied to the interrogatories caused by the opposite party. The complainant also caused interrogatories to the opposite party No.2.
4. In pursuance to the notice of this Forum as to this case of the complainant the opposite parties appeared through their standing counsel and contested the case by filling denial written version by opposite party No.2 and opposite party No.1 adopted the written version of opposite party No.2.
5. The written version of opposite parties admits the deceased policy holder has taken a policy bearing No. 651078825, covering the risk of his life for Rs.50,000/- with accidental benefit and nominated the complainant as his nominee. On the demise of the policy holder on 29.2.2004, the complainant preferred a claim and opposite party No.1 admitted the claim and settled the claim for assured amount of Rs.93,750/- and deducted loan balance amount of Rs.21,871/- and paid Rs.77,879/- to the complainant and repudiated the accidental benefit under the above said policy vide speaking orders dt 3.6.2004, stating that the policy holder was not in sound mind for last 2 or 3 years and met with accident and died. The reports in PIR, FIR and PMR concluded that on the night of 28.2.2004 the policy holder was hit by the running train when he was walking on the railway track, as per condition 10 (b) (i) of AB clause of policy bond, the accident benefit is not payable if the accident is caused due to intentionally self injury, attempted suicide, insanity or immorality or whist the policy holder under the influence of intoxication liquor, drug or narcotic. Therefore, there is no deficiency of service on the part of opposite parties as the basic claim under the policy is settled to the satisfaction of the complainant as per the discharge receipt dt 25.3.2004. As the complainant could not establish the accidental death of the policy holder by placing any valid and legal proof the complainant is not entitled to accidental benefit. Therefore, seeks for the dismissal of complaint with costs.
6. In Substantiation of its case the opposite parties relied on the following documents Viz (1) policy bond bearing No. 651078825 of the deceased (2) proposal form of the deceased dt 20.1.1992 (3) discharge receipt dt 25.3.2004 and (4) attested Xerox of FIR, besides to the sworn affidavit of opposite party No.2 and caused interrogatories to the three third party affidavits filed by the complainant and suitablely replied to the interrogatories caused by the complainant.
7. Hence, the point for consideration is whether the complainant has made out the alleged deficiency of service of the opposite parties to have the accidental claim from the opposite parties?:-
8. The replies of the third parties to the interrogatories caused by the opposite parties being not in a form of the sworn affidavit as contemplated under Order XI Rule 8 and 9 CPC and Appendix –C Form No.3, they are not remaining worthy of consideration.
9. The Ex B.1 is the policy bond bearing No. 651078825 of the deceased, Ex B.2 is the proposal form of the deceased dt 20.1.1992,Ex B.3 is the discharge receipt dt 25.3.2004 signed by the complainant on the revenue stamp for Cross claim amount of Rs.93,750/- the opposite parties deducted Rs.21,871/- as loan amount and paid the balance amount of Rs. 77,879/- to the complainant and the complainant accepted the said amount without any protest.
10. The Ex A.1 is the repudiation letter dt 3.6.2004 of the opposite parties addressed to the complainant stating that they have indisputable proof to show that the life assured was not of sound mind for the last 2 or 3 years and met with accident and died. The opposite parties in substantiation of their case placed reliance on Ex B.4 xerox copy of FIR dt 29.2.2004 of Guntakal Police Station of Kurnool District, it envisages a male dead body aged about 50 – 55 years was found lying in between tracks between Dhone and Malliyala Railway Stations, the inquest report attached to the F.I.R.,envisages that the deceased policy holder O.Sreenivasa Reddy was suffering from unsound mind for the past 2 or 3 years and had taken treatment at several hospitals. On the night of 28.2.2004 the deceased with out informing his wife and sons left the house in unsound mind as per the deceased’s wife and sons and later found the deceased dead body in between the railway tracks. The complainant denies that deceased suffered with any unsound mind, but did not place any material to substantiate their plea. In the inquest report in Ex B.4, clearly says that the deceased was suffering from unsound mind for the past 2 or 3 years, as no prudent man will walk on the railway track at night, therefore, the plea of the opposite party has to be accepted. The opposite parties strongly argued that the deceased was unsound mind and on the night of 28.2.2004 while walking on the track, died when the up coming train hit him and the complainant failed to prove that the deceased did not suffer from unsound mind, hence the contention of the opposite parties are to be accepted. Therefore, there remains no deficiency of service on part of opposite parties in repudiating the accidental claim of the complainant, as the opposite parties repudiated the accidental claim of the complainant after going through the documents and settled the policy for assured amount only.
11. The complainant in support of her case relied on the following citation. Uttar Pradesh State Commission, between United India Insurance Co Ltd Vs M/s Jindal Poly Industries, wherein, it was held that mere execution of discharge voucher would not always deprive the consumer from preferring the claim with respect to deficiency in service in a claim under Insurance Policy. But in the present case the dispute between the parties in for non-settlement of accidental benefit and not on the execution of discharge voucher for part payment. Hence, the decision citied has no relevancy to this case.
12. Therefore, in the result, the complaint is dismissed for want of merit and force.
Dictated to the Stenographer, Typed to the dictation corrected by us, pronounced in the open court this the 22nd day of February, 2005
Sd/-
Sd/- PRESIDENT sd/-
MEMBER MEMBER
