This C.C. is coming on before us for hearing in the presence of Sri. Y.Ramesh, Advocate for complainant and Sri K.P.Satyanarayna Rao, Advocate for opposite parties; upon perusing the material papers on record; upon hearing arguments and having stood over for consideration, this Forum passed the following:-
O R D E R
(Per Sri Vijay Kumar, President)
This complaint is filed under section 12-A of the Consumer Protection Act, 1986. The averments made in the complaint are that the husband of the complainant by name Jamaliah had taken Bheema Gold Insurance Policy from the opposite party No.1 for Rs.50,000/- vide policy bearing No.687551439, which was commenced from 28-10-2006. The complainant is a nominee for the above policy, the husband of the complainant died on 30-12-2006 due to heart stroke and the same was informed to the opposite party No.1 by submitting the claim form with all necessary documents and also approached opposite party No.1 and requested to pay the claim amount under the policy. The opposite party No.1 evaded the payment under one pretext or the other. On 31-03-2008 the complainant received a letter from opposite party No.2 by repudiating the claim on the ground that the deceased committed suicide within one year from the date of commencing of the policy. Having acknowledged the receipt, the opposite party No.2 refused to pay the claim through letter dated 28-9-2008. Without any basis and proper enquiry, the opposite parties unilaterally came to the wrong conclusion. In order to evade the payment made false allegation without any basis. This act on the part of opposite party put to untold mental agony. Hence, the complaint.
Apart from the complaint, the complainant has filed an affidavit, reiterating the contents of the complaint.
On receipt of the notice, the opposite parties have filed written version and admitted that late Jamalaiah had taken the policy. The aforesaid assured died on 10-1-2007 and the death occurred within two months after taking the policy. Treating the said claim as early claim and investigation was caused into the bonafides of the claim. During the investigation, it came to light that the deceased/life assured had committed suicide and this fact is corroborated by a notarized affidavit dt.29-3-2008 executed by Sri.Karri Ranga Rao, Sarpanch of village. As per the condition No.7 of the policy, if the life assured committed suicide, the corporation will not entertain any claim, hence repudiated the claim under the said clause and intimated the same to the complainant and prayed to dismiss the complaint.
On behalf of the complainant, the Panchayat Secretary, Barla Prabhakar is examined as P.W.1 and got marked Exs.A.1 to A.6. Ex.A.1 is the death certificate issued by village Secretary, dt.15-7-2008, Ex.A.2 is the Photocopy of Proposal deposit receipt form, dt.20-10-2006, Ex.A.3 is the status report, Ex.A.4 is the Repudiation letter, dt.31-03-2008, Ex.A.5 is the Letter, dt.25-8-2008, Ex.A.6 is the letter addressed by the opposite party, dt.28-8-2008.
On the other hand on behalf of the opposite party, Exs.B.1 and B.2 are marked. Ex.B.1 is the policy bond and Ex.B.2 is the notarized affidavit, dt.29-3-2008.
On behalf of the opposite party, a memo is filed to treat the contents of written statement as written arguments. Heard the counsel for complainant. Perused the oral and documentary evidence. Upon which the points that arose for consideration are,
1. Whether the complainant is entitled to the claim
covered under the policy?
2. To what relief?
Point No.1:
The undisputed facts of the case are that the deceased by name, Jamalaiah had taken the policy from opposite party No.1 as in Ex.B.1. The sum assured under the policy is Rs.50,000/-. Later the deceased died. At the time of death of the deceased/life assured, the policy was in force. The only dispute is regarding the cause of death of the deceased. It is the contention of the complainant that the deceased died due to heart attack, whereas the opposite party contends that the deceased died by committing suicide, by consuming pesticide. The opposite party attracts the terms and conditions of the policy as in Ex.B.1 and contends that the deceased became disentitled for the policy amount, because he died by committing suicide in contravention of the condition No.7 of the policy. There is lot of difference between natural death and death by suicide. A lot of evidence can be procured to substantiate the death by committing suicide unlike a death by heart attack. The case of opposite party is that the deceased died by committing suicide and as it is early claim they made an investigation and concluded the death as suicide. If the contention is taken to be true then a criminal case will be registered by the concerned policy under section 174 Cr.P.C. followed by an autopsy over the dead body of the deceased. In the absence of aforesaid evidence, it cannot be concluded as a suicidal death. We are unable to understand as what was the need for opposite party to get the affidavit of village surpanch attested by a notary as in Ex.B.2. This act of opposite party itself creates a doubt regarding the cause of death of the deceased. On the other hand the complainant got examined Panchayat Secretary as P.W.1 and got marked Ex.A.1. In his evidence P.W.1 categorically stated that the deceased died due to heart attack. It is very difficult to prove that a person died due to heart stroke, unlike a death by suicide. It is very easy to throw the blame on the complainant by cleaning their hands, but it is very difficult to prove the same. The opposite party cannot escape from its liability by blaming the complainant. In view of the aforesaid reasons, the complaint is fit to be allowed.
In the result, the complaint is allowed, directing the opposite parties to pay an amount of Rs.50,000/- (Rupees fifty thousand only) covered under the policy bearing No.687551439 together with interest at 9% P.A. from the date of repudiation of the claim i.e. from 31-3-2008 till the date of deposit. Opposite parties are further directed to pay an amount of Rs.1,000/- (Rupees one thousand only) towards costs of the litigation.
Dictated to the steno, transcribed by her, corrected and pronounced by us in the open forum on this 5th day of August, 2010.
PRESIDENT MEMBER MEMBER
DISTRICT CONSUMERS FORUM, KHAMMAM
APPENDIX OF EVIDENCE
Witnesses examined for complainant: -None-
Witnesses examined for opposite party: -None-
Exhibits marked for complainant:
Ex.A.1 is the death certificate issued by village Secretary, dt.15-7-2008, Ex.A.2 is the Photocopy of Proposal deposit receipt form, dt.20-10-2006, Ex.A.3 is the status report,
Ex.A.4 is the Repudiation letter, dt.31-03-2008,
Ex.A.5 is the Letter, dt.25-8-2008,
Ex.A.6 is the letter addressed by the opposite party, dt.28-8-2008.
Exhibits marked for opposite party:
Ex.B.1 is the policy bond
Ex.B.2 is the notarized affidavit, dt.29-3-2008.
PRESIDENT MEMBER MEMBER
DISTRICT CONSUMERS FORUM, KHAMMAM
