Date of filing : 18.08.2011
Date of disposal : 03.10.2012
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR.
PRESENT: - Sri T.Sundara Ramaiah, B.Com., B.L., President (FAC)
Smt. M.Sreelatha, B.A., B.L., Lady Member
Sri S.Niranjan Babu, B.A., B.L., Male Member
Wednesday, the 03rd day of October, 2012
C.C.No.136 /2011
Between:
Smt. Thummala Nagarathnamma,
W/o T.Onnurappa,
M/o Late T.Hari Krishna,
H.No.2-46, Yerraguntlapalli (V),
H/o Peddapolamada,
Tadipatri Mandal,
Anantapur District. … Complainant
Vs.
1. The Branch Manager,
L.I.C. of India, R.F. Road,
Tadipatri,
Anantapur District.
2. The Divisional Manager,
L.I.C. of India, Divisional Office,
Jeevan Prakash, College Road,
Kadapa. … Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri B.N.Niranjan Kumar, Advocate for the complainant and Sri V.Krishna Sharma, Advocate for the Opposite Parties 1 & 2 and after perusing the material papers on record and after hearing the arguments of both sides, the Forum delivered the following:
O R D E R
Sri S.Niranjan Babu, Male Member: - This complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986 against the opposite parties 1 & 2 claiming a sum of Rs.1,00,000/- towards accident benefit and Rs.5,000/- towards mental agony with interest @ 12% p.a. from the date of claim till the date of realization.
2. The brief facts of the complaint are that: - The complainant is the mother and nominee of the deceased T.Hari Kirshna who died in a road accident on 04.06.2010 near appecherla village bus stop on S.H.63 Gooty to Tadipatri Road. The deceased T.Hari Krishna had obtained a double accident benefit Jeevan Sarala policy bearing No.655511006 dt.10.03.2010 from the 1st opposite party. After death of the T.Hari Krishna the complainant submitted claim form to the 1st opposite party and the same was honoured and paid a sum of Rs.97,574/- by way of a cheque bearing No.014435 dt.2610.2010, drawn on HDFC Bank, Tadipatri. The opposite parties 1 & 2 did not pay double accident benefit to the complainant on the ground that the complainant has not submitted the driving license of her deceased son T.Hari Kirshna. The complainant had submitted all relevant documents like F.I.R., P.M. report etc., to the opposite parties at the time of claim. The complainant made oral requests for the payment of the double accident benefit but, there was no response from the opposite parties. Then the complainant got issued legal notice dt.06.12.2010 to the opposite parties 1 & 2 and a reply notice was sent by the 2nd opposite party asking to submit the driving license of late T.Hari Krishna in order to pay the double accident benefit. The complainant is not aware of her son’s driving license hence she did not submit the driving license.
3. Subsequently the complainant once again got issued legal notice to the 2nd opposite party on 26.04.2011 but there was no reply for the said notice by the opposite parties. Hence the complainant filed this complaint against the opposite parties 1 & 2 claiming a sum of Rs.1,00,000/- towards double accident benefit and Rs.5,000/- towards mental agony with interest 12% p.a. from the date of claim till the date of realization.
4. The 2nd opposite party filed counter stating that it is true that the deceased T.Hari Krishna had taken the policy bearing No.655511006 from the 1st opposite party. After receiving the death intimation of the policyholder along with claim form a sum of Rs.97,574/- was paid on 26.10.2010 to the complainant. Further the allegation that the opposite party rejected the accident benefit of the complainant is also true. The 2nd opposite party states that as seen from the records the deceased himself was driving his two wheeler at the time of accident and the accident was due to the rash and negligent driving of the deceased. Hence the opposite party insists to furnish driving license of the deceased policyholder in order to pay the double accident benefit which is very essentional as per the policy conditions. Inspite of the insistence the complainant has not furnished neither driving license number nor a copy of driving license of the deceased. Hence, the opposite party rejected the double accident benefit and the same was informed to the complainant. The opposite party also gave a reply notice on 15.12.2010 for the notice dt.06.12.2010 of the complainant.
5. The opposite party further states that the allegation in the complaint that there is no condition in the policy that the policyholder must possess a valid driving license is not correct. Infact as per the policy condition No.11(b)(iv), it is clearly mentioned that the corporation will not be liable to pay the accident benefit claim , if the death of the life assured is as a result from the life assured committed any breach of law. Further the opposite party submits that driving a motor vehicle in public places without holding valid driving license will amount to breach of law, hence, rejected the claim rightly. Further the opposite party submits that the police records clearly shows that there is rash and negligent driving on the part of the deceased himself. It clearly indicates that the deceased do not know the driving properly, which resulted in his death hence, it will not come under the definition of accident. Even other wise also, as stated above driving the vehicle without holding valid driving license is a breach of law under the policy condition No.11 (b) (iv), the opposite party rightly rejected the double accident benefit claim. Hence, the complaint is liable to be dismissed.
6. The 1st opposite party filed a memo adopting the counter filed by the 2nd opposite party.
7. Basing on the above pleadings, the following points that arise for consideration are:-
i) Whether there is any deficiency of service on the part of the opposite parties 1 & 2?
ii) To what relief?
8. In order to prove the case of the complainant, the complainant has filed his evidence on affidavit and marked Exs.A1 to A9 documents. On behalf of the 2ndopposite party, the 2nd opposite party filed evidence on affidavit and marked Ex.B1 to B3 documents on behalf of the 2nd opposite party.
9. Heard both sides
10. POINT NO 1:- It is an admitted fact that the deceased T.Hari Krishna during his life time obtained a double accident benefit Jeevan Sarala policy bearing No.655511006 dt.10.03.2010 from the 1st opposite party. After the death of T.Hari Krishna the complainant submitted claim forms to the 1st opposite party and the 2nd opposite party honoured the claim and paid a sum of Rs.97,574/- by way of a cheque bearing No.014435 dt.26.10.2010 drawn on HDFC Bank, Tadipatri. But the opposite parties 1 & 2 failed to pay the double accident benefit to the complainant on the ground that the complainant has not submitted the driving license of her deceased son T.Hari Krishna.
11. From the arguments it is clear that there is no dispute with regard to the death of the insured but the dispute is only with regard to the payment in addition to sum assured as the deceased died in the said accident only due to his rash and negligence and the deceased was not having a driving license at the time of the accident.
12. The counsel for the complainant argued that at the time of taking the policy by the deceased there was no specific mention of possessing a driving license is a must in order to receive a double accident benefit in case of accidental death. Hence, the opposite parties cannot insist for a driving license at the time of settling the claim. But where as the counsel for the opposite parties argued that the said policy condition 11 (b)(iv) clearly establishes that the corporation will not be liable to pay the accident benefit claim for the death of life assured occurred as a result from the life assured committed any breach of law. Further argued that the driving of the vehicle in public places without holding a valid driving license will amount to breach of law. Hence, the corporation has rightly rejected the double accident benefit of the complainant.
13. After hearing the arguments and perusing the documents and citations submitted by the counsel for the complainant we are of the view that the exclusion clause accidental death due to “life assured committing any breach of law” is not specific, rather it is quite vague not each and every violation however slightest it may be, can be labeled as committing breach of law, terms of policy if vague should be interpreted for the benefit of life assured and the insurance company is liable to pay the accident benefit.
14. The counsel for the opposite parties filed Ex.B3 document issued by Deputy Transport Commissioner, Anantapur in which it is mentioned that T.Hari Krishna S/oVannurappa i.e., deceased was not issued any driving license as per their records. But this document cannot be taken into consideration as a person can have a driving license from any place in India and this document pertains only to Anantapur and there is a chance of taking a driving license from other than Anantapur which cannot be denied.
15. The citation submitted by the complainant and the present case have the same facts and hence the ruling given by NCDRC II (2008) CPJ 61 (NC) is taken into consideration and as per the orders of NCDRC and as the terms of the policy are vague the benefit is given to the life assured and the opposite parties are liable to pay the double accident benefit to the complainant.
16. In the result, the complaint is allowed by directing the opposite parties 1 & 2 to pay to the complainant a sum of Rs.1,00,000/- with interest @ 9% p.a. from the date of claim till the date of realization and further directed to pay a sum of Rs.2,000/- towards costs of the complaint within one month from the date of this order.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 03rd day of October, 2012.
Sd/- Sd/- Sd/-
MALE MEMBER LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR ANANTAPUR
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT
NIL
ON BEHALF OF THE OPPOISITE PARTIES 1&2
-NIL-
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
Ex.A1 Photo copy of compliant 04.06.2010 given father of the deceased T.Hari Krishn
Sub-inspector of police, Peddavadugur.
Ex.A2 Photo copy of F.I.R. in crime No.30/2010 of Peddavadugur P.S.
Ex.A3 Photo copy of inquest report relating to deceased T.Hari Krishna.
Ex.A4 Photo copy of report of postmortem examination relating to deceased T.Hari
Krishna issued by Medical College, Kurnool.
Ex.A5 Photo copy rough sketch in crime No.30/2010 of Peddavadugur P.S.
Ex.A6 Attested copy of proceedings of the Sub-divisional Police Officer, Tadipatri dt.07.09.2010 sent to the S.I. of Police Peddavadugur.
Ex.A7 Office copy of the legal notice dt.06.12.2010 got issued by the complainant to
the opposite parties 1 & 2.
Ex.A8 Reply notice dt.15.12.2010 issued by the 2nd opposite party to the counsel for
the complainant.
Ex.A9 Postal receipt.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTIES 1 & 2
Ex.B1 Original policy bearing No.655511006 issued by the 1st opposite part in favour
of the deceased T.Hari Krishna.
Ex.B2 Original Discharge voucher submitted by the complainant to the 1st opposite
party.
Ex.B3 Photo copy of letter dt.23.07.2012 issued by the Deputy Transport
Commissioner to 2nd opposite party.
Sd/- Sd/- Sd/-
MALE MEMBER LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR ANANTAPUR
