Date of Filing: 27.07.2012
Date of Disposal: 14.05.2013
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR.
PRESENT: - Sri S.Niranjan Babu, B.A., B.L., President (FAC)
Sri M.Sreelatha, B.A.,B.L., Lady Member
Tuesday, the 14th day of May, 2013
C.C.No.44/2012
Between:
B.Muthyala Reddy,
S/o B.Muthyala Reddy,
Ramarajupalli Village and Post,
Pamidi (M),
Anantapur District. … Complainant
Vs.
1. The Branch Manager,
Life Insurance Corporation of India,
Branch Office,
Tadipatri,
Anantapur District.
2. The Divisional Manager,
Life Insurance Corporation of India,
College Road, Divisional Office,
Kadapa. … Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri B.Satyanarayana Reddy, Advocate for the complainant and Sri Bhaskara Ravi Prasad, 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, President (FAC): - This complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986 against the opposite party claiming a total sum of Rs.60,400/-.
2. The brief facts of the complaint are that: - The son of the complainant by name B. Lal Reddy has taken a new Janarakshaw Plan policy with accidental benefits from the opposite party under policy bearing No.653628985 dt.23.03.2005 the sum assure under the policy is Rs.30,000/- and the premium was payable half early. The complainant is nominated as nominee to the policyholder B.Lal Reddy. Subsequently the policyholder met with an accident on 31.08.2006 when the Van bearing No.AP-31-5969 in which he was traveling was hit by a lorry bearing No.KA-34-5332. The accident took place near railway gate at Muddanor- Kondapuram at about 12.30 P.M. In the said accident the policyholder was seriously injured and admitted in Government General Hospital, Kurnool, later the policyholder died on 10.09.2006. The complainant claimed the policy amount by furnishing the necessary documents to the opposite parties, the 1st opposite party paid a sum of Rs.32,700/- only instead of sum of assured for accident death of the policyholder i.e., twice the sum assured with vested bonus and other benefits then the complainant got issued legal notice to the opposite parties on 12.12.2011 claiming accidental benefits as assured under the policy. A reply notice was sent by the 1st opposite party on 14.12.2011 informing that the file was sent to Divisional Office for consideration. Subsequently the 1st opposite party through a letter dt.22.02.2012 informed the complainant that the policy was in a lapsed condition as on the date of accident and so his claim was repudiated. The said policy was revived on 01.09.2006 by paying the arrears of premium and as it was not in a lapsed condition as on the date of death and as the policy was revived retrospectively it is the duty of the opposite party to pay the sum assured under the policy and also to pay the accident benefits covered under the policy. But whereas the opposite parties violated the terms and conditions of the policy and repudiated the claim of the complainant. Hence, there is deficiency of service on the part of the opposite parties and liable to pay the accident benefit along with vested bonus and other benefits including a sum of Rs.10,000/- towards compensation and Rs.15,000/- towards mental agony and costs.
3. Counter filed on behalf of the 2nd opposite party stating that it is true that the complainant’s son by name B.Lal Reddy has taken a New Janarakshaw policy with benefits of accidental benefits from the 1st opposite party under policy bearing No. 653628985 dt.23.03.2005 for a assured sum of Rs.30,000/-. The 2nd opposite party submits that it is true that the complainant is the nominee for the said policy and the accidental death of the policyholder is also not denied by the 2nd opposite party. The 2nd opposite party submits that the allegation of the complainant that the complainant claimed the policy amount by furnishing relevant documents to the 1st opposite party and the 1st opposite party paid a sum of Rs.32,700/- is true. The 2nd opposite party submits that it is incorrect to say that the complainant is entitled for a sum assured for accidental benefit of the policyholder i.e., twice the sum assured with vested bonus and other benefits. The 2nd opposite party further submits that the policyholder opted to pay half yearly premium and in fact the policy was in a lapsed condition as on the date of accident i.e., on 31.08.2006. Since the half yearly premium fell due as on March,2006 as the premium was not paid. Subsequently the premium was paid on 01.09.2006 and also the policy was got in to force after the accident. As the policy was in force as on the date of the death of the policyholder the sum assured under the policy was paid along with bonus and other benefits. But the accident benefit was not paid as the policy was in a lapsed condition as on the date of accident. Hence the claim of the complainant for the accidental benefit was rightly rejected and there is no deficiency of service on the part of the opposite parties.
4. Further the allegation in the complaint that the complainant got issued legal notice to the 1st opposite party claiming accidental benefit and the 1st opposite party gave reply to the complainant after verifying all the records the accidental benefits claimed by the complainant was rejected as he is not eligible for accidental benefits. Further the 2nd opposite party submits that the repudiation of the claim of the complainant, the complainant suffered mentally is not true and the sum of Rs.63,400/- under various heads which is claimed by the complainant is not correct and there is no deficiency of service on the part of the opposite parties.
5. The 1st opposite party filed memo adopting the counter filed by the 2nd opposite party in all material particulars.
6. 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 party?
ii) To what relief?
7. In order to prove the case of the complainant, the complainant has filed his evidence on affidavit and marked Exs.A1 to A9 documents. The 2nd opposite party filed his evidence on affidavit and marked Ex. B1 to B4 documents on behalf of the 2nd opposite party.
8. Heard both sides
9. POINT: - It is an admitted fact that the son of the complainant has taken New Janarakshaw policy from the 1st opposite party on 23.03.2005 for a sum assured of Rs.30,000/-. Subsequently the policyholder met with an accident on 31.08.2006 and was admitted in Government General Hospital, Kurnool. The counsel for the complainant argued that on 01.09.2006 the complainant paid the arrears under the policy along with premium and thereby renewed the policy which was in a lapsed condition. Later the son of the complainant died on 10.09.2006. After the death of the policyholder the complainant made a claim as he is the nominee. The 1st opposite party paid a sum of Rs.32,700/- i.e., Rs.30,000/- towards the sum assured and 2700/- is the vested bonus and other benefits, but did not pay the accidental benefit to the complainant.
10. The counsel for the complainant argued that as the policy was revived by the complainant a part of the claim was also paid by the 1st opposite party and a part (accidental benefit) was rejected by the 1st opposite party and thereby caused deficiency of service by not settling the full claim of the complainant. Further the counsel for the complainant argued that as the policy was revived it is the duty of the opposite party to pay all the benefits under the policy as the policy is revived retrospectively.
11. The counsel for the 2nd opposite party argued that as on the date of accident i.e., 31.08.2006 the said policy was in a lapsed condition on the next day i.e., on 01.09.2006 the policy was revived by paying the arrears. Further the counsel for the opposite party argued it is true that the policy was in force as on the date of death hence, the sum assured under the policy was paid with vested bonus and other benefits, but the accidental benefit was rejected on the ground that as on the date of accident the policy was not in force and it was revived on the next day of the accident. The counsel for the 2nd opposite party argued that the 2nd opposite party has rightly rejected the accidental benefit of the complainant and there is no deficiency of service on the part of the opposite parties.
12. After hearing the arguments and perusing the documents there is no dispute with regard to the taking of the policy or with regard to the death of the policyholder and there is no dispute with regard to the nominee of the policy. Only dispute is with regard to the accidental death benefit. The arguments of the complainant cannot considered as admittedly the policy was in a lapsed condition as on the date of accident i.e., on 31.08.2006 and on 01.09.2006 the policyholder revived the policy by paying the arrears. The argument made by the counsel for the complainant cannot be considered as the policy was not in force as on the date of the accident, but revived on the next day i.e., on 01.09.2006 and was in force as on the date of the death of the policyholder. Hence, the opposite parties have paid a sum assured under the policy along with vested bonus and other benefits to the complainant and has rightly rejected the accidental benefit of the complainant. Considering the point that the policy was not in force as on the date of accident which cannot be denied by the complainant and subsequently the policy was revived on 01.09.2006 i.e., after the accident but before the death of the policyholder. In view of the above observations we have no hesitation to believe the version that there is suppression of fact by the complainant. In the above circumstances the opposite party has rightly rejected the accidental benefit of the complainant and there is no deficiency of service on the part of the opposite parties.
13. In the result the complaint is dismissed without costs.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 14th day of May, 2013.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT:
NIL
ON BEHALF OF THE OPPOISITE PARTY
-NIL-
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
Ex.A1 letter dt.28.01.2007 sent by the 1st opposite party to the complainant.
Ex.A2 Attested copy of F.I.R. in crime No 101/2006.
Ex.A3 Attested copy of death certificate issued by the Kurnool Municipal Corporation
relating to the deceased B.Lal Reddy.
Ex.A4 Letter dt.22.02.2012 sent by 1st opposite party to the counsel for the
complainant.
Ex.A5 office copy of the legal notice got issued by the complainant to the 1st opposite
party.
Ex.A6 Postal acknowledgement signed by 1st opposite party.
Ex.A7 Premium payment statement.
Ex.A8 Letter dt.14.12.2011 sent by the 1st opposite party to the counsel for the
complainant.
Ex.A9. Photo copy policy bearing No.653628985 issued by the 1st opposite party in
favour of the decease B.Lal Reddy.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTIES
Ex.B1 Original policy bearing No.653628985 issued by the 1st opposite party in favour of the deceased B.Lal Reddy.
Ex.B2 Original discharge voucher for Rs.31,832/- .
Ex.B3 Status report of policy bearing No.653628985.
Ex.B4 Attested copy of Double Accident Benefit claims and Disability benefit claims, chapater-5.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR
