BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri. T.Sundara Ramaiah , B.Com B.L., President
And
Sri. M.Krishna Reddy , M.Sc., M.Phil., Male Member
Wednesday the 08th day of September, 2010
C.C.No 159/09
Between:
P.Someswaramma alias Someswari, W/o. Late P.Raghunatha Reddy,
R/o. Dibbaguntla (V) and ( P), Gospadu Mandal, Kurnool District.
…..Complainant
-Vs-
1. The Branch Manager,Life Insurance Corporation of India,
D.No.40/2, R.S.Road, Nandyal Branch, Nandyal-518 501,Kurnool District.
2. The Divisional Manager, Life Insurance Corporation of India,
Post Box No10, D.No.1-55, Jeevan Prakash Building,College Road, Kadapa-516 002.
……Opposite PartieS
This complaint is coming on this day for orders in the presence of Sri. A.Rama Subba Reddy, Advocate, for complainant, and Sri. A.V.Subramanyam, Advocate for opposite parties and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No.159/09
1. This complaint is filed under section 12 of C. P. Act, 1986 praying to direct the OPs
(a) to pay assured sum of Rs.10,00,000/- with bonus and
compensation of Rs.30,000/-
(b) to grant interest @24% p.a from 11-01-2008 till the date of realization ,
( c) to grant costs of the complaint ,
(d) to grant such other reliefs as the Hon’ble Forum may deem fit and proper in the circumstances of the case.
- The case of the complainant in brief is as follows:- The complainant is the wife of Late. P.Raghunath Reddy, who insured his life with Ops 1 and 2 under two polices bearing No.653601444 & 652662230 for Rs.5 lakhs each with accidental benefits. On 24-09-2007 the insured suffered from severe stomach pain and in a confusion he consumed pesticide accident under mistaken impression that it is a medicine . The death intimation was given to OP.No.1 within one month. Both the Ops failed to pay the accidental under two policies to the complainant. The rejection of the accidental benefits to the complainant is illegal amounting to deficiency of service on the part of the Ops. Hence the complaint.
3. OP.No.2 filed written version and the same is adopted by OP.No.1. It is stated in the written version of OP.No.2 that the complaint is not maintainable. It is admitted that the complainants husband Raghunatha Reddy insured his life with OP.No.1 under two policies. Admittedly the policies were inforce on the date of death of Raghunatha Reddy . On 24-09-2007 the insured consumed pesticide intentionally to commit suicide and died Government Hospital, Nandyal. The investigation got done by Ops revealed that the assured committed suicide and death is not an accidental one. Accordingly the Ops settled the claim of the complainant and the complainant received the settlement amount of Rs.22,80,137/- under two policies by way of cheque on 12-01-2008. The complainant executed a discharge voucher. The deceased was an educated person and the question of taking pesticide by him accidentally thinking that it is medicine is not believable. The Ops are not liable to pay the accidental benefits to the complainant as the insured committed suicide and that it was not accidental death. The complaint is liable to be dismissed.
4. On behalf of the complainant Ex. A1 to A7 are marked and the sworn affidavit of the complainant is filed. On behalf of the OPs Ex.B1 to B6 are marked and sworn affidavit of OP.No.2 is filed.
5. Both parties filed written arguments.
6. The points that arise for consideration are
(i) whether there is deficiency of service on the part of OPs?
(ii) whether the complainant is entitled to any relief ?
- To what relief?
7. Points No.1 & 2 :- Admittedly the complainant is the widow. The deceased P. Raghunatha Reddy insured his life with Ops under Ex.B3 and B4 policies dated 20-01-2001 and 28-06-2004 respectively. Admittedly Raghunatha Reddy died on 24-09-2007 while the policies were inforce. It is the case of the complainant that her husband died accidentally by consuming pesticide instead of medicine and that she is entitled to all the benefits under Ex.B3 and B4 policies. It is the contention of the Ops that Raghunatha Reddy committed suicide by consuming pesticide and that the complainant is not entitled to accidental benefits. The Ops did not place any evidence on record to show that the Raghunatha Reddy committed suicide on 24-09-2007. The complainant in support of her contention that her husband died by consuming pesticide instead of medicine relied on Ex.A5 copy of FIR. As seen from Ex.A5 it is very clear that II town police, Nandyal registered a case in Cr.No. 158/07 U/S 174 CRPC basing on the report given by P. Venkata Subba Reddy father of the deceased. In the said FIR it is clearly mentioned that the deceased accidentally consumed poison and died. It is mentioned in Ex.A5 copy of the FIR that on 24-09-2007 at 4-30 AM the deceased being unable to bear stomach pain accidentally consumed pesticide instead of medicine and that he died while undergoing treatment in Government Hospital, Nandyal . The Ops filed Ex.B6 copy of the Post mortem certificate. The cause of the death is not noted in Ex.B6. The complainant in her sworn affidavit clearly stated that her husband died accidentally by consuming poison instead of medicine. Her version is supported by contents of FIR in Ex.A5.
8. It is also the contention of the Ops that the complainant in full satisfaction of her claim received Rs.22,80,,137/- under the two policies by way of cheque on 12-01-2008 and signed discharge voucher Ex.B1 and B2 .Receipt of the amount of Rs.22,80,137/- by the complainant is not under dispute. Merely because the complainant executed discharge receipts it can not be said that she is not entitled to other benefits due under the policies. In a decision reported in 1999 (3) C.P.R. Page 53, it is held that mere execution of discharge voucher would not always deprive the consumer from preferring claim with respect to deficiency of service or claiming consequential benefits. It is submitted by the learned counsel appearing for the complainant that the complainant was not paid the accidental benefits under the two policies. The learned counsel for the Ops cited a decision reported in I (2008) CPJ 253 (NC) .The said decision is not applicable to the facts of the present case for the simple reason that the assured in the said case died by committing suicide. In the present case there is evidence on record to show that the deceased Raghunatha Reddy died accidentally by consuming poison instead of medicine. Therefore the complainant is entitled to all the benefits due under the policies. Admittedly the Ops did not pay the entire amount due under the policies to the complainant. They paid only Rs.22,80,137/-. The complainant is entitled to accidental benefits under two policies also.
9.Point No:-3 In the result the complaint is partly allowed directing the Ops jointly and severally to pay all the benefits including the accidental benefits to the complainant after deducting the amount of Rs.22,80,137/- which is already paid with interest at 9% from the date of the complaint i.,e 22-09-2009 till the date of payment. In the circumstances of the case no costs.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 08th day of September, 2010.
Sd/- Sd/-
MALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nil For the opposite parties : Nil
List of exhibits marked for the complainant:-
Ex.A1. Photo copy of policy NO.653601444, dt.28-06-2004.
Ex.A2. Photo copy of letter dt.11-01-2008 of OP.No.2 to complainant.
Ex.A3. Photo copy of status report of policy No.652662230.
Ex.A4. Photo copy of letter dt.11-01-2008 of OP2 to the complainant.
Ex.A5. Photo copy of FIR in Cr.No.158/2007 of Nandyal
II Town P.S, dt.25-09-2007.
Ex.A6. Photo copy of Death Certificate.
Ex.A7. Photo copy of letter dt. 01-01-2008 of OP.No 2 to complainant.
List of exhibits marked for the opposite parties:
Ex.B1. Discharge vouchers executed by complainant in full and final settlement.
Ex.B2. Discharge vouchers executed by complainant in full and final settlement
Ex.B3. Policy NO.652662230, dt.20-01-2001.
Ex.B4. Policy NO.653601444, dt.28-06-2004.
Ex.B5. True copy of FIR in Cr.No.158/2007 of Nandyal
II Town P.S, dt.25-09-2007.
Ex.B6. True copy of Postmortem certificate.
Sd/- Sd/-
MALE MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the
A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties
Copy was made ready on :
Copy was dispatched on :
