This C.C. is coming on before us for final hearing in the presence of Sri.K.Jagan Mohan Rao, Advocate for complainant and of Sri.B.Gangadhar, Advocate for opposite party; upon perusing the material papers on record; upon hearing the arguments and having stood over for consideration, this forum passed the following:
O R D E R
(Per Sri R. Kiran Kumar, Member)
This complaint is filed u/s.12-A of Consumer Protection Act, 1986. The averments made in the complaint are that the complainant is the wife of R.Ravindra Reddy, who practiced as an Advocate at Khammam Bar Association, his enrolment No.AP/1075/99. The husband of the complainant had obtained Long Term Group Janata Personal Accident Policy, the opposite party company issued policy bearing No.4750211, dt.7-5-1999 vide certificate No.1108 for a period of 15 years i.e. from 3-5-1999 to 2-5-2023 for Rs.5,00,000/-. On 31-7-2006 at about 4-00 p.m. at the house of Gattu Srinu, Garla Bayyaram, the CPI(ML) New Democracy dalam members murdered the husband of the complainant. As on the date of murder the husband of the complainant, the policy was in force. The complainant is entitled for the sum assured, as such after the death of her husband, the complainant approached the opposite party company and submitted necessary documents on 7-2-2007, but the opposite party company did not respond. As the opposite party company has not settled the claim, the complainant approached the Forum for the deficiency of service.
To support the claim of the complainant, the following documents were filed and marked as Exs.A.1 to A.7.
Ex.A.1 - Attested True Copy of F.I.R., dt.31-7-2006
Ex.A.2 - Photocopy of P.M.E. report, dt.1-8-2006
Ex.A.3 - Photocopy of Death Certificate, dt.2-8-2006
Ex.A.4 - Letter addressed by the complainant requesting the opposite
party to settle the claim along with claim form, dt.7-2-2007.
Ex.A.5 - Photocopy of letter addressed by the opposite party
requesting the complainant to furnish documents,
dt.29-1-2007.
Ex.A.6 - Photocopy of Form No.JNP-4
Ex.A.7 - Photocopy of Long Term Group Janata Personal Accident
Policy Certificate of Insurance, dt.7-5-1999.
On receipt of the notice, opposite party company appeared through their counsel and filed counter. In their counter the opposite party admitted the husband of the complainant by name R.Ravinder Reddy is the member of Janata Personal Accident Policy Certificate of Insurance and further submitted that as per condition No.5 of the said policy that the company may at any time by notice in writing terminate the policy/ certificate provided that the company shall in that case return to the insured then last paid premium in respect of such persons in respect of whom no claim has arisen, the company authorities have taken decision to terminate all long terminate Janatha Personal Accident Policies. On 24-7-2002 the opposite party company sent a letter under certificate of posting to the deceased by mentioning and requested to surrender the original policy / certificate and also submitted that after receipt of said letter, the deceased surrendered the original policy before the opposite party company by accepting the termination of policy. After the death of the deceased, the complainant filed application for getting the amount under the above said policy. On 7-2-2007 the opposite party company clearly explained the facts, having satisfied with the explanation the complainant went away and after lapse of three years, the complainant filed this false claim by suppressing the real facts. In the above circumstances, the opposite party company has no liability to pay claim, as such prayed to dismiss the complaint.
On behalf of the opposite party, the following documents were filed and marked as Exs.B.1 to B.3.
Ex.B.1 - Form No.AN-12 issued by the opposite party company.
Ex.B.2 - Provisos and conditions of Long Term Janatha Personal
Accident Insurance Policy of opposite party.
Ex.B.3 - Certificate of Posting, dt.24-7-2002
The complainant as well as opposite party filed their written arguments. Upon perusing the material papers on record, now the points that arose for consideration are,
1. Whether the complainant is entitled for the claim?
2. To what relief?
Point No.1:
In this case the husband of the complainant who was practiced as an Advocate in Khammam Bar Association had obtained Long Term Group Janata Personal Accident Policy from the opposite party vide policy bearing No. 6124004750211, dt.7-5-1999. On 31-7-2006 the CPI (ML) New Democracy Dalam Members murdered the husband of the complainant. After the death of her husband, the complainant submitted claim form along with required documents on 7-2-2007 to the opposite party company. As the opposite party company failed to settle the claim, the complainant approached the Forum for redressal. The opposite party company in their counter submitted that as per condition No.5 of the policy, the company may at any time by notice in writing terminate the policy/ certificate and also submitted that the company authorities had taken decision to terminate all Long Term Janata Personal Accident Policies, on 24-7-2002 they sent a letter under certificate of posting to the complainant, on that the complainant submitted the original policy by accepting the termination of policy. As such they prayed to dismiss the complaint.
From the documents and material available on record, we observed that the complainant submitted original policy/ certificate to the opposite party company only after her husband’s death, but not by the husband of the complainant as claimed by the opposite party company. To support their case, the opposite party company simply filed Ex.B.3, Certificate of post Letter, but on that letter, nowhere the postal department endorsement or seal seen. The version of opposite party company is true and as per the condition No.5, if at all the husband of the complainant handed over the original policy, the opposite party company shall in that case return to the insured then last paid premium in respect of such persons in respect of whom no claim has arisen, less pro-rate part there of for the portion of the current insurance period which shall have expired. For that the opposite party company has failed to produce any document to show for the return of premium amount in respect of whom the claim has arisen, as per Ex.A.4 and from the written arguments, the complainant submitted original policy along with claim form. The opposite party company in order to escape from their liability created Ex.B.3 and filed along with their counter. As such the question of surrender the policy by the husband of the complainant by accepting the cancellation, before the opposite party company, does not arise.
In these circumstances, the complainant is entitled for the claim amount. Hence, this point is answered accordingly in favour of the complainant.
Point No.2:
In the result, the complaint is allowed, directing the opposite party company to pay the claim amount of Rs.5,00,000/- (Rupees five lakhs only) with interest at 9% P.A. from the date of claim (i.e. from7-2-2007) till the date of payment and also directed to pay an amount of Rs.5,000/- (Rupees five thousand only) towards costs of the litigation.
Dictated to steno, transcribed by her, corrected and pronounced by us in the open forum, on this 10th day of March, 2011.
PRESIDENT MEMBER
DISTRIC CONSUEMRS FORUM,
KHAMMAM
APPENDIX OF EVIDENCE
Witnesses examined for complainant:- None
Witnesses examined for opposite parties:- None
Exhibits marked for Complainant:
Ex.A.1 - Attested True Copy of F.I.R., dt.31-7-2006
Ex.A.2 - Photocopy of P.M.E. report, dt.1-8-2006
Ex.A.3 - Photocopy of Death Certificate, dt.2-8-2006
Ex.A.4 - Letter addressed by the complainant requesting the opposite
party to settle the claim along with claim form, dt.7-2-2007.
Ex.A.5 - Photocopy of letter addressed by the opposite party
requesting the complainant to furnish documents,
dt.29-1-2007.
Ex.A.6 - Photocopy of Form No.JNP-4
Ex.A.7 - Photocopy of Long Term Group Janata Personal Accident
Policy Certificate of Insurance, dt.7-5-1999.
Exhibits marked for opposite parties:-
Ex.B.1 - Form No.AN-12 issued by the opposite party company.
Ex.B.2 - Provisos and conditions of Long Term Janatha Personal
Accident Insurance Policy of opposite party.
Ex.B.3 - Certificate of Posting, dt.24-7-2002
PRESIDENT MEMBER
DISTRIC CONSUEMRS FORUM,
KHAMMAM
