Andhra Pradesh

Anantapur

CC/12/54

Yaparla Rangamma W/o Late Y.Venkata Reddy - Complainant(s)

Versus

The Branch Manager,Shiram Direct to Home Pvt.Ltd. - Opp.Party(s)

D.Shyam Prasad,N.P.Srinivasulu

30 Sep 2014

ORDER

District Counsumer Forum
District Court Complax
Anantapur
 
Complaint Case No. CC/12/54
 
1. Yaparla Rangamma W/o Late Y.Venkata Reddy
Bandarkapalli Village, Kolimigundla Mandal , Kurnool District
KURNOOL
ANDHRA PRADESH
2. Yaparla Sailaja W/o late Y.Venkata Gopal Reddy
Bandarkapalli Village, Kolimigundla Mandal , Kurnool District
KURNOOL
ANDHRA PRADESH
3. Yaparla Teja D/o Late Venkata Gopal reddy
Bandarkapalli Village, Kolimigundla Mandal , Kurnool District
KURNOOL
ANDHRA PRADESH
...........Complainant(s)
Versus
1. The Branch Manager,Shiram Direct to Home Pvt.Ltd.
C/o Shriram Chits, D.No./, Surya Towers, C.B.Road, Tadipatri
Anantapur
ANDHRA PRADESH
2. The Claims Incharge
SKI Retail Capital Ltd.,First Floor No.1,Sambandham Street,G.N.Chetty Road,T.Nagar,Chennai
Chennai
KARNATAKA
3. Road Safety Club Pvt. Ltd.,
First Floor No.1, Sambandham Street, G.N.Chetty Road, T.Nagar, Chennai
Chennai
KARNATAKA
4. The Claims Incharge
SKI Retail Capital Ltd., First Floor No.1, Sambandham Street, G.N.Chetty Road, T.Nagar, Chennai
Chennai
TAMILNADU
5. Road Safety Club Pvt. Ltd.,
First Floor No.1, Sambandham Street, G.N.Chetty Road, T.Nagar, Chennai
Chennai
TAMILNADU
6. M.s Bajaj Allianz General Insurence C.Ltd.,
GESCO PLaza,Airport Road,Yerrawada,Pune
Pune
MAHARASTRA
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. Sri S.Niranjan Babu PRESIDING MEMBER
 HONORABLE S.Sri Latha Member
 
For the Complainant:D.Shyam Prasad,N.P.Srinivasulu, Advocate
For the Opp. Party: N R K Mohan op1, Advocate
 K Chandra Sekhar Rao op2&3, Advocate
 T Rama Krishna op4, Advocate
ORDER

Date of filing: 27-09-2012

Date of Disposal:30-09-2014

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM: ANANTHAPURAMU

 

PRESENT:- Sri S.Niranjan Babu, B.A.,B.L., President (FAC).

           Smt.M.Sreelatha, B.A., B.L., Lady Member

 

Tuesday, the 30th day of September, 2014

 

C.C.NO.54/2012

 

Between:

 

  1. Yaparla Rangamma

W/o Late Y.Venkata Reddy

 

  1.  Yaparla Sailaja

 W/o late Y.Venkatagopal Reddy

 

  1.   Yaparla Teja

  D/o Late Y.Venkatagopal Reddy

  aged 6 years, minor rep. by natural

  guardian/mother Y.Sailaja

 

  All are residing at Bandarlapalli Village,

  Kolimigundla Mandal, Kurnool District.                        … Complainants

 

         

Vs.

 

  1.  The Branch Manager,

 Shriram Direct to Home Pvt. Ltd.,

 C/o Shriram Chits, D.No.15/1836,

 Surya Towers, Upstairs, C.B. Road,

 Tadipatri – 515 411,

 Ananthapurmau District.

 

  1.  The Claims Incharge,

 SKI Retail Capital Ltd.,

 First Floor, No.1 Sambandham Street,

 G.N.Chetty Road, T.Nagar,

  •  

 

  1.  Road Safety Club Pvt. Ltd.,

 First floor, No.1 Sambandham Street,

 G.N.Chetty Road, T.Nagar,

  •  

 

  1.  M/s Bajaj Allianz General Insurance Co. Ltd.,

 GESCO Plaza, Airport Road, Yerrawada,

 Pune – 411 006.                                                                    ….  Opposite Parties

           

 

 

            This case coming on this day for final hearing before us in the presence of                           Sri D.Shyam Prasad, Advocate for the complainant and Sri N.R.K.Mohan, Advocate for                    1st opposite party, Sri K.Chandrasekhar Rao, Advocate for the opposite parties 2 & 3 and Sri T.Ramakrishna, Advocate for the 4th opposite party and after perusing the material papers on record and after hearing the arguments on 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 parties 1 to 4 claiming a sum of Rs.3,00,000/- towards the sum assured under policy as per Membership Certificate and interest @ 24% p.a. on Rs.3,00,000/- from 07-06-2011 till the date of realization, Rs.25,000/- towards deficiency of service and mental agony and Rs.5,000/- towards costs of the complaint.

 

2.     The brief facts of the complaint are that :-  The 1st complainant is the mother of Yaparla Venkatagopal Reddy S/o Late Y.Venkata Reddy and the complainants 2 & 3 are wife and daughter of Yaparla Venkatagopal Reddy.  The deceased Y.Venkatagopal Reddy during his life time had taken Membership from the 3rd opposite party through 1st opposite party at Tadipatri. The Membership Certificate was issued by the 3rd opposite party for a period of 96 months starting from 09-09-2003 and the sum promised is Rs.3,00,000/- in case of accidental death of the Membership-holder.  The 3rd opposite party had issued AMS Classic Card bearing No.000002022349, which is valid up-to September, 2011. The 3rd opposite party in turn insured the life of the certificate holder with Insurance Company and the insurer is being changed from year to year by the 3rd opposite party.

3.         The Certificate-holder Y.Venkatagopal Reddy died in a road accident on                         07-06-2011.  By the date of taking the policy the deceased Y.Venkatagopal Reddy was unmarried and his mother was made as nominee. After the death of Y.Venkatagopal Reddy the 1st complainant approached the 1st opposite party and submitted claim forms.  The 1st opposite party sent the claim forms to third opposite party and in turn the                               3rd opposite party sent a letter on 25-07-2011 requesting the 1st complainant to submit some more documents along-with claim forms.  Then the 1st complainant submitted all the documents pertaining to the death of Y.Venkatagopal Reddy i.e. Doctor’s report, attested copy of FIR, attested copy of Postmortem Certificate and attested photo I.D. of the deceased and beneficiary along-with completed claim form and sent the same on                   22-08-2011 to the 1st opposite party.   Subsequently, the 1st opposite party informed that they are mediating with the opposite parties 2 & 4 to settle the claim.  But unfortunately neither the claim was settled nor repudiated by the opposite parties.  Then the                                    1st complainant issued a notice to the opposite parties 2 & 3 on 17-12-2011.  Though the said notice was served on the opposite parties 2 & 3, there was no reply.  Late Y.Venkatagopal Reddy paid the amount to the 3rd opposite party through the 1st opposite party, but all the opposite parties are shifting burden on one another and have not taken any action to settle the claim of the complainants.  The 1st complainant vexed with the attitude of the opposite parties got issued a legal notice to the opposite parties 1 to 4 on 16-08-2012, which was served on them. Inspite of receipt of the said notice, the opposite parties have neither settled the claim nor repudiated the claim. Further on enquiry the complainants came to know that every year the 3rd opposite party is changing the insurance company. Further the complainants came to know that the 4th opposite party is the present insurer for the 3rd opposite party as per the information given by the                                   1st opposite party.  As per the first insurance policy, the deceased mother was the nominee as per the policy deceased was unmarried at the time of taking membership.  Subsequently he got married, his wife, daughter and son were also included the present complaint claiming Rs.3,00,000/- as per membership certificate and interest @ 24% p.a. from the date of death till the date of realization, Rs.25,000/- towards deficiency of service and mental agony and Rs.5,000/- towards costs of the complaint.

4.         The 1st opposite party filed a counter stating that they never promised to settle the claim within 10 days and in fact the 1st opposite party worked on service motto without any profit.  In addition to that on all the occasions the 1st opposite party behaved diligently by corresponding with the opposite parties and there is no consumer relation between the complainant and the 1st opposite party.

5.         The 1st opposite party submitted that as per the complaint, which clearly reveals the fact that immediately after collecting all the documents from the complainant forwarded the same to the 3rd opposite party without any delay.  So the question of deficiency of service on the part of the 1st opposite party does not arise.  The 1st opposite party will not come under any of the mode as contemplated in the complaint and the complaint is liable to be dismissed for misjoinder of parties as the 1st opposite party is unnecessarily dragged into the case.

6.         Memo filed by the 2nd opposite party adopting the counter of the 3rd opposite party.

7.         The 3rd opposite party field a counter stating that the complainant has suppressed the material facts and figures and filed this unjust complaint for wrongful gain.  The                         3rd opposite party submitted that the Membership Certificate shows that it is valid from 09-09-2003 for a period of 96 months and it is false to say that the 3rd opposite party has promised to pay Rs.3,00,000/- to the nominee of the said certificate-holder.  The allegation made in para 3 of the complaint is denied and it is not to their knowledge that the certificate-holder died on 07-06-2011.  Further the 3rd opposite party submits that the final report clearly shows that it is due to negligent driving of the deceased only the accident has occurred in which the said Y.Venkatagopal Reddy died.

8.    The 3rd opposite party submits that the counter filed by the 4th opposite party in para 5 has not revealed the complete contents of the letter dt.26-02-2011. The 3rd opposite party has stated in the above letter that “ at the time necessary software has been sent to all our locations to cease the issuance of certificates of insurance.  However from your statement, it appears that some of the locations had not executed the necessary program in the system. Probably resulting in erroneously issuing certificates of Insurance even after the termination of the arrangement”, which clearly shows that there could have been certificates issued erroneously and the same was not confirmed by the 3rd opposite party at any point of time.  Further the 3rd opposite party submits that at the time of giving evidence before the Hon’ble Ombudsman the 3rd opposite party clearly stated that the above facts and the same were recorded.

9.         Further the 3rd opposite party submits that the premium amount was paid by the 3rd opposite party which was lying with the 4th opposite party from 2004 onwards there is an outstanding of Rs.11,13,554/-, which belongs to the 3rd opposite party, which is lying with the  4th opposite party accounts.   Further the 3rd opposite party submits that numerous correspondence was made with the 4th opposite party and executives of 4th opposite party at various levels did not even reply and the above contents is not disputed by the 4th opposite party, which clearly shows that the premium amount paid by the 3rd opposite party still lies with the 4th opposite party.  Hence the question of non-payment of premium does not arise.  Therefore before fixing the responsibilities it would be better if the outstanding amount due to the 3rd opposite party is also settled. Hence the claim should be paid by the 4th opposite party only but not by this 3rd opposite party.  Further the 3rd opposite party is coordinating with the insurance companies who provide the policies to their members.  Hence the 3rd opposite party cannot be made liable.  The Insurance Company provided the policy is liable to satisfy the claim of the complainants.

10.     Further the 3rd opposite party submits that the role of 3rd opposite party is only to bring awareness among the public with regard to Road Safety and thereby educate them and make them as members of the club so as to enable them to get insurance cover from the insurance company. Once the insurance company provides the policy cover the role of the 3rd opposite party ends. The service of 3rd opposite party is only confined to the extent of arranging insurance policy by insurance company to its members and in this case Bajaj Allianz General Insurance Company already provided the policy and therefore a contract is formed between the 2nd complainant’s husband and the concerned Insurance Company only.  Further the 3rd opposite party submits that the insured obtained membership in the club of 3rd opposite party to get insurance benefits from the insurance company. As such there is no privity of contract between the complainant and this opposite party for payment of any compensation under the Insurance Policy provided to the insured through Insurance Company.  The contract of insurance benefits is only between insured and the insurer and even as per the terms and conditions mentioned in the membership certificate, the 3rd opposite party is neither liable nor responsible for payment of any compensation or damages directly or indirectly.

11.       Further the 3rd opposite party submits that as per the terms and conditions of Road Safety Club Programme printed on the membership certificate the member specifically acknowledges that the issuer (Road Safety Club) will not be liable in any manner whatsoever by virtue of any insurance cover provided and that the insurance company will be solely liable in case of any claim and the member shall not hold the issuer (Road Safety Club) responsible for any matter arising out of or in connection with such insurance cover, whether for or in respect of any deficiency or defect in such insurance cover recovery or payment of compensation , processing or settlement of claims or otherwise however all such matters shall be addressed to and sorted out directly with the insurance company. Further the 3rd opposite party submits that as there is no deficiency of service on the part of the 3rd opposite party, they are not liable to pay any compensation to the complainants.

12.       Counter filed by the 4th opposite party stating that the complainant is not a consumer as defined under section 2(d) of Consumer Protection Act and the complaint filed by the complainants does not come under the purview of Consumer Dispute envisaged in section 2(e) of the Act.  The 4th opposite party submits that absolutely no transaction between the complainant and this opposite party within the jurisdiction of this Forum.  As such the present complaint is liable to be dismissed.

13.       The 4th opposite party submits that the tie up of 3rd opposite party has ended up with the Road Safety Colum i.e. 3rd opposite party in September, 2008  itself and thereafter the 4th opposite party has not issued any policy to the members of the Road Safety Club.  The policy might have been issued by the Road Safety Club as stated by them in the letter that they have erroneously issued the certificate of insurance even after the termination of the arrangement and SKI shall be taking the liability for the said polices, which were erroneously issued and as the above mentioned certificate is also issued erroneously the Road Safety Club shall be liable for any compensation if any to be paid to the complainants.  Hence the 4th opposite party is not liable to pay any compensation to the complainants and the complaint is liable to be dismissed against the 4th opposite party.

14.       Further the 4th opposite party submits that Road Safety Club has mentioned in its letter dt.26-02-2011 to this opposite party stating that “ as per records the arrangements came to an end since September, 2008 “ and at the time necessary software has been sent to all their locations to cease the issuance of the certificate of insurance. However, from your statement it appears that some of the locations had not executed the necessary programme in their system resulting in erroneously issuing certificate of insurance even after termination of the agreement. Further the 3rd opposite party mentioned in the reply stating that “ we will assure you that in case of any claims under such erroneously issued cases, SKI shall be taking the liability  based on the merits of the case.  This clearly shows that the 4th opposite party has no liability whatsoever and risk of certificates issued by the 3rd opposite party is not liable to pay any amount to the complainants and the complaint is liable to be dismissed against the 4th opposite party.   The 4th opposite party submits that similar case is also filed on the file of Insurance Ombudsman, Hyderabad in complaint No.I.O.(HYD)-G-11.11.346.2010-11 and in the said case the official of the 3rd opposite party attended before that court and submitted to the court that it had no tie up with this opposite party No.4 and no premium is paid by them to cover the risk of their certificates issued by them and it is further represented by the said official of 3rd opposite party stating that the insurance facility which was provided by them is only a complimentary one and they have withdrawn the same and the same is also intimated to all the membership holders, further it is represented that the member also agrees that even during the continuation of his membership the issuer may at any time (at their sole discretion and without giving any notice thereof to the members or assigning any reasons thereof) suspend, withdraw or cancel the benefit of such insurance cover and there will be no binding obligation on the insurer to continue this benefit. And in view of the above fact it is clear that there is no insurance coverage to the said Y.Venkata Gopal Reddy and the complainants are not entitled for any amounts and the complaint is liable to be dismissed on this ground.  The AGM of the Road Safety club also admitted that after the tie up ended they have erroneously issued the policies.  Hence, it is clear that there is no policy issued by this opposite party and as such the claim is liable to be dismissed on this sole ground only.   Further the 4th opposite party denies all the allegations of the complainants that all the efforts made by them proved futile.  Hence, the complaint filed by the complainants for deficiency of service is liable to be dismissed as the 4th opposite party has not caused any deficiency of service to the complainant.

15. Basing on the above pleadings, the points that arise for consideration are:-

    1. Whether there is deficiency of service on the part of the opposite Parties 1 to 4 ?

    2. To what relief?

16.       In order to prove the case of the complainants, the evidence on affidavit of the                       1st complainant has been filed and marked Ex.A1 to A17 documents. On behalf of the                   1st opposite party, no evidence on affidavit of the 1st opposite party has been filed, on behalf of the opposite parties 2 & 3, evidence on affidavit of 2nd opposite party has been field and on behalf of the   4th opposite party, no evidence on affidavit of 4th opposite party has been filed and marked Ex.B1 & B2 documents.

17.       Heard on both sides.

18.   POINT NO.1 -  The counsel for the complainants submitted that during the life time of the deceased Yaparla Venkatagopal Reddy had taken Membership with the                                      3rd opposite party through 1st opposite party by paying a sum of Rs.4,000/- to the 3rd opposite party and Membership Certificate was issued bearing No.2022349.  The counsel for the complainants submitted that lured by the canvass of 1st opposite party, the deceased paid a sum of Rs.4,000/- to the 3rd opposite party  and became member of the 3rd opposite party and the term of membership is for a period of 96 months starting from 09-09-2003 and as per the certificate, the 3rd opposite party promised to pay a sum of Rs.3,00,000/- to the nominee of the certificate-holder in the event of accidental death of the Certificate-holder.  The 3rd opposite party had issued AMS Classic Card bearing No.000002022349, which is valid up-to September, 2011 in the name of Y.Venkatagopal Reddy. The 3rd opposite party in turn insured the life of the certificate-holder with Insurance Company. The counsel for the complainant submitted that the said Y.Venkatagopal Reddy died in a road accident on 07-06-2011 and claim for the payment of insurance amount to the nominee of the policy-holder was made by the 1st complainant.  The counsel submitted that at the time of taking the policy as the deceased Y.Venkatagopal Reddy was not married his mother was made as nominee and even as per the policy issued by TATA AIG General Insurance Company Ltd., The name of the nominee is Yaparla Rangamma, who is the 1st complainant. After the death of certificate holder the 1st complainant approached the 1st opposite party and gave claim forms and in turn the   st opposite party sent the claim forms to 3rd opposite party.  Subsequently a letter was sent by the 3rd opposite party on 25-07-2011 requesting the 1st complainant to submit some more documents along-with claim forms.  Then the 1st complainant submitted all the documents pertaining to the death of Y.Venkatagopal Reddy i.e. Doctor’s report, attested copy of FIR, attested copy of Postmortem Certificate and attested photo I.D. of the deceased and beneficiary along-with claim form and the same were sent on 22-08-2011 to the 1st opposite party.   Subsequently, the   1st opposite party informed the complainants that they are mediating with the opposite parties 2 & 4 to settle the claim.   Hence the opposite parties 2 & 3 were impleaded as parties in the present complaint.

19.    The counsel for the complainants argued that unfortunately a claim was not settled as assured alongwith other benefits to the complainants.  Then the 1st complainant issued notice to the opposite parties 2 & 3 on 17-12-2011, which was received by them, but there was no reply for the said notice.  Policy number mentioned in the claim form was 501996000000002 , reference No.DEA/HO-9074/11 and enrollment No.2022349 and application No.1023046.  The counsel for the complainants contended that though late Y.Venkatagopal Reddy paid the amount to the 3rd opposite party, all the opposite parties are shifting burden on one another by protracting the litigation and evading the settlement of the claim to the complainants.  Further contended that the opposite parties neither settled the claim nor repudiated the claim inspite of request made by the complainants.

20.       Further the counsel for the complainants contended that vexed with the attitude of the opposite parties, the 1st complainant got issued legal notice to the opposite parties                1 to 4 on   16-08-2012.  Though the said notices were received neither the opposite parties settled the claim nor repudiated the claim. The counsel for the complainants contended that the Certificate of Insurance sent by TATA AIG General Insurance Company Ltd., which is marked as Ex.A1 was sent and on enquiry it came to light that every year the 3rd opposite party is changing the insurance company, which is not intimated to the membership-holders.

21.       As per the information given by the 1st opposite party, the 4th opposite party is the present Insurance Company for the 3rd opposite party.  The counsel for the complainants contended that as the opposite parties 1 to 4 have failed to settle the claim of the complainants for which they are legally entitled clearly shows that there is deficiency of service on the part of the opposite parties 1 to 4 and they are liable to pay as per membership card Rs.3,00,000/-  towards the death of membership cardholder and interest @ 24% p.a.  on Rs.3,00,000/- from the date of death till the date of realization and the opposite parties 1 to 4 also liable to pay Rs.25,000/- towards deficiency of service and mental agony and Rs.5,000/- towards costs of the complaint.

22.       The counsel for the 1st opposite party submitted that the 1st opposite party has not promised to settle the claim as contended by the complainants. In fact, the 1st opposite party has worked on service motto and there is no interest of profit in the transactions, hence there is no consumer relationship between the 1st opposite party and the complainants.  Further contended that they have acted diligently and corresponded with the opposite parties in favour of the complainants.  Further the counsel for the 1st opposite party contended that even as per the complaint itself, it is clearly established that immediately after collecting all the documents from the complainants forwarded the same to the 3rd opposite party without any delay.  Hence there is no deficiency of service on the part of 1st opposite party and they are not liable to pay any compensation and they are not at all necessary party as there is no consumer relationship between the complainants and the 1st opposite party.  Hence the complaint against the 1st opposite party is liable to be dismissed.

23.  The counsel for the opposite parties 2 & 3 submitted that all the allegations made in the complaint are created only for the purpose of unjust claim and the allegation that membership certificate contains that the certificate is valid for 96 months i.e. 09-09-2003 and that the 3rd opposite party has promised to pay Rs.3,00,000/- to the nominee of the said certificate-holder is false and all the averments made in the complaint are not correct.  Further the counsel for the opposite parties 2 & 3 submitted that they were not aware of the death of the certificate-holder on 07-06-2011.  Further the counsel contended that the final report which is marked as Ex.A3 clearly shows that the accident occurred only due to rash and negligent driving of the deceased Y.Venkatagopal Reddy.

24.       Further the counsel submitted that in the counter filed by the 4th opposite party the fact that a letter dt.26-02-2011 stating that “ at the time necessary software has been sent to all our locations to cease the issuance if certificates of insurance.  However from your statement, it appears that some of the locations had not executed the necessary program in the system. Probably, resulting in erroneously issuing certificates of Insurance, even after the termination of the arrangement “ , which clearly shows that the certificates were issued erroneously and the same was not confirmed by the 3rd opposite party at any point of time and for these acts the  4th opposite party alone is liable to any claims arising out of the policies issued by them. Further the counsel contended that at the time of giving evidence before the Hon’ble Ombudsman, the 3rd opposite party has clearly stated that the above facts and the same were recorded. Further contended that when the claim is made to the 3rd opposite party, the same will be forwarded to the concerned Insurance Company and as far as this claim is concerned, it was intimated to the 4th opposite party on 06-07-2011 and all the claim papers were forwarded by the 3rd opposite party vide letter dt.25-07-2011 addressed to the 4th opposite party.  Hence, there is no deficiency of service on the part of the 3rd opposite party.  Further the counsel contended that the 4th opposite party has issued Group Personal Accident Master Policy specifically mentioning the name of each member though the 3rd opposite party is reflected as insured and the ultimate beneficiary is the member for whose benefit the policy has been issued.  Further the counsel contended that in view of the terms and conditions laid down in the membership certificate, the opposite parties 2 & 3 are not proper and necessary parties, hence the complaint against the opposite parties 2 & 3 is liable to be dismissed.

25.       The counsel contended that though the deceased Y.Venkatagopal Reddy had obtained membership in the club of the opposite parties 2 & 3, it is only to get insurance benefits from the Insurance Company.  Hence the contract of insurance is between the deceased and 4th opposite party as ultimate beneficiary is deceased and even as per the terms and conditions of the membership certificate the opposite parties 2 & 3 are neither liable nor responsible for payment of any compensation directly or indirectly.  Further the counsel contended that the complainant without utilizing Arbitration clause provided in the terms and conditions of the Road Safety Club  Programme, straightaway approached the District Consumer Forum, which is not maintainable as there is a specific clause mentioning with regard to the provisions of the Arbitration and Conciliation Act, 1996.  Further contended that the 3rd opposite party also reserves its right to withdraw substitute or cancel the facility at any time.  Further the counsel contended that as per the terms and conditions of the membership card if any dispute in relation to this will be subject to jurisdiction of Chennai Courts only.  Hence, this Forum has no jurisdiction to entertain the complaint under section 12 of the Consumer Protection Act, 1986.  Hence, the complaint is liable to be dismissed.

26.       The counsel for the 4th opposite party submitted that the complainant is not a consumer as defined under section 2(d) of Consumer Protection Act and there is no transaction between the complainants and 4th opposite party.  Hence, the complaint is liable to be dismissed.  The counsel for the 4th opposite party submitted that the tie up between the 4th opposite party and 3rd opposite party had ended in September, 2008 and thereafter the 4th opposite party has not issued any policy to the members of the 3rd opposite party.   Further the counsel contended that though the policy might have been issued by the 4th opposite party as stated by them in the letter that they have erroneously issued certificate of insurance even after the termination of the arrangement  and SKI shall be taking the liability for the said policies which were erroneously issued and as the above mentioned certificate is also one such certificate issued by the  4th opposite party, hence it is the liability of opposite parties 2 & 3 to settle the claim. Hence the 4th opposite party is not liable to pay any compensation to the complainants as claimed in the complaint.

27.       Further the 4th opposite party submitted that as per the letter dt.26-02-2011 “ as per records the arrangement came to an end since in September, 2008 and at the time necessary software has been sent to all their locations to cease the issuance of certificate of insurance, however from our statement it  appears that some of their locations had not executed the necessary programme in their system, probably  resulting erroneously issuing certificate of insurance, even after termination of the arrangement. “ Further submitted that the 3rd opposite party has clearly mentioned in its reply that “ we will assure you that in case of any claims under such erroneously issued cases, SKI shall be taking the liability based on the merit of the case. “ From the above letter, which clearly shows that it is the liability of 2nd opposite party to cover the risk of the certificates issued by the 3rd opposite party.

28.       Further the counsel contended that similar case was also filed on the file of Insurance Ombudsman, Hyderabad and in the said case the official of the 3rd opposite party attended before that court and submitted to the court that it had no tie up with the 4th opposite party and no premium is paid by them to cover the risk of their certificates issued by them and further represented that Insurance facility which was provided by them is only a complimentary one and they have withdrawn the same and the same is also intimated to all the membership-holders.  Further the 3rd opposite party represented that the member also agrees that even during the continuation of his membership the issuer may at any time (at their sole discretion and without giving any notice thereof to the members or assigning any reason thereof) suspend, withdraw or cancel the benefit of such insurance cover and there will be no binding obligation on the insurer to continue this benefit.  Further the counsel contended that in the AGM  of the Road Safety Club also they have admitted that after tie up ended they have issued erroneously policies which clearly shows that the 3rd opposite party has issued policies erroneously for which the 4th opposite party cannot be held liable.  Hence the 4th opposite party is not liable to pay any compensation as claimed by the complainants and there is no deficiency of service on the part of the 4th opposite party.

29.       After hearing the arguments of both sides, it is an admitted fact that the deceased Y.Venkatagopal Reddy was a member of Road Safety Club as per Ex.A1.  As per the arguments and as seen from the documents, the deceased Y.Venkatagopal Reddy died in a road accident on 07-06-2011.  As per the contention of the complainants, it is the liability of the opposite parties 1 to 4 to pay the compensation.  But after hearing the arguments of the opposite parties 1 to 4 it is true that the opposite parties 2 & 3 have entered into an agreement with the 4th opposite party and had taken policies from the 4th opposite party for their members. But the opposite parties 2 & 3 have entered into agreements for one year only and they have changed the Insurance Companies frequently after expiry of the said policies and from the arguments of both sides, it is very clear that at the first instance the opposite parties 2 & 3 have taken the insurance policy from TATA AIG General Insurance Company Ltd., on behalf of all the members, which is marked as Ex.A3.  As seen from Ex.A4, A5, A6 and A7, it is very clear that the deceased Y.Venkatagopal Reddy died in a road accident on 07-06-2011.  Hence, there is no dispute with regard to the death of Y.Venkatagopal Reddy, who is a member of the opposite parties 2 & 3.  Here the point that arises for consideration is that whether the opposite parties 2 & 3 have taken the insurance policy from the 4th opposite party on behalf of the deceased or not.  The contention of the opposite parties 2 & 3 is that they have taken the policy on behalf of the deceased and further they have forwarded the claim forms along-with other documents, which were submitted by the complainants to the 4th opposite party for settlement of the claim. But the opposite parties 2 & 3 have not filed any documents to show that they have forwarded the claim forms along-with necessary documents. And as per the contentions of the 4th opposite party, the 4th opposite party has filed Ex.B1 & B2, which clearly shows that as per Ex.B1 letter, which was addressed by the Road Safety Club to the 4th opposite party wherein they have clearly admitted that some of the locations could not be up-dated and issued certificates erroneously and they are trying to identify such cases if any and also assured that in case of any claims under such erroneously issued cases, SKI  shall be taking liability based on the merit of the case .  SKI, which is none other than 2nd opposite party and in their documents, which is marked as Ex.B2, which is proceedings of the Insurance Ombudsman, which is though not related to this case clearly shows that the 4th opposite party cannot be held liable as the                      3rd opposite party erroneously issued policies there is no contract between the membership-holders and the 4th opposite party.

30.       In the above circumstances, the 4th opposite party cannot be held liable as the                      3rd opposite party which has erroneously issued a certificate of insurance in favour of the membership-holders, it is only the liability of opposite parties 2 & 3 to compensate the Membership-holders and even as per their own letter Ex.B1, the 3rd opposite party has specifically mentioned that SKI shall take the liability in case of erroneously issued certificates.  Hence, we are of the view that it is liability of the opposite parties 2 & 3 to compensate the insurance sum to the complainants.

31.   POINT NO.2 -  In the result, the complaint is allowed by directing the opposite parties 2 & 3 to pay a sum of Rs.3,00,000/- towards the sum assured as per Road Safety Club Membership Certificate with interest @ 9% p.a. from the date of death of the deceased i.e. 07-06-2011 till the date of realization and also to pay a sum of Rs.5,000/- towards deficiency of service to the complainants within one month from the date of this order.  However the complaint against the opposite parties 1 & 4 is dismissed without costs.

            The amount of Rs.3,00,000/- with interest is to be shared by the complainants equally and as the 3rd complainant is a minor her mother is kept as guardian and her share amount shall be kept in F.D. till she attains the majority.

      Dictated to Steno, transcribed by him, corrected and pronounced by us in open Forum this the 30th day of September, 2014.

 

                         Sd/-                                                                         Sd/-

LADY MEMBER,                                                   PRESIDENT(FAC),

DISTRICT CONSUMER FORUM,                         DISTRICT CONSUMER FORUM,

ANANTHAPURAMU                                              ANANTHAPURAM

 

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

ON BEHALF OF THE COMPLAINANT:       ON BEHALF OF THE OPPOSITE PARTIES

-NIL-                                                                     -NIL-

 

EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT

 

Ex.A1 -  Original Membership Certificate  No.2022349 issued by the 3rd  opposite party

              to the deceased Y.Venkatagopal Reddy.

 

Ex.A2 -  Classic Card issued by the 3rd opposite party in favour of the deceased

              Y.Venkatagopal Reddy.

 

Ex.A3 -   Certificate of Insurance dt.06-10-2003 issued by TATA AIG General Insurance

               Co. Ltd., Chennain in favour of deceased Y.Venkatagopal Reddy.

 

Ex.A4 -    Photo copy of Medical Certificate relating to deceased Y.Venkatagopal Reddy.

 

Ex.A5 -    Attested copy of FIR in Cr.No.l81/2011 of Penukonda P.S.

 

Ex.A6  -   Attested copy of Inquest Report relating to deceased Y.Venkatagopal Reddy.

 

Ex.A7  -   Attested copy of Postmortem Certificate relating to deceased Y.Venkatagopal

                Reddy.

 

Ex.A8  -   Photo copy of Photo Identity Card relating to deceased Y.Venkatagopal Reddy.

 

Ex.A9  -   Photo copy of Photo Identity Card relating to Y.Rangamma/1st complainant.

 

Ex.A10 -  Photo copy of letter of the 1st complainant submitted to the 3rd  opposite party.

 

Ex.A11 – Photo copy of Family Members Certificate relating to deceased Y.Venkatagopal

               Reddy issued by the Tahsidlar, Kolimigundal.

 

Ex.A12 -  Original Death Certificate relating to Y.Venkatagopal Reddy issued by the

                Panchayat Secretary, Penukonda Mandal.

 

Ex.A13 -   Attested copy of final report submitted by the Sub Inspector of Police, Penukonda

                 P.S. to the Judicial First Class Magistrate, Penukonda.

 

Ex.A14 -   Paper cutting relating to insurance claim.

 

Ex.A15 -  Office copy of legal notice dt.17-12-2011 got issued by the 1st complainant to the

                Opposite parties 2 & 3.

 

Ex.A16 -  Office copy of legal notice dt.16-08-2012 got issued by the 1st complainant to the

                Opposite parties 1 5o 4.

 

Ex.A17  -  Postal acknowledgments signed by the opposite parties 1 to 4.

 

EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTIES 1 to 3

  • NIL

 

EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.4

 

Ex.B1 – Photo copy of letter dt.26-02-2011 sent by the 3rd opposite party to the 4th opposite 

            party.

 

Ex.B2 – Photo copy of proceedings of the Insurance Ombudsman, Hyderabad.

                   

                           Sd/-                                                                              Sd/-

                       LADY MEMBER,                                               PRESIDENT(FAC),

DISTRICT CONSUMER FORUM,                         DISTRICT CONSUMER FORUM,

                 ANANTHAPURAMU                                         ANANTHAPURAM

 

 

Typed JPNN

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
[HON'BLE MR. Sri S.Niranjan Babu]
PRESIDING MEMBER
 
[HONORABLE S.Sri Latha]
Member

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