BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.<br /> <br /> COMPLAINT NO. DCFR. 98/07.<br /> <br /> THIS THE 20th DAY OF MAY 2008.<br /> <br /> P R E S E N T<br /> <br /> 1. Sri. N.H.Savalagi, B.A.LLB. (Spl) PRESIDENT.<br /> 2. Sri. Gururaj, B.com.LLB. (Spl) MEMBER.<br /> 3. Smt. Pratibha Rani Hiremath,M.A. (Sanskrit) MEMBER.<br /> *****<br /> <br /> COMPLAINANT :- Smt. Holiyamma W/o. late Piddappa, Age: 24 <br /> years, Occ: Household & Coolie, R/o. IIIrd Mile Camp, Tq. Sindhanoor, Dist: Raichur. <br /> <br /> //VERSUS//<br /> <br /> RESPONDENT :- The Branch Manager, United India Insurance <br /> Company Limited., Branch Sindhanur, Dist: Raichur.<br /> <br /> CLAIM :- For awarding Rs. 50,000/- as compensation <br /> towards their negligence, deficiency in service and unfair trade practice along with interest at 12% there on from 07-02-06 till realization. He has also sought for cost of Rs. 5,000/-.<br /> <br /> Date of institution :- 12-12-07.<br /> Notice served :- 21-01-08.<br /> Date of disposal :- 20-05-08.<br /> <br /> Complainant represented by Sri. T.M. Swamy, Advocate. <br /> Respondent represented by Sri. M.S. Baig, Advocate.<br /> -----<br /> This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.<br /> <br /> <br /> <br /> <br /> JUDGEMENT<br /> <br /> This is a complaint filed U/s. 12 of Consumer Protection Act by the complainant-Smt. Holiyamma against Respondent the Branch Manager, United India Insurance Company Ltd., Branch Sindhanur for deficiency in service. The brief facts of the complaint are as under:<br /> <br /> The complainant is the wife of late Piddappa S/o. Durgappa who was working as Hamali in Karnataka Warehousing Corporation at Sindhanur. The said Piddappa died on 13-10-05 in Government Hospital Sindhanur due to chest pain which was the result of accidental fall of paddy bags on him in the Warehouse. On the complaint by the brother of deceased Piddappa, the Town Police Sindhanur have registered case in UDR No. 15/05 on 13-10-05.<br /> <br /> During his life-time late husband Piddappa had insured his life with Respondent Insurance Company under policy No. 240230/47/05/61 for Rs. One Lakh which was valid upto 01-04-05 to 31-03-06. The complainant being the nominee of insured has submitted the claim on 07-02-06 before the Respondent along with required documents as sought for by him through letter dt. 31-01-06. Even after the receipt of the same the Respondent neither paid the assured amount nor replied in any manner. Hence the complainant filed a Petition before the Commissioner for Workmen’s Compensation & Labour Officer, Raichur in W.C. No. 218/07 on 03-02-07 against the Karnataka Warehousing Corporation, Sindhanur and this Respondent. The said case stands now posted for evidence of this complainant.<br /> <br /> The Respondent ought to have paid the assured amount soon after the receipt of the claim form and documents. So the non-payment of assured amount of Rs. One Lakh made the complainant to file the Petition in W.C. No. 218/07 before the Labour Officer for recovery along with liability of Warehouse Corporation Sindhanur. So the non-payment of the assured amount of the policy subsequent to the receipt of all documents without assigning any the reasons for the same till today is nothing but deficiency in service, negligence and un-fair trade practice. Hence for all these reasons the complainant has sought for awarding Rs. 50,000/- as compensation towards their negligence, deficiency in service and unfair trade practice along with interest at 12% there on from 07-02-06 till realization. He has also sought for cost of Rs. 5,000/-.<br /> <br /> 2. In response to service of notice the Respondent United India Insurance Company appeared through counsel and filed written version denying the claim of the complainant. This Respondent is not in the knowledge that the complainant is the wife of deceased Piddappa and he was working in the Karnataka Warehousing Corporation at Sindhanur. It is specifically denied that deceased Piddappa was injured in the accident on 11-10-07 died on 13-10-05. The cause of death was “Myo Cordial Infection” as per the Report of District Surgeon. The policy issued by the Respondent is a ‘Janatha Personal Accident Policy’ and said Piddappa has not died due to accident as such this Respondent is not liable to pay any compensation.<br /> <br /> The complainant has submitted a claim form and after receipt of the same this Respondent caused investigation and investigator has enquired with the Warehouse Manager, State Warehouse Sindhanur and the said Manager has given a letter stating that there was no such incident on 11-10-05 and deceased Piddappa was not injured in the incident. There is no connection between the warehouse Corporation and the incident. Meanwhile on 03-02-07 the complainant filed a claim petition before the Commissioner for Workmen Compensation at Raichur in W.C. No. 218/07 and the Respondent’s appearance was fixed on 23-03-07. When the complainant has chosen one Forum for deciding her claim she cannot file complaint before this Forum regarding the same incident as such the complaint is not maintainable abinitio. There is no deficiency in service on the part of this Respondent. The complainant only claims that her claim form was not processed in time. That the Respondent has given the said claim for investigation and the report clearly shows that the cause of death was kept pending for want of Chemical Examination Report from Bangalore as the Visra sent to Bangalore and therefore this Respondent cannot come to conclusion that the death was due to accident. The report came only on 18-09-07 after receipt of the Investigation Report and the Investigator stated that he came to know that the cause of death on 12-09-07 and after collecting all the documents from the police and then this Respondent came to know that the cause of death was “Myo Cordial Infection” and not due to accident as such there is no deficiency in service. Hence for all these reasons the Respondent has sought for dismissal of the complaint with cost.<br /> <br /> 3. During the course of enquiry the complainant Holiyamma filed her sworn-affidavit by way of examination-in-chief as PW-1 and has also filed one more affidavit of Ramanna S/o. Durgappa by way examination-in-chief as PW-2. In rebuttal the Respondent Corporation has filed sworn-affidavit of its Administrative Officer by way of examination-in-chief. On behalf of complainant (17) documents were got marked as Ex.P-1 to Ex.P-17. On behalf of Respondent (5) documents were got marked as Ex.R-1 to Ex.R.5.<br /> <br /> 4. Heard the arguments of both sides and perused the records. The following points arise for our consideration and determination:<br /> <br /> 1.Whether the complainant proves deficiency of service by the Respondent Corporation in not processing the claim of the complainant and in not replying in any manner in that regard, as alleged.?<br /> <br /> 2.Whether the complainant is entitled for the reliefs sought <br /> for?<br /> <br /> 5. Our finding on the above points are as under:-<br /> 1) In the negative. 2) As per final order for the following<br /> <br /> REASONS<br /> <br /> POINT NO.1 :-<br /> <br /> 6. In this complaint the complainant has not sought for awarding the policy amount but the claim in this complaint is for deficiency in service by the Respondent Corporation in not processing her claim and for not replying in the matter. So with this limited scope in the complaint we have to consider her case.<br /> <br /> 7. There is no dispute that late Piddappa S/o. Durgappa was a Hamali by profession and had taken the policy from the Respondent under “Janatha Personal Accident Policy”. It is the case of the complainant that she is the wife of late Piddappa and nominee under the said policy. Her husband Piddappa who was working as Hamali in Karnataka Warehousing Corporation Sindhanur died on 13-10-05 in Government Hospital Sindhanur due to chest pain which was result of accidental fall of paddy bags on him in the warehouse on 11-10-05. The Notarized copy of UDR No. 15/05 of Town Police Station Sindhanur along with complaint of one Durgappa is produced at Ex.P-1. <br /> From perusal of Ex.P.1 it shows that the UDR came to be registered on the complaint of one Durgappa S/o. Durgappa Huchirappanavar R/o. Jumalapur Tq. Kustagi on 13-10-05. From the complaint/statement of this Durgappa dt. 13-10-05 it shows deceased Piddappa was his brother and who was residing in Sindhanur near 3rd Mile Camp by doing Hamali. His wife Holiyamma had been to her parental house at Vadarkal for Dasara Festival. On 13-10-05 at about 2-00 PM when he was engaged in sowing Jawar Seeds in his land at Jumlapur, at that time one Muslapur Durgappa of Sindhanur came and informed that he was told by Ramanna & Devendrappa-colleague of late Piddappa, that on 11-10-05 at about 12-00 PM in the Karnataka Warehouse Corporation at Sindhanur, the late Piddappa while removing the Paddy Bags (at that time) about (20) bags fell and out-of which one Paddy bag fell on the chest of Piddappa who suffered chest pain. In-spite of advise by his colleague Ramanna & Devendrappa to go to Hospital but Piddappa neglected and went away to his house. On 13-10-05 in the morning at 6-00 A.M. when the said Ramanna & Devendrappa had gone to the house of Piddappa who was having severe chest pain so they took him and admitted in the Government Hospital Sindhanur, where he died in the hospital at 8-30 A.M. The same has been informed to Holiyamma, wife of Piddappa over phone. Thereafter complaint Durgappa immediately went to Sindhanur hospital and saw the dead body of his brother Piddappa. His brother Piddappa has died due to fall of Paddy bag on his chest. Ramanna PW-2 has reiterated the same in his affidavit-evidence.<br /> <br /> 8. The Respondent Insurance Company has produced Notarized Copy of Post Mortem Report at Ex.R-5 issued by Government Hospital Sindhanur. It shows that the cause of death was kept pending for want of Chemical Examination Report. They have also produced the Notarized copy of Final Report/Letter dt. 31-07-07 at Ex.R-2 addressed to PSI Town Police Station, Sindhanur issued by Senior Specialist, District Hospital Raichur stating that the cause of death is “Myo Cordial Infection”. The Respondents have also produced Notarized Copy of Letter dt. 12-05-06 addressed to the complainant-Holiyamma stating that in their letter dt. 17-03-06 they had requested to clarify the cause of death which was kept pending for want of Chemical Examination Report but till date she has not clarified the same and mean time her Advocate along with CPI leaders have assured to submit Post Mortem Report and on the receipt of the same they shall look into the matter further.<br /> <br /> 9. Admittedly late Piddappa died on 13-10-05 and P.M.E. over the dead body was conducted on the same day by Medical Officer, Sindhanur. The cause of death was kept pending for want of Chemical Examination Report. The Final opinion/letter came to be issued on 31-07-07 by the Senior Specialist, District Government Hospital Raichur vide Ex.R-2 stating that the cause of death was “Myo Cordial Infection”. This Final opinion/letter issued by District Hospital Raichur, is addressed to PSI Town P.S. Sindhanur who has received the same on very day. This means the Final opinion for which the cause of death was kept pending (as per P.M.E. Report) came to be issued by Hospital Authorities and received by PSI Town P.S. (Sindhanur) on 31-10-07. The complainant has not produced any evidence to show that the complainant has made any correspondence with the Respondent Insurance Company regarding the process of her claim. On the contrary the letter dt. 12-05-06 at Ex.R-4 issued by Respondent discloses that the Respondent had made earlier correspondence requesting the complainant to clarify regarding the cause of death (of Piddappa) which was kept pending for want of Chemical Examination and on the receipt of the same they shall look into the matter further. Even assuming that the complainant had made correspondence or personal approach or through her representatives, but in the absence of Final Opinion/Report from the Government Hospital Sindhanur/Raichur (as seen from the Final opinion/letter dt. 31-07-07 vide Ex.R-2) the Respondent Insurance Company could not have processed the claim of the complainant till the receipt of Final opinion/letter of the Chemical Examiner. Admittedly the Final report is dt. 31-07-07. So to say before this date there was no Final report regarding the cause of death deceased Piddappa. But the complaint averments go to show that the complainant-Holiyamma had filed her petition U/s. 22 of Workmen Compensation Act before the Commissioner Workmen’s Compensation in W.C. No. 218/07 on 03-03-07 at Ex.P-10 and the present Respondent in that case had filed written version on 12-04-07. This means the complainant has filed said petition No. 218/07 even earlier to the issuance of Final Opinion/letter from the medical authorities. Hence it cannot be said that the claim petition filed before the Commissioner Workmen’s Compensation was the out come of the deficiency in service by the Respondent. Added to this the Respondent company have produced a letter issued by Warehouse Manager State Warehouse Sindhanur dt. 16-03-06 at Ex.R-1 stating that no accident as alleged has taken on 11-10-05 in the Warehouse. However we do not want to consider this letter of the Warehouse Manager produced at Ex.R-1, since it does not come under the purview in this complaint and since the matter in W.C. No. 218/07 before Commissioner Workmen’s Compensation Raichur is pending for enquiry. <br /> <br /> 10. So from a close perusal of material on record we do not find any iota of deficiency in service by the Respondent Corporation in not processing the claim of the complainant and in not replying in that regard. On the contrary the letter of the Respondent dt. 31-01-06 produced by the complainant at Ex.P-6 shows the Respondent asking the complainant for producing certain documents sl.No. 1 to 6 which in-turn shows the initiation of processing on her claim form. Another letter of the Respondent dt. 12-05-06 produced by the Respondent at Ex.R-4 as discussed above states that the Respondent asked the complainant to clearly regarding the Final/medical opinion of the cause of death of deceased which was kept pending for want of Medical Examination Report and after the receipt of the same they shall look into the matter. If this is so we are at a loss to know as to how the Respondent Insurance Company is deficient in not processing of her claim. Hence we hold that the complainant has failed to prove deficiency in service by the Respondent as alleged. Therefore Point NO-1 is answered in the Negative.<br /> <br /> POINT NO.2:-<br /> <br /> 9. In view of our discussion and finding on Point No-1 in the negative, the complainant is not entitled for reliefs sought for. In the result we pass the following order:<br /> ORDER<br /> The complaint of the complainant being devoid of merits is hereby dismissed. No order as to cost.<br /> Office to furnish certified copy of this order to both the parties forth with free of cost.<br /> (Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 20-05-08)<br /> <br /> Sd/- Sd/- Sd/-<br /> Smt.Pratibha Rani Hiremath, Sri. Gururaj Sri. N.H. Savalagi,<br /> Member. Member. President, <br /> Dist.Forum-Raichur. Dist-Forum-Raichur Dist-Forum-Raichur.<br />