Date of filing:20.05.2013
Date of disposal:30.06.2014
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR.
PRESENT: - Sri S.Niranjan Babu, B.A., B.L., President (FAC)
Smt. M.Sreelatha, B.A.,B.L., Lady Member
Monday, the 30th day of June, 2014
C.C.No.47/2013
Between:
Smt. M.Lakshmidevi,
W/o Late Subbi Reddy,
R/o Talamarla Village,
Kothacheruvu Mandal,
Ananthapuramu District. … Complainant
Vs.
1. The Branch Manager,
Andhra Pragathi Grameena Bank,
Talamarla Village & Post,
Kothacheruvu Manadal,
Ananthapuramu District.
2. The Divisional Manager,
United India Insurance Company Limited,
D.No.11-170-B, 1st Floor, Meda Mansion,
Subash Road,
Ananthapuramu. … Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri R.Yerri Swamy, Advocate for the complainant and Sri B.Nagalingam, Advocate for the 1st Opposite Party and Sri V.Krishna Sarma, Advocate for the 2nd Opposite Party 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
Smt. M.Sreelatha, Lady Member: - This complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986 against the opposite parties 1 & 2 claiming a sum of Rs.1,00,000/- towards insurance policy amount, Rs.40,000/- towards mental agony and Rs.10,000/- towards legal expenditure, totaling to a sum of Rs.1,50,000/- with interest @18% P.A. till the date of payment.
2. The brief facts of the complaint are that: - This complaint filed by the complainant stating that her husband by name M.Subbi Reddy is an agriculturist and obtained crop loan of Rs.9,000/- from the 1st opposite party under Kisan Credit Card Khatha No.155/11 S.B. No.4582, New No.1933088820. The 1st opposite party had taken insurance policy on behalf of his loanees by paying premium insuring their lives under Personal Accident Scheme. It is submitted that the 1st opposite party had insured the lives of loanees with the 2nd opposite party by paying premium under Personal Accident Insurance Scheme. The complainant stated that her husband died on 21.06.2011 due to snake bite. After the death of her husband the complainant submitted claim forms to the 2nd opposite party through the 1st opposite party reporting the accident but the 2nd opposite party repudiated the claim unilaterally stating that the claim closed due to non-receipt of document inspite of reminder by the 2nd opposite party. The 2nd opposite party repudiated the claim of the complainant stated that the deceased died not due to snake bite. The complainant stated that though she submitted all relevant documents with regard to cause of death of the deceased without considering the documents the 2nd opposite party repudiated the claim which is illegal and arbitrary. Hence it is a clear case of deficiency of service on the part of the opposite parties 1 & 2. Hence, the complainant is claiming an amount of Rs.1,00,000/- towards insurance amount and Rs.40,000/- towards mental agony and Rs.10,000/- towards legal expenses.
3. The 1st opposite party filed counter stating that the husband of the complainant by name M.Subbi Reddy opened savings bank amount with the 1st opposite party and he became Pragathi Kisan Credit Card account holder with bearing No.155/11(P.K.C.C.account No.16022/20110155) the Personal Accident Insurance coverage is provided for every crop loan holder provided if he/she is below 70 years. The 1st opposite party submitted that Pragathi Kisan Credit Card account holder covered under Personal Accident Insurance Scheme by debiting Rs.5/- as premium per annum and eligible for claim of Rs.50,000/- only under the policy bearing No.051000/47/10/43/00000129. The 1st opposite party also submitted that in terms of consolidated policy taken by Head Office, covering the Kisan Credit Card borrowers of all branches in Ananthapur, Kadapa, Kurnool, Nellore and Prakasham Districts for a period of one year. Branches need not submitted any statement giving the list of Pragathi Kisan Credit Card borrowers to be covered under Personal Accident Insurance Scheme and also need not remit any premium to the insurance company. The Head Office estimated the outstanding Pragathi Kisan Credit Card accounts based on the information submitted by the branches as on 31st July on every year and paid premium to the insurance company for renewal of the policy for a period of one year with 5% extra premium to cover the fresh Pragathi Kisan Credit Card limits to be sanctioned. The 1st opposite party also submitted the list of Pragathi Kisan Credit Card account holders including LIC/DD and NPA accounts and are required to debit borrower’s share of Personal Accident Insurance Scheme premium of Rs.5/- on due date i.e., after completion of one year from the earlier debt. The 1st opposite party submitted that as per rules the 1stopposite party Head Office remitted the premium regularly to the company as per coverage particulars the 1st opposite party have covered 1994 Pragathi Kisan Credit Card account in respect of Talamarla Branch with 5% additional accounts for the year 2010-11. The 1st opposite party also submitted that the application of the complainant about the death of Late M.Subbi Reddy forwarded to the United India Insurance Company Limited the claim form submitted by the complainant for settlement of claim. The duty of the 1st opposite party is to comply with the requirements of claim and the same was done by taking the premium as per prescribed the rules and forwarding the claim with all relevant papers to the insurance company. The duty of the 1st opposite party will come to an end as soon as premium deducted and forwarded claim forms to insurance company. Thus there is no deficiency of service on the part of this opposite party and insurance company is the proper authority to settle the claim and this opposite party is no way concern to settlement of claim. There is no deficiency of service on the part of this opposite party. Hence, the complaint is liable to be dismissed with costs against the 1st opposite party.
4. The 2nd opposite party filed counter stating that the deceased M.Subbi Reddy was paid premium to 1st opposite party and obtained Kisan Credit Card policy and the said policy is force as on the date of alleged occurrence is not admitted. The 2nd opposite party also denied the allegation that the deceased is the beneficiaries of Kisan Credit Card Khatha and the complainant is entitled the death benefit of Rs.1,00,000/- as nominee. The 2nd opposite party stated that the allegation that the deceased M.Subbi Reddy went to his field and after watering to the field he was bite by a snake on 21.06.2011 at about 7.30 A.M. and immediately shifted to Government General Hospital Kothacheruvu for treatment and as per advise of the doctors shifted to Government General Hospital Penukonda and where the doctors declared him as dead and conducted postmortem in the said hospital and confirmed the death of the deceased is due to snake bite is not an admitted fact. The 2nd opposite party denied that the deceased was having crop loan account in the bank and which covers the accidental death benefit is to be proved by the complainant. The 2nd opposite party also submitted that there is abnormal delay in intimating the death of the deceased as there was stipulated period of 30 days for death intimation. The 2nd opposite party also denied the allegation that the death of the deceased was due to snake bite which covered under policy is false. The alleged postmortem certificate is clearly mentioned that the cause of death of the deceased was only due to snake bite is not correct. In the postmortem certificate, the doctors clearly mentioned the cause of death of the deceased is reserved pending RFSL report. RFSL report dt.08.08.2011 clearly mentioned that there is no chemical poison found in viscera contents analysis and the RFSL report is binding on all. The 2nd opposite party also contended that as per records at the time of alleged snake bite there is no eye witness and the complaint is lodged by the relatives of the complainant with false grounds. The death of the decease is not due to snake bite and the death of the deceased was not covered under the Kisan Credit Card policy. Hence the question of paying of compensation does not arise. As the complainant violated the policy condition No.1 as the stipulated time is 30 days but the complainant presented his claim forms with an abnormal dely. The 2nd opposite party also submitted that after receiving the belated intimation about the death of the deceased, the 2nd opposite party repudiated the claim on valid grounds through letter dt.17.05.2012 there is no deficiency of service on the part of this opposite party and the repudiation is under valid grounds and the complainant is not entitled any claim as made in complaint. The 2nd opposite party prayed this Forum to dismiss the complaint with exemplary costs.
5. Basing on the above pleadings, the following points that arise for consideration are:-
- Whether there is any deficiency of service on the part of the opposite party?
ii) To what relief?
6. In order to prove the case of the complainant, the complainant has filed his evidence on affidavit and marked Exs.A1 to A6 documents. On behalf of the 1st opposite party, the 1st opposite party filed evidence on affidavit and marked Ex.B1 & B2 documents. On behalf of the 2nd opposite party, the 2nd opposite party filed evidence on affidavit and marked Ex.B3 to B6 documents.
7. Heard both sides
8. POINT NO 1:- The counsel for the complainant argued that the complainant is the nominee of deceased by name M.Subbi Reddy who was the account holder of the 1st opposite party. The deceased M.Subbi Reddy obtained crop loan from the 1st opposite party and the 1st opposite party insured the life’s of all loaness by paying premium to 2nd opposite party, M.Subbi Reddy was also entitled the benefit under Kisan Credit Card holder Khatah as premium was deducted by the 1st opposite party from his account. The counsel for the complainant argued that on 21.06.2011 at about 7.30 A.M. the deceased by name M.Subbi Reddy went to his field for watering where he was bite by a snake and shifted to Government General Hospital, Kothacheruvu for treatment as per the advice of the doctors the said M.Subbi Reddy was shifted to Government General Hospital, Penukonda and where the doctors declare that he died and a postmortem was conducted on the same. The counsel for the complainant argued that the complainant got registered a criminal case with Kothacheruvu P.S. in crime No.41/2011 under section 174 of Cr.P.C. After the death of the deceased the complainant send all relevant documents to 2nd opposite party through the 1st opposite party for settlement of claim. But the 2nd opposite party not responded properly for settling of the claim and repudiate the claim with false allegations and the reason for repudiation stated that the husband of the complainant was not died due to snake bite. Then the complainant got issued legal notice through her counsel on 24.09.2012 requesting the opposite parties 1 & 2 to settle the claim, for this the 2nd opposite party gave reply with false allegations. Hence the complainant is constrained to file the present complaint for compensation.
9. The counsel for the 1st opposite party argued that the deceased by name M.Subbi Reddy having S.B. account with the 1st opposite party and he became a Pragathi Kisan Credit account holder with bearing No.155/11 the facility of Personal Accident Insurance coverage will provided for on crop loan account holders and the deceased is the Pragathi Kisan Credit account holder as per scheme a sum of Rs.5/- per annum was debited from his account and liable for claim of Rs.50,000/-. The counsel for the 1st opposite party argued that the policy was in force at the time of death of the deceased an amount of Rs.5/- was deducted from his account towards premium for the year 2010-11. The 1st opposite party also argued that the 1st opposite party received death intimation from the complainant and the 1st opposite party forward the same to the 2nd opposite party for settlement of the claim along with all the relevant documents submitted by the complainant. The counsel for the 1st opposite party argued that the duty of this opposite party will come to an end. Since premium deducted regularly and forwarded claim forms to the insurance company. The counsel for the 1st opposite party argued that as per the rules the Head Office remitted the premium regularly to the company. The counsel for the 1st opposite party argued that there is no deficiency of service on the part of this opposite party as premium amount was send to the 2nd opposite party every year and death intimation records also send to the 2nd opposite party immediately. Hence, the 1st opposite party is no way concern to the settlement of compensation and the claim is to be dismissed against this opposite party.
10. The counsel for the 2nd opposite party argued that the allegation of the complainant that her husband was a crop loan holder and he paid premium to 1st opposite party and eligible for Kisan Credit Card Khatha holder and the said policy was in force on the date of death of the deceased is false. The counsel for the 2nd opposite party argued that the deceased by name M.Subbi Reddy went to his field and after watering to the field he was bite by snake on 21.06.2011 and died in Government General Hospital, Penukonda is not reliable as the complainant has not filed any document relating to treatment at Government General Hospital, Kothacheruvu and Government General Hospital, Penukonda. The counsel for the 2nd opposite party argued thatbthe death of the deceased was not due to snake bite as per R.F.SL report at 08.08.2011. The counsel for the 2nd opposite party argued that the criminal records i.e., F.I.R. and P.M. does support the case of the complainant as the F.I.R. was given by some relative of the deceased. The counsel for the 2nd opposite party also argued that no eye witness was present at the time of occurrence of the alleged snake bite. The counsel for the 2nd opposite party also argued that the Kisan Credit Card holders get only Rs.50,000/- but not Rs.1,00,000/-as claimed by the complainant. The counsel for the 2nd opposite party argued that the complainant intimated about the death of M.Subbi Reddy at belated stage as per policy condition No.1 the intimation should be given within 30 days from the date of death of the policyholder. The counsel for the 2nd opposite party also argued that the complainant not proved her case as her husband died due to snake bite and the 2nd opposite party rightly repudiated the claim of the complainant and there is no deficiency of service on the part of the 2nd opposite party and the complaint is liable to be dismissed against this opposite party.
11. There is no dispute with regard to opening of S.B.account with the 1st opposite party by late M.Subbi Reddy and he became Kisan Credit Card holder bearing No.155/11. As per the 1st opposite party the Kisan Credit Card holder will get Personal Accident Insurance coverage by debiting of Rs.5/- per annum. The 1st opposite party also submitted that for the year 2010-11 the master policy was issued bearing No.051000/47/10/43/00000129 and the policy was issued for the year on 01.08.2010 to 31.07.2011. The death was occurred on 21.06.2011 it means the policy was in force, and an amount of Rs.5/- was debited under Ex.B1 from the account of M.Subbi Reddy by the 1st opposite party. Under Ex.B1 it clearly shows that the policy was for the academic year of 2010-11 and death of M.Subbi Reddy occurred within policy period. The 1st opposite party Bank filed the list of village and members of Kisan Credit Card holders under Ex.B2. In Ex.B2 the villager of the deceased i.e., Talamarla is also included in the list and number of Kisan Credit Card holders are 1994. As per the 1st opposite party every year the 1st opposite party used to send the premium to the insurance company at 31st July every year. Then the 2nd opposite party used to issue the polices to the account holders. The 1st opposite party was issued a claim number in the name of Late M.Subbi Reddy bearing No.051000/47/11/43/90000875 and the account holder will get the Personal Accident Insurance of Rs.50,000/-.
12. The dispute only with regard to the cause of death. The complainant stated that her husband by name M.Subbi Reddy as a farmer by cultivation. On 21.06.2011 at about 7.30 A.M. her husband went to his field for cultivation and he was bite by snake and immediately shifted to Government General Hospital, Kothacheruvu for treatment later on the advise of the doctors shifted to Government General Hospital, Penukonda where the doctors declared that her husband died. The complainant filed Ex.A1 to A6 documents to prove her case. Ex.A1 is the F.I.R. and Ex.A2 is the postmortem report of late M.Subbi Reddy. Ex.A6 is the final report issued by the Civil Assistant Surgeon. The counsel for the 2nd opposite party argued that there is delay in submitting the claim forms to 2nd opposite party company and the death was not due to snake bite to prove the case about the cause of death of Late M.Subbi Reddy, the complainant filed criminal records i.e., F.I.R., P.M. certificate and final report clearly reveals that the death of M.Subbi Reddy was caused due to snake bite. In final report i.e., Ex.A6 issued by the Civil Assistant Surgeon Penukonda it is opinioned the reasons for the death of the deceased would appeared to have been died of Cardio Respiratory Failure due to poisonous snake bite. About the delay in intimating the death, complainant nor the 2nd opposite party filed any document to show that when the complainant submitted his claim forms to the 1st opposite party and when the 1st opposite party forwarded the same to 2nd opposite party entire complaint or in the counters filed by the 2nd opposite party is silent. The arguments of the 2nd opposite party the delay is not to be considered and rejected by this Forum because in getting the documents the complainant has to spent some time due to it she might have submitted the claim records with delay as per Ex.B5. No grounds mentioned in repudiation letter about the delay of intimation. When the complainant proved her case beyond reasonable doubt that the husband of the complainant was Pragathi Kisan Credit Card holder and the death was caused due to snake bite and being nominee of Kisan Credit Card holder she is entitled claim. The 2nd opposite party ought to have considered the claim of the complainant the humanitarian grounds and settle the claim before approaching this Forum because the policy was in force at the time of death of the policyholder and premium was deducted from account of M.Subbi Reddy. The 2nd opposite party argued that no eye witness was present at the time of occurrence of snake bite is not considerable argument.
13. We are of the opinion that the death was caused due to snake bite and the complainant informed the same even though the 2nd opposite party was not settled the claim which amounts to deficiency of service on the part of the 2nd opposite party. Hence this point is answered accordingly in favour of the complainant and against the 2nd opposite party, and repudiation of opposite party is not justified.
14. In the result, the complaint is allowed by directing the 2nd opposite party to pay a sum of Rs.50,000/- towards sum assured with interest @ 9% P.A. form the date of death of the deceased i.e.,21.06.2011 till the date of realization within one month from the date of receipt of this order. In the circumstances no costs is awarded and the both parties do bear their own costs. The claim against the 1st opposite party is dismissed.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 30th day of June, 2014.
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 Attested copy of F.I.R. in Crime No.41/11 of Kothacheruvu P.S.
Ex.A2 Attested copy of Postmortem Certificate relating to deceased M.Subbi Reddy.
Ex.A3 Office copy of legal notice dt.24.09.2012 got issued by the complainant to the
opposite parties 1 & 2.
Ex.A4 Reply notice got issued by the 2nd opposite party to the counsel for the
complainant.
Ex.A5 Postal acknowledgement signed by the opposite parties 1 & 2.
Ex.A6 Photo copy of final report relating to deceased M.Subbi Reddy issued Civil
Assistant Surgeon, Community Health Centre, Penukonda.
EXHIBITS MARKED ON BEHALF OF THE 1st OPPOSITE PARTY
Ex.B1 Statement of account relating deceased M.Subbi Reddy issued by the
1st opposite party.
Ex.B2 Photo copy of list of outstanding P.K.C.C. accounts as on 31.07.2010 branch
wise issued by the 1st opposite party.
EXHIBITS MARKED ON BEHALF OF THE 2nd OPPOSITE PARTY
Ex.B3 Forensic Science Laboratories Report relating to deceased M.Subbi Reddy
issued by Assistant Director, A.P. Forensic Science Laboratories.
Ex.B4 Kisan Credit Card Scheme policy No.05100/47/10/43/00000129 relating to
deceased M.Subbi Reddy issued by the 2nd opposite party.
Ex.B5 Repudiation letter dt.17.05.2012 issued by the 2nd opposite party
Ex.B6 Attested copy of endorsement dt.16.09.2011 issued by the Tahsildar
Kothacheruvu.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR
