Andhra Pradesh

Visakhapatnam-II

CC/186/2012

Andhavarpau Anuradha - Complainant(s)

Versus

The Divisional Manager - Opp.Party(s)

S. Narasinga Rao

22 Jan 2015

ORDER

 Reg.of the Complaint:20-06-2012

                                                                                                                                 Date of Order:22-01-2015

BEFORE THE DISTRICT CONSUMERS FORUM-II

AT VISAKHAPATNAM

                   Present:

1.Sri H.ANANDHA RAO, M.A., L.L.B.,

       President

2.Sri C.V.RAO, M.A., B.L.,

                                             Male Member

3.Smt.K.SAROJA, M.A., B.L.,

       Lady Member

                                            

THURSDAY, THE 22^ND DAY OF JANUARY, 2015

CONSUMER CASE NO.186/2012

 

BETWEEN:

ANDHAVARAPU ANURADHA W/O LATE RAMESH,

HINDU, AGED 40 YEARS, R/O NEW COLONY,

KASIBUGGA TOWN POST MANDAL, SRIKAKULAM DISTRICT,

PRESENTLY R/A C/O GUDLA VENKATA GURUNADHA GUPTA,

GUDLA STREET, LOLUGU VILLAGE AND POST,

PONDURU MANDAL, SRIKAKULAM DISTRICT.

…COMPLAINANT

AND:

1.THE DIVISIONAL MANAGER, NATIONAL INSURANCE COMPANY LTD.,

DIVISION-III, 8 INDIA EXCHANGE PLACE,

KOLKATTA-700 001.

2.SENIOR DIVISIONAL MANAGER,  NATIONAL INSURANCE COMPANY LTD.,

REST –DO-

3. THE BRANCH MANAGER, GOLDEN MULTI SERVICE CLUB (GIFS)

CARE OF DIVISIONAL MANAGER,  NATIONAL INSURANCE COMPANY LIMITED,

DWARAKANAGAR, VISAKHAPATNAM.

4.THE MANAGER NATIONAL INSURANCE CO.,LTD.,

SRIKAKULAM.

…OPPOSITE PARTIES

This case coming on 05-01-2015 for final hearing before us in the presence of SRI S.NARASINGA RAO, Advocate for the Complainant, and of SRI A.VENUGOPALA RAO, Advocate for the 1^ST & 4^TH OPs, SRI B.S.S.N.RAJU, Advocate for the 2^nd OP, and of SRI P.MURALI GOPAL, Advocate for the 3^rd the OP, and having stood over till this date for consideration, this Forum made the following.

ORDER

 (As per SMT.K.SAROJA, Honourable Lady Member on behalf of the Bench)

1.       The case of the complainant in brief is that the complainant’s husband obtained a Janatha Personal Accident Insurance Policy on 01-03-2003 and it is valid upto 28-02-2018 and paid premium Rs.281/- vide policy bearing No.100300/47/01/9600022/02/96/30406. Subsequently, the complainant’s husband in a motor accident on 18-08-2004, where under the complainant shown as nominee and the complainant intimated the same to the 3^rd OP along with a claim form as well as necessary documents to settle the claim and the same were acknowledged on 7-10-2004. In spite of many requests made by the complainant, OPs did not settle the claim of the complainant. Then, the complainant issued a Legal Notice dated 21-04-2014, the OPs received the same and sent a reply notice on 03-04-2010 and issued a reply notice by 3^rd OP on      3-4-2010  stating that the burden of payment shifted to 1^st and 2^nd OPs. Hence, this complaint.

a.       To direct the Opposite Parties to pay the insured amount of Rs.50,000/- to the complainant towards policy amount;

b.       To order the Opposite Parties to pay Rs.2,00,000/- for mental agony, harassment and deficiency of service.

c.       To grant interest at 18% p.a., on the policy amount of Rs.50,000/- from the date of death of the insurer till its realization.

d.       Litigation expenses of Rs.2,000/- ; and

e.       Such other relief/reliefs as the Honorable Forum deems fit and proper in the circumstances of the case.

2.       The 1^st and 4^th Opposite Parties filed the Vakalat but failed to file counter affidavit as well as written arguments.

3.       The 2^nd and 3^rd OPs strongly resisted the claim of the complainant by contending as can be seen from their individual counters .

The 2^nd Opposite Party strongly resisted the claim of the complainant by stating that the complainant did not send any relevant documents to this OP inspite of several  demands made by them. This OP has a right to repudiate the claim U/s 44 and 45 of Insurance Act. So, repudiation does not come under the deficiency in service. There is no delay on the part of the OPs. As the complainant fails to submit the documents, they have no liability to pay any reliefs asked by the complainant.

The 3^rd OP strongly resisted the claim of the complainant, as can be seen from its counter, it is contended that the complainant submitted the documents and after initial verification, the same was forwarded to National Insurance Company Limited, Kolkata on 16-08-2005 who is the 1^st OP and the 3^rd OP reminded further to the National Insurance Company Limited for early settlement of the said claim on a letter dated 03-08-2007. The 3^rd OP is only a facilitator and this complaint is not maintainable against these OPs. So, they have no liability to pay any reliefs asked by the compliant.

4.       At the time of enquiry, the complainant filed evidence affidavit as well as written arguments to support their contentions. Exhibits A1 to A8 are marked for the Complainant. No documents are marked for the OPs.  Heard both sides. Treated as heard on behalf of the complainant, and OPs 1,2 and 4.

Exhibit A1 is the copy of Policy dated 01-03-2003, Exhibit A2 is the Requisition Letter submitted by the Complainant dated 13-06-2003, Exhibit A3 is the Certificate of Death of husband of Complainant dated 03-08-2004,  Exhibit A4 is the FIR copy in crime no.61/2004 of Srikakulam Mahila P.S., dated 18-08-2004, Exhibit A5 is the Charge Sheet dated 13-10-2004, Exhibit A6 is the PM certificate of Deceased Husband of the Complainant, dated 19-08-2004, Exhibit A7 is the Legal Notice dated 21-04-2010 and Exhibit A8 is the Reply Notice sent by the Opposite Parties, dated 03-04-2010.

5.       The fact shown from Exhibit A2 reveals that the Complainant issued a letter in favour of 3^rd OP to settle her husband’s death claim. Exhibit A8 reveals that the 3^rd OP received claim documents from the complainant  and they were also sent to the Insurer i.e., National Insurance Company Limited collected as long back on 16-08-2005 followed by a remainder dated 03-08-2007.

6.       The point that would arise for determination is:

Whether there is any deficiency of service on the part of the OPs? if so, Whether the Complainant is entitled to the   reliefs asked for?

7.       After careful perusal of the case record, this forum finds that there is no dispute regarding the death of the complainant’s husband. After reeiving the claim documents from the complainant, the 3^rd OP sent to the Insurer who is the National Insurance Company and requested them to settle the Complainant’s claim as early as possible dt.16-08-2005 followed by reminder dated 3-8-2007. According to Exhibit A8, the 3^rd OP sent the claim form as well as documents to the Insurance Company to settle her claim. So, the 3^rd OP has no liability to pay any reliefs asked by the complainant, as they were only facilitator. The 1^st and 2^nd OPs kept silent. They failed to settle the complainant’s claim nor repudiate the claim. Even though, the 3^rd OP sent the claim form as well as documents to the Insurance Company, they did not settle the claim even after these long period, the accident occurred in the year 2004, but till today the Insurance Company did not settle the claim.  So, the 1^st and 2^nd OPs bound to pay the insurance claim for their deficiency in service coupled with unfair trade practice. Moreover, the 4^th OP has no connection with this case at any point of time. So, the 4^th OP is not liable.

          As such, the complainant suffered a lot of mental agony since 2004 to till today by the acts of the OPs i.e., National Insurance Company Limited. Hence, the complainant is entitled to the insured amount with interest, some compensation and costs too.

8.       In the result, the Complaint is allowed, directing the Opposite Parties 1&2,  to pay the insured amount of Rs.50,000/- (Rupees Fifty thousand only) with 9% p.a., from 07-10-2004 till the date of actual realization, to pay a compensation of Rs.10,000/- (Rupees Ten Thousand only) and costs of Rs.2,000/- (Rupees Two Thousand only)  to the Complainant.  Time for compliance, one month from the date of this order.

However, the case against the OPs 3 and 4 is dismissed. No costs.

Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, on this the 22^nd day of January, 2015.

 

  Sd/-                                                      Sd/-                                        Sd/-

M.MEMBER                                                     PRESIDENT                                                L.MEMBER  

APPENDIX OF EVIDENCE

Exhibits Marked for the Complainant:

Exhibits	Date	Description	Remarks
A-1	01-03-2003	Policy Bond	Photocopy
A-2	13-06-2003	Requisition Letter submitted by the Complainant	Photocopy
A-3	23-08-2004	Certificate of Death of husband of Complainant	Photocopy
A-4	18-08-2004	FIR in crime no.61/2004 of Srikakulam Mahila P.S.,	Photocopy
A-5	13-10-2004	Charge Sheet	Photocopy
A-6	19-08-2004	PM certificate of Deceased Husband of the Complainant	Photocopy
A-7	21-04-2010	Legal Notice	Office copy
A-8	03-04-2010	Reply Notice sent by the 3rd Opposite Party	Original

Exhibits Marked for the OPs     -nil-

Sd/-                                                       Sd/-                                         Sd/-

M.MEMBER                                                     PRESIDENT                                                L.MEMBER