Before the District Forum: Kurnool
Present: Sri K.V.H.Prasad B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy B. Com., LL.B., Member
Wednesday the 5th day of May, 2005
C.D.No. 25/2004
1. Malya Baskhi Bai,
W/o. Late. Malya Swami Naik.
2. Malya Sesha Naik,
S/o. Late. Malya Swami Naik.
3. Malya Bala Naik,
S/o. Late. Malya Swami Naik.
4. Malya Pedda Pullanna Naik,
S/o. Late Malya Swami Naik.
5. Malya Chinna Pullanna Naik,
S/o. Late Malya Swami Naik.
6. Malya Kalyani Bai,
D/o. Late. Malya Swami Naik.
All are R/o. Sugalimetta (V),
Panyam (M),
Kurnool Dist. . . . Complainant represented by their counsel
Sri A. Ramasubba Reddy.
-Vs-
The Divisional Manager,
M/s. The New India Insurance Co., Ltd,
Kurnool. . . . Opposite party represented by his counsel
Sri P. Ramanjaneyulu
O R D E R
(As per Smt C.Preethi, Member)
1. This CD complaint of the complainants is filed under section 12 of C.P. Act, 1986, seeking a direction on the opposite party to pay Rs. 1,00,000/- with 24% interest per annum from 12.7.2002, Rs. 10,000/- as compensation, cost of the complaint and any such other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The first complainant is the wife, complainant No. 2 to 5 are sons and complainant No.6 is the daughter of the deceased Late Malay Swamey Naik, who insured his life with opposite party under policy bearing No. 4761150203797 for a period from 10.2.1997 to 9.2.2007. The opposite party assured to pay Rs.1,00,000/- in case of accidental death of the policy holder. The said policy holder Malay Swamy Naik on 12.7.2002 accidentally slipped into the water channel while drinking water and drowned which resulted in his death. The Assistant Secretary informed about the accident to the police, who conducted inquest and also got post mortem done. The complainant informed about the accidental death of policy holder to the opposite party on 2.8.2002 and furnished all necessary papers. To the dismay of the complainant the opposite party replied stating that it is not entertaining the claim as per policy conditions No. 1,2,&4. But the complainant submits that as per condition NO.1 the claim should be made within one month, this condition is satisfied. As per condition No.2 the complainant submitted FIR, Inquest and postmortem to the opposite party this condition also is satisfied. There is no fraud committed by the complainants or anybody to claim accidental benefits. Therefore condition No.4 is not applicable. Hence, the rejection of valid claim of the complainant’s by the opposite party is amounting to deficiency of service by the opposite party to the complainant.
3. In support of its case the complainant filed the following documents (1) death certificate dt 7.1.2003 issued by Secretary, Village Office, Panyam (2) Xerox copy repudiation letter dt 18.12.2002 (3) FIR dt 12.7.2002 in FIR NO. 78 of Panyam Police Station (4) Inquest Report and (5) Xerox copy of postmortem certificate, besides to the sworn affidavit of the complainant N0.3 and caused interrogatories to opposite party and third party.
4. In pursuance to the notice of this Forum as to this case of the complainant the opposite party appeared and contested the case by filing denial written version as defence and alleging complainants case as not maintainable either in law or on facts.
5. The opposite party admits the deceased Malay Swamy has obtained a Janatha Accidental Policy for a Period of 10 years from 10.2.1997 to 9.2.2007 by paying premium of Rs. 300/- for assured sum of Rs. 1,00,000/- and the policy was in force at the time of the alleged accident.
6. The written version of opposite party submits that the complainant’s filed this complaint suppressing material facts with malafide intention. The cause of death of the deceased is not due to drowing in the water channel but it is natural or suicidal. The complainant manipulated it as accidental death for covering the risk under the said accidental policy. The opposite party further submits that the said water channel is not a channel it is only a vanka of stagnant water with a width of 15 feet and depth in the middle of is about 3 feet and its edges starts from ½ feet. The said Vanka is having thorny bushes on three sides and only one way to enter into the channel, so, there is no question of slipping into the said Vanka and drowned in the said Vanka. All the story of the complainant is fictitious and fabricated one for the purpose of getting the policy amount and there is no deficiency of service on part of the opposite party and seeks for the dismissal of complaint with exemplary costs.
7. In support of its case the opposite party relied on the following documents Viz (1) Death certificate dt 7.1.2003 issued by Secretary, Village Office Panyam, (2) Xerox copy repudiation letter dt 18.12.2002 (3) FIR dt 12.7.2002 in FIR NO. 78 of Panyam Police Station (4) Inquest report (5) Xerox copy of Post Mortem Certificate dt 29.7.2002, besides to the sworn affidavit of opposite party in reiteration of written version as defence and the above documents are marked as Ex B.1 to B.6 for its appreciation in this case. The opposite party also relied on the third party sworn affidavit of E.Nagendraiah, who suitablely replied to the interrogatories caused by the complainant.
8. Hence the point for consideration is to what relief the complainant is entitled alleging deficiency of service and deficient conduct on part of the opposite party:-
9. It is a simple case of the complainant alleging the accidental death of deceased Malay Swamy Naik on 12.7.2002 by accidental slip into the water channel and drowned. On the claim preferred by the complainants the opposite party repudiated stating that death of Malay Swamy Naik is not accidental it is natural or it is suicidal. In the instant case the basic contention of opposite party is that the deceased committed suicide or it is a natural death. It is needless to observe that the opposite party to discharges its onus or obligation as above was required to place adequate material on record of the complaint to show that the deceased committed suicide or its is a natural one. In support of its contention the opposite party did not place any material whatsoever regarding cause of death, except the sworn affidavit of third party E. Nagendraiah, investigator of opposite party. The said third party is of the opinion that there is no possibility of death by drowing into the water of the said Vanka as the depth of said Vanka is only 4 feet. It is clear that the said sworn affidavit observations made there in cannot form the basis for recording a finding in the instant complaint. The finding in the complaint will have to be given on the basis of material placed on record. As pointed above no material what so ever has been placed by the opposite party to show that the deceased committed suicide or it is a natural, except filling Ex B.1 to B.6 i.e policy bond, death intimation, claim form, letter dt 18.12.2002, postal acknowledgment and photograph. Even the investigator report of their investigation or the opinion of the doctor has not been placed on record to substantiate the above avernemnts. It may also be mentioned in the sworn affidavit of the third party, no definite finding has been recorded regarding cause of death. It has only been observed/opinion therein that there is no possibility of drowning and that it appears to be a suicidal or natural. The above observation, even if taken into consideration, doesnot constitute definite finding regarding caused of death of the deceased Malay Swamy Naik.
10. In view of the above, it is clear that no material has been placed on record by opposite party to show that the deceased committed suicide or it is a natural one. While such is so the complainants case is that the deceased death is due to drowning and thus the burden in on the complainant to prove the same and relied on Ex A.1, death certificate dt 7.1.2003 issued by Secretary, Village of Panyam Ex A.2 repudiation letter dt 18.12.2002, Ex A.3 FIR dt 12.7.2002 in FIR N678 of Panyam Police Station, Ex A.4 Inquest report and Ex A.5 xerox copy of Post mortem certificate dt 29.7.2002. The Ex A.3, A.4&A.5 in unitone says that the deceased Malay Swamny Naik caused of death is due to drowing as water is found in stomach, kings and nostrils. Therefore, it is clear that the death of Malay Swamy Naik is due to drowning. Hence, the complainants are entitled to the policy amount under the above said policy and the opposite party is liable to pay the said amount to the complainants as there is deficiency of service on part of opposite party in repudiating the valid claim of the complainants.
11. The opposite party except alleging malafide claim of the complainants and filling Ex B.1 to B.6 did not substantiate its bonafides and malafides of the complainant by substantiating the same by any accepting corroborative material.
12. Hence, in the circumstances discussed, above the opposite party utterly failed to substantiate their contention by placing any supporting cogent material on record and as there is clear deficiency of service on part of opposite party in repudiating the claim of the complainants, the complainants are remaining entitle to compensation for suffering, damage and mental agony at the deficient conduct of opposite party.
13. Therefore, in the result, the complaint is allowed directing the opposite party to pay the policy amount of Rs. 1,00,000/- to the complainants with 12% interest from the date of death of the deceased till realization and Rs. 5,000/- as costs within a month of receipt of this order.
Dictated to the Stenographer, Typed to the Dictation corrected by us, Pronounced in the Open Court this the 5th day of May, 2005
PRESIDENT
MEMBER MEMBER
