EFORE THE DISTRICT FORUM (UNDER CONSUMER PROTECTION ACT, 1986) MEDAK AT SANGAREDDY
Present : Sri. P.V. Subrahmanyam, B.A. B.L.,President
Smt. Meena Ramanathan, B.Com., Lady Member
Sri. G.Sreenivas Rao, M.Sc.,B.Ed.,LL.B., PGADR (NALSAR)
Male Member
Thursday, the 21st day of July 2011
C.C. No. 35 of 2010
Between:
M. Laxmi w/o Anjaiah,
Aged: 45 years, Occ: House-hold,
R/o H.No. 1-5-20, Brahmanwada,
Sangareddy town and Mandal. …….Complainant
And
1. The Divisional Manager,
Shriram Life Insurance Co., Ltd.,
Main Road, Opp. New bus Stand,
Sangareddy, Medak District – 502 001.
2. M/s Shriram Life Insurance Co., Ltd.,
Having its Reg.,& Head office at 3-6-478,
III floor, Anand Estotes, Liberty Road,
Himayath nagar, Hyderabad – 500 029.
Rep by its: Assistant General Manager.
3. M/s Shriram Life Insurance Co., Ltd.,
Having its Divisional Office at 12-13-1274,
Near St’ Ann’s High School,
Tarnaka, Secunderabad – 500 017.
Rep by its: Divisional Manager . …Opposite parties
(Amendment is carried out as per order I.A. No. 48/2010, dated 04.10.2010)
This case came up for final hearing before us on 07.07.2011 in the presence of Sri C. Vittal Reddy, Advocate for complainant and Sri K. Rajeshwar Rao, Advocate for opposite parties, upon hearing arguments of both parties, on perusing the record and having stood over for consideration till this day, this Forum delivered the following:
O R D E R
(Per Sri P.V. Subrahmanyam, President)
This complaint is filed under section 12 of The Consumer Protection Act, 1986 to direct the opposite parties to pay the policy amount of Rs.10,00,000/- in respect of policy No. LN070800055673 with interest and costs and to award compensation of Rs.5,00,000/-.
The averments in the complaint in brief are as follows:
1. The complainant is resident of Sangareddy. In the year 2008 opposite party No. 1 has offered subscriptions from the public to subscribe Shri plus unit linked insurance plan (withdrawal as pension) and requested Kum. Malleswari, the daughter of complainant, who was running a beauty parlour, to subscribe. The complainant and her daughter responded to the same. As per the guidelines of the policy, subscriber has to pay Rs. 1,00,000/- every year for a minimum period of three years and the policy term is 15 years and there is a withdrawal option after three years by maintaining a minimum balance equal to annual premium and surrender option also available after lapse of three years from the date of commencement. The deposited amount will be invested in various companies by the opposite party and the matured amount will be paid to the policy holders by covering the minimum life insurance of Rs. 10,00,000/-. In case of death of the policy holder pending maturity, the sum assured will be paid to the nominee or legal heir of the policy holder. After verifying the policy conditions and privileges the complainant’s daughter kum. M. Malleswari subscribed for two policies worth Rs.10,00,000/- each with the opposite party on 16.02.2008 and paid Rs. 1,00,000/- for each policy as first installment, on that the opposite parties passed separate receipts 0442574 and 0442575 dated 16.02.2008 for Rs.1,00.000/- each and proposal was sent vide proposal No. 104508000136 and 104508000137 on 15.03.2008 and the same was accepted by the opposite party and intimation was also sent to the policy holder by issuing policy to the deceased Malleswari vide policy No. LN070800055571 and LN07080005673 and the policies were commenced on 28.04.2008 and maturity date is 28.04.2023. While so on 20.07.2008 when the deceased was heating water in the kitchen suddenly she sustained burns due to flames while starting the stove. Immediately she was shifted to Government hospital, Sangareddy where she succumbed to the injuries on 24.07.2008 while undergoing treatment. In that connection Sangareddy town police registered a case in crime No. 114/08 U/s 174 Cr.P.C. The complainant intimated the matter to the opposite party and on their advise she filed claims separately before them in respect of both the policies enclosing all necessary papers for which receipts were passed 24.04.2009 acknowledging the claims and depositing of originals. The complainant sent all necessary papers whenever the opposite party asked for them. Finally the opposite party sent a letter dated 30.06.2009 stating the investigation revealed that the deceased M. Malleswari committed suicide by dousing kerosene on her and setting herself ablaze, to end her life, as such no claim arises under the above policies and nothing is payable and thus refused to pay the sum assured.
Malleswari died due to fire accident and the police Sangareddy town also filed their final report stating that deceased died due to fire accident. The complainant invested Rs.10,00,000/- each to obtain the two policies for the future life of the deceased Malleswari as she was not married. The opposite party intentionally prolonged the matter for one year and finally refused payment. The complainant is nominee under the policies. Hence the complaint.
2. The opposite party No. 1 filed a counter to the following effect:
The complaint is not maintainable. The first opposite party is not a proper and necessary party for the claim made in the complaint. It is a only service provider by collecting the premium amount on behalf of Shri Ram Chits Company Limited and forwarding the proposal forms / claim forms to the concerned Divisional / Head Office which is a proper party, as it has issued the policy. Hence the complaint against the opposite party No. 1 may be dismissed.
3. Later another counter is filed on behalf of opposite parties No.1 to 3 which in brief is as follows:
The complaint allegations are false. (All most all the allegations in the complaint are specifically mentioned and denied. In order to avoid repetition they are not being reiterated). The complainant and her daughter verifying the policy conditions and privileges and subscribing to two policies etc are true. The allegation that the policy holder Malleswari caught fire accidentally on 20.07.2008 and succumbed to injuries while undergoing treatment on 24.07.2008 are all false. The investigation of the opposite parties revealed that she committed suicide, as such no claims arise under the policies and nothing is payable and hence the opposite parties refused to pay the sum assured. With regard to refund of the deposited premium, only fund value can be paid back without prejudice to the contentions of the opposite parties regarding suicidal death. The complaint is barred by limitation. On receipt of death information the investigator of the company of the opposite party conducted enquiry into the matter and collected credible information on 20.07.2008 that the deceased / life assured had a quarrel with her neighbour and due to the same around 8:00 a.m. she doused kerosene on her body and set herself ablaze and rushed to the street, then she was shifted to government hospital. He also took photographs of the place of occurance. On 20.07.2008 after the life assured was admitted in the hospital with 40% burns a Magistrate recorded her dying declaration on that day itself which goes to show that she committed suicide by dousing kerosene by herself and setting herself ablaze because her neighbour one Prabhakar and his wife scolded her and abused her in filthy language. The investigator of the opposite parties had been informed by the police that basing on the information given by the father of the deceased they conducted panchnama and investigated into the matter and filed their final report in the Magistrate Court. Thus it is clear that the death of life assured was not accidental death and it is a clear case of suicide and hence the claim is unlawful.
In fact the deceased was not at all running any beauty parlour but in order to obtain policies, false representations were made that she was running beauty parlour and earns sufficient income to pay the premium amount. The opposite parties have no branch of it at Sangareddy and policy was issued at Secunderabad and claim was also taken up by the head office at Hyderabad as such this forum has no jurisdiction. The complaint is therefore liable to be dismissed with exemplary costs.
4. Complainant’s evidence affidavit is filed (PW.1) to prove the contents of the complaint. Assistant General Manager of Opposite party No. 3 filed his evidence affidavit (RW.1). Exs.A1 to A14 are marked on behalf of the complainant and Exs.B1 to B20 are marked on behalf of the opposite parties. Thereafter evidence affidavit of PW. 2 is filed on behalf of the complainant as additional evidence and then evidence affidavit of RW. 2 is filed on behalf of the opposite parties as additional evidence. Written arguments of both sides filed. Oral arguments are also advanced. Perused the record.
5. The points for considerations are :
i) Whether this forum has territorial jurisdiction?
ii). whether the death of the policy holder Kum. Malleswari was accidental or suicide?
iii). Whether the complainant is entitled for the policy amounts and other reliefs claimed in the complaint?
6. Point No. (i) :
The case of the complainant is that her eldest daughter Kum. Malleswari remained unmarried as she was not interested in marriage, so the complainant has performed the marriage of her second daughter. It is the further case of the complainant that the first daughter Malleswari was running a beauty parlour. In the year 2008 two policies were obtained in the name of Malleswari for Rs.1,00,000/- each from opposite party No. 1 by paying yearly premium of Rs.1,00,000/-to opposite party No.1 towards each policy and policy term is 15 years. The version of opposite parties that they have no branch office at Sangareddy therefore this forum has no jurisdiction is disproved by their own document Ex.B1 wherein it is stated “Branch: SANGAREDDY CHIT” As payment of premium was at Sangareddy this forum has jurisdiction. This point is answered against the opposite parties.
Point Nos. ii) & iii)
The case of the complainant is that on 20.07.2008 when the complainant’s daughter Malleswari tried to ignite stove to heat water, flames raised and accidentally Malleswari caught fire and thereby she sustained burn injuries and immediately she was shifted to Government Hospital, Sangareddy and police also registered a case in Crime No. 114/08 u/s 174 Cr.P.C and Malleswari succumbed to the injuries on 24.07.2008 while undergoing treatment in the hospital. Thereafter the complainant made a claim to the opposite parties for payment of the sum assured under both the policies but the opposite party No. 1 refused to pay the amount on the ground that their investigation revealed that Malleswari committed suicide therefore no amount is payable under the policies.
7. Obtaining of policies is not in dispute. The only point to be decided in this case is whether the death of Malleshwari was accidental or suicide. According to the complainant the death is accidental therefore she, being nominee under the policy, is entitled for the sum assured but the opposite parties say that it is a suicide and as per clause 15 of the policy (Ex.A1&Ex.B5)opposite parties are not liable to pay the amount assured. To prove that the death is accidental complainant has relied upon Ex.A6 (Same as Ex.B16) final report which is submitted by the police in the Magistrate court closing the case as accidental death.
8. The learned counsel for the opposite parties has contended that a constable of the very same police station has served a notice on the Magistrate on 20.07.2008 to record dying declaration of Malleshwari and on receipt of the same, to the knowledge of the police, magistrate has recorded dying declaration of the individual on the same day i.e. on 20.07.2008 and the same can be seen in Ex.B18 dying declaration. It shows that the deceased Malleshwari had stated before the Magistrate that she had a quarrel with her neighbour Prabhakar and as the said Prabhakar and his wife abused her in filthy language she came back to her house and poured kerosene on her body by herself and set herself ablaze. It is not known as to why the police have not taken Ex.B18 into consideration before submitting Ex.B16 final report. As seen from Ex.B16 the father of the deceased gave complaint to police on 24.07.2008 stating that his daughter Malleshwari died due to burn injuries. Ex.B16 further shows that in the said report the father of the deceased has stated that the mental condition of his daughter Malleshwari was not good therefore she did not agree for marriage. The report of the father of the deceased can also be seen in Ex.A3 F.I.R. (Ex. B14).
9. When the learned counsel for complainant is asked about the contents of Ex.B18 which shows that Malleshwari attempted to commit suicide he has adverted our attention to the word “antinchukunnaadu” ( ) and contended that because masculine gender “du”( ) is used it cannot be said that Malleshwari set herself ablaze. On a reading of Ex.B18 it does not show that the deceased Malleshwari had stated that somebody else set fire to her. It is clear from Ex.B18 that Malleshwari attempted to commit suicide. Finally she succumbed to the injuries in the hospital on 24.07.2008 while undergoing treatment.
10. The learned counsel for the opposite parties referred to clause 15 in Ex.B5 which is marked on behalf of the complainant also as Ex.A1. It is Policy Covering Note. Clause 15 in the said policy covering note is as follows: “If the life assured commits suicide, whether sane or insane, within one year from the date of commencement of risk under the policy, the policy shall be void and no claim will be payable.”
11. Before coming to a conclusion the police have not taken into consideration the neighbours of the deceased and Ex.B18. Simply basing upon the statements of the father of the deceased and the blood relations the case was closed as accidental death. Not referring to Ex.B18 by the police clearly goes to show that the final report is not a correct report even to the knowledge of the police. From the circumstances of the case and in view of the discussion supra the death of Malleshwari (policy holder) is a clear case of suicide but not accidental death. In view of Clause 15 in EX.A1 & Ex.B5 the policy in question became void and no claim is payable there under, because the policy commenced from 28.04.2008 and the death due to suicide is 24.07.2008 ie. within one year. It is therefore held that the complainant is not entitled to the policy amount or to any other amount in respect of the policy as claimed in the complaint. The points (ii) & (iii) are answered against the complainant.
12. In the result the complaint is dismissed. No costs.
Typed to dictation, corrected and pronounced by us in the open forum this 21st day of July 2011.
Sd/- *** ***
PRESIDENT LADY MEMBER MALE MEMBER
Sd/-
PRESIDENT
CC. 35/2010
Dissenting order of the Members
(Per Smt. Meena Ramanathan, Lady Member and
Sri. G. Sreenivas Rao, Male Member)
The points for consideration are whether this forum has the territorial jurisdiction.
ii). Whether the death of the policy holder Kum. Malleshwari was accidental or deliberate attempt to commit suicide.
And
iii) Whether the complainant is entitled to the policy amounts and other reliefs claimed for in the complaint.
The facts of the case in brief are:
1. The complainant states that her eldest daughter kum.M. Malleshwari subscribed to two policies worth Rs.10,00,000/- each with the opposite parties on 16.02.2008 and paid Rs.1,00,000/- towards each policy on 1st installment/ premium and was duly issued separate receipts. The policy duly commenced from 28.04.2008 and date of maturity is 28.04.2023. unfortunately on 20/07/2008 her daughter while heating water on the stove, sustained burn injuries to which she succumbed while undergoing treatment in the government hospital at Sangareddy. The police registered the case. The opposite parties were informed and they finally sent a letter dated 30.06.2009 stating that on investigation it was revealed that the deceased M. Malleshwari committed suicide by dousing herself with kerosene and set ablaze. Hence no claim can arise and nothing is payable.
2. Firstly Ex.A2 – the deposit acknowledgement receipt clearly states – Sangareddy Branch and the opposite parties have wrongly claimed that this forum has no jurisdiction.
3. We are of the opinion that the complaint ought to be allowed. The deceased definitely subscribed to two policies and paid Rs. 1,00,000/- towards each. This is not in dispute. Based on the police panchanama – Ex.A4 it clearly states that she succumbed to burn injuries while heating the water.
4. The surveyor report dated .09.03.2008 (where as she died on 24.07.2008) conflicting dates on the surveyors report makes us feel very strongly about the CASUAL approach and lackadaisical attitude of the surveyor / investigator who found fault with all the government reports submitted. According to Ex.A13where Shri Ram Life Insurance Company limited, has written a letter to the complainant, wherein they state that they are in receipt of the claim forms A, B &C on 28.04.2009. Whereas the final report submitted by the insurance surveyor / investigator of Shri Ram Life Insurance Company limited (Ex.B13) clearly shows that the investigator conducted preliminary enquiry on 19.02.2009. This proves that the preliminary investigation was conducted by the opposite parties learned surveyor prior to the submission of the claim forms.
5. The opposite parties are relying on this casual report where in all other reports are treated disdainfully. This instills grave doubts in our mind and any layman can easily understand the devious attitude of the esteemed company.
6. The opposite parties further relied upon the Ex.B18 dying declaration (DD) of the deceased. On careful observation of dying declaration, It has a covering letter addressed to the Magistrate Sangareddy about the two burn cases namely Beebi 30 years female with 90% burns and Malleshwari 25 years, female (60% burn) bearing no signature of either hospital or police authorities. However an endorsement seen at top right corner of the letter as “received at 10:15 a.m. through P.C. 1369 of P.S. Sangareddy town” with signature of Prl. Junior Civil Judge, Sangareddy. In the dying declaration, the statement made by the deceased for question No. (4) – ‘Ekkada vuntaru’? Replied as ‘Bhavanigudi Dhaggara’. Whereas she stays at Brahmanwada and for question No. 5 – ‘Neethopatu mee intilo evaru vuntaru? She replied as “Amma, Nanna, Chelli, natho vuntaru, oka chelli pelli aeindi”, but she has three sisters and two sisters have got married and has a brother too. Which she did not / could not reveal. This raises suspicious over the mental and physical fitness of the deceased at the time of giving the statement. So the note written by the civil Asst surgeon of District Hospital Sangareddy as “ The patient is conscious, coherent and is in a fit state of mind to give statement “ seems to be incorrect. Adding to this, the reply to question No. 6 shows “ that the neighbour Prabhakar and his wife abused her in filthy language and the deceased immediately returned to her house and doused herself with kerosene and set herself ablaze”. This version is totally different from what is reported in Panchnama, FIR and final report of the police, which shows that while lighting the stove for heating the water accidentally she caught fire and rushed out screaming. Her family members took her to the Government Hospital in 108 ambulance.
From the above discussions, many questions arise in our minds like
1). Whether the victim was capable of making a statement, as she has suffered 60% burn (below head to thighs) so definitely her mental and physical fitness was not proper.
2). A reasonable nexus needs to be established between the quarrel and the suicide of the lady, but it is a petty quarrel with no grave reason for committing suicide can be established.
3). Intention to commit suicide is also a casual one – using filthy language by a neighbour and it’s not a continuous feature, but she attempted suicide.
The oral statement as to be proved through the witness and who can be subjected to cross examination, which is not followed in this instant case. From every angle discussed above, dying declaration seems to be suspicious, so it should not be acted upon without corroborative evidence. So from all the exhibits - in general and the dying declaration in particular had been scrutinized in the light of other evidence available. The opposite parties had failed to establish beyond reasonable doubt that the deceased committed suicide. This is a case of accidental death, for which FIR, Panchnama, death certificate, original policy documents and claim forms submitted by nominee with correct ID proof is more than sufficient to the insurance company to release give the policy benefits along with accidental benefits.
In the result the complaint is allowed, the nominee / complainant is entitled to the policy amount paid i.e. Rs.1,00,000/- plus 1/10th of the sum assured along with interest at 12% p.a. from the date of submission of claim forms till the disbursement. Time for complying is one month only.
Typed to dictation, corrected and pronounced by us in the open forum this 21st day of July 2011.
Sd/- Sd/-
LADY MEMBER MALE MEMBER
Copy to
1) The Complainant
2) The Opposite party
3) Spare copy Copy delivered to the Complainant/
Opp.Party On _________
Dis.No. /2011, dt.
