Date of filing : 27-03-2012
Date of Disposal :09-05-2013
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
Thursday , the 9th day of May, 2013
C.C.NO.12/2012
Between:
Smt.D.Hampamma
W/o Late Chandrappa
D.No.4/257, Muddalapuram (V)
Kudair Mandal
Anantapur District. … Complainant.
Vs.
United India Insurance Company Ltd.,
rep. by its Divisional Manager, 11/170-B,
Meda Mansion, 1st floor, Subash Road
Anantapur. …. Opposite party
This case coming on this day for final hearing before us in the presence of Sri M.C.Ram Kumar, Advocate for the complainant and Sri A.G.Neelakanta Reddy, Advocate for the opposite party and after perusing the material papers on record and after hearing the arguments on the both sides, the Forum delivered the following:
O R D E R
Sri S.Niranjan Babu, Preisdent (FAC): - This complaint has been filed by the complainant under section 12 of Consumer Protection Act, 1986 against the opposite party claiming a sum of Rs.50,000/- towards Insurance Claim amount and Rs.25,000/- towards mental agony and grant such other relief or reliefs.
2. The brief facts of the complaint are that: - The complainant is the wife and nominee of the deceased D.Chandrappa, resident of Muddalapuram Village, Kudair Mandal, Anantapur District. The complainant’s husband died due to snake bite on 16-11-2010. On 16-11-2010 at about 10.00 A.M. the deceased went to his fields alongwith bullocks to graze them. Usually the complainant used to return in the evening but on that day as the deceased did not return back, the brother of the deceased went in search and noticed the dead-body of his brother in his fields. The same was reported to the Police and a case was registered and investigated by them. The body of the deceased was sent to Government Medical College, Anantapur for conducting postmortem.
3. The deceased was a member of Primary Agricultural Co-operative Society of Muddalapuram Village and he was insured under Kisan Credit Card under Policy No.051000/47/10/43/00000686, which is valid from 01-11-2010 to 31-10-2013. As the complainant’s husband died due to snake bite, the complainant made a claim under the said policy by submitting necessary documents. The opposite party disposed off her claim by sending a regret letter that her claim was repudiated for non-submission of necessary documents. As the claim of the complainant was repudiated, the complainant got issued legal notice on 11-01-2012 for which the opposite party gave reply with false and untenable allegations for the repudiation.
4. The counter filed by the opposite party stating that the alleged death of the deceased due to snake bite on 16-11-2010 at his fields is absolutely false and it is a make belief affair. The opposite party submits that the complainant has to prove that she is a nominee of the deceased under the Kisan Credit Card. The opposite party alleged that the deceased died due to serious pre-existing disease and other ailments but not due to snake bite on 16-11-2010. Hence the complaint is liable to be dismissed. The opposite party submits that all the documents filed alongwith the complaint are nothing but created in collusion with the concerned personnel for the purpose of claiming compensation under the said policy. Further the opposite party submits that the complainant has not submitted the Forensic Laboratory Report since the alleged death is due to alleged snake bite and as per memorandum of understanding the said document is required in the case of death for processing the claim. Since the complainant has failed to comply with the necessary requirements of the company and thereby grossly violated the terms and conditions of the said policy. Further the opposite party submits that there is abnormal delay in giving intimation to the company about the death of the deceased due to alleged snake bite and thereby violated the terms and conditions of the policy. Hence, there is no deficiency of service on the party of the Insurance Company and hence the opposite party has rightly repudiated the claim of the complainant.
5. Basing on the above pleadings, the points that arise for consideration are:-
1. Whether there is deficiency of service on the part of the opposite party ?
2. To what relief?
6. To prove the case of the complainant, evidence on affidavit filed on behalf of the complainant and marked Ex.A1 to A8 documents. On behalf of the opposite party, evidence on affidavit of the opposite party has been filed and marked Ex.B1 to B4 documents.
7. Heard both sides.
8. POINT NO.1: -The counsel for the complainant argued that the complainant’s husband was a member in Primary Agricultural Co-operative Society of Muddalapuram Village, Kudair Mandal and aKisan Credit Card Holder under Policy No.051000/47/10/43/00000686. Subsequently when the complainant’s husband while grazing his bullocks in his fields he died due to snake bite on 16-11-2010. Usually the complainant’s husband used to return home in the afternoon but on that day as the deceased did not return, the brother of the deceased went in search and found the dead-body of the deceased in his fields. Then they made a complaint to the Kudair Police Station and a case was registered as the death due to accidental snake bite. After that inquest was conducted on the body of the deceased, which is marked as Ex.A2 and subsequently postmortem was conducted by the Government Medical College, Anantapur, which is marked as Ex.A3. The counsel argued that both the inquest report and postmortem report clearly reveal that the complainant’s husband died due to snake bite and the Police investigation also reveal the same and a final report submitted by the Station House Officer, Kudair Police Station also reveals that the deceased died due to snake bite and the same is marked as Ex.A4. The counsel for the complainant argued that all the above said documents clearly establish that the complainant’s husband died due to snake bite and the complainant is nominee as per the insurance policy issued by the opposite party, which is marked as Ex.A8.The claim of the complainant was repudiated inspite of submitting all the necessary documents stating that the claim of the complainant was repudiated as the complainant did not furnish necessary documents as required by the opposite party. The counsel for the complainant argued that inspite of all the efforts the opposite party repudiated the claim, which is deficiency of service. Hence the opposite party is liable to pay the sum assured under the policy and also pay compensation for mental agony.
9. The counsel for the opposite party argued that it is true that the complainant’s husband is a Kisan Credit Card Policy-holder under Policy No. 051000/47/10/43/00000686. The arguments of the counsel for the opposite party is that the complainant’s husband did not die due to snake bite but due to long standing illness. The counsel for the opposite party argued that all the documents filed along-with complaint are created documents in collusion with the concerned personnel for the purpose of claiming compensation under the said policy and the complainant failed to submit Forensic Science Laboratory Report, which is required to establish that the deceased died only due to snake bite and thereby violated the terms and conditions of the company. Further the counsel for the opposite party argued that there was abnormal dealy in giving intimation to the company about the death of the deceased due to alleged snake bite and thereby grossly violated the terms and conditions of the said policy. Hence the claim of the complainant was rightly repudiated and there is no deficiency of service on the part of the opposite party and hence the complaint is liable to be dismissed.
10. After hearing the arguments and perusing the documents, it is an admitted fact that the complainant’s husband was the policyholder as on the date of the death of the deceased. The main reasons shown by the opposite party for repudiation are that the complainant failed to submit FSL Report (Forensic Science Laboratory Report) in order to ascertain the death of the deceased and that there was abnormal delay in intimating the death of the deceased. Ex.A2, A3 and A4 clearly show that the deceased died due to snake bite only. Ex.A2 is the inquest report, wherein it is clearly mentioned that the deceased died due to snake bite. Ex.A3, which is postmortem report of the deceased wherein the cause of death is shown as death due to snake bite and final report submitted by the Station House Officer,Kudair Police Station to the Mandal Tashildar, Kudair to accord permission for treating the case as action dropped as there was no foul play suspected in the death of the deceased and the deceased died due to snake bite.
11. In the above circumstances, the cause of death is established beyond doubt that the complainant’s husband died only due to snake bite and another plea taken by the opposite party that there was abnormal delay of 2 ½ months in intimating the death of the deceased can not be taken into consideration as the complainant has to secure all the necessary documents to claim the insurance amount. Hence the delay can not be a reason for repudiating the claim. In view of the above observations, the repudiation of the claim made by the complainant is not justified as the complainant has submitted the above documents while claiming but the opposite party has insisted for Forensic Science Laboratory Report, which could not be produced by the complainant as the complainant can not insist for sending FSL Report of the deceased.
12. It is held in LIC of India, Secunderabad and another Vs. Banavath Kamlee reported in 2000 ALD (Cons.,) Page 96 that:
“ Complainant’s husband took an insurance policy under Double Accident Benefit Scheme – Claim was made by the complainant that her husband died due to snake bite and produced the death extract given by Mandal Revenue Officer – Insurance Company paid the assured amount but refused to pay the accident benefit on the ground that the complainant failed to produce the post-mortem certificate, FIR or inquest report – Held, illegal – When the cause of death is a snake bite but not a suspicious one obtaining FIR and other documents does not arise – Further, no opportunity was given to the complainant to establish the cause of death – In the circumstances denial of claim by Insurance Company is illegal. “
13. In view of the above citation, the present complaint which is having similarities to that of the citation and in the above circumstances, the complainant’s claim was not rightly repudiated and the opposite party is liable to pay the sum assured under the policy to the complainant.
14. POINT NO.2 - In the result, the complaint is allowed by directing the opposite party to pay a sum of Rs.50,000/- towards the sum assured to the complainant with interest @ 9% p.a. from the date of complaint till the date of realization and also to pay a sum of Rs.2,000/- towards costs of the complainant within one month from the date of this order.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 9th day of May,2013.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT: ON BEHALF OF THE OPPOISITE PARTY
-NIL- - NIL-
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
Ex.A1 - Attested copy of FIR in Cr.lNo.100/2010 of Kudair P.S.
Ex.A2 - Attested copy of inquest report relating to deceased D.Chandrappa.
Ex.A3 - Attested copy of Postmortem report relating to deceased D.Chandrapa.
Ex.A4 - Attested copy of final report relating to deceased D.Chandrappa.
Ex.A5 - Office copy of legal notice dt.11-01-2012 got issued by the complainant to the
Opposite party and United India Insurance Co. Ltd., Regional Officer, Hyderabad.
Ex.A6 - Postal acknowledgment signed by the opposite party.
Ex.A7 - Attested copy of Family Member Certificate relating to deceased D.Chandrappa.
Ex.A8 – Kishan Credit Card Scheme Policy No.051000/47/10/00000686 issued by the
Opposite party.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY
Ex.B1 - Kishan Cred Cardit Scheme Policy No.051000/47/10/00000686 issued by the
Opposite party.
Ex.B2 - Photo copy of application for intimation of claim submitted by the complainant to the
Opposite party.
Ex.B3 - Photo copy of repudiation letter dt.15-12-2011 issued by the opposite party.
Ex.B4 - Photo copy of legal notice dt.11-02-2012 got issued by the opposite party to the
Complainant.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC),
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
Typed by JPNN
