PRESENT SRI P.V. NAGESWARA RAO, M.A., LL.M., PRESIDENT

 

Tuesday, 8^th June 2010

 

 

1) Boggula Lakshmi Veeranjanamma,

2) Boggula Sreeja Reddy, D/o  Late Bala Narasimha Reddy,

3) Boggula Teja Reddy, S/o Late Bala Narasimha Reddy,

 

Vs

 

1) The General Manager, Telecom District, Kadapa.

2) Cholamandalam M.S. General Insurance Co. Ltd., Rep. by its

 

 

This complaint coming on this day for final hearing on 31-5-2010 in the presence of Sri A. Raja Reddy, Advocate for complainant and Sri D. Lakshminarayana, Advocate for R1 and Sri G.S. Moorthy, Advocate for R2 and upon perusing the material papers on record, the Forum made the following:-

 

 

 

1.                Complaint filed under section 12 of the Consumer Protection Act 1986.

 

2.                The brief facts of the complaint are as follows:- The 1^st complainant was the wife of Late Boggula Bala Narasimha Reddy and 2^nd and 3^rd complainants were the minor daughter and minor son of the 1^st complainant and Late Boggula Bala Narasimha Reddy.  Boggula Bala Narasimha Reddy died in a road accident on            14-2-2009 at Church on Proddatur Road at a distance of 2 Kms towards north.    The Yerraguntla police station registered a case in Cr. No. 18/2009 under section 304 A IPC. The husband of the 1^st complainant had a telephone connection bearing No. 280226 CCBPTS and running a telephone booth, while he was alive. He paid                  Rs. 7,000/- towards deposit to the R1.   The R2 was insurance company had a tie-up with R1. If the service holder would die he would be entitled for accidental benefit of Rs. 50,000/-. As there was coverage of accidental benefit to the husband of the 1^st complainant and the legal heirs were entitled to claim Rs. 50,000/-. The terms and conditions of the contract were not known to the complainant because policy certificate was not supplied to the deceased at the time of becoming a member. The terms and conditions were known to R2. The claim was preferred on 30-3-2009 before Divisional Engineer, BSNL, Kadapa, who inturn forwarded the same to R1.    The Accounts Officer of R1 addressed a letter to the 1^st complainant stating that the address was not tallied with the address shown in the House Hold card and so it could not be forwarded to R2 company.   Later the address was furnished to the R1. The 1^st complainant was not aware when the claim was forwarded to R2. On               24-7-2009 the R2 wrote a letter to the 1^st complainant rejecting the claim on the ground that the claim was not preferred within 60 days. 

 

3.                The complainants were not aware for 60 days period for submitting the claim form. However, the claim was submitted on 30-3-2009 before Divisional Engineer, BSNL, Yerraguntla.   It was within the prescribed period. On that account the claim could not be rejected. The family members certificate issued by the Tahsildar, Yerraguntla was clear regarding legal heirs of the deceased.   Therefore, the R2 was liable to pay Rs. 50,000/- to the complainants. Since R2 failed to settle the claim, it would amount to deficiency of service.    There was no claim against R1, which was a formal party. Thus the complaint was filed for Rs. 50,000/-payable by R2 together with Rs. 5,000/- towards mental agony and Rs. 2,000/- towards costs. 

 

4.                The R1 filed a counter denying the complaint averments except those which were specifically admitted to be true and correct. Since there was no relief against R1, the complaint may be dismissed against R1.   It was correct that there was coverage of accidental benefit for the customers of BSNL land line mobile post paid and STD PT customers for Rs. 50,000/- payable by R2 company. The deceased was a customer of STD PT bearing No. 280211. On 3-4-2009 the Accounts Officer (TRA), Kadapa received death intimation of the deceased STD PT customer submitted by 1^st complainant through Sub-Divisional Engineer, Yerraguntla, who inturn on           6-4-2009 requested the complainants to submit relevant documents like claim form, indemnity bond, affidavit of the legal heirs, House hold card, telephone bill and latest telephone bill and driving license of the deceased.   The complainants submitted the documents on 21-5-2009 through Sub-Divisional Engineer, Yerraguntla i.e. after 133 days from the date of death of the deceased.  As the address was not tallying from the house hold card, On 23-5-2009 the Accounts Officer (TRA), Kadapa addressed a letter to the 1^st complainant informing about the same, who sent telephone bills as proof through Sub-Divisional Engineer, Yerraguntla on 2-7-2009. Subsequently the same was forwarded to R2 on 14-7-2009. The claim of the complainants was not considered by R2 on the reason of delay of receiving the death intimation. The settlement of claim was completely related to R2. except receiving and forwarding the documents of the claimants. There was no other obligation on the part of the R1. Hence, the complaint may be dismissed with costs. 

 

5.                The R2 filed a counter denying the allegations of the complaint, except those which were admitted to be true and correct. The 1^st complainant should prove that she was legally wedded wife of the deceased and the complainants 2 & 3 were their children.   The complainants must prove that the deceased Boggula Bala Narasimha Reddy deposited Rs. 7,000/- with R1 towards deposit of telephone connection. A group personal accident policy was issued to BSNL under policy No. APG – 00004621 – 000-00 for the period from 14-1-2009 to 13-1-2010 covering 324,96,363 persons for the sum insured of Rs. 50,000/- for accidental death and permanent total disablement. The liability was subject to various terms and conditions of the policy. The insurance was a contract of indeminity. Any violation of the contract it would become void and the insurance company was not liable. Therefore, the terms of the agreement had to be followed.   The insured could not claim anything more than what was covered under the policy. The claim was intimated by the complainant on 21-7-2009 stating the alleged death on 14-2-2009.   It was after a lapse of five months.   As per MOU with BSNL the claim intimation should be intimated within 60 days from the date of alleged loss.   The time limit for settlement of the claim by the BSNL customers should be 60 days from the date of occurrence of the accident. The respondent sent a letter dt. 24-7-2009 expressing its  inability to consider the same in view of terms and conditions of the policy. Both parties should follow the terms and conditions of the policy issued by the insurance company.   The insured would not claim beyond the terms and conditions. There was no deficiency of service. The deficiency of service could not be alleged without attributing fault, imperfection, nature and manner of performance, inadequacy in the quality. The allegations that no policy  certificate was provided and it must be proved by the complainants. 

 

6.                It was not correct that the claim was preferred by the complainants on 30-3-2009 before the Divisional Engineer, BSNL, Kadapa who inturn forwarded to R1. It was not correct that the Accounts Officer, TRA, Kadapa addressed a letter to the complainants that the address was not tallied with the house hold card address and hence, he could not forwarded the claim to R2 and after receiving the address it would be forwarded to R2. It was not correct that the complainants were not aware when the claim would be preferred to R2. The death intimation was received on     21-7-2009 beyond 60 days and hence, the R2 rejected the claim and was not liable. The claim was not intimated to R2 within 60 days period but it was intimated more than five months later. Thus the complainants were not entitled to the claim amount of Rs. 50,000/- because they have not intimated within stipulated period of 60 days. Thus the complaint may be dismissed with costs. 

7.                On the basis of the above pleadings the following points are settled for determination. 

i.                   Whether there is any negligence and deficiency of service on the part of the respondents?

ii.                 Whether the complainants are entitled to the relief’s as prayed for?

iii.              To what relief?

 

8.                On behalf of the complainant Ex. A1 to A9  were marked and on behalf of the respondent Ex. B1 to B10 were marked.

 

9.                Point No. 1& 2.  It was not dispute that late Boggula Bala Narasimha Reddy, died in a road accident near Church on Proddatur road on 14-2-2009 and the Yerraguntla police station registered a case in Cr. No. 18/2009 under section 304A IPC and the deceased had a telephone connection bearing No. 280211 a customer of STD PT and No. 280226, a customer of CCB PT. The deceased was a Member of Group personal Accident Policy issued to R1 by R2 under the policy No. APG – 0004621-000-00 for the period from 14-1-2009 to 13-1-2010 covering 324,96,363 persons and sum insured for each connection for accidental death, permanent total disablement was Rs. 50,000/-.   The copy of the policy along with terms and conditions was Ex. B7. 

10.              After the death of Boggula Bala Narasimha Reddy on 14-2-2009 the Yerraguntal police registered a case in Cr. No. 18/2009. The Photostat copy of FIR was Ex. A1 and Photostat  copy of post mortem certificate was Ex. A2.   The Photostat  copy of inquest report was Ex. A3.   The complainants filed Ex. A4 a Photostat  copy of family members certificate issued by Tahsildar, Yerraguntla mentioned that the 1^st complainant was wife and 2^nd and 3^rd complainants were minor daughter and minor son of the 1^st complainant and the deceased Boggula Bala Narasimha Reddy. Later the complainants submitted an application to the Sub-Divisional Engineer, Groups, BSNL, Yerraguntla, who addressed a letter to the Accounts Officer, (TRA) office of GMTD, Kadapa on 30-3-2009 stating that the subscriber Boggula Bala Narasimha Reddy died due to accidental death and forwarding the application received from the 1^st complainant for issuing of accidental insurance scheme, as well as change of proprietory name on the name of his wife. The Photostat  copy of letter was Ex. A6. So after the death of Boggula Bala Narasimha Reddy on 14-2-2009, the 1^st complainant informed the death on 30-3-2009 to the Sub-Divisional Engineer, who informed the same to the Accounts Officer, (TRA) GMTD, Kadapa On 30-3-2009. It was happened within 60 days of the accident. The Accounts Officer, (TRA), GMTD, Kadpa wrote a letter on 23-5-2009 to the 1^st complainant that the address of the claimants was not tallied with the house hold card. The letter was Ex. A7.   Ex. A8 were receipts in the name of Boggula Bala Narasimha Reddy towards payment of telephone bill, to BSNL, Kadapa for the telephone No. 280226 & 280211. Ex. B9 was Photostat  copy of death certificate of Boggula Bala Narasimha Reddy.   On 24-7-2009 the R2 rejected the claim on the ground that it was not intimated within the stipulated period of 60 days, because the intimation was received on 21-7-2009, though the death was occurred on 14-2-2009. The R1 filed Ex. B1, a Photostat copy of the letter addressed by the Sub-Divisional Engineer, BSNL, Yerraguntla to the A.O (TRA), GMTD, Kadapa dt. 30-3-2009. The similar Photostat  copy was filed by the complainant under Ex. A6. On perusal of Ex. B1, it was received by the Accounts Officer, (TRA), GMTD, Kadapa on 3-4-2009. 

11.              On 6-4-2009 the Accounts Officer, (TRA), GMTD, Kadapa addressed a letter to the Sub-Divisional Engineer, Groups, BSNL, Yerraguntla requesting certain documents such as claim form, indemnity bond, household card, telephone bill, driving license of the deceased, latest payment receipt of the telephone bill, affidavit of the legal heirs for insurance claim. The Photostat  copy of the letter was Ex. B2. Ex. B3 was Photostat  copy of letter from Sub-Divisional Engineer, BSNL, Yerraguntla to the Accounts Officer, GMTD, Kadapa, dt. 21-5-2009 that the required documents were forwarded for insurance claim of the complainants.  Ex. B4 was Photostat  copy of letter from Accounts Officer, (TRA), GMTD to the 1^st complainant, dt. 23-5-2009 that the address was not tallied. The similar copy was filed by the complainant under Ex. A7. Ex. B5 was Photostat  copy of another letter from Sub-Divisional Engineer, Yerraguntla to the Accounts Officer, (TRA), GMTD, Kadapa forwarding the telephone bills of the two telephones belonged to the deceased Boggula Bala Narasimha Reddy. Ex. B6 was Photostat  copy of another letter from Chief Accounts Officer, GMTD, Kadapa to the R2, dt. 2-7-2009 submitting the documents for insurance claim. Therefore, the 1^st complainant as wife of the deceased and mother of the minor complainants 2 & 3 informed the death intimation and the claim of the insurance amount on 30-3-2009 and same was received by the Accounts officer, (TRA), GMTD, Kadapa on 3-4-2009 within the period of 60 days. The delay in submitting the documents and application form to R2 by R1 was an administrative act of R1. It was not delay with the complainants but it was a delay due to administrative functioning of R1 and R2.   It was a continuous action without any break. 

 

12.              However, the R2 filed Ex. B7a copy of policy with terms and conditions. Under condition No. 7 in part – 3 it was mentioned that it should be a condition precedent for any claim to be made by the insured under the policy or for liability attaching to the company hereunder that written notice of claim must be given immediately to the company upon the occurrence or commencement of any loss or as soon, thereafter as reasonably possible and in any event not later than 30 days of such occurrence or commencement.    The first complainant gave intimation and submitted the application within 30 days to R1 through the Sub-Divisional Engineer, Yerraguntla. So the said condition was not violated.   Under Ex. B7 the terms and conditions mentioned that the submission of the claim document by the complainants would be within a maximum period of 60 days from the occurrence of the incident and in any special case it would be 75 days with valid reason. Ex. B8 was a Photostat  copy of BSNL personal accident insurance scheme.  Ex. B9 was a letter from R1 to R2, dt. 27-6-2009 submitting the documents for insurance claim. The similar letter was filed by R1 under Ex. B6. Ex. B10 was repudiation letter. The complainant filed similar letter under Ex. A5. Therefore, there was no delay on the part of complainants but it was only an administrative delay of the R1.   But R1 had no liability because the insurance claim amount would be paid by R2 only and R1 was only forwarding the documents. Therefore, there was no relief sought against R1 and R1 was only a formal party. In view of the above discussion there is deficiency of service on the part of R2.  Hence, the points are answered accordingly. 

 

13.              Point No. 3 In the result, the complaint is allowed, directing the R2 to pay Rs. 50,000/- (Rupees Fifty Thousand only) together with Rs. 3,000/- (Rupees Three Thousand Only) towards mental agony and Rs. 1,000/- (Rupees one Thousand Only) towards costs proportionally to the complainants i.e. Rs. 18,000/- to each of the complainants. The R2 is directed to deposit in fixed deposit of the share of the complainants 2 & 3 in a National bank till the complainants 2 & 3 attain majority and further directed the R2 to hand over F.D receipt to the complainant No. 1. The complainant No. 1 is at liberty to withdraw interest on F.D’s of complainants 2 & 3 till they attain majority for their maintenance and welfare. The case against R1 is dismissed without costs. 

 

Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open forum, this the 8^th June 2010

 

 

Witnesses examined.

For Complainant    NIL                                                  For Respondent :     NIL

Exhibits marked for Complainant : -  

 

 

Ex. A1         P/c of FIR in Cr. No. 18/2009 Yerraguntla Police station.

Ex. A2         P/c of Post mortem certificate.

Ex. A3         P/c of inquest report under Cr. No. 18/2009.

Ex. A4         P/c of family members certificate issued by Tahsildar, Yerraguntala

Ex. A5          P/c of letter from R2 to complainant, dt. 24-7-2009.

Ex. A6          P/c of letter from SDE, Yerraguntal to A.O. GMTD, Kadapa dt. 30-3-09.

Ex. A7          Letter from R1 to complainant, dt. 23-5-2009.

Ex. A8          Receipts issued by the R1 on different dates on two telephones.

Ex. A9          P/c of death certificate issued by panchayatraj Department, dt. 27-2-09

 

Exhibits marked for Respondents: -                   

 

Ex. B1         P/c of letter from SDE, Yerraguntla to the A.O. GMTD, Kadapa,

dt. 30-3-2009.

Ex. B2         P/c of letter from A.O. GMTD, Kadapa to the SDE, Yerraguntla,

dt. 6-4-2009.

Ex. B3         P/c of letter from SDE, Yerraguntla to the A.O. GMTD, Kadapa,

dt. 21-5-2009.

Ex. B4         P/c of letter from R1 to complainant, dt. 23-5-2009.

Ex. B5         P/c of letter from SDE, Yerraguntla to the A.O. GMTD, Kadapa,

dt. 2-7-2009.

Ex. B6         P/c of letter from R1 to R2, dt. 2-7-2009.

Ex. B7         Copy of Schedule Group personal Accident policy issued by R2 and terms

and conditions. 

Ex. B8         P/c of BSNL Personal Accidental insurance scheme.

Ex. B9         Letter from R1 to R2, dt. 27-6-2009.

Ex. B10       P/c of letter from R2 to complainant, dt. 24-7-2009.

 

 

 

1)     Sri A. Raja Reddy, Advocate for complainant                                                               

2)     Sri D. Lakshminarayana,  Advocate for R1.

3)     Sri G.S. Moorthy, Advocae for R2.   

 

 

2) Copy was dispatched on      :

3) Copy of delivered to parties :