BEFORE THE DISTRICT CONSUMER FORUM : WARANGAL

Present:       Sri D.Chiranjeevi Babu

                                                President.

                                               Sri N.J.Mohan Rao,

                                               Member.

                                      AND

                                                Smt. V.J. Praveena,

                                                Member.

          Wednesday the 01^st  May, 2008.

CONSUMER DISPUTE NO. 110/2005

Between:

Kanukuntla Sujatha,

W/o.Late Srinivas,

Age: 26 yrs., Occu.: Housewife,

R/o.Chelvai Village,

Govindaraopet Mandal,

Warangal District.

           …              Complainant

AND

1.  The ING-VYSYA Bank,

     Main Road, Village Chelvai,

     Govindaraopet (M),

     Warangal District

     Rep.by its Branch Manager,

2.  The Senior Manager,

     The United India Insurance Co.,Ltd.,

     40/3, Geeta Mansion, KG Road,

     Bangalore – 506 009.                                       …       Opposite Parties

Counsel for the Complainant               : Sri.  L.Jalandhar Reddy, Advocate

Counsel for the Opposite Party No.1    :  Sri. Y.Aravind, Advocate

Counsel for the Opposite Party No.2   :  Sri.  A.Madanmohan Rao, Advocate

This complaint coming for final hearing before this Forum, the Forum pronounced the following Order.

                                               ::  ORDER  ::

     Sri D.Chiranjeevi Babu, President

          This is a complaint filed by the complainant Smt.Kanukuntla Sujatha, against the Opposite Parties under section 12 of Consumer Protection Act, 1986 for a direction to grant Rs.3,00,000/- with interest 18% P.A. from the date of death of K.Srinivas and Rs.50,000/- may be granted towards mental pain and agony.

The brief averments contained in the complaint filed by the complainant are as follows:

01.     The case of the complainant is that, her husband namely K.Srinivas opened a Premium Savings Bank Account (PSB Account) jointly bearing A/c.No.10525 in the branch of Opposite party No.1 on 17-01-2002 by depositing an amount of Rs.1.200/-.  The conditions and advantages of the said PSB account are : 

1.                 Account to be maintained with a minimum balance of Rs.1,000/- all through.

2.                 Accidental insurance coverage will be provided.

3.                 Risk coverage of Rs.3,00,000/- for three years.

4.                 Insurance charges @ 100/- per head shall be debited to the account of account holder.

5.                 The insurance cover shall commence from the date of opening of the account and will be continued for a period of three years.

6.                 Insurance coverage will be for the persons who are aged 5 years to 70 years.

7.                 The insurance is covered for accidental death or disability.

8.                 It is also applicable to the joint account holders by paying Rs.100/- per head.

02.     The complainant’s husband died on 17-03-04 due to snake bite.  The complainant fulfilled all the terms and conditions of the opposite parties i.e.Opposite party No.1 debited Rs.200/- from their account, the death is within three years, minimum balance is maintained and the death is accidental i.e. due to snake bite.  A case was registered vide crime No.12 of 2004 of P.S. Pasra.  The inquest panchanama and Post mortem report clearly shows that the death of K.Srinivas is due to snake bite.  After the death of K.Srinivas the complainant approached the Opposite Party No.1 to settlement of claim as per the terms of the P.S.B. Scheme i.e. Rs.3,00,000/-, the complainant submitted all the required documents.  Vexing with the attitude of the opposite parties the complainant had got issued a legal notice dated 29-07-2005. There is no hope of recovery of insured amount of Rs.3,00,000/- without aid and assistance of the Hon’ble Forum.  The complainant suffered with much mental pain and agony is claiming Rs.50,000/-.

03.     It is true that the complainant and her husband were having a Premium Savings Bank Account with this Opposite Party the life of the customer is covered by accident for a sum of Rs.3,00,000/- for a period of 3 years under Group Accident Insurance Policy covered by opposite party No.2 subject to certain terms and conditions.  Opposite party has no knowledge about the incident of snake bite occurred on 17-03-2004 and subsequent events as narrated in para No.2 of the complaint.  It is false to say that postpone the payment of amount and did not give reply to the notices given by the complainant are false and baseless.  As per the Memorandum of understanding entered by this opposite party with opposite party No.2 with regard to settlement of claims in Premium Savings Bank Account, the role of this Opposite party is very limited  only to the extent of collecting the premium from the customers and remitting the same to the Opposite Party No.2.  The responsibility of claim settlement rests solely with opposite party No.2.  Any dispute arising in settlement of claims shall be dealt by the account holders/claimants directly with opposite party No.2 without involving this opposite party.  A copy of the Memorandum of Understanding entered by this opposite party Bank with opposite party No.2 is filed for perusal of this Hon’ble Forum.  It is clearly mention that  the complainant’s Post Mortem Report clearly establishes the cause of death of her husband is due to snake bite is not correct and the delay of settlement of claim amounts to deficiency of service is also not correct.  The Opposite party has entered into an agreement with the opposite party No.1 covering the risk of its account holders who ever pays the requisite premium on certain terms and conditions.  As per the terms and conditions of the policy this opposite party is liable to settle the claim in respect of the accidental deaths.  As per the Column No.7 of the Inquest Report it is clearly mentioned that no external injuries were found on the person of the deceased.  As per the Post Mortem Examination Report also no external injuries were found on the dead body.  Finally mention that the policy covers the risk of accidental deaths only.  When the death of the deceased was not accidental, question of this opposite party paying the claim amount does not arise. 

          Now the point for consideration whether the complainant is entitled for grant of Rs.3,50,000/- i.e. insured amount with interest 18% per annum from the date of death of K.Srinivas and also an amount of Rs.50,000/- towards mental agony and with costs.  

To What Relief:

          After the arguments of the both side counsels our reasons like this.  The case of the complainant is that the complainant and her husband namely Kanukuntla Srinivas opened a Premium Savings Bank Account (PSB Account) jointly bearing A/c.No.10525 in the branch of Opposite Party No.1 on 17-01-2002 by depositing an amount of Rs.1,200/-.  The conditions and advantages of the said PSB Account are :

1. Account to be maintained with a minimum balance of Rs.1,000/- all through.

2. Accidental insurance coverage will be provided.
3. Risk coverage of Rs.3,00,000/- for three years.
4. Insurance charges @ 100/- per head shall be debited to the account of account holder.

5. The insurance cover shall commence from the date of opening of the account and will be continued for a period of three years.

6. Insurance coverage will be for the persons who are aged 5 years to 70 years.

7. The insurance is covered for accidental death or disability.

8. It is also applicable to the joint account holders by paying Rs.100/- per head.

     The husband of the complainant died on 17-03-2004 due to snake bite accidentally.  The complainant fulfilled all the terms and conditions of the Opposite Parties i.e. Opposite party No.1 debited Rs.200/- from their account, the death is within three years, minimum balance is maintained and the death is accidental i.e. due to snake bite.  After the death of complainant’s husband due to Snake bite the case was registered vide crime No.12 of 2004 of P.S.Pasra.  The inquest panchanama and Post Mortem Report clearly herewith.

          After the death of husband of the complainant they informed and sent all concerned documents to the Opposite Party No.2 but they have rejected to given the same.  Thereafter the complaint refused to return insurance policy amount of Rs.3,00,000/-,  thereafter the complainant got issued legal notice to Opposite party No.1,  but  did  not  give  any  reply  and there is no hope recovery of insured amount of Rs.3,00,000/- without aid and assistance of the Hon’ble Forum.  Thereafter they filed this C.D.

          Opposite Parties 1 & 2 filed their counters stating that, the deceased K.Srinivas not died due to Snake bite.  Since the deceased died due to snake bite and the conditions in the policy not covered, so the insurance company is not liable to pay the policy amount to the complainant for the death of K.Srinivas.  

Now the Forum has to see whether the documentary proof to show that whether the deceased K.Srinivas died due to Snake Bite or natural death.  To give our answer for the above question certainly we have to verify the documents filed by the complainant side, the counsel for the Opposite Party No.2 argued that the deceased K.Srinivas not died due to Snake bite because the post mortem certificate i.e. Ex.A-5 show that there are no external injuries except there is a swelling of right foot, and Doctor has not written about the death of the deceased clearly in post mortem certificate i.e. in Ex.A-5.  The counsel for the complainant argued that it is clearly mentioned in the post mortem certificate that the deceased K.Srinivas died only due to Snake bite, for this our answer is that as per Ex.A-5 in page No.2  it is clearly mentioned that no external injuries found on the dead body and there is a swelling of right foot and blue in colour no external dot marks of snake bite, so when the Doctor stated in this clearly it is not comes under Snake bite, further Doctor stated that in the same opinion  the Forum and Ex.A-5 in post mortem certificate that the death of the deceased due to the bite snake leading to circulating failure in cardiac, so  this shows he died due to Snake bite but he has not given any reasons what is the condition of the death body at the time of taking post mortem by the Doctor, actually if any Doctor conducted autopsy  he has to mention all the circumstances of the dead body in post mortem certificate.  But surprisingly Doctor has not stated anything.  In page No.2 he has mentioned no injuries in the opinion Forum the deceased died due to Snake bite.  As per jurisprudence   if any Doctor conducted the post mortem of the Snake bite man certainly the following appearances should be there:

Post-mortem Appearances:  Poisonous snakes leave two or occasionally one fang mark.  Non-poisonous snakes leave a semicircular set of tooth-marks.  The punctures are 1.2 cm. Deep in colubrine and 2.5 cm. Deep in viperine bites.  Sometimes, the bite marks may not be visible.  In colubrine bite, the site of bite contains fluid and haemolysed blood causing staining of vessels.  In viperine bite, there is discolouration, swelling and cellulites about the mark and haemorrhages occur from the puncture and mucous membranes.  Haemorrhages into the howel, purpuric spots on pericardium, and haemorrhages in the lungs and in many tissues may be seen.  Kidneys are inflamed.  Internal organs are congested.  Washing from the bite area may contain cholinesterase or thromboplastin.

          In the present case except the swelling there is no external injuries on the dead body of the K.Srinivas and further there is no any abrasion on the foot of the deceased and further there are no any Snake bite i.e. dots on the foot so definitely the deceased not died to due to Snake bite.

          So it is clear cut when the deceased not died due to Snake bite the insurance is not liable to pay the policy amount to the complainant. 

The counsel for the Opposite party No.2 cited 2001 (3) CPR 65 (NC) in Smt.Manjulaben Kantibhai Patel Appellant Vs. National Insurance Co.Ltd., and another the National Consumer Disputes Redressal Commission, New Delhi held that Consumer Protection Act 1986 Sec.12 and 17 Insurance claim under personal claim policy insured, husband of appellant met with accident while driving a two wheeler scooter claim repudiated on ground that insured did not meet with accident and death was due to natural cause, State Commission dismissed complaint holding that medical evidence did not justify that insured died of any accident Pillion rider on scooter was not examined, Appeal, Nothing to show what injury was suffered by insured if he met with accident, Insured was unconscious when brought to hospital, No medico legal case was prepared, No illegality in impugned order.

This judgment is applicable to the case of the Opposite Party No.2, in this case also the husband of the deceased died due to natural cause, in the present case also when we came to conclusion that the deceased cause involves not the Snake bite certainly his death is natural cause.  So this judgment is applicable.  So on the basis of discussions given by me we come to conclusion that the death of the K.Srinivas is purely only on natural cause but not due to Snake bite.  If really the death of the deceased is due to Snake bite the duty of the Doctor who conducted the post mortem has to explain the conditions and circumstances of the body of the deceased, but he has not mentioned about the conditions of the circumstances of the dead body when has raised in medical jurisprudence what I have stated in Supra.  So the complainant is not entitled to get any premium amount from the Opposite Party No.2.  Further as per Ex.B-2 the investigation report i.e.  Ex.B-2 is also clearly goes to show that the deceased K.Srinivas is not died to Snake bite and further the deceased wife Smt.Sujatha also agreed on 17-03-2004 at about 8.00 P.M. after dinner slept and next morning 6.00 A.M. noticed white foam coming from mouth of deceased K.Srinivas right foot was black in colour since 1 ½ year.  After inquest prior to taking photographs bleeding started from nose and mouth of deceased.  On noticing white foam coming from mouth concluded the death was because of poisonous insect bites. The inquest report also shows that in column No.7 is it is clear that there are injuries on the death body the right foot was black in colour no dot marks are seeing on the dead body. 

So in the above stated circumstance clearly goes to show that, the deceased is not died due to Snake bite, he died only due to natural death.

          In the result there are no merits in the complaint filed by the complainant and accordingly the same is dismissed but without costs.

  01^st  May, 2008).

        Sd/-                Sd/-

                                                     Sd/-

                                                  Member           Member          President,

                                                        District Consumer Forum, Warangal.

APPENDIX OF EVIDENCE

ON BEHALF OF COMPLAINANT

ON BEHALF OF COMPLAINANT                          ON BEHALF OF OPs.

Affidavit of Complainant filed                         Affidavit on behalf of OPs. filed.

ON BEHALF OF COMPLAINANT EXHIBITS MARKED

No.10525.

2. Ex.A-2 is the F.I.R. dated 18-03-2003.
3. Ex.A-3 is the Letter to the Sub-Inspect of Police, Pasra.
4. Ex.A-4 is the Inquest panchanama, dated 18-03-2004.
5. Ex.A-5 is the Post Mortem Report, Dated 18-03-2004.
6. Ex.A-6 is the Death Certificate, dated 10-05-2004.
7. Ex.A-7 is the Letter addressed by Opposite Parties 1 & 2.
8. Ex.A-8 is the Letter to ING Vysya Bank, dated 19-05-2004.
9. Ex.A-9 is the Office copy of legal notice, dated 29-07-2005.
10. Ex.A-10 is the acknowledgement cards.

ON BEHALF OF Opposite parties

Ex.B-1 is the Agreement of Memorandum of Understanding.

Ex.B-2 is the Investigation Report Group JPA Claim Vysya Bank PSB  

           A/C Holder – Snake Bite _ Death of K.Srinivas.

                                                                                                          Sd/-                          Sd/-                           Sd/-

                                                           Member       Member        President,

                                                            District Consumer Forum, Warangal.