BEFORE 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

Wednesday, the 11^th  day of May 2011

C.C. No. 56 of 2010

Between:

Smt. Reva Padma W/o Late R. Muthyam Reddy,

Aged about 44 years, House Wife,

R/o H.No. 10/C, Flat No. 201,

Sai Sadguru Apartments,

Phase – I, R.C. Puram, BHEL,

Hyderabad.                                                                              …..Complainant

                   And

M/s The Life Insurance Corporation of India,

Rep. by its Branch Manager, Medak Branch,

3-9-93/5, Golkonda Locality Town,

Medak – 502 110.                                                         ….Opposite party

     This case came up for final hearing before us on 02.05.2011 in the presence of Sri R. Vinod Reddy, Advocate for complainant and Sri M. Prabhakar Gupta, Advocate for the Opposite party, upon hearing arguments of both sides, on perusing the record and having stood over for consideration till this day, this Forum delivered the following:

O R D E R

(Per Se Meena Ramanathan, Lady Member)

1.             This complaint is filed under section 12 of Consumer Protection Act, 1986 by Complainant alleging that her Late Husband Sri. R. Muthyam Reddy had taken an insurance policy from opposite party and had insured his life for a sum of Rs. 1,00,000/- unde Jeevan Anand ( with profits and also with accident benefits), vide policy No. 602683103. The complainant is the nominee of late Sri Muthyam Reddy.

It is further submitted that Sri Muthyam Reddy died in accident, which occurred on 17.05.2009 at about 11:00 a.m., opposite to blue sea hotel, St. Johan Road, Secunderabad/ Hyderabad. The death occurred owing to an accident. Muthyam Reddy was proceeding from Suchitra to Musheerabad when he tried to avoid another motor cyclist coming from the opposite direction. As a result, he hit an electric pole and succumbed to his injuries. Passersby informed the police and P.S. Gopalapuram registered it under FIR. No.183/2009, dated 17.05.2009 under section 304(A)IPC. A post mortem was also conducted and the final report submitted to X Addl. Chief Metropolitan Megistrate, Secunderabad – as “ACTION ABATED”.

The complainant further submitted that when a claim was made to the opposite party, after due enquiry they paid a sum of Rs. 98,059/- covered under the insurance policy but did not pay the accident benefits. On 04.03.2010 they issued a letter to the complainant to submit the deceased’s driving licence. The driving licence was lost in the above mentioned accident and as such the complainant submitted a certificate to that effect – which was issued by inspector of police, P.S. Gopalapuram – Secunderabad.

Despite receiving all the relevant documents the opposite party are deliberately not paying the amount covered by accident benefit. When the original driving licence has been lost and the complainant, contends that the opposite party are not entitled to demand for production of driving licence. The said act of the opposite party in not responding to its customers amounts to deficiency of service. Despite the fact that a letter / certificate have been issued by Government authorities – that the driving licence is not traced, they are not paying the due amount.

The office of the opposite party is located at Medak District and falls under the territorial jurisdiction of this Hon’ble court.

As such, filed the present complaint with a prayer to direct opposite party to pay accidental benefit claim to complainant with interest from 17.05.2009; to pay Rs. 5000/- towards damages due to non compliance of representations of the complainant and award costs of this complaint.

2.           The opposite party filed their counters stating that R. Muthyam Reddy obtained a policy bearing No. 602683103 with risk commencing from 22.04.2008 for a sum of Rs. 1,00,000/- under T & T 149-50 (15) from LIC of India, Medak. A valid nomination was submitted in favour of Smt R. Padma. On 17.05.2009 when smt R. Padma submitted the information regarding the death of R. Muthyam Reddy, they issued all claim forms to the nominee. All were duly submitted but not the driving licence which was necessary to process the claim for accident benefit.

           They settled the claim for basic sum assured + bonus and paid an amount of Rs. 98,053/-. The other claim regarding accident benefit was kept pending for want of driving licence. As the accident occurred to the life assured by losing control over the bike causing him to  dash against an electric pole and succumb to the injuries, they called for driving licence.

                   It is further stated that the police report clearly mentioned that the deceased was proceeding from Suchitra to Musheerabad on his two wheeler bearing No. AP 28 B 6922 when at 11:00 a.m. the accident occurred. The complainant submitted a certificate from police department where in it is stated that inspite of their efforts, no details as regards driving license nil, RTO having issued the driving licence are available. They are requesting the complainant to produce not only the driving licence. But even a certificate from RTO Showing the necessary details. These details are net mentioned in the FIR, they have not rejected the claim for accident benefit under the said policy but unable to process it for want of necessary driving licence. As per policy conditions No. 10(b) (4) incorporated in the policy bond – the corporation shall not be liable to pay the accident benefit, if death of the life assured results from the life assured committing breach of law.

               They further submitted that there is no deficiency of service on their part. They are ready to process the accident benefit provided the nominee / complainant submits a duplicate licence / certificate from RTO office showing the details of driving licence number etc. There is no deficiency on their part, hence to dismiss the complaint.

3              Both the parties have filed their affidavits reiterating the facts stated in the complaint and counter respectively – on behalf of the complainant Ex. A1 to A7 are marked. On behalf of opposite party Ex.B1 to B6  are marked. Perused the record.

4                Ex. A1 is Xerox copy of policy No.  602683103 (1 to 4 pages).Ex.A2 xerox copy of FIR. Ex.A3 xerox copy of inquest report. Ex. A4 xerox copy of Requisition for Post Mortem Examination. Ex. A5 Xerox copy of certificate regarding loss of driving licence by P.S. Ex.A6 Payment of claim by LIC and Ex. A7 xerox copy of  letter from LIC to Submit Driving Licence at the earliest.

5.                Ex.B1 Original policy bond bearing No. 602683103. Ex.B2 Certificate from police – no details regarding driving licence Ex.B3 Letter from complainant stating driving licence was lost . Ex.B4 FIR – does not contain details of driving licence. Ex.B5 Death certificate and Ex.B6 Final Report dated 31.08.2009.

6.             Point for consideration is i) whether the complainant is entitled for the claim as stated in the complaint, ii) whether there is any deficiency of service on the part of the opposite party – settling the claim? And if so, to what relief the complainant is entitled to?

Point:

7.                There is no dispute with regard to the death of the policy holder on the intimation of the death of the policy holder. The dispute is that the policy holder died due to an accident and for the complainant to claim the accident benefit, the details of the policy holders driving licence should necessarily be produced. To prove the same, the complainant has only produced Ex.A5, which is a letter / certificate by the inspector of police, P.S. Gopalapuram, Secunderabad that the original driving licence of Sri R Muthyam  Reddy (The deceased) was lost although efforts to trace it were made but in vain.

                The opposite party have requested for details of driving licence from the RTO. But even that was not furnished by the complainant. As per the policy conditions – Ex.A1, page 4 – the opposite party is not liable to pay the additional sum assured for accident benefit, if death results from the life assured committing any breach of law. The opposite party have settled the basic claim for the sum assured and paid an amount of Rs. 98,053/-, the accident benefit has been kept pending. They need evidence, that the deceased knew driving, hence the requirement of driving licence or necessary details.

                The accident and subsequent death of the husband of the complainant is a great tragedy, but there is no deficiency in rendering service on the part of the insurer and the insurer is justified in asking for the deceased’s driving licence or necessary details. In view of the afore mentioned discussion, since there is no deficiency of service, the complaint is dismissed.

8.             In the result, the complaint of the complainant dismissed but with no costs.

                 Typed to dictation, corrected and pronounced by us in the open forum  this    11^th  day of May 2011.

   Sd/-                                   Sd/-                                         Sd/-

President                       Lady Member                           Male Member

APPENDIX OF EVIDENCE

                                        WITNESS EXAMINED

For Complainant:                                                           For Opposite party:

          -Nil-                                                                                -Nil-

 EXHIBITS MARKED

For Complainant:                                                            For Opposite party:

                                                                                                       Sd/-

Lady Member

President’s elucidation for the conclusion

The complainant claimed for the sum assured and equal amount as additional sum towards accident benefit under  Ex.B1 policy, for the death of her husband / life assured. The opposite party paid the assured amount only to the complainant, who is nominee under the policy but has not paid the accident benefit on the ground that on demand the complainant has failed to produce  driving licence of the life assured. According to them as per condition No. 10 (b)(4) of Ex.B1 the insurance company shall not be liable to pay accident benefit, if the  life assured committed any breach of law. Under Motor Vehicles Act driving motor vehicle without possessing valid driving licence is illegal; that is to say it amounts to breach of law. Even though there is no direct evidence to show that the life assured had committed any breach of law, because the complainant has failed to produce driving licence or atleast particulars of the driving licence of the life assured, it gives rise to a presumption that life assured was not possessing valid driving licence at the time of accident. Mere certificate of police that they could not trace the driving

licence of the life assured, which was stated to have been lost, cannot substitute proof of possession of driving licence by the life assured. As the complainant has failed to produce driving licence or particulars there of, of the life assured it is deemed that he was not possessing valid driving licence at the time of accident which amounts to breach of law, to attract  condition No. 10 (b) (4) of Ex.B1. It is therefore held that the opposite party has rightly refused to pay the additional amount towards accidental benefit. In the circumstances it cannot be said that such refusal amounts to deficiency of service. The complainant is therefore held to be not entitled for the additional amount claimed by her towards accidental benefit.

            Typed to dictation, corrected and pronounced by us in the open forum this              11^th       day of May 2011.               

                                                                                          Sd/-                                                                                                                        PRESIDENT   

                                                                                         Sd/-

                                                                                 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.