BEFORE THE DISTRICT CONSUMER’S FORUM: KURNOOL
Present: Sri.Y.Reddappa Reddy, M.A., L.L.M., President,
And
Smt. S.Nazeerunnisa, B.A., B.L., Lady Member
Thursday the 30th day of April, 2015
C.C.No.92/2014
Between:
V.Bhagyalakshmamma,
W/o V.Ankanna,
House Wife, Aged about 56 Years,
H.No.20/37A, Peta,
Poola Bazaar,
Kurnool-518 001. …Complainant
-Vs-
1. The Manager,
Andhra Pragathi Grameena Bank,
Main Branch, D.No.40/826, Upstairs,
Club Road, Kurnool-518 004.
2. The United India Insurance Company Limited,
Divisional Office, 2/194(2),
Lakshmi Ranga Road,
Kadapa-516 001 …OPPOSITE PARTIES
This complaint is coming on this day for orders in the presence of Sri.B.Balaji Singh, Advocate for complainant and Sri.A.V.Subramanyam, Advocate for opposite party No.1 and Sri.Kusupati Muralidhar, Advocate for opposite party No.2 and upon perusing the material papers on record, the Forum made the following. ORDER
(As per Smt. S.Nazeerunnisa, Lady Member,)
C.C. No.92/2014
1. This complaint is filed under section 12 of Consumer Protection Act, 1986 praying:-
- To refund the amount of Rs.1,00,000/- and Rs.50,000/- towards compensation for causing the petitioner’s mentally and physically harassment jointly and severally by the opposite parties for their mismanagement and also direct the opposite parties to pay the costs of the petition in the interest of justice.
2. The case of the complainant in brief run as follows:- The complainant is the resident of Kurnool. The complainant’s son C.V.Rama Krishna was a SB Account holder of opposite party No.1 Bank. Opposite party No.2 is the Insurance Company. The opposite party No.1 Bank and opposite party No.2 United India Insurance Company entered into memorandum of understanding that opposite partyNo.2 covering the personal accident risk of SB Account holders of opposite party No.1 Bank. As per the agreement in case of accidental death of SB Account holder of opposite party No.1 Bank, the nominee will be paid a sum of Rs.1,00,000/- by opposite party No.2. Accordingly opposite party No.1 Bank collected the premium amount of Rs.25/- towards Personal Accidental Insurance Policy from the account holder C.V.Rama Krishna and credited the same to opposite party No.2 Company. The complainant is the nominee under the policy. The deceased/insured was working as lineman in electricity department. On 15.04.2013, while he was on duty fell down from the electric pole due to electric shock and immediately he was brought to the Viswa Bharathi Hospital, Kurnool, after wards he was shifted to Global Hospital, Hyderabad for special treatment. During the course of treatment, he died on 18.05.2013 due to septic shock with multi organs failure. The complainant being the nominee submitted the claim form along with relevant documents to opposite party No.1 on 17.06.2013. The opposite party No.1 forwarded the same to opposite party No.2. But the opposite party No.2 did not take steps to settle the claim. At last he complainant got issued a legal notice dated 23.05.2014 to opposite party No.1. The opposite party No.1 gave reply to the complainant by stating that insurance company has to settle the claim of the complainant. There is deficiency of service on the part of opposite parties not honouring the claim of the complainant and cause mental agony to the complainant.
3. Opposite party No.1 filed written version stating that the complaint is unjust and neither maintainable in law nor on facts. The complainant is not a Consumer under section 2(d) and this Forum has no jurisdiction to entertain this complaint. It is admitted that the complainant’s son C.V.Rama Krishna was a SB Account holder of opposite party No.1 Bank and there is a M.O.U. (Memorandum of Understanding) between opposite parties 1 and 2 that in case of accidental death of SB Account holder of opposite party No.1, the nominee will be paid a sum of Rs.1,00,000/- by opposite party No.2 Company. Accordingly opposite party No.1 collected premium amount from the account of deceased and credited the same to opposite party No.2 Company. Subsequently after the death of C.V.Rama Krishna, the opposite party No.1 intimated the same to opposite party No.2 and forwarded the claim form along with relevant documents furnished by the complainant. The complainant got issued legal notice dated 23.05.2014, after the receipt of notice, the opposite party No.1 gave reply to the complainant and reminded to opposite party No.2 to settle the claim of the complainant. There is neither negligence nor any deficiency of service on the part of opposite party No.1 Bank. The complaint is liable to be dismissed against this opposite party No.1.
Opposite party No.2 filed written version stating that the complaint is illegal and untenable and it suffers from total lack of any cause of action. It is admitted with regard to opening of SB Account with opposite party No.1 existence of policy with terms and conditions enshrined therein between the parties. The opposite party No.2 Company bound to act in accordance with the terms and conditions of policy. The complainant never made any direct correspondence or direct approach to this opposite party No.2, all the correspondence through opposite party No.1. Even the legal notice also issued to opposite party No.1. This opposite party No.2 had demanded production of documents for settlement of claim as made in correspondence to opposite party in letter dated 16.06.2014. The complainant has no cause of action to file this complaint. There is no deficiency of service on the part of opposite party No.2 and the complaint is liable to be dismissed.
4. On behalf of the complainant filed Ex.A1 to Ex.A18 are marked and sworn affidavit of complainant is filed. On behalf of the opposite parties filed Ex.B1 is marked and sworn affidavits of opposite parties are filed.
5. Both sides filed written arguments.
6. Now the points that arise for consideration are:
- Whether there is deficiency of service on the part of opposite parties?
- Whether the complainant is entitled for the reliefs as prayed for?
- To what relief?
7. POINTS i and ii:- Admittedly the complainant son C.V.Rama Krishan opened SB Account in opposite party No.1 Bank. The copy of Account Pass Book is marked as Ex.A18. There is a M.O.U. (Memorandum of Understanding) between opposite parties 1 and 2. As per the agreement, the insurance cover is available only on the death of the account holder due to accident in Road, Rail, Air, Fire Bomb Blast, House collapse, Electrocution, Earthquake, Biting of insects etc. In the event of death due to accident, the insurance company opposite party No.2 will pay a sum of Rs.1,00,000/- to the nominee or legal representations of the deceased. The agreement is marked as Ex.B1. It is the case of the complainant that the deceased/insured was working as lineman, Kallur Section. On 15.04.2013 the deceased went to rectification of failed 25KVA Distribution Transformer under Laxmipuram SS.4 in Kallur Section, while attending the above said work, the casuvality got induction on and fallen down from pole and he was brought to Viswa Bharathi Hospital for first aid treatment, after wards shifted to Global Hospital, Hyderabad for better treatment, but unfortunately, he died on 18.05.2013 during the course of treatment. Ex.A1 is the preliminary report on the said electrical accident. Ex.A7 the photo copy of Death Certificate issued by the Greater Hyderabad Municipal Corporation, Hyderabad dated 12.06.2013. Ex.A4 is the photo copy of Discharge Summary issued by Viswa Bharathi Hospital, Kurnool. Ex.A6 is the photo copy of Death Summary issued by Global Hospital, Hyderabad and Ex.A5 is the copy of Death Report issued by Global Hospital, Hyderabad dated 18.05.2013. After the death of insured the complainant submitted claim form to opposite party No.2 through opposite party No.1 along with relevant documents. Ex.A8 is the photo copy of claim form and Ex.A9 is the claim intimation letter to opposite party No.1. Ex.A10 is the photo copy of Accident Death Certificate issued by the Divisional electrical Engineer Operation, Kurnool. Ex.A11 is the Family Members Certificate issued by Thasildar, Kurnool dated 12.07.2013. As the opposite parties did not settle the claim of the complainant. The complainant got issued legal notice to opposite party No.1 dated 23.05.2014 and requested to settle the claim, which is marked as Ex.A14, postal receipt is marked as Ex.A15. The opposite party No.1 got issued reply notice dated 23.06.2014 it is marked as Ex.A16. The opposite party No.2 sent a letter to opposite party No.1 for production of relevant documents dated 16.06.2014 which is marked as Ex.A17. The complainant sent requisition letter to opposite party No.1 and informed that he had already submitted the documents which are in his possession under Ex.A3 dated 15.06.2013. But the opposite parties did not take steps to settle the claim of the complainant.
The opposite party No.1 in his sworn affidavit stated that opposite party No.1 was forwarded the claim of the complainant along with documents which were submitted by the complainant. The opposite party No.2 has to settle the claim of the complainant, the opposite party No.1 is no way connected to the alleged delay in settling the claim. Hence there is no deficiency of service on the part of opposite party No.1. It is the case of opposite party No.2 that there is no direct correspondence between opposite party No.2 and complainant. The complainant not produced the documents as required by the opposite party No.2 so as to settle the claim of the complainant. The learned counsel appearing for the opposite party No.2 contended that F.I.R., is not registered in regard to alleged accident. The Certificate issued by the Divisional Electrical Engineer, Operation, APCPDEL, Kurnool regarding the cause of death is not admissible. The said engineer is not examined. But the opposite party No.2 did not denay the about said documents which was already submitted to opposite party No.2. Inspite of opposite party No.2 demanded for production of required documents in letter dated 16.06.2014 (Ex.A17) to opposite party No.1. The complainant not submitted the required documents to opposite party No.2. Therefore the complainant violated the terms and conditions of policy. Opposite party No.2 is not liable to pay any amount under the said policy.
The learned counsel appearing for the complainant argued that as per the terms and condition of the above said SB Account the claim information should be given to the opposite party within 90 days and the documents relating to the claim submit within 180 days from the date of accidental death/injury. The complainant intimated and submitted claim form along with documents to opposite party No.1 and the same were sent to opposite party No.2 and contacted from time to time for settlement of claim. But the opposite parties did not settle the claim of the complainant.
There is no dispute with regard to opened of SB Account in opposite party No.1 Bank and M.O.U., (Memorandum of Understanding) between the opposite parties 1 and 2 that in case of accidental death of account holder of opposite party No.1, the nominee will be paid one lakh by opposite party No.2 Insurance Company. Accordingly the opposite party No.1 collected premiums and credited the same to opposite party No.2. The dispute relates to non registration of F.I.R., and there is no direct correspondence between opposite party No.2 and complainant and not furnished the required documents for the settlement of claim.
According to the conditions in M.O.U., (Memorandum of Understanding) between opposite parties 1 and 2 it is very clearly mentioned in their agreement that the Bank shall after receipt of information about the happening of the event, forthwith give notice to Insurance Company and all correspondence will be routed through the corresponding branch of the banker. In this case also the complainant gave information and submitted claim form to opposite party No.2 through opposite party No.1 so the contention of opposite party No.2 is not tenable and accepted. Opposite party No.2 contended that F.I.R., was not registered, it is the obligation on Hospital Authorities to inform the accident to the police as medical legal case but neither the Viswa Bharathi Hospital, Kurnool nor the Global Hospital, Hyderabad inform the same to police. The complaint would not suffer for the fault committed by Hospital Authorities. The Preliminary Report on Electrical Accident Death Certificate issued by the Assistant Divisional Engineer Operation, APCPDEL, Kurnool Ex.A1 and the accident Death Certificate issued by the Ex.A10 and Ex.A2 clearly reveals the cause of death the deceased/insured that he was accidentally fell down from the electric pole due to electrical shock while the deceased was on duty. The medical records Ex.A4 to Ex.A6 established that due to the accidentally fell down his backbone was fractured and during the course of treatment, he died at Global Hospital, Hyderabad. The opposite party No.2 sent a letter to opposite party No.1 Ex.A17 dated 16.06.2014 where in it is mentioned that in case of electric shock collect letter from the APSPDCL for consideration of claims, but in the instant case inspite of the complainant submitted the letter from Assistant Divisional Engineer APSPDCL, Kurnool the opposite party No.2 did not take any steps to settle the claim of the complainant. Therefore we found there is a deficiency of service on the part of opposite party No.2. Hence opposite party No.2 is liable to pay an accidental claim amount of Rs.1,00,000/- to the complainant. Opposite party No.1 intimated and forwarded the claim along with relevant documents furnished by the complainant to opposite party No.2. Opposite party No.1 is merely a facilitator, there is no deficiency of service on the part of opposite party No.1.
8. POINT No.iii: The complainant claimed for accidental claim amount of Rs.1,00,000/- and Rs.50,000/- towards compensation for mental agony with its expenses. Basing on the evidence placed on record, facts and circumstances of the case the complainant is entitle for accidental claim amount of Rs.1,00,000/- with interest at 9% per annum from the date of complaint i.e., on 11.07.2014 till the date of payment and further entitle for Rs.5,000/- towards mental agony.
9. In the result, the complaint is partly allowed directing the opposite party No.2 to pay amount of Rs.1,00,000/- (one lack only) with interest at 9% per annum from the date of complaint i.e., on 11.07.2014 till the date of payment and to pay a sum of Rs.5,000/- towards mental agony and Rs.1,000/- as costs of the case. The complaint against opposite party No.1 is dismissed. Time for compliance is one month from the date of receipt of this order.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 30th day of April, 2015.
Sd/- Sd/-
LADY MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant: Nil For the opposite parties: Nil
List of exhibits marked for the complainant:-
Ex.A1 Photo copy of Preliminary Report on Electrical Accident issued by Assistant Divisional Engineer Operation, APCPDCL, Kurnool.
Ex.A2 Photo copy of Letter No.SC/O/KNL/AO(E)/JAO/PRS/C4/ D.No.360/13 dated 16.04.2013, of Superintending Engineer, Operation Circle, APCPDCL, Kurnool.
Ex.A3 Office copy of Requisition Letter dated15.06.2013 of the
complainant addressed to the opposite party No.1.
Ex.A4 Photo copy of Discharge Summary (Medical Treatment) at
Viswa Bharathi Hospital, Kurnool.
Ex.A5 Death Report issued by Global Hospital, Hyderabad.
Ex.A6 Death Summary issued by Global Hospital, Hyderabad.
Ex.A7 Death Certificate issued by the Greater Hyderabad Municipal Corporation, Hyderabad.
Ex.A8 Claim Form.
Ex.A9 Photo copy of Claim Intimation Letter.
Ex.A10 Photo copy of Accident Death Certificate issued by the Divisional Electrical Engineer Operation, Kurnool.
Ex.A11 Photo copy of Family Member Certificate issued by the Thasildar, Kurnool.
Ex.A12 Letter dated 22.08.2013 of opposite party No.2.
Ex.A13 Requisition Letter dated 20.09.2013 of complainant.
Ex.A14 Office copy of Legal Notice dated 23.05.2014.
Ex.A15 Postal Receipt.
Ex.A16 Reply Letter dated 23.06.2014 to the Legal Notice issued y the
opposite party No.1.
Ex.A17 Letter dated 16.06.2014 of opposite party No.2.
Ex.A18 Rayalaseema Grameena Bank Account Pass Book
List of exhibits marked for the opposite parties:-
Ex.B1 Agreement of Group Janata Personal Accident Insurance Policy to SB Account Holder dated 24.03.2012.
Sd/- Sd/-
LADY MEMBER PRESIDENT
// Certified free copy communicated under Rule 4 (10) of the A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties :
Copy was made ready on :
Copy was dispatched on :
