This case came up for final hearing before us on 07.10.2014 in the presence of Sri N. Chandra Shekar Rao, Advocate for complainants and Sri. P. Rama Rao,Advocate for opposite party, 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 Sri Patil Vithal Rao, President)

                   The present complaint, initially, was filed by the complainants seeking a direction to the opposite party - insurance Corporation to pay two insurance policy amounts of one deceased Dobbala Bala Krishna along with compensation and damages, under Section 12 of the Consumer Protection Act, 1986. The opposite party - corporation filed the counter resisting the said claim on the premise that the policy amounts of the deceased were already paid to the complainants as his nominees. Then the complainants amended the complaint by filing I.A. 125/2013 seeking bonus and accidental death benefits of the deceased with compensation of Rs. 50,000/- and damages of Rs. 25,000/- and also costs of the proceedings.

                 The complainants have contended that the deceased Dobbala Bala Krishna, during his life time obtained insurance policy bearing no. 600172050 in Money Back Plan Scheme on 28.01.2008 for an assured sum of Rs. 1,00,000/- and also another policy bearing no. 643092958 in Jeevan Mithra Triple claim Scheme on 09.01.2008 for an assured sum of Rs. 1,50,000/-, from the opposite party - insurance company. The complainant no. 1 was nominee under the first policy and the complainant no. 2 was nominee under the second policy being father and sister, of the deceased, respectively. After demise of the insured in a road accident on 06.12.2010, when both the complainants claimed accidental death benefits, the opposite party - corporation did not pay the same which amounts to deficiency in service. Therefore the complainants prayed to allow the complaint with costs.

2.             The defense setup by the opposite party - insurance company, in the written version, in brief, is that the complainants did not submit driving licence of the deceased and also a copy of final report of the police investigation in the accident case and that as such the claim of accidental death benefits of the insured could not be processed. On these counts the opposite party - corporation has denied deficiency in service on its part and prayed to dismiss the complaint with costs.

3.               The complainant no. 1 has filed his evidence affidavit as PW.1. Exs. A1 to A9 were relied on by the complainants in support of their claim. The opposite party - corporation has filed evidence affidavit of its manager (L&HPF), as RW1 and relied on Ex. B1, in defence.

                     Both the parties have filed their written arguments. Heard both the learned counsel.

4.               Now the point for consideration is that, whether there is any deficiency in service on the part of the opposite party, if so, to what relief?

Point:

5.          The complainant no. 1 is father of the complainant no. 2 and the insured, deceased Dobbala Bala Krishna. The deceased during his life time, had subscribed two insurance policies from the opposite party - corporation viz., Money Back Plan Scheme for a sum of Rs. 1,00,000/- on 28.01.2008 and Jeevan Mithra Triple claim Scheme for a sum of Rs. 1,50,000/- on 09.01.2008 by appointing the complainant no. 1 and complainant no. 2 respectively as his nominees for the said policies. He died on 06.12.2010 in a road accident. Ex. A3 is a copy of deceased’s identity card and Exs. A1 and A2 are copies of his death certificate whereas Ex.A4 is a copy of death report issued by the competent authorities.

6.                After the death of the insured, both the complainants submitted claims for the assured sum under both the policies as nominees vide Ex. A5. Ex. A8 is a copy of reminder of Ex. A5 whereas Ex. A9 is a copy of acknowledgement issued by the opposite party - corporation.

7.               It is now not a disputed fact that the death claim was settled by the opposite party - corporation by making payment of the assured policy amounts to both the complainants as evident from the copies of status reports under Exs. A6 and A7. Ex. B1 is a document containing two letters dated 25.1.2012 addressed by the opposite party - corporation as per which an amount of Rs. 1,12,288 was paid to complainant no. 1 and an amount of Rs. 4,71,911 was paid to the complainant no. 2 in terms of contract of the policies.

8.         After receipt of the sum assured under the policies, both the complainants have put forth their claim for the bonus and accidental death benefits. In fact the letters under Ex. B1, referred above, clearly show that the amounts of vested bonus were already paid to the complainants. Thus now the dispute is confined only to the accidental death benefits of the insured.

9.             The bone of contention of the opposite party - corporation is that to settle the claim of accident death benefits, the complainants have to furnish either original driving licence of the deceased insured or an authenticated copy thereof which is mandatory in terms of the certificate of the insurance policies. But as per the contention of the complainants, under their applications vide Exs. A5 and A8, the driving licence was lost in the accident along with other documents such as ATM card, credit card etc of the deceased and that despite efforts made by them they could not secure a copy of driving licence and that as such it could not be submitted as demanded by the opposite party - corporation. It is pertinent to note that evidently the complainants have submitted the original policy documents to the opposite party - corporation at the time of making claims. Thus the said documents are with the opposite party - corporation. But despite said fact the corporation did not file the said policy documents to establish its plea that driving licence of the insured was mandatory for deciding accident death benefits. Instead of the same they have filed a copy of the order dated. 11.05.2011 passed by this Forum in CC. No. 56/2010 wherein the claim of nominee of a deceased insured was dismissed for non-submission of driving licence or its necessary details. But it is to be noted that in the said case original policy bond was filed by the opposite party – corporation as per which either original driving licnce or a certificate from the R.T.O., showing its necessary details was necessary to process the claim for accident benefits vide condition no. 10 (b) (4) of the policy bond. The said insurance policy was of Jeevan Anand category. But the facts of the present case are different because the original policy bonds or even their copies are not placed on record by the opposite party - corporation, to verify the terms and conditions therein, despite reasonable opportunity was given to it even by reopening the case after it was reserved for orders. Further, the policies in issue are of different category than that of the policy in CC. 56/2010. Even otherwise the orders passed by this Forum in some other case cannot be taken as a binding precedent to decide the present case. In the given set of facts and circumstances, in our opinion, the complainants have established their claim for accidental death benefits of the insured whereas the defense setup by the opposite party - corporation is devoid of any merits and that as such we hold that the deficiency in service on the part of it has been duly established. Therefore the complainants are certainly entitled for the accumulated accident death benefits of the insured, Dobbala Balakrishna with reasonable compensation and damages of Rs. 20,000/- to meet the ends of justice.

10.                The point is answered accordingly in favour of the complainants.

11.                In the result, the complaint is allowed directing the opposite party - corporation to pay the accidental death benefits of the insured to the complainants as per Insurance Rules with interest @ 9% p.a. from the date of the claim i.e. 15.03.2011 till the date of realization with compensation and damages of Rs. 20,000/- and costs of Rs. 5,000/-. Time for compliance: one month.

                   Dictated to Stenographer, after transcription and correction, the order is pronounced by us in the open court today, on this the 09^th day of October, 2014.

                   Sd/-                                                        Sd/-

                     LADY MEMBER                                        PRESIDENT

APPENDIX OF EVIDENCE

                                 WITNESS EXAMINED

For the complainant:                                                For the opposite party:-

DOCUMENTS MARKED

For the complainants:                                                 For the opposite party:-

                       Sd/-                                                          Sd/-

               LADY MEMBER                                       PRESIDENT