Andhra Pradesh

Visakhapatnam-II

CC/154/2012

Beesetti Ganesh - Complainant(s)

Versus

The Managing Director - Opp.Party(s)

Boddeti Varalakshmi

01 Dec 2014

ORDER

                                              Date of Registration of the Complaint:18-05-2012

                                                                                                Date of Order:01-12-2014

BEFORE THE DISTRICT CONSUMERS FORUM-II AT

                             VISAKHAPATNAM

 

P  r  e  s  e  n  t:

1.Sri H. Ananda Rao, M.A., L.L.B.,

     President           

2. Smt K. Saroja, M.A. B.L.,

     Lady Member 

                                3. Sri C.V. Rao,  M.A., B.L.,

                                     Male Member

 

                          Monday, the 1^st day of December, 2014.

                                 CONSUMER CASE No.154/2012

Between:-

Beesetti Ganesh, S/o Narasinga Rao,

aged 25 years, resident of D.No.3-102,

T. Sirasapalli, Thotada Post, Munagapaka

Mandal, Visaskhapatnam District.

….. Complainant

And:-

1.The Managing Director, Birla Sun Life

    Insurance Company Ltd., One India Bulls

   Centre, Tower-1, 15^th and 16^th Floor, Jupiter

   Mill Compound, 841, Senapati Bapat Marg.

   Elphinstone Road, Mumbai-400 013.

2.The Branch Manager, Birla Sun Life Insurance

   Company Ltd., 1^st Floor, Eswar Paradise,

   Dwarakanagar Main Road, Visakhapatnam.

                                                                                      …  Opposite Parties      

                     

          This case coming on 06.11.2014 for final hearing before us in the presence of Smt. B. Varalakshmi, Advocate for the Complainant and Sri  Sanapala Karuna & Smt. Sailaja, Advocates for the Opposite Parties 1 and 2 and having stood over till this date for consideration, this Forum made the following:

 

                                                ORDER

          (As per Sri C. V. Rao, Honourable Male Member, on behalf of the Bench)

 

1.       The Complainant asked the Forum to pass orders in his favour and against the Opposite Parties as follows: a) To direct the opposite Parties to pay the amount of Rs.5,09,375/- along with interest of 24% per annum from 31.01.2012, b) To direct the Opposite Parties to pay the damages of Rs1,00,000/- for causing mental agony and also for deficiency of services, c) To direct the Opposite Parties to pay the cost of this Petition Rs.5,000/-, and d) To grant the relief or reliefs as the Forum deems fit and proper in the circumstances of the case.

  

2.     The Opposite Parties 1 and 2 strongly resisted the claim of the Complainant and asked the Forum to dismiss the complaint with exemplary costs. 

         

 3.      The case of the Complainant, as can be seen from the Complaint, is that the Complainant’s father Beesetti Narasingarao had obtained a Life Insurance Policy for Rs.5,00,000/- (Rupees Five lakhs only) during his life

time from Birla Sun Life Insurance through Policy No.4742711.   The father of the Complainant has nominated the Complainant’s name as nominee. The Complainant stated that on 4^th August, 2011 the father of the Complainant  died due to heart attack in the early hours of the morning.   The Complainant stated that the fact was intimated to the Opposite Parties who advised the Complainant to produce all relevant original documents along with claim form.    The Complainant submitted all the relevant documents as advised by the Opposite Parties along with claim form and waited for claim cheque.   The Complainant stated that he received a letter from the Opposite Parties dated 31^st January, 2012,   it clearly mentioned that the Opposite Parties have forwarded the cheque for an amount of Rs.5,09,375/- (Rupees Five lakh, Nine thousand, three hundred and seventy five only) towards full and final settlement.    The Complainant after receipt of this letter went to the local Opposite Party’s office several times and requested to pay the cheque amount, but there is no response from the Opposite Parties.  The Complainant again and again requested the Opposite Parties to give the cheque.   But his request was in vain.   The Complainant further stated that the Opposite Parties have deliberately, intentionally and knowingly mischievously with a malafide intention were avoiding the payment to cause loss to the Complainant.   The Opposite Parties did not render their services properly towards the Complainant and there is a deficiency of service on the part of the Opposite Parties.   The Opposite Parties caused lot of mental agony to the Complainant.   The Opposite Parties attitude caused number of problems both physically and mentally due to which the Complainant suffered a lot.   Due to the negligence and deficiency of service or services the Opposite Parties had to pay the damages of Rs.1,00,000/- along with Policy Claim amount and costs.   Hence, this complaint.

 

4.       The Complainant filed an affidavit, and also written arguments to support his claim.   Exs.A1 and A2 are marked for the Complainant.

 

5.       On the other hand, the Opposite Parties 1 and 2 resisted the claim of the Complainant by contending, as can be seen from their written statement,  that during the course of the investigation, the Opposite Parties being the customer friendly organization admitted the claim of the Complainant without any detailed investigation.   However, during the investigation it was highlighted that the DLI was an alcoholic, but the Opposite Parties acted as Customer friendly organization admitted the claim of the Complainant and same was informed to the Complainant by letter dated 31.01.2012.   The Opposite Parties stated that during the process of the issuing the cheque for the said claim, it was revealed that the Complainant had mislead the investigator; hence the said claim for investigation was re-opened.   The Opposite Parties stated that currently the said claim is being investigated and the Opposite Parties have already forwarded the investigation of the Death of DLI  to Tahsildar, Munagapaka upon which the Tahsildar replied by letter dated 3.7.2012 that the said enquiry is under process.   The said investigation is under process and therefore, the Opposite Parties seek time to scrutinize & investigate the said claim under the said Policy & decide upon whether the said claim is liable to be admitted or repudiated.      The Opposite Parties  prayed for time to file the proper reply after the result of the investigation.   So, they contended that there cannot be any complaint of deficiency of service and unfair trade practice against the Opposite Parties by the Complainant and the present complaint deserves to be dismissed with costs.

 

6.       The Opposite Parties filed an affidavit and also written arguments to buttress their contentions.   Ex.B1 to B5 are suomoto marked for the Opposite Parties 1 and 2 at the time of delivering this order.

 

7.       The matter has been heard on behalf of the Complainant as well as the Opposite Parties.

 

8.       After careful perusal of the case record, this Forum finds that as per Ex.A2 (which is also first part of Ex.B5),  the Opposite Parties admitted the claim of the Complainant herein on 31.01.2012 itself and forwarded a cheque for Rs.5,09,375/- (Rupees five lakh, nine thousand, three hundred and seventy five only) towards full and final settlement of the policy.   But, as per the Complainant, after receipt of the letter dated 31.01.2012, though the Complainant approached the Opposite Parties’ office, they did not give the cheque.   The Opposite Parties have admitted that they sent the letter dated 31.01.2012 (Ex.A2 which is also Ex.B5) along with a cheque, they did not give the cheque to the Complainant as it was allegedly revealed that the Complainant had mislead the investigator; hence the said claim for investigation was reopened and they (the Opposite Parties) approached the Thasildar, Munagapaka, and as the enquiry by the Tahsildar was in progress, they did not pay the claim amount to the Complainant.  To buttress this contention, they have filed Ex.A4 letter from the Tahsildar, Munagapaka, which was dated 3.7.2012 in which the said Tahsildar stated that enquiry was under progress in the case of the Death Certificate issued to Sri Beesetti Narasinga Rao i.e., the deceased/insured.   But very peculiarly, after the said date of 03.07.2012, the Opposite Parties prima facie never approached the said Tahsildar, Munagapaka regarding the said enquiry.   They kept silent for the last one year and 4 months to date.   This clearly shows that the report, if any, given by the Opposite Parties to the Tahsildar, Munagapaka, is only a ruse to deprive the Complainant from getting the claim amount which is clearly due to him.   In the circumstances, it can be clearly seen that there is clear cut deficiency of service coupled with unfair trade practice on the part of the Opposite Parties.   So, the Complainant is entitled to the amount of insurance besides compensation and costs.

 

9.       In the result, this Forum directs the Opposite Parties 1 and 2: a ) to pay the claim amount of Rs.5,09,375/- (Rupees five lakh, nine thousand, three hundred and seventy five only) with interest @ 9% p.a. from 31.01.2012 till the date of actual realization, and to pay b) a compensation of Rs.20,000/- (Rupees Twenty thousand only) and c) Costs of Rs.2,000/- (Rupees two thousand only) to the Complainant.   Time for compliance, one month.

     Dictated to the Steno, transcribed by him, corrected and pronounced by us in the Open Forum, this the 1^st  day of December, 2014.

 Sd/-                                         Sd/-                                         Sd/-

President                            Lady Member                             Male Member

 

 

                             APPENDIX OF EVIDENCE

For the Complainant:-

NO.	DATE	DESCRIPTIONOFTHEDOCUMENTS	REMARKS
Ex.A01	28.02.2011	Life Insurance Policy issued by the Ops.	Photo copy
Ex.A02	31.01.2012	Letter received from 2nd OP to Complainant.	Original

For the Opposite Parties:-                                  

NO.	DATE	DESCRIPTIONOFTHEDOCUMENTS	REMARKS
Ex.B01	28.02.2011	Life Insurance Policy issued by the Ops.	Photo copy
Ex.B02	28.02.2011	1st Premium Receipt in favour of the Complainant	Photo copy
Ex.B03	05,01.2012	Insurance Claim Form	Photo copy
Ex.B04	04.07.2012	Re-verification of Death Certificate	Photo copy
Ex.B05	31.01.2012	Death Claim Policy issued by the Ops.	Photo copy

                            

Sd/-                                   Sd/-                                                          Sd/-            

President                        Lady Member                                   Male Member