BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri.S. Chinnaiah,B.A.,B.L.,I/C President
And
Smt. C.Preethi, M.A.LL.B., Lady Member
Friday the 18th day of April, 2008
C.C.No. 112/07
Between
M. Munivarnisa, W/o. Late M. N. Abdul Razak,
H.No.18-76, Kothapeta Street, Atmakur, Kurnool District. … Complainant
Versus
The Oriental Insurance Company Limited, Represented by its Divisional Manager,
Bhupal Complex, Kurnool. … Opposite party
This complaint is coming on this day for orders in the presence of Sri.M.Azmathulla, Advocate, Kurnool, for the complainant, and Sri.D.Sreenivasulu, Advocate, Kurnool for the opposite party and upon perusing the material papers on record, the Forum made the following:-
ORDER
As per Smt. C.Preethi, Lady Member
C.C.No.112-07
1. This consumer complaint of the complainant is filed U/S 12 of C.P.Act 1986, seeking a direction on the opposite party to pay to the complainant policy amount of Rs.2,00,000/- with 18% interest per annum, Rs.1,00,000/- towards compensation, cost of the complaint and any other relief or reliefs which the complainant is entitled in the circumstances of the case.
2. The brief facts of the complainants case is that the complainant’s husband Momin Abdul Razak obtained an Individual Personal Accident Policy bearing No.2005/115 for Rs.2,00,000/- which commenced from 11-3-2005. After completion of said year again the deceased renewed the said policy and obtained policy from opposite party bearing No.2006/318 for Rs.2,00,000/-, which is valid from 11-3-2006 to 10-3-2007. The deceased nominated the complainant as his nominee. On 22-6-2006 the deceased Abdul Razak died due to accidental burn injuries and the same was intimated by the nominee to the opposite party and submitted FIR, inquest, post mortem, death certificate along with claim form on 16-9-2006. Again on 2-12-2006 the complainant submit her representation for early settlement of claim and the opposite party replied on 11-12-2006 stating that they entrusted the claim for investigation and after receipt of report they will proceed the matter thereafter the complainant approached the opposite party and requested for early settlement of claim, but there was no response. In spite of several request the opposite party did not cared to settle the claim. The non settlement of claim by the opposite party is clear deficiency of service on their part. Hence the complainant was constrained to approach the forum for redressal.
3. In support of her case the complainant relied on the following documents (1) Xerox copy of policy bearing No.318/06, (2) xerox copy of claim form, (3) certified copy of FIR in crime No.89/06 of Atmakur police station , (4) certified copy of inquest report, (5) certified copy of post mortem report, (6) certified copy of proceedings of DSP Atmakur, (7) Xerox copy of death certificate and (8) reply letter dated 11-12-2006 of opposite party to the complainant, besides to the sworn affidavit of the complainant in reiteration of her complaint averments and the above documents are marked as Ex.A1 to A8 for its appreciation in this case.
4. In pursuance to the notice of this forum as to this case of the complainant, the opposite party appeared through their standing counsel and contested the case by filling written version.
5. The written version of opposite parties admits the deceased Momin Abdul Razak has taken an Individual Personal Accident Policy for Rs.2,00,000/- for a period from 11-3-2006 to 10-3-2007 and nominated the complainant Smt. Munivarnisa as his nominee. It also admits that intimation of the accident was given belatedly and the opposite party was not in a position to take necessary steps as contemplated in the policy conditions. Thereafter, after receipt of claim form from the complaintant the opposite party appointed a private investigator to find out the actual cause of death, as the fire accident is suspicious. Since the fire accident is suspicious the opposite party has sort for fire brigade report from the complainant and the complainant fail to produce the same. The complainant fail to appreciate the endeavour of the opposite party to verify the geniness of the complaint and has rushed to the forum before the opposite party could settle the claim. Hence, there is no deficiency of service on part of the opposite party and seeks for the dismissal of complaint, as the settlement of claim is pending for the receipt of fire brigade and investigation report.
6. In support of their case the opposite party file the following documents viz., (1) policy bond, (2) letter dated 21-8-2007 of opposite party to the complainant along with acknowledgement and (3) reply letter dated 21-8-2007 addressed by opposite party to fire brigade officer, along with acknowledgement, besides to the cross affidavit of opposite party in reiteration of his written version averments and the above documents are marked as Ex.B1 to B3 for its appreciation in this case.
7. Hence the point for consideration is to what relief the complainant is entitled alleging deficiency of service?
8.It is the case of the complainant that her husband Momin Abdul Razak has insured his life under Individual Personnel Accident Policy bearing No.2006/318 commenced from 11-3-2006 to 10-3-2007 vide Ex.A1/B1. On 22-6-2006 the policy holder died due to accidental burn injuries. The same was intimated to opposite party and claim form vide Ex.A2 was submitted to the opposite party and the opposite parties reply vide Ex.A8 dated 11-12-2006 stating that they have received the claim and claim was entrusted for investigation. Thereafter, the opposite parties did neither settled the claim nor paid the insured amount to the complainant.
9.The Ex.A3 is the certified copy of FIR in crime No.89/06 of Atmakur, PS, dated 23-6-2006, the Ex.A4 is the certified copy of Inquest Report and held over the dead body of Momin Abdul Razak on 23-6-2006 at 11.30 a.m , the Ex.A5 is the post mortem report, dated 23-6-206 of the deceased Momin Abdul Razak. The Ex.A3 to A5 envisages the demise of Momin Abdul Razak husband of the complainant and holder of policy concerned in this case due to accidental burn injuries.
10.The Ex.A8 letter dated 11-12-06 of Opposite Party to the complainant indicates submission by the complainant all required documents i.e., Ex.A3 to A5 to the Opposite Party along with duly filled claim form. While the Ex.A6 proceedings of sub-divisional Police Officer, Atmakur dated 18-09-06 holds the accidental demise of Momin Abdul Razak due to accidental burn injuries occurred on account of mosquito curtain catching fire on jump of a cat on kerosene lamp. The Ex.A7 is the death certificate of Abdul Razak. In the absence of any material contra to the above material, there appears any material to doubt the bonfides of accidental demise of the said policy holder due to burns especially when the sub-divisional Policy Officer, Atmakur dropped the action as there was no foul play and stated that the death of the deceased was due to accidental burn injuries only.
11.When any statement was recorded by the fire brigade these appears any justification on the conduct of Opposite Parties in insisting for fire brigade report to believe the accidental death of the Policy Holder. When Ex.A6 indicates the closer of the case proceedings holding the demise of Momin Abdul Razak (Policy Holder) due to accidental injuries there appears any justification in the conduct of Opposite Party in insisting to those documents which are not in existence and in not acing upon that material in Ex.A6 which lends support to the accidental demise of policy holder envisaged in other documents and in not satisfying in the mode of demise of policy holder and in not holding the accidental demise of the policy holder for whom the complainant is nominee and in not setting the claim accordingly. Hence, the complainant is certainly remaining entitled to the insured amount of her husband Momin Abdul Razak.
12.In the result, the complaint is allowed partly directing the Opposite Party to pay to the complainant the insured amount of Rs.2,00,000/- with interest at 9% per annum fro the date of filling of this complaint i.e., 20-08-2007 and Rs.1,000/- towards costs of the complaint. The Opposite Party is directed to comply with the order, with in one month from the date of receipt of this order.
13.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 18th day of April, 2008.
Sd/- Sd/-
MEMBER I/ C PRESIDENT
Appendix of evidence
Witness examined
For Complainant: For Opposite parties:
-Nil- -Nil
Documents marked
For the Complainant:
Ex.A-1. Xerox copy of policy No.318/2006.
Ex.A-2. Xerox copy of claim form.
,
Ex.A-3. Certified copy of FIR in Cr.No.89/06 of Atmakur P.S.
Ex.A-4. Certified copy of Inquest Report.
Ex.A-5. Certified copy of post mortem report.
Ex.A-6. Certified copy of proceedings of DSP, Atmakur.
Ex.A-7. Xerox copy of Death Certificate.
Ex.A-8. Reply letter, dated 11-12-2006 of opposite party
to letter dated 02-12-2006 of complainant.
For the opposite parties:
Ex.B-1. Policy bond.
Ex.B-2. Letter dated 21-8-2007 of opposite party to the
complainant along with acknowledgement.
Ex.B-3. Reply letter dated 21-8-2007 addressed by
opposite party to fire brigade officer, along
with acknowledgement.
By the Forum:
Nil Sd/-
I/C PRESIDENT
1.Sri. M. Azmathulla, Advocate,Kurnool for the complainant.
2.Sri.D. Sreenivasulu,Advocate, Kurnool for the opposite
Party
Copy was made ready on :
Copy was dispatched on:
Copy was delivered to parties
