Before The District Consumer Forum:Kurnool
Present: Sri K.V.H.Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B.Com., LL.B., Member
Wednesday the 7th day of January, 2004
C.D.No.69/2002
Smt U.Lingamma,
W/o. Late U.Ramachandraiah,
Thandur Village,
Dhone Mandal,
Kurnool District. . . . Complainant represented by his
Counsel Sri S.A.Subhan
-Vs-
The Oriental Insurance Company Limited,
Represented by its Divisional Manager,
Bhupal Complex,
Kurnool Dist.. .. . Opposite party represented by his
Counsel Sri C.Nagendra Nath
O R D E R
(As Per Smt C.Preethi, Member)
1. This CD complaint of U.Lingamma is filed under section 12 to 14 of C.P.Act, 1986 seeking a direction on the opposite party to declare the repudiation of complainant’s claim as illegal, to pay RS.1,00,000/- insured amount to the complainant with 24% interest per annum, RS.15,000/- as compensation for mental agony and costs and any other reliefs which the complainant is entitled in the circumstances of the case.
2. The case of the complainant is that her late husband U.Ramachandraiah @ Ramachandrudu was the member and borrower of Primary Agricultural Co-operative society, Ramadurgam, the said Society introduced the opposite party for the benefits of its members and lonees under Janata Personal Accident Insurance Policy covering them with insurance policy for assured amount of RS.1,00,000/- and the complainant paying premium of RS.21/- and hence the complainant’s late husband was covered under the said above policy. On 7.11.2000 the complainant’s husband was murdered by some unknown persons and a case was registered in Cr.No.197/2000 under section 302 IPC by Dhone Police Station. The complainant who is the legal heir of the deceased immediately informed the said fact to the opposite party and submitted all relevant documents but the opposite party did not pay the insured amount. On 12.12.2001 the opposite party sent a letter sating that the claim of the complainant is repudiated on the reason that the insured violated the terms and conditions of the policy, the said repudiation is made only to escape its liability and to avoid payment of claim amount. The conduct of opposite party in not paying the insured amount to the beneficiary is amounting to deficiency of service on its part in not performing the agreement policy under taken to the benefit of the group policy members of the above said society.
3. The complainant in support of his case filed the following documents Viz (91) certified copy of First Information Report in FIR No.197 dt 7.11.2000 of Dhone Police Station (2)Certified copy of inquest report dt 7.11.2000 relating to Ramachandrudu (3) certified copy of Postmortem report relating to Ramachandrudu dt 7.11.2000 (4) certified copy of memo of evidence in Cr.No.197/2000 under section 302 IPC (5) attested Xerox copy of list of borrowing members of Ramadurgam PACS for Jantha Insurance Policy for the year May 2000 to May 2001. (6) attested copy of disbursement- cum – loan ledger of Ramachandrudu of Ramadurgam PACS (7) Certified copy of Judgement dt 30.10.02 in SCNo.431/2001 on the file of III Additional Dist & Sessions Judge and (8) Repudiation letter dt 12.12.2001 issued by opposite party. The complainant filed her sworn affidavit in support of her complaint averments and documents, hence the supra documents are marked as Ex A.1 to A.8 for their appreciation in this case.
- In pursuance to the notice of this Forum of this case the opposite party made appearance through its standing counsel and filed its written version denying the truth and bonafidies of the complaint averments and maintainability of the complaint on fact and law.
5. It further alleges that the complaint is bad for non joinder of necessary party, the society is directly liable to the complainant as it was the society which collected premium from the complainant, if the claim is not in-violation of terms and conditions then the opposite party is vicariously liable. It submits that as per record information the death of the deceased took place because of murder. The motive for the murder was abusive and provocative comments with deliberate intention by the deceased on the wife of the accused, which provoked the accused to kill complainant’s husband. The above situation falls under the exceptions of clause 5 (e) of the policy. Hence the opposite party rightly repudiated the claim of the complainant and prays for the dismissal of complaint.
6. The opposite party has not placed any documents.
7. Hence the point for consideration is whether the complainant has made out any deficiency of service on the part of the opposite party and her entitleness to the insured amount?:-
8. The Ex A.8 is the letter addressed by the opposite party, it dated to 12.12.2001. It repudiates the claim made by the complainant on the reason that the deceased violated terms and conditions of the policy, by this conduct and written version averments what appears is that the opposite party is indirectly admitting the privy under Group Janata Personal Accident Insurance scheme with the deceased Ramachandrudu and him as policy holder under the said scheme and the complainant as the wife of the deceased Ramachandrudu.
9. The only reason for repudiation of the claim of the complainant is the alleged demise of Ramachandrudu by murder due to past rivalry. But the opposite party did not file any documentary record to substantiate the Cr.No.197/2000 of Dhone Police Station covering the murder of the complainant’s husband Ramachandrudu as an off shoot and logical consequence of abusive and provocative comments made by the deceased against the wife of the accused which provoked the accused to kill the deceased nor any relevant cogent material is placed by the opposite party to substantiate the said contentions to prove the said violation of terms and conditions by the deceased Ramachandrudu, nor the opposite party filed any documentary record of Cr.No.197/2000 showing that the murder of Ramachandrudu occurred on account of past rivalries.
10. It is needless to observe that the burden is on the opposite party to establish that there is violation of terms and conditions of the policy, the opposite party did not adduce any evidence to discharge this burden. Hence absolutely there is no material on record in support of the contentions of the opposite party in repudiating the claim. For want of substantiating material in support of the opposite party contentions the Act of repudiation of the claim of the insurance by the opposite party as is remaining without any justifiable excuse, the said conduct of the opposite party is certainly amounting to failure on the part of the opposite party in performing the statutory duty in repudiating the claim and there by amounting to deficiency of service and there by entitling the complainant to the claim as the bonafidies of the complainant’s claim are not otherwise disturbed.
11. In the result and in sum up of the above discussions, the complaint is allowed directing the opposite party to pay the insured amount of RS.1, 00,000/- of the deceased to the complainant with interest of 9% P.A from the date of death of the deceased till realization along with costs of RS.5,000/- and the opposite party is granted one month time from the date of receipt of this order for compliance in default the opposite party shall pay the supra stated amount with 12% interest from the date of default till realization.
Dictated to the Stenographer, Typed to the Dictation Corrected by us, Pronounced in the Open Court this the 7th day of January, 2004
PRESIDENT
MEMBER MEMBER
APENDIX OF EVIDENCE
Witnesses Examined
For the complainant:-Nill For the opposite party:-Nill
List of Exhibits marked for the complainant:-
Ex.A1 Certified copy of First Information Report in FIR No.197 dated 07.11.2000 of Dhone P.S.
Ex.A2 Certified copy of Inquest Report dated 07.11.2000 relating to K.Ramachandrudu.
Ex.A3 Certified copy of Post Mortem Certificate relating to K.Ramachandrudu dated 07.11.2000.
Ex.A4 Certified copy of Memo of Evidence in Crime No.197/2000 Under Section 302 IPC.
Ex.A5 Attested copy of Showing the list of borrower members of Ramadurgam P.A.C.S. for Janatha Insurance Policy for the year May, 2000 to May, 2001.
Ex.A6 Attested copy of disbursement – cum – loan ledger regarding to K.Ramachandraiah of Ramadurgam P.A.C.S. Limited.
Ex.A7 Certificate copy of Judgment dated 30.10.2002 in S.C.No.431/2001 on the file of III Additional District and Session Judge.
Ex.A8 Repudiation Letter dated 12.12.2001 issued by opposite party.
List of Exhibits marked for the opposite party:- Nil
MEMBER PRESIDENT MEMBER
//Certified free copy communicated under Rule 4 (10)
of the A.P.S.C.D.R.C. Rules, 1987//
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Complainant and Opposite parties :
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