Date of filing : 19-07-2012
Date of Disposal :27-05-2013
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR.
PRESENT: - Sri S.Niranjan Babu, B.A., B.L., President (FAC).
Smt. M.Sreelatha, B.A., B.L., Lady Member
Monday, the 27th day of May, 2013
C.C.NO.41/2012
Between:
1. U.Chandrasekhar Naidu
S/o Late U.Venkataramappa
2. U.Rajagopal @ U.Gopal Naidu
S/o Late U.Venkataramappa
3. U.Ramaiah @ U.Raghuramaiah
S/o Late U.Venkaramappa
4. U.Venkatalakshmamma
D/o Late U.Venkataramappa
All are residing at R.Kottur Village,
Bukkarayasamudram Mandal,
Anantapur District. … Complainants.
Vs.
- The ADCC Bank rep. by President,
Branch Office, 15/130, Subash Road,
Anantapur.
2. United India Insurance Co. Ltd., rep. by
its General Manager, D.No.15/130,
Subash Road, Anantapur. … Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri C.Raghurama Reddy and Sri C.Ashok Kumar Reddy, Advocates for the complainants and the 1st opposite party is called absent and Sri A.G.Neelakanta Reddy, Advocate for the 2nd opposite party and after perusing the material papers on record and after hearing the arguments on both sides, the Forum delivered the following:
O R D E R
Sri S.Niranjan Babu, Preisdent (FAC): - This complaint has been filed by the complainant under section 12 of Consumer Protection Act, 1986 against the opposite parties 1 & 2 claiming a sum of Rs.1,00,000/- with interest @ 24% p.a. from the date of death of the insured and also Rs.10,000/- towards mental agony and costs.
2. The brief facts of the complaint are that: - The complainants 1 to 3 are sons of the policyholder and the complainant No.4 is the daughter of the policyholder. The father of the complainants had availed loan from the 1st opposite party and he was a Kishan Credit Card Holder and he was insured by the 2nd opposite party under Policy No.051004/47/10/43/00001119, which is valid from 31-01-2011 to 30-01-2012 and the sum assured under the policy is Rs.1,00,000/- in case of accidental death.
3. Subsequently, on 05-03-2011 at about 10.30 A.M. the said U.Venkataramappa, who is the policyholder died due to electric shock in the fields of Satya Prakash Reddy. Later a case was registered under Cr.No.41/11 and the Police after investigation filed their final report. The complainants submitted a claim to the 1st opposite party to forward it to the 2nd opposite party enclosing all the necessary documents. The 1st opposite party forwarded the same to the 2nd opposite party, but the 2nd opposite party rejected the claim of the complainants vide letter dt.09-02-2012 on the ground that (1) inspite of letters and reminders sent to the complainants, they have not complied to the required documents and (2) Death of Kishan Credit Card Holder U.Venkataramappa was not under the insurable age and also suspected the case of suicide while involved in unauthorized activity. As the claim was rejected by the 2nd opposite party, the complainants filed this complaint against the opposite parties 1 & 2 claiming a sum of Rs.1,00,000/- towards the sum assured with interest @ 24% p.a. from the date of death of the insured and also Rs.10,000/- towards mental agony.
4. The counsel for the 2nd opposite party filed a counter stating that the deceased Venkataramappa has grossly violated the terms and conditions of the Janatha Personal Accident Insurance Policy issued to Kishan Credit Card Holders by deliberately participating in the criminal, illegal and unauthorized activities as on the date of incident/death. Hence the 2nd opposite party is not liable to pay any amount of compensation to the complainants.
5. The 2nd opposite party submits that as per the record of police investigation and the documentary evidence on record, the deceased might have committed suicide due to unbearable acute Asthma disease and other family problems by catching hold of the electric transformer intentionally or while putting fuse wire died due to electric shock. Hence there can not be any liability fastened on the 2nd opposite party. The 2nd opposite party submits that there is abnormal delay in giving intimation to the 2nd opposite party regarding the death of the deceased and grossly violated the terms and conditions of the said insurance policy. Further the 2nd opposite party submits that the deceased was not under insurable age as the deceased‘s age was 80 years as on the date of death. Hence, the 2nd opposite party is not liable to pay any compensation. The 2nd opposite party submits that the claim of the complainants was rejected on certain facts and there is absolutely no deficiency of service on the part of the 2nd opposite party. The 2nd opposite party submits that by considering all the above said facts, it is very clear that the 2nd opposite party has repudiated the claim and there is no deficiency of service on the part of the 2nd opposite party. Hence the 2nd opposite party is not liable to pay compensation under the said contract of insurance.
6. The 1st opposite party is called absent.
7. Basing on the above pleadings, the points that arise for consideration are:-
1. Whether there is deficiency of service on the part of the opposite party?
2. To what relief?
8. In order to prove the case of the complainants, the evidence on affidavit of the 1st complainant has been filed and marked Ex.A1 to A7 documents. On behalf of the 2nd opposite party, the evidence on affidavit of the 2nd opposite party has been filed and marked Exs.B1 to B9 documents.
9. Heard arguments on both sides.
10. POINT NO.1: - Admittedly there is no dispute with regard to taking of the policy by the deceased from the 2nd opposite party under Policy No.051004/47/10/43/00001119 and the period of insurance is from 31-01-2011 to 30-01-2012. Subsequently, the father of the complainants’ died due to electric shock on 05-03-2011 in the fields of Satya Prakash Reddy. This is also not disputed by the 2nd opposite party.
11. The counsel for the complainants argued that the deceased died while fixing fuse wire due to electric shock. Hence the death was only on accidental death and a case was also registered under Cr.No.41/2011 and the police after investigation have filed final report dt.05-08-2011 stating that further action was dropped treating the case as death due to electric shock. The counsel argued that it clearly shows that the deceased died only due to electric shock and hence the 2nd opposite party is liable to pay the compensation of Rs.1,00,000/- as per the policy.
12. The counsel for the 2nd opposite party argued that it is true that the father of the complainants died due to electric shock but the FIR & Inquest report show that the deceased died due to electric shock due to catching hold of the electric transformer in order to commit suicide as he was suffering from acute asthma or died due to shock while putting fuse wire. The counsel for the 2nd opposite party argued that the above two facts show that the deceased might have committed suicide or died while putting fuse wire, which is a unauthorized activity in which the deceased died for which 2nd opposite party is not liable to pay any compensation under the policy as the death of the deceased does not come under the purview of accidental death. Further the counsel for the 2nd opposite party argued that the deceased was 80 years old at the time of death and the insured is not under the insurable age as per the terms and conditions of the Master policy. Hence, he is not covered under the policy. Further the counsel for the 2nd opposite party argued that the death intimation was given after 5 months after the incident and as per the terms and conditions of the policy the death intimation should be given immediately. Hence the deceased has violated the terms and conditions of the policy.
13. After hearing the arguments and perusing the documents Ex.A1, which is Kishan Credit Card-cum-Pass Book issued by the 1st opposite party in which the age of the deceased is mentioned as 45 years. By this document, it is very clear that the 2nd opposite party has covered the deceased under the policy but original age of the deceased as on the date of the death is 80 years which clearly establish that the deceased has given a wrong statement with regard to his age. If the complainants’ father has mentioned the correct age i.e. 80 years in Kishan Credit Card-cum-Pass Book, the 2nd opposite party might not have issued the policy to the deceased. Further the arguments of the complainants that the deceased died only due to electric shock while putting fuse wire can not be considered as the investigation report, which is marked as Ex.A3, wherein it is clearly mentioned that the deceased might have caught hold of the transformer in order to commit suicide due to acute asthma or died due to electric shock while putting fuse wire. Further the police investigation also establishes the same and the final report filed by the police, which is marked as Ex.A5 also establish the same thing that the deceased died due to electric shock, but it is not clearly mentioned whether he committed suicide or died while putting a fuse wire.
14. The counsel for the complainants filed citation reported in ALD 2012-6-684 between P.Laxmi Vs. Life Insurance Corporation of India that “ Act of putting fuse wire, unless done with an intention to commit crime, said clause can not be invoked – No criminal intention exist in making an attempt to put a fuse wire, though, that may be function of employee of Power Supplying Company –On account of lack of proper arrangements on part of Electricity Supplying Companies and lack of adequate man power with them, attempts are made by consumers to restore supply, if any breakdown of supply occurs on account of any minor lapses – Impugned letter repudiating claim by petitioner-wife of deceased, set-aside – writ petition allowed directing respondents to extend benefit under policies to petitioner and other legal heirs of deceased. “ The deceased might have died while putting fuse wire accidentally is not established by the complainants. Similarly, the 2nd opposite party also did not establish that the deceased died only by catching hold of the transformer in order to commit suicide.
So considering the above citation the 2nd opposite party is liable to pay the compensation. But the other terms and conditions of the policy are to be looked into in order to pay the compensation.
15. The counsel for the 2nd opposite party filed the following citations in support of his arguments:
(1) II (2012) CPJ 1 - between Jasmer Singh Vs. Reliance General Insurance Co. Ltd., that “ delay in intimation – Breach of policy condition – Claim repudiated – Alleged deficiency in service – complaint filed – Complainant gave intimation about alleged accident to Insurance Company after 69 days of accident – Delay in intimation caused great prejudice to OP to get the vehicle surveyed and assess the loss – Complainant has committed breach of condition No.1 of policy – Repudiation justified. “ This citation suits to the present case as there was a delay of 5 months in intimating the death of the deceased. Hence it is treated that there is breach of terms and conditions of the policy.
(2) IV (2012) CPJ 148 (NC) between IND Swift Limited Vs. New India Assurance Co. Ltd., & ors wherein National Commission observed that “ Insurance – Construction of policy – It is to be construed strictly as per terms and conditions of policy document which is a binding contract between parties and nothing can be added or subtracted by giving different meaning to words mentioned therein. “
(3) I (2012) CPJ 488 (NC) between Usha Sharma & ors Vs. New India Assurance Co. Ltd., & ors that “ Insurance Policy – Principle –Policy is a contract between parties and both parties are bound to terms of contract. “
16. Considering the citations filed by the counsel for the 2nd opposite party, we are of the view that in the instant case, there was a breach of policy conditions i.e. putting a fuse wire unauthorizedly does not come under the purview of accidental death. Further the delay of 5 months in giving intimation is also a violation of terms and conditions of the policy. Further the important aspect is that the deceased is not under the insurable age as per the terms and conditions of the policy as it is clearly mentioned in Ex.B9, which is attested Xerox copy of the Master Policy in which the second condition is that “ a person under the age of 70 years are only eligible to be covered under the Kishan Credit Card policy. “
17. Considering all the above facts, we are of the view that the 2nd opposite party has not committed any deficiency of service and the 2nd opposite party has rightly repudiated the claim of the complainants. Hence the 2nd opposite party is not liable to pay any compensation to the complainants.
18. POINT NO.2 - In the result, the complaint is dismissed without costs.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 27th day of May, 2013.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC),
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT: ON BEHALF OF THE OPPOISITE PARTY
-NIL- - NIL-
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
Ex.A1 - Photo copy of Kishan Credit Card-cum-Pass Book issued by the 1st opposite party
In favour of deceased U.Venkataramappa.
Ex.A2 - Photo copy of FIR in Cr.No.41/2011 of Bukkarayasamudram P.S.
Ex.A3 - Photo copy of Inquest Report relating to deceased U.Venkataramappa.
Ex.A4 - Photo copy of Postmortem Report relating to U.Venkataramappa.
Ex.A5 - Attested copy of final report submitted by the Sub Inspector of Police,
B.K.Samudram to the Mandal Tahsildar & Executive Magistrate, B.K.Samudram.
Ex.A6 - Photo copy of letter dt.09-02-2012 sent by the 2nd opposite party to the 1st
Opposite party.
Ex.A7 - Photo copy of Kishan Credit Card Scheme Policy bearing No.051004/47/10/43/
00001119 issued by the 2nd opposite party.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.2
Ex.B1 - Photo copy of Kishan Credit Card Scheme Policy bearing No.051004/47/10/43/
00001119 issued by the 2nd opposite party.
Ex.B2 - Photo copy of FIR in Cr.No.41/2011 of Bukkarayasamudram P.S.
Ex.B3 - Photo copy of Inquest Report relating to deceased U.Venkataramappa
Ex.B4 - Photo copy of Postmortem Report relating to U.Venkataramappa
Ex.B5 - Attested copy of final report submitted by the Sub Inspector of Police,
B.K.Samudram to the Mandal Tahsildar & Executive Magistrate, B.K.Samudram
Ex.B6 - Attested copy of Household card relating to deceased U.Venkataramappa.
Ex.B7 - Letter dt.29-07-2011 sent by Chief Executive Officer, Singanamala PACS to
the 2nd opposite party.
Ex.B8 - Carbon copy of letter dt.09-02-2012 sent by the 2nd opposite party to the 1st
Opposite party.
Ex.B9 - Photo copy of Kishan Credit Card Scheme Policy terms and conditions.
Sd/- Sd/-
LADY MEMBER PRESIDENT (FAC),
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
