BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri K.V.H. Prasad, B.A., LL.B., President
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B. Com., LL.B., Member
Tuesday the 19th day of July, 2005
CD No. 169/2003
Juturu Usha Rani,
W/o. Late Juturu Sreedhar Reddy,
R/o. Gargeyapuram (V),
Kurnool (M), Dist. . . . Complainant
-Vs-
1. The Secretary,
Primary Agricultural Co-
Operative Credit Society Ltd.,
Reg No. 957,
Gargeyapuram (V),
Kurnool (M), Dist.
2. The Divisional Manager,
M/s The Oriental Insurance Co Ltd.,
Bhopal Complex,
Kurnool. . . . Opposite party.
This complaint coming on 13.7.2005 for arguments in the presence of Sri P. Ramanjaneyulu, Advocate for complainant, Sri E.Giddaiah Advocate for opposite party No.1 and Sri C. Nagendranath, Advocate for opposite party No.2 and stood over for consideration till this day, the Forum made the following.
O R D E R
(As per Smt C.Preethi, Member)
1. This CD complaint of the complainant is filed under section 12 of C.P. Act 1986, seeking a direction on the opposite parties to pay Rs. 1,00,000/- with 12% interest from the date of death of insured i.e 11.11.2001 till realization, Rs. 10,000/- towards compensation for mental agony, Rs. 3,000/- towards costs of the complaint and any other relief or reliefs which the complainant is entitle in the circumstance of the case.
2. The brief facts of the complainant case is that the complainant is the wife Late Juturu Sreedhar Reddy who accidentally fell down from a stationed tractor on 10.11.2001 and sustained grievous injuries thereafter, admitted in the Government General Hospital, Kurnool and died on 11.11.2001. The said deceased was a member of opposite party No.1 who collected premium from its member and assured to pay a sum of Rs. 1,00,000/- to each of its members in case of accidental death of any member and paid the collected premium to opposite party No.2. The opposite party No.2 issued a Group Insurance Policy to the members of first opposite party and the deceased was one of its member and the policy was inforce at the time of the accident. Thereafter, the complainant put forth a claim with opposite party No.2 through opposite party No.1 by submitting claim form along with original documents like FIR, inquest report, Postmortem certificate, proceedings of MRO pass book and two cash receipts. To the dismay of the complainant the opposite party No.2 did not pay the insured amount but replied through their letter dt 15.3.2002 requesting the complainant to submit family members certificate and the same was submitted to opposite party No.1, intern to submit the same to opposite party No.2. After receipt of said certificate the opposite party No.2 did not settled the claim inspite of several requests and demands by the complainant till today.
3. Hence, there is deficiency of service on part of opposite parties in not settling the claim nor repudiation the claim and kept the claim pending with them for the reasons best known to them only. Hence, the complainant is entitled to the insured amount along with 12% interest, and compensation also.
4. The complainant in support of her case filed the following documents Viz (1) Receipt for paying share capital, membership fee, Group Insurance Premium, dt 27.09.2000, receipt dt 28.3.2001 for payment of Rs. 8,653/- including Insurance amount (2) pass book issued by opposite party No.1 to the late Sreedhar Reddy ( the husband of the complainant) (3) Letter dt 15.3.2002 addressed by opposite party No.2 to opposite party No.1 requesting to send family membership certificate (4) xerox copy of CC of FIR issued by MRO, Kurnool, dt 11.11.2001 (5) CC of Inquest Report issued by MRO, Kurnool, dt 11.11.2001 (6) CC of Postmortem Examination Report issued by MRO, Kurrnool, dt 11.11.2001 and (7) CC of Final Report ( Accidental Death) issued by MRO, Kurnool, besides to the sworn affidavit of the complainant in reiteration of her complaint averenmtns and above documents are marked as Ex A.1 to A.7 for its appreciation in this case.
5. In pursuance to the notice of this Forum as to this case of the complainant the opposite parties appeared through their standing counsel and filed separate written version as defence.
6. The written version of opposite party No.1 admits the complainant as wife and nominee of deceased Juturu Sreedhar Reddy who died in accident on 11.11.2001. It also submits the deceased was member of their society and was allotted G.No. 3234 and the deceased paid insured premium amount Rs.21/- to the said society and inturn remitted the said insurance amount to their Co-Operative Bank, Krishna Nagar Branch, Kurnool and the complainant is entitled to received insurance amount of Rs. 1,00,000/- from opposite party No.2. It further submits that the complainant put forth an application before the opposite party No.1 and the same was forwarded to opposite party No.2 for settling the claim but express their inability to know what happened to the said claim. Hence, their society is not at all liable to pay any amount to the complainant as it is for the opposite party No.2 to pay insurance amount to the complainant and seeks for the dismissal of the complaint.
7. The written version of opposite party No.2 denies the complainant is not maintainable either in law or on facts. But it admits the deceased was member of opposite party No.1 and was covered and Janatha Personal Accident Policy of opposite party No.2 but subject terms and conditions of the policy. It further submits that the death of the decease is highly suspicious, as the deceased was aged 35 years and hale and healthy and would not have died by the injuries he received by falling from a tractor, the death must have been due to heart-attack or some other aliment which must have been existing prior to the death of the deceased. The complainant with help of the concerned officials manipulated the relevant police and medical records in order to claim the insurance amount under the G.P.A policy. The postmortem report does not reveal any grievous injuries to vital organs which would result in the death of the deceased so instanteously. It further submits the opinion of the Doctor who conducted the Postmortem stated that death occured due to shock and due to injuries to lungs which is suspicious, hence, the opposite party No.2 return repudiation the claim of the complainant and there is no deficiency of service on part of opposite parties and seeks for the dismissal of the complaint with costs.
8. In support of their case the opposite parties 1 and 2 filed their sworn affidavit in reiteration of their written versions, the opposite party No.1 did not filed any documents the opposite party No.2 filled the following documents Viz (1) letter dt 29.9.2004 of superintendent Govt. General Hospital, Kurnool to Dist Forum, Kurnool (2) Accident Registrar pertaining to the Accident of Late Jutur Sreedhar Reddy dt 10.11.2001 and (3) claim form issued by opposite party No.2 and X1 proceedings of MRO, Kurnool in H.L No. 1/2002 dt 6.2.2002 and the above documents are marked as Ex B.1 to B.3 and X.1 for its appreciation in this case.
9. The opposite party No.2 also relied in the deposition RW1 and RW2 and caused interrogatories to the complainant.
10. Hence, the point for consideration is to what relief the complainant is remaining entitle alleging deficiency of service on part of opposite parties:-
11. There is no dispute as to the deceased Juture Sreedar Reddy covered under the policy issued by opposite party No.2 and the said deceased died on 11.11.2001 and there is no dispute as to the complainant’s entitleness to the insured amount under the above said policy and on the claim preferred by the complainant was neither settled nor repudiated by opposite party No.2.
12. The only dispute is whether the insured had suffered any serious injuries or not, or whether he died a natural death. It is admitted fact that the deceased J.Sreedhar Reddy died on 11.11.2001 due to fall from a stationed tractor. The learned counsel for complainant strongly argued that the death of J. Sreedhar Reddy is an accident and in support of the case relied on Ex A.1 to A.7. The Ex A.1 is payment receipt dt 27.9.2000 and 28.3.2001 issued to the deceased J.Sreedhar Reddy. It envisages the payment of Rs. 1,453/- and Rs. 8,653/- by the deceased including Rs. 21/- towards insurance amounts. The Ex A.2 is the pass book issued by opposite party No.1 to the deceased J. Sreedhar Reddy. The Ex A.3 is the letter dt 15.3.2002 of opposite party No.2 to opposite party No.1, it envisages the receipt of claim form of the deceased J. Sreedhar Reddy bearing claim No. 2002/29 and requests to send family member certificate. The Ex A.4 to A.7 are certified copies of FIR, Inquest Report, Postmortem Report and Final Report, all the material in uni-tone says that the deceased (complainant’s husband) fell from a stationed tractor and sustained injuries and died of those injuries, this is nothing else but an accident death. The final report in Ex A.7 says that after investigation and enquires made in this particular case, clearly discloses that the incident is accidental one and no foul play is suspected over the death of the deceased J. Sreedhar Reddy.
13. The learned counsel for opposite party No.2 argues that the death of the deceased J. Sreedhar Reddy may not be an accident, it may be natural one, al might be heart attack or any other ailment, but to get money the complainant had made it an accidental death and manipulated the relevant police records and medical records, the second argument is that the deceased was aged about 35 years hale and healthy person cannot die from a fall from a stationed tractor and all these facts lead to suspicion. The opposite party No.2 in support of their contention relied on documentary record of Ex B.1 to B.2 and got examined RW1 and RW2. The Ex B.1 is the letter dt 29.9.2004 of Superintendent, Govt. General Hospital, Kurnool to District Consumer Forum, it envisages that a patient Sreedhar Reddy was brought to the casualty of their hospital for treatment at 9.10 P.M and expired at 9.30 P.M on the same day, and no entries were made in the casualty admission register and opening of case sheet does not arise and there are no enteries regarding MLC’s and X-rays. The Ex B.2 is the attested xerox copy of Accident Register pertaining to the accident of Juturu Sreedhar Reddy, it envisages that the patient was alleged to have fallen from Tractor at his village on 10.11.2001 at 8.45 A.M and was brought un conscious and died at 9.30 P.M on 11.11.2001. The Ex B.3 is the claim form of opposite party No.2 which was duly filled and submitted to opposite party No.2 through opposite party No.1. The deposition of RW1 relied by the opposite party No.2 says that the Ex B.2 is of their hospital pertaining to a patient by name Juturu Sreedhar Reddy and further says if it is not a case of MLC dead body will be handed over to relatives. The deposition of RW2 says that after receiving information from the out post Police Station in Govt. General Hospital Kurnool and after recording statement of Juturu Sulochana, mother of the deceased registered the case under crime No. 127/01 under section 174 Cr PC and on enquiring as to the death of the deceased came to know that there is no suspicious circumstances in the demise of Juturu Sreedhar Reddy. Hence, there is absolutely no material placed by the opposite party No.2 in substantiating their contentions as to the death of Juturu Sreedhar Reddy as not accidental but a natural one and the exhibits marked and depositions of RW1 and RW2 doesn’t support the contentions of opposite party No.2. In the absence of any material in support of their contentions and the non payment of claim amount by opposite party No.2 appears to be not in accordance with any sound and valid reasons and there by the conduct of opposite party No.2 in not paying the claim amount to the complainant under the above said policy is amounting to deficiency of service.
14. The complainant alleges that she is entitled to insured amount of Rs 1,00,000/- under the said Group Janatha Insurance Policy and the said fact is not being denied by opposite party No.2 the complainant as wife of the deceased Juturu Sreedhar Reddy as insured barrowing member of opposite party No.1’s society is remaining entitled to the insured sum of Rs. 1,00,000/-. As the opposite party No.2 by delaying the payment of insured amount to the complainant driven the latter to the Forum for redressal, the complainant is remaining entitled to reasonable interest and costs from the date of cause of action. As no cause of action is made against opposite party No.1case against opposite party No.1 is dismissed.
15. In the result the complaint is allowed directing the opposite party No.2 to pay Rs.1,00,000/- to the complainant towards Insurance claim of her husband Juturu Sreedhar Reddy as covered under the Group Insurance Policy as borrowing member of the opposite party No.1’s society with 12% interest per annum from the date of death of deceased i.e 11.11.2001 till realization and cost of Rs. 5,000/- within one month from the date of receipt of this order.
Dictated to the Stenographer, Typed to the dictation corrected by us pronounced in the Open Court this the 19th day of July, 2005
PRESIDENT
MEMBER MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant For the opposite parties
-Nil- Deposition of RW1 (H. Hanuman-
tha Rayudu).
Deposition of RW2 (S.M. Basha)
List of Exhibits Marked for the complainant:-
Ex A.1 Receipt for paying share capital membership fee, Group Insurance Premium, dt 27.9.2000, receipt dt 28.3.2001 for payment of Rs.8,653/- including Insurance amount.
Ex A.2 pass book issued by Op No.1 to the late Sreedhar Reddy ( the husband of the complainant).
Ex A.3 letter dt 15.3.2002 addressed by opposite party No.2 to opposite party No.1requesting to send family membership certificate.
Ex A.4 Xerox copy of CC of FIR issued by MRO, Kurnool dt 11.11.2001.
Ex A.5 C.C of Inquest report issued by MRO, Kurnool dt 11.11.2001.
Ex A.6 CC of Postmortem Examination Report issued by MRO, Kurnool
dt 11.11.2001.
Ex A.7 CC of Final Report (Accidental Depot) issued by MRO, Kurnool.
List of Exhibits Marked for the opposite parties :-
Ex B.1 letter dt 29.9.2004 of Superintendent Govt. GeneralHospital, Kurnool to Dist Forum,Kurnool.
Ex B.2 Accident Register pertaining To the accident of Late Jutur Sreedhar Reddy Dt 10.11.2001.
X1. Proceedings of MRO, Kurnool in H.L No. 1/2002 dt 6.2.2002.
PRESIDENT
MEMBER MEMBER
