BEFORE THE DISTRICT FORUM:KURNOOL
Present: Sri K.V.H.Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Friday the 4th day of May, 2007
C.C. No.158/2006
T.R. Seshamma,W/o Late Nataraj,
Resident of Gargeyapurma Village,Krunool Mandanl and District. ... COMPLAINANT
Verses
1) The Secretary, Primary Agriculture,
Co-Operative Society Ltd.,Gargeyapuram Village, Kurnool Mandal District.
2) The Branch Manager,
District Co-Operative Central Bank Ltd.,Krishnanagar, Kurnool.
3) United India Insurance Company Ltd.,
Rep. by its Divisional Manger, Kurnool. ... OPPOSITE PARTIES
This complaint coming on this day for hearing in the presence of Sri. S. Sivaramakrishna Prasad, Advocate, Kurnool for Complainant and Sri. G. Sudhakar Reddy, Advocate, Kurnool for Opposite Parties No.l and 2 and Sri K. Muralidhar, Advocate, Kurnool for Opposite Party No.3 upon the perusing the material papers on record, the Forum made the following:-
ORDER
(As per Smt. C. Preethi, Member)
1. This consumer dispute of the complaint is filed U/S 12 of C.P. Act., 1986 seeking a direction on the Opposite Parties to pay a sum of Rs. 1,00,000/- under policy bearing No. 051100/47/00228, Rs. 1,00,000/- towards mental agony, costs 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 complainant’s case is that the complainant’s husband T. Nataraj was a member of Opposite Party No.1 society and he has a credit card calling Kissan Credit Card. The Opposite Party No.1 society used to deduct from the account of its members premium to pay to the Opposite Party No.3 (insurance company) for covering its members who died accidentally. On 28-03-2005 the husband of the Complainant died due to Sunstroke, a telegraphic intimation was sent to Opposite Parties No.2 and 3. On the claim preffered by the Complainant it was repudiated on the ground that the death of the deceased will not fall within the meaning of accident. Hence, the Complainant resorted to the forum for reliefs.
3. In support of her case the Complainant relied on the following documents viz., (1) Letter dated 07-03-2006 of Opposite Party to Complainant and (2) Repudiation letter dated 27-06-2006 of Opposite Party No.3 to the Complainant, besides to the sworn affidavit of the Complainant in reiteration of her complaint avernments and the above documents are marked as Ex.A1 and A2 for its appreciation in this case. The Complainant caused interrogatories to Opposite Parties No.1 to 3 and suitably replied to the interrogatories caused by Opposite Parties 1 to 3.
4. In pursuance to the notice of this forum as to this case of the Complainant the Opposite Parties appeared through their standing counsels and filed separate written versions.
5. The written version of Opposite Party No.1 submits that it has informed that Complainant in his letter dated 07-03-2006 to submit required documents to him to settle the claim. Hence, there is no negligence on their part, the deceased Nataraj was covered under the scheme “Accidental death Benefit Insurance Policy”, therefore it is Opposite Party No.3 who is liable to pay compensation. Hence there is no deficiency of service on his part and seeks for the dismissal of complaint with costs.
6. The written arguments of Opposite Party No.2 submit that it has paid premium through Opposite Party No.1 on behalf of deceased to Opposite Party No.3 under the scheme Accidental death benefit Insurance Policy and it is only Opposite Party No.3 who is liable to pay compensation and there is no negligence or delay in any manner on part of Opposite Party No.2 and seeks for the dismissal of complaint with costs.
7. The written version of Opposite Party No.3 submits that the policy covering the husband of the Complainant covers the death or permanent disability only and if they resulted out of any accident caused by external violent and visible means. The policy holder herein admittedly died due to ‘sunstroke’ and the said cause of death can never be brought under the definition of an accident under the insurance policy scheme. In other words “accident” in so far as the insurance matters are concerned clearly excludes operation of natural causes brought into by chance and all other fortuitous reasons. Therefore the repudiation of the claim of the Complainant by Opposite Party No.3 is valid and proper and can not be brought with in the scope of deficiency of service and lastly seeks for the dismissal of complaint with costs.
8. In support of their case the Opposite Parties relied on the following document viz., (1) Terms and Conditions of Master Policy i.e., Personal Accident Insurance to Kisan Credit card holder, besides to the Sworn Affidavit of Opposite Parties No.1 to 3 and the above document is marked as Ex.B1 for its appreciation in this case. The Opposite Parties No. 1 to 3 caused interrogatories to the Complainant and suitably replied to the interrogatories caused by the Complainant.
9. Hence the point for consideration is to what relief the Complainant is entitled alleging deficiency of service on part of Opposite Parties?
10. It is the case of the Complainant that her husband Nataraj died on 28-03-2005 due to Sunstroke and the said Nataraj was covered under the Personnel Accident Insurance to Kisan Credit Holders issued by Opposite Party No. 3. On the claim preffered by the Complainant it was repudiated by Opposite Party No.3 vide Ex.A2 dated 27-06-2006 stating that policy scheme covers accidents by external, violent and visible means only and the death of the deceased does not fall within the scheme cited and will not fall within the meaning of accidental.
11. The perusal of dictionary meaning of accident it will be clear that any event which happens without any cause or is not expected to be caused in normal circumstances is covered under it. It is also an unfortunate causing physical harm or damage caused by some unintentional act. Thus the event which happened in the present case was merely accident. It is not routine or a normal course that every person moving or exposing under the sun will be attacked by sunstroke and will die and every person in their day to day life to attend their regular duties have to expose under the heat of the sun and all those person are not attacked by sunstroke. Hence what appears is that sunstroke does not occur in normal course of life to every person. Thus the event which occurred in the present case is by chance and is covered by the word accident. The word accident is to be given its normal meaning by which it is understood by common man. Even a common man will say that such an event happens it is by chance accident and not a natural phenomena occurring so often. Thus the non payment of assured amount to the Complainant on this ground is total baseless and devoid of any reasoning which has been adopted by Opposite Party No.3.
12. To sum up the above discussions there is no hesitation to hold that the Opposite Party No.3 miserablely failed to establish their case and the conduct of Opposite Party No.3 is not paying the assured amount is certainly amounting to deficiency of service and thereby entitling the Complainant to the assured amount under the policy of her husband. As no cause of action is made a against Opposite Parties No.1 and 2, case against Opposite Party No.1 and 2 is dismissed.
13. In the result, the complaint is allowed directing the Opposite Party No.3 to pay to the complainant the policy amount under the policy bearing No. 051100/47/04/00228 with 9% interest from the date of filling of this case i.e., 22-11-2006 till realization along with costs of Rs. 500/-, with in a month of receipt of this order.
Dictated to the Computer Operator transcribed by him, corrected and pronounced in the Open bench on this the 4th day of May, 2007.
Sd/- Sd/-
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant: Nil For the opposite party: Nil
List of exhibits marked for the complainant:-
Ex.A1 Letter dated 07-03-2006 of Opposite Party to Complainant.
Ex.A2 Repudiation letter dated 27-06-2006 of Opposite Party No.3 to the
Complainant
List of exhibits marked for the opposite party:-
Ex.B1 Terms and Conditions of Master Policy i.e., Personal Accident
Insurance to Kisan Credit card holders.
Sd/- Sd/-
MEMBER PRESIDENT
Copy to:-
1. Sri. S. Sivaramakrishna Prasad, Advocate, Kurnool.
2. Sri. G. Sudhakar Reddy, Advocate, Kurnool.
3. Sri. K. Muralidhar, Advocate, Kurnool.
Copy was made ready on :
Copy was dispatched on :
Copy was delivered to parties :
