This Complaint coming up before us for hearing on 16-11-11 in the presence of Sri R.K. Srinivasa Murthy, advocate for complainant,                             Sri A. Varadaraju , advocate for 1^st opposite party and of Sri K. Srinivasa Rao, advocate for 2^nd opposite party, upon perusing the material on record and after hearing both sides and having stood over till this day for consideration this Forum made the following:-

O R D E R

Per Sri A. Hazarath Rao,  President:-

        The complainant filed this complaint under section 12 of the Consumer Protection Act seeking an award of Rs.1,00,000/- being the policy amount, interest on it and Rs.50,000/- as compensation besides costs.

2.   In brief the averments of the complaint are these:

        The complainants 2 and 3 are children of the 1^st complainant and her husband Sivaiah (deceased).   The said Sivaiah was a Kisan Credit Card holder of the 1^st opposite party.   The 1^st opposite party obtained the policy bearing No.15080047074300000013 for its members under Kisan Credit Card Scheme covering the risk of the farmers in case of any eventuality.   The said Sivaiah died on 22-11-07 due to hit by an RTC bus.   The complainants approached the 1^st opposite party immediately and informed the same to the 2^nd opposite party also.    The complainant submitted FIR, PM report, Inquest, Death certificate and legal heir certificate.   So far the 2^nd opposite party did not settle the claim.   The 2^nd opposite party thus committed deficiency of service.   The complaint therefore be allowed.

3.     The contention of the 1^st opposite party in brief is hereunder:

        The deceased Sivaiah was a Kisan Credit Card holder and was having personal accident insurance coverage to an extent of Rs.1,00,000/- under the policy issued by the 2^nd opposite party.   The 1^st opposite party informed the death of the said Sivaiah to the 2^nd opposite party immediately.    The 2^nd opposite party sent claim forms with a request to return the same enclosing the documents mentioned there under.   The complainants duly filled the claim form and enclosed relevant papers like FIR, PM report, Inquest, Death Certificate and legal heir certificate to the 1^st opposite party who in turn transmitted the same to the 2^nd opposite party.   The 1^st opposite party informed the repudiation of claim to the complainants.   The remedy if any is against the 2nd opposite party only.   The 1^st opposite party did not commit any deficiency of service.   The complaint therefore be dismissed against the 1^st opposite party.   

4.    The contention of the 2^nd opposite party in brief is hereunder:

        There was no correspondence between the complainants and the 2^nd opposite party.    The 1^st opposite party on 03-01-08 informed the death of the said Sivaiah to the 2^nd opposite party.    The 2^nd opposite party on 14-01-08 sent a letter with claim form and requested to send the same duly filling all the columns and countersigned by the                     1^st opposite party along with documents mentioned therein.   After scrutinizing all the documents the 2^nd opposite party repudiated the claim and informed the same to the 1^st opposite party on 17-06-08.   No person can drive vehicle without a valid and effective driving license. The complainants intentionally concealed the fact of the deceased not possessing driving license.   The 1^st opposite party along with claim form submitted notarized attested photo copy of learner’s license of the said Sivaiah bearing No.LLRAP 60720192006 said to have been issued by RTA, Piduguralla and it was valid from                  20-10-07 to 19-04-08.  The 2^nd opposite party sent that learner’s license to the authorities of the RTA.   The validity dates were changed and forged by using computer technology.   Being a road accident claim the deceased Sivaiah must possess a valid driving license at the time of accident.   The 2^nd opposite party repudiated the claim as the deceased Sivaiah did not possess valid driving license at the time of accident.   The 2^nd opposite party on 17-06-08 intimated to the 1^st opposite party regarding repudiation of claim.   The 2^nd opposite party did not commit any deficiency of service.   The complainants did not approach the Forum with clean hands.  The complaint is barred by time.     Rest of the allegations contra mentioned in the complaint are invented by the complainants to suit their claim. The complaint therefore be dismissed.

5.   Exs.A-1 to A-10 on behalf of the complainants and Exs.B-1 to B-8 on behalf of the 2^nd opposite party were marked.

6.   Now the points that arose for consideration in this complaint are: 

1. Whether the complaint is barred by limitation?
2. Whether the repudiation by the 2^nd opposite party is proper?
3. Whether the complainants are entitled to compensation and if so by whom?
4.  To what relief?

7.    Admitted facts in this case are these:

        1. Husband of the 1^st complainant Sivaiah was a Kisan Credit                     Card holder of the 1^st opposite party (Ex.A-5 & A-6).

2. The 1^st opposite party intimated the death of the said Sivaiah         to the 2^nd opposite party who died in road accident (Ex.A-7).

3. The complainant addressed a letter to the 1^st opposite party on 14-01-08     enclosing claim forms to be sent to the LRs of the deceased Sivaiah (Ex.A-1=B-2)

4. The complainants submitted claim form with FIR, PM report, inquest (Ex.A-2), death certificate (Ex.A-3) and legal heir certificate (Ex.A-4) to the 2^nd opposite party through the 1^st opposite party (as desired by the 2^nd opposite party-Ex.A-1).

1. The complainants got issued notice to the opposite parties (Exs.A-8 and A9).

8.   POINT No.1:-     The deceased Sivaiah was not a party to the insurance policy bearing No.150800/47/07/43/00000013 issued under Kisan Credit Card scheme.  The said policy covered 2,31,706 Kisan Credit Card holders each for a sum of Rs.1,00,000/-.   The contention of the 2^nd opposite party is that it informed the repudiation of claim to the 1^st opposite party on 17-06-08.    The 1^st opposite party in its version and affidavit mentioned that after receipt of the letter of repudiation from 2^nd opposite party informed the same to the complainants immediately.  They were silent when the 1^st opposite party informed the repudiation of claim to the complainants.   On               16-11-11 the 1^st opposite party filed a letter said to have been acknowledged by the 3^rd complainant about it intimating the repudiation of claim on 07-07-08.    If the said acknowledgement is available with the 1^st opposite party nothing prevented them from mentioning the date in its version or affidavit.  Filing of the letter dated 07-07-08 on 16-11-11 said to have executed by the                          3^rd complainant (at a belated stage) created a doubt in minds of the Forum regarding that letter and as such no credence be given to it.

9.   It is not the case of the 2^nd opposite party that it has communicated its repudiation to the complainants for want of address.   The 1^st opposite party took the insurance policy for benefit of its Kisan Credit Card holders.   When 2^nd opposite party received claim form and other relevant documents from the complainants it can be presumed that address of complainants available with it.   It is not the                       1^st opposite party who can initiate legal proceedings on knowing repudiation of claim.   When such is the case a responsibility is cast on the 2^nd opposite party to inform the repudiation by addressing a copy either directly to the complainants or through the 1^st opposite party under acknowledgment.   Even the 1^st opposite party did not send copy of Ex.B-7 to the claimants under certificate of posting or registered post.   It is quite apt to make a mention here that citizens are living in a period of confrontation.   Therefore it has to be inferred that the claim is pending and as such the claim is in time.   We therefore answer this point against the opposite parties.

10.   POINT No.2:-     Ex.B-7 dated 17-06-08 reads as follows:

                “Please note that your claim stands repudiated since, the learners driving license of Late Sri Jonnalagadda Sivaiah submitted by the claimant was sent for verification and was declared forgered and fake by the RTA, Piduguralla.   Since, the deceased person does not have valid driving license at the time of accident, the claim is repudiated. We absolve ourselves from any further liabilities, arising out of this claim, which please note”

11.   No person can drive a motor vehicle without having valid driving license as rightly contended by the 2^nd opposite party.   The contention of the complainants is that the deceased did not take any insurance policy for his vehicle and Ex.B-1 insurance policy did not contain any such exclusion clause. 

12.   Ex.B-1 policy covered personal accident to 2,31,706 KCC holders for Rs.1,00,000/- each.   KCC holders aged beyond 70 years as on           24-04-07 were excluded under Ex.B-1 policy.    If the claim is one arising from vehicle insurance the contention of the 2^nd opposite party in our considered opinion holds good.  The deceased possessing valid driving license or not is immaterial to consider the claim arising from out of Ex.B-1 policy.   In the absence of exclusion clause under Ex.B-1 policy the contention of the 2^nd opposite party in repudiating the claim in our considered opinion is not proper.   We therefore opine that the 2^nd opposite party is liable to pay Rs.1,00,000/- to the legal heirs of the deceased Sivaiah.   We therefore answer this point in favour of the complainant.

13.   POINT No.3:-    The complainants claimed Rs.50,000/- as compensation.    Neither of the parties sent copy of Ex.B-7 letter to any of the complainants.  The 1^st opposite party also failed in discharging his obligation properly and is guilty of deficiency of service.  Under those circumstances directing the 1^st opposite party to pay Rs.5,000/- as compensation will meet ends of justice.    Hence this point is answered accordingly.

14.   The legal heir certificate filed by the complainants revealed that Illa Padmavathi W/o Pradeep and Mudigondla Sita Mahalakshmi W/o Ramesh are also Class-I heirs of the deceased Sivaiah besides the complainants.   All of them are therefore entitled to receive the benefits of insurance.

15.  POINT No.4:-   In view of above findings in the result the complaint is partly allowed as indicated below:

1. The 2^nd opposite party is directed to pay Rs1,00,000/- (Rupees one lakh only)  together with interest @9% p.a., from the date of repudiation i.e., 17-06-08 till the date of realization to the complainants, Illa Padmavathi W/o Pradeep and Mudigondla Sita Mahalakshmi W/o Ramesh.
2. The 1^st opposite party is directed to pay Rs.5,000/- (Rupees five thousand only) as compensation to the above persons.
3. The 2^nd opposite party is directed to pay Rs.1,000/- (Rupees one thousand only) towards costs to the complainants.   
4. The amounts ordered above shall be paid within a period of six weeks from the date of receipt of the copy of the order.

        Typed to my dictation by Junior Stenographer, corrected by me and pronounced in the open Forum dated this the 22^nd day of November, 2011.

          MEMBER                                                                 PRESIDENT

APPENDIX OF EVIDENCE

DOCUMENTS MARKED

For Complainant:

For opposite parties : 

                                                                                            PRESIDENT

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