FA.No.699/2007 AGAINST C.C.No.150/2006  DISTRICT FORUM, KARIMNAGAR

Between:

Choppadandi Shanthamma

W/o.late Kanakaraju, aged 23 years

Occ:Housewife, R/o.Gadishelapeta Village

Dharmaram mandal, Karimnagar District.                                                                 Appellant/

                                                                                                                                      Complainant

                   A N D

1. The United India Insurance Company Ltd.,

    D.No.6-73/1, Near Venkateshwar Talkies

    Mancherial, Adilabad District

    Rep. by its Branch Manager.

2. The United India Insurance Company Ltd.,

    CVRN Road, Karimnagar,

    Rep. by its Branch Manager.                                                                                   Respondent/

                                                                                                                                      Opposite parties

Counsel for the Appellant: Mr.J.Prabhakar

Counsel for the Respondents: Mr.N.Mohan Krishna

QUORUM:      SMT.M.SHREESHA,  MEMBER

&

SRI K.SATYANAND, MEMBER

THURSDAY, THE TWENTY NINTH DAY OF OCTOBER,

TWO THOUSAND NINE

Oral Order( Per Sri K.Satyanand,Hon’ble Member)
                                                          ***

        This is an appeal filed by the unsuccessful complainant assailing the order of the District Forum and seeking relief she sought for in the complaint.

        The facts of the case briefly stated are as under:

        The complainant was a widow of  late Choppadandi Kanaka Raju, a badili workman, owning a two wheeler.  He obtained insurance from the opposite party No.1 in respect of the said vehicle for the period 25-11-2003 to 24-11-2004 for an amount of Rs.1 lakh. Whileso late KanaKa Raju met with an accident on 30-6-2004 near Pakistan camp at Ramakrsihnapur and sustained fatal injuries.  The police concerned registered a case against the said Kanaka Raju under Section 337 of IPC and he was immediately shifted to MGM Warangal.  On 2-7-2004 at about 9.00 am., he was shifted to NIMS for better treatment.  There he succumbed to his injuries on 4-7-2004.  The police Punjagutta registered a new crime and transferred the same to the Ramakrsihnapuram Police on point of jurisdiction.  Ultimately the crime was closed as the accused himself died.  The complainant, therefore, filed an insurance claim to the opposite party, insurance company rep. by two functionaries at different levels.  Inspite of receipt of the claim dated 14-2-2006 along with the relevant documents, the respondent failed to pay the death benefits under the personal accident policy.  Though the complainant approached the opposite party No.1 several times, she could not get any relief.  Thus according to her the insurance company was deficient of service.  She therefore preferred the complaint from out of which this appeal arises.

        Opposite party No.1 filed a counter denying the allegations.  The opposite party emphatically maintained that the husband of the complainant, who was driving the vehicle had no valid license, was in a drunken state while driving as borne out from the charge sheet averments and the findings given by the surveyor and loss assessor.  Ultimately on these grounds the insurance claim was rightly repudiated according to them.  They also took the stand that there was delay in informing the incident and therefore barred by limitation.  They questioned the relationship between the complainant and the driver of the vehicle.

        In support of her case, the complainant filed her own affidavit and marked Exs.A1 to A10.  The opposite parties relied upon documents marked as Exs.B1 to B3.

        On a consideration of the evidence adduced, the District Forum came to the conclusion that the complainant’s husband died in a motor cycle accident and at the time of driving the vehicle he was in a drunken condition as revealed by the police in their charge sheet and as discovered by the surveyor and loss assessor and therefore on those grounds, the deceased was found to have violated the terms and conditions of the insurance policy and accordingly the District Forum dismissed the complaint.

        Aggrieved by the said order, the complainant filed the present appeal finding fault with the District Forum for having readily accepted the plea of the opposite parties that the deceased violated the terms of the contract by driving the vehicle in a drunken state.  Though the FIR, postmortem examination and other first hand documents did not disclose any such evidence.

        Heard both sides.

        The point for consideration is whether the order of the District Forum suffers from any infirmities and if it calls for any interference?

        It is abundantly clear from the discussion on merits which reflected the pleas taken by the respondent, insurance company, that the District Forum agreed with the insurance company that the deceased was in a drunken state at the time of the accident and thereby violated the terms of the insurance contract.  But a close look at the record shows that the opposite parties relied upon the charge sheet, the surveyors report and 162 statements to substantiate its plea that the complainant’s husband drove the vehicle in a drunken state and thereby violated the terms of the contract..  The District Forum appeared to have been carried away by this version of the opposite parties overlooking the more reliable evidence found in the signed first information that formed the basis for registration of the FIR and the post mortem examination which did not even make any whisper about the viscera having shown any evidence of alcohol.  It is even more funny to note that the insurance company successfully persuaded the District Forum to accept its theory by adverting to the surveyor’s report which merely embodied second hand information as also 162 statements of one of the witnesses containing a casual statement that the deceased was in the habit of consuming liquor without in so many words firmly stating that he was so drunken at the relevant point of time.  It is  a matter of common knowledge that charge sheet can never take the place of proof.  Likewise the random report of the surveyor can hardly be given any credence to prove an important fact like this.  The reliance on 162 statement is still worse.  Thus the opposite parties mustered strength in order to repudiate the claim by relying upon material which hardly answers the description of any evidence.  As a matter of fact to the signed first information and the post mortem examination, the material relied upon by the insurance company can hardly be a match.  Thus the repudiation was clearly made on the basis of untenable evidence.  The insurance company expressed doubt about the relationship between the complainant and the deceased.  This is also rather atrocious without any proper investigation by it for which it has got ample wherewithal.  As regards delay there is no material to show that either the complaint is barred or the delay was relevant by virtue of any terms of the contract.  On the other hand there is ample evidence to show that the police were duly intimated about the accident.  The provisions of the Motor Vehicles Act clearly provide for the police sending a copy of the FIR to Motor Vehicles Accidents Claims Tribunal and the Motor Vehicles Accidents Claims Tribunal in its turn is supposed to issue notice to the insurance company.  Thus there are statutory safeguards inbuilt in the MV Act to appraise the insurance company about the potential claims without any delay.  Inspite of all these implied obligations fastening to the insurance companies, it is rather surprising that the insurance company pleads ignorance of the claim in every second case.  Even otherwise, we rely on the judgement of the National Commission reported in 2000 NCJ (NC) 406 wherein it was held by the National Commission that

“Merely because the claim is not made within the stipulated period, it is not void”.

In any view of the matter, the insurance company cannot be heard to say that it did not have knowledge about the accident or the claim.  Moreover, the so called latches having vitiated the claim has not been proved. 

Inspite of so many circumstances in favour of the complainant, the District Forum dismissed  the complaint.  We do not think that the District Forum was justified in dismissing the complaint as merits are more in favour of the complainant than the opposite parties.  This takes us to the position that we can hardly sustain the order of the District Forum.  In other words, we have got every reason to interfere with the order of the District Forum and set it aside. 

Accordingly the appeal is allowed setting aside the order of the District Forum and in its stead passing an order directing the insurance company to pay to the complainant an amount of Rs.1,00,000/- with interest at 9% p.a. from the date of complaint till the date of realization and also pay an amount of Rs.3,000/- by way of costs within six weeks of receipt of this order.

                                                                   Sd/

                                                                                                                                                MEMBER.

                                                                                                                                                  Sd/-

                                                                                                                                                MEMBER

                                                            Dt.29-10-2009