COMPLAINT FILED ON: 02.12.2009

DISPOSED ON:22.11.2011

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AT BANGALORE (URBAN)

22^nd DAY OF NOVEMBER-2011

       PRESENT:- SRI. B.S.REDDY                PRESIDENT                        

                         SMT. M. YASHODHAMMA         MEMBER    

                         SRI.A.MUNIYAPPA                   MEMBER

O R D E R

SRI. B.S.REDDY, PRESIDENT

This is a complaint filed u/s. 12 of the C.P. Act of 1986 by the complainant seeking direction against he Opposite Party (herein after called as OP) to pay an sum of Rs.1,37,603/- which is interest on claim amount in a sum of Rs.1 Lakh at the rate of 18% p.a. from 10.04.2002 to up to date and to pay compensation Rs.10,000/- to the complainant on the allegations of deficiency in service.

2. The case of the complainant to be stated in brief is that:-

Complainant’s deceased husband B.C.Shivaram was employed in the Karnataka State Police Department as Police Constable, Intelligence Wing, Bangalore. The said B.C.Shivaram while in service on 10.04.2002 succumbed to death on account of Motor Accident. Complainant being nominee under the insurance coverage extended by the Op under the special group insurance company laid a claim through the employer of deceased husband i.e., the Director General and Inspector General of Police, Karnataka State, Bangalore. OP having received the claim submitted through the employer of the deceased husband required the complainant to submit sum more particulars regarding his employment with Department for settling the claim. Complainant as per eh request of the Op submitted particulars sought by the OP. In spite of it claim laid by complainant was not settled and no further information regarding the same was provided to the complainant. Since OP did not settled the claim for more than a year complainant caused legal notice to the OP calling upon to settle her claim. OP in response to the notice issued a letter dt.06.10.2009 to the complainant stating the claim made by the complainant was under consideration. On 12.11.2009 issued another letter to the complainant stating OP settled the claim amount for a sum of Rs.1 lakh as full and final settlement of the claim made by the complainant by issuing cheque dt.12.11.2009. The payment made by OP for a sum of Rs.1 lakh towards final settlement under the Group Insurance Policy did not included the interest on the amount of sum of Rs.1 lakh from 10.04.2002 till date of settlement of claim amount. Non including the interest payable on insurance amount by the OP has render deficiency in service and nonpayment of interest on insurance amount has deprived the legitimate rights of the complainant. Hence complainant felt deficiency in service on the part of the OP. Under the circumstances he is advised to file this complaint for the necessary relief’s.

3.   On appearance OP filed version mainly contending that the complaint is highly belated one and the complainant is estopped from claiming any relief as she has suppressed the very material fact in the complaint. OP admits issuance of policy covering the risk of personal accident of Police Department unnamed police staff as mentioned in the policy; As per the policy the maximum liability of the company shall be limited to Rs.1 lakh only in the event of accidental death of the beneficiary. As per the terms the sum assured is Rs.1 lakh and nothing else; When that is so the complaint is filed on false and frivolous grounds; Initially the OP has repudiated the claim of the complainant on the ground that the deceased was a clerk in the Police Department; Later on OP got clarified from the police authorities and learnt that Police Constable will be posted for office work as clerk; Immediately OP has settled the claim amount of Rs.1 lakh by way cheque dt.12.11.2009 drawn on IndusInd Bank, Bangalore with letter dt.12.11.2009; Complainant has encashed the said cheque. The complainant for the first time before this Forum claim interest on the sum assured; From the date of repudiation till 05.10.2009 complainant has not filed any claim of interest on the sum assured. On 05.10.2009 complainant got issued legal notice claiming the sum assured of Rs.1 lakh only and nothing more; At the time of receiving the cheque. Complainant has not raised any objections; All of a sudden she has filed this complaint claiming interest over the sum assured; Complainant is not entitled for any relief’s as there is no provision in the policy to pay interest; There is no averment in the legal notice dt.05.10.2009; Complainant has not raised any objection till she receives the cheque; Hence complainant is estopped from claiming interest for the first time before this Forum; Among other grounds OP prayed for dismissal of the complaint.

4.   In order to substantiate the complaint averments, complainant filed her affidavit evidence and produced copy of the notice dt.08.09.2009, intimation letter issued by OP dt.06.10.2009 and 12.11.2009. On behalf of OP Sri.Sridhar, Divisional Manager, United India Insurance Company Limited, Museum Road, Bangalore filed his affidavit evidence and produced Xerox copy of the letter dt.12.11.2009 and copy of the order of repudiation dt.15.09.2004 and copy of the policy and legal notice. Op submitted written argument. Heard oral arguments from both sides.

5.   In view of the above said facts the points now that arise for our consideration in this complaint are as under:

Point No.1:-Whether the complainant has proved the deficiency in service on the part of the OP?

           Point No.2:-If so, whether the complainant is  

                             entitled for the relief’s now claimed?

           Point No.3:-To What order?

6.   We have gone through the pleadings of the parties both affidavit and documentary evidence and the arguments advanced. In view of the reasons given by us in the following paragraphs our findings on the above points are:

    Point No.1:-Negative

            Point No.2:-Negative

           Point No.3:-As per final order.

R E A S O N S

7. At the out set it is not in dispute that the complainant’s husband B.C.Shivaram who was employed in the Karnataka State Police Department as Police Constable, Intelligence Wing, Bangalore; While in service on 10.04.2002 succumbed to death on account of Motor vehicle accident. Complainant being nominee under Insurance coverage extended by OP made a claim under the Special Group Insurance through employer of her deceased husband i.e., Director General and Inspector General of Police, Karnataka State, Bangalore. It is also not in dispute that Op having received the claim submitted by the complainant through the employer of her deceased husband required complainant to submit some more particulars regarding his employment with the department for settlement of he claim. As per the request of OP, complainant submitted the particulars. OP did not settle the claim for more than a year. Hence complainant got issued legal demand notice to OP on 08.09.2009. OP by its letter of dt.12.11.2009 informed the complainant having settled the claim for an amount of Rs.1 lakh as full and final settlement, by issuing the cheque dt.12.11.2009. Though OP has paid Rs.1 lakh towards full and final settlement as claimed by the complainant which did not include interest on the sum assured of Rs.1 lakh from 10.04.2002 to till the date of settlement of claim amount. Hence complainant is before this Forum.

8.  As against the case of the complainant, the defence of the OP is that OP has repudiated the claim of the complainant. Initially on the ground that the deceased was a clerk in the Police Department later on OP got clarified from the authority and learnt that police constable will be posted for office work as clerk. Hence OP has settled the claim amount of Rs.1 lakh by way of cheque dt.12.11.2009 drawn on IndusInd Bank, Bangalore along with the covering letter dt.12.11.200. Complainant has encashed the said cheque; Now for the first time filed complaint before this forum claiming interest on the sum assured from the date of repudiation till 05.10.2009. Complainant has not filed any claim for sum assured only on 05.10.2009 complainant got issued the legal notice claiming a sum of Rs.1 lakh only. Immediately OP has settled the claim by way of cheque. Complainant received the cheque without raising any objections. Now complainant is not entitled for any relief.

9.The complainant has produced copy of claim statement dt.29.05.2002 and copy of the letter dt.01.06.2002 addressed to the Director General and Inspector General of Police by Additional Director General of Police having forwarded the claim application of the complainant for taking further action. The copy of the letter dt.20.06.2002 is addressed to the Branch Manager of OP by Director of General and Inspector General of Police having forwarded the claim application of the complainant to settle the claim. OP has produced copy of repudiation letter dt.15.09.2004 sent to Director General and Inspector General of Police for having repudiated the claim, on the ground that the claimant is a clerk in the office hence he is not covered under the policy. Thus it becomes clear that while forwarding the claim application of the complainant to OP necessary clarification was not made regarding the fact that the Police Constable will be deputed to work as a clerk in the Office. Because of not furnishing required clarification the claim was repudiated.

            In the complaint, affidavit evidence of the complainant it is stated that some more particulars regarding employment of her deceased husband were sought for settling the claim, she has submitted the particulars but the claim was not settled. The complainant has not furnished the date or month or year as to when she has furnished the required particulars to the OP for settling the claim. Without furnishing the required details OP was not able to settle the claim, the complainant has not stated as to when she furnished the required particulars. In the legal notice dt.08.09.2009 got issued by the complainant, it is stated that OP having received the claim submitted through the employer of the complainant’s deceased husband required submission of some more particulars regarding his employment from the department for settling the claim. Despite submission of particulars sought the claim was not settled till this day. In the notice also it is not stated as to when the Department has furnished the required particulars to OP for settling the claim. OP in the version at Para-3 stated that initially the claim of the complainant was repudiated, on the ground that the deceased was a clerk in a Police Department. Later on OP got clarified from the Police authorities and learnt that Police Constable will be posted for office work as clerk. Then immediately settled the claim for an amount of Rs.1,00,000/- by issuing cheque dt.12.11.2009. Thus it becomes clear that the delay in settling the claim was on account of not furnishing the required clarification from the Department where the husband of the complainant was employed. Soon after OP got clarified from the Department that Police Constable will be posted for office work as clerk, the claim has been settled. Under these circumstances, we are of the view that there was no any unreasonable delay on the part of the OP in settling the claim after receipt of the required clarifications from the Department. Therefore, OP is not liable to pay interest claimed on the settled claim amount. The complaint is devoid of merits, the same is liable to be dismissed. Accordingly we proceed to pass the following:

O R D E R

The complaint filed by the complainant is dismissed.  Considering the nature of dispute no order as to costs.

        Send copy of this order to both the parties free of costs.

(Dictated to the Stenographer and typed in the computer and transcribed by her, verified and corrected, and then pronounced in the Open Court by us on this the 22^nd day of November-2011.)

MEMBER                            MEMBER                          PRESIDENT

Cs.