Andhra Pradesh

Anantapur

61

N.Aswarthappa and 3 others - Complainant(s)

Versus

The United India Insurence Co.Ltd.,1 other - Opp.Party(s)

K.Gundur rao,L.V.Ranga reddy

31 Jul 2008

ORDER


District Consumer Forum Anantapur
District Consumer Forum Anantapur
consumer case(CC) No. 61

N.Aswarthappa and 3 others
...........Appellant(s)

Vs.

The United India Insurence Co.Ltd.,1 other
...........Respondent(s)


BEFORE:
1. Smt.S.Lalitha 2. Sri S.Chinnaiah

Complainant(s)/Appellant(s):
1. N.Aswarthappa and 3 others

OppositeParty/Respondent(s):
1. The United India Insurence Co.Ltd.,1 other

OppositeParty/Respondent(s):
1. K.Gundur rao,L.V.Ranga reddy

OppositeParty/Respondent(s):
1. A.G.Neelakanta reddy



ORDER

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DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR

 

PRESENT:- Sri S.Chinnaiah, B.A., B.L., President

 

      Smt.S.Lalitha, M.A., M.L., Lady Member

                                   

Thursday, the 31st day of July,2008

 

C.C.No.61/2007

 

Between:

 

            1. N.Aswarthappa died & as per memo

               dt.13-12-2007 the complainants 2 to 4 are

               recognized as L.Rs., of N.Sanjeevamma.

 

2.      Smt.T.Narayanamma

W/o T.Gangadharappa

r/o Chilamathur (V) & (M)

Anantapur District.

 

            3. Smt.T.Sivamma

                W/o T.Kristappa

                r/o Madireddypalli Village

                h/o Morasalapalli Village

                Chilamthur Mandal

                Anantapur District.

 

4.      Smt.T.Lakshmidevi

W/o T.Sreenivasulu

r/o Chilamthur Mandal

Anantapur District.                                                         Complainants

 

Vs.

 

1.      M/s United India Insurance Co. Ltd.,

rep. by its Divisional Manager

Divisional Office,

Anantapur.

 

2.      The Secretary

Primary Agriculture Co-operative Society

r/o Somagatta Village

Chilamathur Mandal

Anantapur District.                                             ….   Opposite Parties

 

 

This case coming on this day for final hearing before us in the presence of Sri K.Gundu Rao, advocate for the complainant and Sri A.G.Neelakanta Reddy,  Advocate for the  1st opposite party and Sri B.Harshavardhana Reddy, advocate for the 2nd opposite party and after perusing the material papers on record and after hearing the arguments of both sides, the Forum delivered the following:

                                   

 

ORDER

(Per Sri C.Chinnaiah, Hon’ble President)

 

 

1.         This is a complaint filed under section 12 of Consumer Protection Act, 1986 by the complainants to direct the opposite party No.1 to pay a sum of Rs.50,000/- towards policy amount and Rs.21,500/- towards expenses incurred for visiting office several times, correspondence expenses, mental agony and advocate fee, total Rs.71,500/- with interest @ 18% p.a. from 18-01-2006 till the date of realization.

2.         The averments of the complaint in brief are that late N.Sanjeevamma is the wife of Aswarthappa, 1st complainant herein. Late N.Sanjeevamma (hereinafter referred to as the deceased for convenience sake) was a borrower in Primary Agricultural Co-operative Society, Somagatta Village, Chilamthur Mandal, who is 2nd opposite party and she availed Kissan Credit Card facility covered under Policy No.051000/47/04/43/000482 issued by the 1st opposite party.  The premium towards the policy was remitted by the deceased through the 2nd opposite party and period covered by the policy was from 2005-2006. At the time of death of the deceased, the policy was in force.  It is further stated that the complainants are legal heirs of the deceased/insured late Smt.N.Sanjeevamma covered under Kissan Credit Card Policy.   Kissan Credit Card Policy-holder Smt.Sanjeevamma died due to snake bite on 18-01-2006.  She suffered snake bite on 16-01-2006 and she was immediately admitted in Government Hospital, Bagepalli of Karnataka State on the same day and was given treatment till 17-01-2006.  She had expert treatment and she was discharged from the hospital on 17-01-2006 at 5.00 P.M.  While she was being taken to Bangalore, her health condition became serious and immediately she was admitted into Government Hospital, Hindupur and while she was undergoing treatment died on 18-01-2006. After her death, the complainants have approached Chilamathur P.S. and reported that the deceased died accidentally. But the Police refused to register a case stating that no case will be registered for snake bite and advised them to go for postmortem examination directly on the dead-body of Sanjeevamma.  At their request, postmortem examination was held over the body of Sanjeevamma and issued certificate to that effect.  The postmortem examination report confirmed that Sanjeevamma died due to snake bite.  The death of the deceased was informed to the 2nd opposite party on 19-01-2006 and in turn it was reported to the 1st opposite party by the 2nd opposite party on the same day.  The complainants submitted the accidental death claim in the month of February, 2006 and necessary documents to the 1st opposite party through the 2nd opposite party and that the documents were received by the 1st opposite party on   28-02-2006.  The 1st opposite party addressed a letter to the 2nd opposite party on 23-03-2006 calling for the documents such as (a) Family Members Certificate from the Mandal Revenue Officer (b) F.I.R. (c) Inquest Report and (d) complete claim form.  In reply, the complainants submitted Family Members Certificate and claim form duly filled with signature through the 2nd opposite party on 28-04-2006 to the 1st opposite party.  In the said letter, the 2nd opposite party was informed that the Police at Chilamathur did not register a case and issue F.I.R.  The 1st opposite party once again addressed a letter dt.24-07-2006 to the 2nd opposite party calling for FIR and inquest report.  Inquest report was sent to the 1st opposite party through the 2nd opposite party in his letter dt.03-08-2006.  Inspite of sending all the required documents except F.I.R., the Police did not register the case and the 1st opposite party did not settle the claim.  Once again after lapse of  six months, the 1st opposite party  called for F.I.R. and Inquest  Report through a letter dt.12-01-2007 as final reminder  to the 2nd opposite party.  The 2nd opposite party immediately gave reply to the 1st opposite party stating that all required documents were sent except F.I.R.  They also explained the reason for not sending F.I.R. as the concerned Police Chilmathur did not register a case.  Inspite of explaining the position for not sending F.I.R., the 1st opposite party kept silent and did not settle the claim.  As the 1st opposite party did not settle the claim even after one year of  the death of the deceased/insured and receiving all necessary documents from the complainants, a legal notice got issued on 24-03-2007 and the same was acknowledged by the opposite parties 1 & 2 on 26-03-2007.  But the 1st opposite party neither gave reply nor settled the claim.  Hence, the 1st opposite party has committed deficiency of service in not settling the claim.  Thus, the case of the complainants. 

3.         The 1st opposite party filed a counter opposing complaint contents contending that the allegations as mentioned in the complaint that N.Sanjeevamma died due to snake bite on 18-01-2006 is absolutely false and it is a make believe affair.  The complainants are put to strict proof that they are legal heirs of the deceased N.Sanjeevamma and that Sanjeevamma died due to snake bite and that they are entitled to claim the compensation for the death of the deceased.  It is stated that the deceased Sanjeevamma did not die due to alleged snake bite on 18-01-2006 and as such the 1st opposite party company is not liable to pay any compensation to the complainants under Janatha Personal Accident Insurance Policy to Kissan Credit Card-holders. The alleged documents filed by the complainants’ alongwith complaint are nothing but created for the purpose of claiming compensation fraudulently under the said Janatha Personal Accident Insurance Policy to Kissan Credit Cardholders.  It is stated that the deceased died due to alleged snake bite are invented only for the purpose of this unjust claim and absolutely there is no truth in it.  It is stated that the claim for compensation under Janatha Personal Accident Insurance Policy is bogus one and false claim was made on the basis of the fabricated documents in order to suppress the cause of death of the deceased.  It is stated that the complainants have not submitted F.I.R., Inquest Report, Postmortem Certificate, Final Investigation Report and Forensic Laboratory Report since the alleged death is due to the alleged snake bite and as per the Memorandum of Understanding; the said documents are required in the case of death for processing with the claim.  Since the complainants have not complied with necessary requirements of the company and grossly violated the terms and conditions of the said Janatha Personal Accident Insurance Policy, there is absolutely no deficiency in service on the part of the 1st opposite party company.  It is stated that the District Forum has no jurisdiction to entertain the claim against the 1st opposite party company as there is absolute no deficiency in service.  There is no delay, default or fraud committed by the 1st opposite party company and has rejected the claim of the complainants on certain facts. It is submitted that the issue involved complicated question of fact and law.  The issues raised can not be determined without taking elaborate oral and documentary evidence and such elaborate scrutiny can be determined and performed only in a civil suit and only civil suit is maintainable in a competent civil court.  The complainants have claimed a sum of Rs.71,500/-  towards compensation on different heads.  The amount claimed is highly excessive, arbitrary and out of proportionate and that the complainants are not entitled to any amount or any portion thereof.  Hence to dismiss the complaint with costs. 

4.         The 2nd opposite party filed a counter admitting that the deceased Smt.N.Sanjeevamma was borrower in Primary Agricultural Co-operative Society, Somagatta and she availed Kissan Credit Card facility covered under the policy as claimed in the complaint by the complainants. It is a fact that the deceased during her life was remitting premium amount through the 2nd opposite party and period covered by the policy was from 2005-2006 and that the said policy was in force on the date of death of Sanjeevamma.  It is stated that the complainants are put to strict proof that they are legal heirs of the deceased Sanjeevamma. It is submitted that it is a fact that the policy-holder died due to snake bite on   08-01-2006.  It is stated that all the documents were submitted to the 1st opposite party through the 2nd opposite party on 28-02-2006 is true and correct.   It is stated that the fact of addressing letters and sending the documents except F.I.R. to the 1st opposite party is true and correct.  It is stated that the policy issued by the 1st opposite party was in force on the date of death of the deceased and if any award is passed, the 1st opposite party alone is liable to pay the same.  There is deficiency of service only on the part of the 1st opposite party.  There is no deficiency of service on the part of the 2nd opposite party.  Hence, to dismiss the complaint against the 2nd opposite party.

5.         Heard arguments both sides.

6.         The point that arises for consideration herein is:

            Whether the complainants have proved the deficiency of service on the

           part of the opposite parties ?

 

7.        Ex.A1 to A14 are marked for the complainant and Ex.B1 to B5 are marked for the opposite party No.1. 

Ex.A1 is attested copy of Co-operative Kissan Credit Card-cum-Pass Book.   Ex.A2 is the attested copy of inpatient case sheet relating to deceased Sanjeevamma.  Ex.A3 is the attested copy of Admission Discharge Certificate issued by the Government Hospital, Bhagepalli. Ex.A4 is the attested copy of Postmortem Certificate relating to deceased Sanjeevamma.  Ex.A5 is the attested copy of letter dt.19-01-2006 addressed by the 2nd opposite party to the 1st opposite party.  Ex.A6 is the attested copy of Death Certificate relating to deceased Sanjeevamma.  Ex.A7 is the attested copy of letter dt.28-02-2006 addressed by the 2nd opposite party to the 1st opposite party.  Ex.A8 is letter dt.23-03-2006 of the 1st opposite party addressed to the 2nd opposite party. Ex.A9 is the attested copy of letter dt.28-01-2006 addressed by the 2nd opposite party to the 1st opposite party.  Ex.A10 is the attested copy of letter dt.24-07-2006 addressed by the 1st opposite party to the 2nd opposite party.  Ex.A11 is the attested copy of letter dt.03-08-2006 addressed by the 2nd opposite party to the 1st opposite party alongwith inquest report of deceased Sanjeevamma.  Ex.A12 is  letter dt.12-01-2007 addressed by the 1st opposite party to the 2nd opposite party.   Ex.A13 is the office copy of the legal notice got issued by the 1st complainant to the opposite parties 1 & 2.  Ex.A14 are the postal acknowledgements signed by the opposite parties 1 & 2.

Ex.B1 is the certified copy of Insurance Policy No.051000/47/04/00482. Ex.B2 is the carbon copy of letter dt.24-07-2006 of the 1st opposite party addressed to the 2nd opposite party.  Ex.B3 is the carbon copy of letter                dt.28-09-2006 of the 1st opposite party addressed to the 2nd opposite party.  Ex.B4 is the carbon copy of letter dt.12-01-2007 of the 1st opposite party addressed to the 2nd opposite party.   Ex.B5 is the Xerox copy of intimation of claim dt.28-04-2006.  We have gone through the contents of the complaint, counter, chief affidavit, cross-affidavit, written arguments, documents and the relevant material available on record.

8.  POINT:-   At the outset, it is relevant to clarify the position of the complainants, who filed this complaint claiming insurance amount for the death of N.Sanjeevamma covered under Kissan Credit Policy claiming that she died due to snake bite.  It is to be stated that originally N.Aswarthappa, who is the husband of late N.Sanjeevamma and 3 others i.e. complainants 2 to 4 filed this complaint including N.Aswarthappa as complainant No.1 and that the said Aswarthappa was conducting the proceedings.  During pending enquiry of the complaint, the 1st complainant N.Aswarthappa, who is husband of the deceased Sanjeevamma expired on 25-10-2007.  After his death the complainants 2 to 4, who are already on record filed a memo stating that except themselves, there are no other legal heirs to late N.Aswarthappa.  Hence, under the circumstances and in view of the memo dt.13-12-2007, the complainants 2 to 4 are recognized as legal heirs of deceased Sanjeevamma and 1st complainant N.Aswarthappa for further proceedings in this case.

9.         The case of the complainants is that Smt.N.Sanjeevamma (herein after referred to as the deceased for convenience sake) during her life time was member of Primary Agricultural Co-operative Society, Somagatta, who is 2nd opposite party herein and that she had availed Kissan Credit Card facility.  The borrowers, who availed Kissan Credit, were covered under accidental insurance policy introduced by the 1st opposite party.  The deceased as a borrower in  Kissan Credit Card (Ex.A1) covered under Insurance Policy issued by the                 1st opposite party.  Ex.A1 is the Kissan Credit Card.  Insurance premium towards Kissan Credit Card Policy was covered the period of 2005-2006. By the time of death of deceased Sanjeevamma, the Insurance Policy was in force.

10.       The contention of the complainants is that N.Sanjeevamma suffered a snake bite on 16-01-2006 and she was admitted in Govt. Hospital, Bagepalli of Karnataka State at 10.00 A.M. for treatment.  Ex.A2 is the inpatient sheet.  As the patient did not respond to the treatment, it was advised to shift her to Bangalore and accordingly she was discharged on 17-01-2006. Ex.A3 is copy of Discharge Certificate. As her health had become serious, she was admitted in Govt. Hospital, Hindupur on 17-01-2006 as the same is nearest medical facility. She died on 18-01-2006 in the said hospital and that the dead-body was sent for postmortem examination on the same day and the Medical Officer, who conducted postmortem and declared N.Sanjeevamma died due to snake bite.  Ex.A4 is the copy of Postmortem Certificate, which reveals that she died due to snake bite.  The death of Smt.N.Sanjeevamma was reported to Chilamathur P.S. that she died due to snake bite.  But the Police did not register the case and stated that for the death of snake bite, there could not be any investigation and accordingly they refused to register the case. The death of Sanjeevamma, who died due to snake bite, was informed by the 2nd opposite party to the 1st opposite party through letter dt.19-01-2006.  Ex.A5 is the copy of the letter dt.19-01-2006.  On the very next day, on the death of the deceased Sanjeevamma, the                    1st opposite party did not take any action.  Thus, the death of the deceased Sanjeevamma was informed to the 1st opposite party by the 2nd opposite party by virtue of letter under Ex.A5 that she died due to snake bite. 

11.       The 2nd opposite party is not disputing the death of deceased that she died due to snake bite and as such the 2nd opposite party has informed the cause of death to the 1st opposite party and requested to pay insurance amount to the complainants.  On the other hand, the 1st opposite party is disputing the very contention of the complainants and the 2nd opposite party contending that the place where the deceased sustained snake bite, time of incident and on which part of the body, the deceased suffered snake bite are not mentioned either in the main complaint or in the chief affidavit.  Their next contention is that the type of snake, which bitten the deceased and the nature of injuries sustained by the deceased are not mentioned in the main complaint as well as in the chief affidavit of the 2nd complainant.  Their further contention is that postmortem examination was conducted without registering the case by the concerned Police i.e. without F.I.R. and Inquest held by the concerned Police.  According to the complainants, although they approached the concerned police, they did not register the case can not be believed.  Their further contention is that without requisition of the police, the doctors shall not conduct postmortem examination and hence Ex.A4 can not be taken into consideration.  It is contended that the concerned police will send requisition to the doctor to conduct postmortem examination since it is medico-legal case. In the postmortem examination, the external injuries and internal injuries are not mentioned and hence no credence should be given to Ex.A4.   Their next contention is that as seen under Ex.A4, no opinion as to the cause of death of the deceased is given in the postmortem examination report, hence no reliance can be placed under Ex.A4 and the same is created for the purpose of claiming compensation under Insurance Policy.  Their next contention is that the complainants have not examined the concerned doctor, who conducted postmortem examination over the dead-body of the deceased and as such the said Postmortem Certificate went unproved. Their next contention is that as seen under Ex.A2 and A3 i.e. inpatient case sheet and Admission & Discharge Certificate maintained by the Govt. Hospital, Bagepalli  do not reveal time of discharge and that the doctors, who treated  in the said hospital are not examined by the complainants to prove the contents of the documents and hence the documents are unproved.  On the other hand, the hospital records, which are Ex.A2 and A3 can not be given to the patients and hence no reliance can be placed upon such documents, which are not proved.  Their next contention is that Ex.A6 is Death Certificate issued by the Panchayat Secretary, which discloses that the deceased died at Madireddipalli Village and Ex.B5 is claim intimation letter submitted by the husband of the deceased shows that she died at Madireddipalli village.  Whereas, the main complaint and chief affidavit of the 2nd complainant discloses that the deceased died in the Govt. Hospital, Hindupur, while undergoing treatment and hence the complainants have not come forward with true version and they have come forward with false version in order to claim insurance amount to have unlawful gain.  His further contention is that Ex.A13 is the legal notice, which discloses that the deceased has also taken treatment in Govt. Hospital, Chickballapur and also at Puttaparthy hospital and the said fact has been suppressed for the reasons best known to the complainants and the said fact has not been mentioned either in the complaint or in the chief affidavit. Hence, any amount of suspicion can be thrown, in which manner the complainants have come forward claiming the insurance amount.

12.       The next contention of the 1st opposite party is that no eye-witness to the incident is examined and that the complainants have not examined to prove the contents of documents filed by them and as such the case of the complainants’ falls to the ground as devoid of merits. As the complainants have not examined anybody regarding incident or to prove the contents of the documents filed by them, the 1st opposite party lost an opportunity to cross-examine those witnesses. Their next contention is that the complainants have not complied with necessary requirements of the company, inspite of repeated requests and Ex.B2 to B4 are the letters of correspondence.  Since the complainants have not complied with the necessary requirements of the company, there is absolutely no deficiency of service on the part of the 1st opposite party and relied on a decision reported in 2002(4) A.L.T. page 38 C.P.A., National Commission.  Their next contention is that the complainants and the 2nd opposite party are colluded with each other for the reason that counter, chief affidavit and written arguments filed by the 2nd opposite party shall speak to that effect and that drafting and the letters of computer typing is one and the same.  Hence, no credence should be given to the contention of the complainants and the 2nd opposite party.  The next contention of the 1st opposite party is that the purpose for which the deceased was admitted in the hospitals at Chickballapur and Puttaparthy, there is no documentary evidence and the said fact has been suppressed by the complainants and as such it creates doubt whether the deceased died with some ailment.  Their last contention is that the complainants have failed to prove that the deceased Sanjeevamma died due to snake bite and as such they are not entitled for relief as come forward by them.

13.       After going through the rival contentions we have to necessarily reject the contention of the opposite party No.1. It is to be stated that the complainants have proved that the deceased Sanjeevamma died due to snake bite.  Ex.A2 and A3 i.e. Case Sheet and Discharge Certificate amply goes to show that deceased Sanjeevamma was admitted in the Government Hospital, Bagepalli, Karnataka state for treatment of snake bite and Ex.A4 Postmortem certificate goes to show that the death was due to snake bite. It is pertinent to go through Ex.A4 postmortem certificate.  A perusal of Ex.A4 Postmortem Certificate issued by the doctor, Govt.General Hospital, Hindupur, who conducted postmortem examination on the dead-body of the deceased stated that the deceased died due to poison throughout her body.  Hence, Ex.A2, Ex.A3 and Ex.A4 amply goes to show that the deceased died due to snake bite.  Added to it, we are having Ex.A11 Inquest Report of Villagers of Madireddipalli.  A perusal of Ex.A11 goes to show that the Villagers of Madireddipalli opined that the deceased Sanjeevamma died due to snake bite while she was attending the works in a hayrick-yard.  Hence, Ex.A11 lends additional support to the case of the complainants that the said Sanjeevamma died due to snake bite. Added to it, under Ex.A4 Postmortem Certificate, it is stated that she died on 18-01-2006 while undergoing treatment.   Simply because, the time of death is not mentioned in the complaint or in the chief affidavit of the 2nd complainant alone is not a ground to reject the case of the complainants.  It is no doubt true that the complainants have not examined anybody to speak the contents of the documents filed by them and on that ground the entire case of the complainants can not be rejected.  The decision relied on by the opposite party No.1 as mentioned supra is not applicable to the facts of the present case.

14.     The staunch contention of the opposite parties is that the complainants have not filed F.I.R. and so any amount of suspicion can be placed on the face of the complaint.  It is to be remembered that the opposite parties have come forward that after death of the deceased they have approached Chilamathur P.S. to register the case for the death of the deceased due to snake bite, but the said Police refused to register the case and issued F.I.R. stating that in case of snake bite, there could not be any investigation.  Hence, the complainants have given sufficient explanation for not filing the F.I.R. as contended by the opposite party No.1.

15.       On this aspect, the complainants have relied on decision reported in                   II (2004) C.P.J. Page 126 – A.P.State Consumer Disputes Redressal Commission, Hyderabad  - Oriental Insurance Co. Ltd., Vs. Garapati Taraka Mohan.  In the above said decision, their lordships held that in respect of accidental death is proved, FIR need not be filed.  In the above said decision, one person died due to collapse of shed.

            The decision reported in 2000 A.L.D. (Cons.) page 96 LIC of India, Secunderabad and another Vs. Banavath Kamlee, their lordships have held that 

  Complainant’s husband took an insurance policy under Double Accident Benefit Scheme – Claim was made by the complainant that her husband died due to snake bite and produced the death extract given by Mandal Revenue Officer – Insurance Company paid the assured amount but refused to pay the accident benefit on the ground that the complainant failed to produce the post-mortem certificate, FIR or inquest report – Held, illegal – When the cause of death is a snake bite but not a suspicious one obtaining FIR and other documents does not arise – Further, no opportunity was given to the complainant to establish the cause of death – In the circumstances denial of claim by Insurance Company is illegal. “

The facts of the present case are that the deceased Sanjeevamma died due to snake bite.  In the present case, the complainants have proved that the deceased died due to snake bite.  Thus, the complainants both in complaint and chief affidavit have proved by filing relevant documents that the deceased Sanjeevamma died due to snake bite. Subsequent to the death of the deceased, the complainants claimed the insurance amount from the 1st opposite party through the 2nd opposite party with necessary documents such as Ex.A4 Postmortem Certificate, Ex.A6 Death Certificate and Ex.A1 Kissan Credit Card.  All these documents were supplied by the 2nd opposite party to the 1st opposite party alongwith death claim under Ex.A7.  The 1st opposite party in its letter dt.23-03-2006 addressed to the 2nd opposite party directed to send Family Members Certificate, F.I.R., Inquest Report and claim in prescribed format. Ex.A8 is the said letter.  The 2nd opposite party sent the Family Members Certificate of the deceased Sanjeevamma and the claim form vide letter dt.28-01-2006. Ex.A9 is the said letter.  Again the 1st opposite party addressed a letter dt.24-04-2006 calling for F.I.R. and Inquest Report under Ex.A10.  The 2nd opposite party after obtaining inquest report sent the same to the 1st opposite party under Ex.A11.  Again after 5 months, the 1st opposite party addressed another letter calling for F.I.R. and Inquest Report.  Inspite of sending the inquest report and informing the 1st opposite party, the fact of Police not registered the case and hence there will be no F.I.R.  and Ex.A12 is the such letter. Hence, the complainants have claimed Insurance amount relating to the deceased goes to show that the  1st opposite party had no inclination to settle the amount inspite of the complainants have supplied sufficient and necessary documents as required by them.  Ex.A13 is the legal notice issued by the complainants for settlement of the claim amount.  Now it is the case of the opposite parties that inspite of issuing notice claiming insurance amount and supplied necessary documents as required by them except FIR, the 1st opposite party did not settle the claim.  The proceedings on record, goes to show that the 1st opposite party is only bent upon the F.I.R. which is not available with the complainants.  The staunch case of the complainants is that no FIR is registered as there could not be any investigation, in case of snake bite by the Police.   The fact of non-filing of F.I.R. in case of snake bite is discussed in the previous lines. Hence, the 1st opposite party pressing the complainants to supply F.I.R. is not tenable and it appears that they are unnecessarily throwing blame on the complainants in order to escape from the liability.

16.       The contention of the complainants is that inspite of issuing notice to the 1st opposite party; they did not produce the investigation report.  On the other hand the contention of the learned counsel appearing for the 1st opposite party on this aspect that the entire original claim file has been sent to the Regional Office, Hyderabad for information and perusal and copy of it is not available in the claim file and that the company is unable to produce the said document.  His next contention is that even other-wise, the complainants have to prove their case beyond reasonable doubt by adducing oral and documentary evidence.   After going through the rival contentions, we are satisfied that the contention of the counsel appearing for the 1st opposite party is too far away from  acceptance for reasons that if the original file is sent to the Regional Office, Hyderabad, it is not difficult to secure the same and file it before the Forum.  If at all the version of the 1st opposite party is true, the deceased had not died due to snake bite.  The explanation for non-production of the investigation report by the opposite parties is not convincing.  Hence, under the circumstances, an adverse inference can be drawn against the 1st opposite party for not producing investigation report. 

17.       In a decision reported in I (2003) C.P.J. 216 (N.C.)  - Ms.Shefalibhargava Vs.Indraprastha Apollo Hospital & another, their lordships have held that “ party in position to produce evidence, if not produce it, must suffer adverse inference against itself. “ The above said decision is amply applicable to the facts of the present case for the reason that though the 1st opposite party is in possession of the investigation report, they failed to produce the same before this Forum inspite of complainants issuing a memo. 

18.       The 1st opposite party filed Ex.B1 Insurance Policy and Ex.B2 to B5 are letters of correspondence.  Ex.B2 to B4 are in no way improve the case of the   1st opposite party for the reasons discussed supra.

19.       To some up, we are satisfied that the complainants have proved the death of the deceased Sanjeevamma was due to snake bite and Ex.A2 and A3 establishes that Sanjeevamma was admitted into Govt. Hospital, Bagepalli, Karnataka State for treatment of snake bite and Ex.A4 Postmortem report amply establishes that the death was due to snake bite.  So under the circumstances of the case, the contention of the 1st opposite party that the death was not due to snake bite can not be believed.  The complainants have filed all the necessary documents as required by the 1st opposite party for discharging the liability except F.I.R.    No case was registered by the Police and the same was informed to the 1st opposite party under Ex.A9 by the 2nd opposite party. The death of Sanjeevamma is not an incidental for investigation by the Police and so insisting F.I.R. by the 1st opposite party is an intentional evasive tactics to escape from the liability, which amounts to deficiency of service.  On the other hand, the             1st opposite party has no ground to repudiate the claim though the complainants have produced sufficient documents in order to show that the deceased died due to snake bite, which is accidental death.  It is not in dispute that the Insurance  Policy belongs to the deceased is in force and as such, the complainants are entitled for the Insurance amount and the 1st opposite party is bound to pay the assured sum as there is deficiency of service committed by them.

20.       The complainants are entitled to sum of Rs.50,000/- towards policy amount belongs to Sanjeevamma, who died accidentally due to snake bite to be payable by the 1st opposite party.  They are claiming interest @ 18% p.a. which is on higher side.  In our considered opinion, we are inclined to award interest             @ 9% p.a. as the 1st opposite party had delayed the payment of Insurance amount to the complainants.  The complainants are claiming Rs.21,000/- on various heads, which is on higher side.  In our considered opinion, awarding a sum of Rs.5,000/- towards mental agony is reasonable.  The complainants are not entitled for rest of the amounts as claimed by them under various heads.  As the 2nd opposite party is only collecting the amount and sending the same to the                   1st opposite party, they are not liable to pay any amount.  As the amount received by the 1st opposite party, he alone is liable to pay the insurance amount as claimed by the complainants.

21.       In the result, the complaint is partly allowed directing the opposite party No.1 to pay a sum of Rs.50,000/- (Rupees fifty thousand only) towards Insurance Policy amount with interest @ 9% p.a. from the date of death of the deceased i.e. 18-01-2006 till the date of realization and further directed to pay a sum of Rs.5,000/- (Rupees five thousand only) towards mental agony and Rs.500/- (Rupees five hundred only) towards costs of the complaint.  This order shall be complied with, within one month from the date of receipt of the order.  The complaint against the opposite party No.2 is dismissed without costs.

Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 31st day of July, 2008.

 

 

 

                          Sd/-                                                                     Sd/-                                                                 

                 LADY  MEMBER                                                PRESIDENT

DISTRICT CONSUMER FORUM,                     DISTRICT CONSUMER FORUM,

                  ANANTAPUR                                                    ANANTAPUR

 

 

 

 

 

 

 

APPENDIX OF EVIDENCE

 

WITNESSES EXAMINED FOR

 

COMPLAINANT:   NIL                                             OPPOSITE PARTY: NIL

 

 

EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT

 

Ex.A1 -       Attested copy of Co-operative Kissan Credit Card-cum-Pass Book. 

 

 Ex.A2 -      Attested copy of inpatient case sheet relating to deceased

                  Sanjeevamma. 

 

Ex.A3 -      Attested copy of Admission Discharge Certificate issued by the

                  Government Hospital, Bhagepalli.

 

Ex.A4 -      Attested copy of Postmortem Certificate relating to deceased

                 Sanjeevamma.

 

Ex.A5 -     Attested copy of letter dt.19-01-2006 addressed by the 2nd opposite

                 party to the 1st opposite party.  

 

Ex.A6 -     Attested copy of Death Certificate relating to deceased Sanjeevamma. 

 

Ex.A7 -    Attested copy of letter dt.28-02-2006 addressed by the 2nd opposite

                party to the 1st opposite party.

 

Ex.A8 -    Letter dt.23-03-2006 of the 1st opposite party addressed to the 2nd

                opposite party.

 

Ex.A9 -    Attested copy of letter dt.28-01-2006 addressed by the 2nd opposite

                party to the 1st opposite party. 

 

Ex.A10 - Attested copy of letter dt.24-07-2006 addressed by the 1st opposite

               party to the 2nd opposite party. 

 

Ex.A11-  Attested copy of letter dt.03-08-2006 addressed by the 2nd opposite

               party to the 1st opposite party alongwith inquest report of deceased

               Sanjeevamma.

 

Ex.A12-  Letter dt.12-01-2007 addressed by the 1st opposite party to the 2nd

               opposite party.

 

Ex.A13 - Office copy of the legal notice got issued by the 1st complainant to the

               opposite parties 1 & 2.

 

Ex.A14 -  Postal acknowledgements signed by the opposite parties 1 & 2.

 

 

EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.1

 

Ex.B1 -   Certified copy of Insurance Policy No.051000/47/04/00482.

Ex.B2 -  Carbon copy of letter dt.24-07-2006 of the 1st opposite party

              addressed to the 2nd opposite party.

 

 Ex.B3 -  Carbon copy of letter dt.28-09-2006 of the 1st opposite party addressed

               to the 2nd opposite party.

 

 Ex.B4 - Carbon copy of letter dt.12-01-2007 of the 1st opposite party addressed

              to the 2nd opposite party.

 

Ex.B5-  Xerox copy of intimation of claim dt.28-04-2006. 

 

                         Sd/-                                                                      Sd/-  

               LADY  MEMBER                                                  PRESIDENT

DISTRICT CONSUMER FORUM,                     DISTRICT CONSUMER FORUM,

                  ANANTAPUR                                                    ANANTAPUR

 

 

Typed by JPNN

 

 

           

 

 

 

 

 

 




......................Smt.S.Lalitha
......................Sri S.Chinnaiah