CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR. PRESENT: - Sri C.Thyagaraja Naidu, B.Sc., B.L., President Smt.S.Lalitha, M.A., M.L., Lady Member, Sri S.Niranjan Babu, B.A., B.L., Male Member Wednesday 3rd day of February, 2010 C.C.NO.32/2007 Between: Smt. J,Madhavi Latha @ A.Madhavi Latha, W/o Sri J.Raja Rathnam babu, Lecturer in English, K.V.R. Government Degree College for Women, Kurnool, Rr/o D.No.310, Amrutha Apartments, Sankal Bagh, Kurnool. … Complainant. Vs 1. The United India Insurance Company Limited, Rep. by its Branch Manager, 15/130, Subash Road, Opposite Lalithakala Parishad, Anantapur. 2. The United India Insurance Company Limited, Rep. by its Divisional Manager, Divisional Office, 11/170-B 1st Floor, Meda Mansions, Subash Road, Anantapur. 3. The United India Insurance Company Limited, Rep. by its Regional Manager, Regional Office, Basheer Bagh, Post Box No. 1020, Hyderabad- 500 029. … Opposite parties. This case coming on this day for final hearing before us in the presence of Sri I.Ravindranath, Advocate for the complainant and Sri V.Krishna Sharma, Advocate for the opposite parties 1 to 3 and after perusing the material papers on record and after hearing the arguments of both sides, the Forum delivered the following: O R D E R Sri C.Thyagaraja Naidu, President: - This complaint has been filed by the complainant against the opposite parties1 to 3 under section 12 of the Consumer Protection Act, 1986 to pass an award in favour of the complainant and against the opposite party 1 to 3 for a sum of Rs.12,95,500/- with interest and costs from the date of murder of the deceased Smt. A. Frank Rachel who obtained a Janata Personal Accident Insurance Policy for a sum of Rs.5,00,000/- from the 1st opposite party with effect from 09.12.1996 to 08.12.2006. 2. The brief facts of the complaint are that: - The mother of the complainant by Smt. A. Frank Rachel wife of Late Sri P.L. Johanus (herein after referred to as the deceased) has obtained Janata Personal Accident Insurance Policy for a sum of Rs.5,00,000/- from the 1st opposite party with effect from 09.12.1996 to 08.12.2007 under insurance policy dt.10.12.1996 bearing No. Janata Personal Accident Insurance Policy-051004/400/47/56/10/1/49348/96 wherein the complainant is the nominee. On 19.10.1998 night at about 11.15 P.M. the deased was murdered at her residence by unknown offenders. As per the terms and conditions of the said Janata Personal Accident Insurance Policy the entire insurance policy amount of Rs. 5,00,000/- became payable to the complainant by the opposite party. The complainant submitted the claim form under the said policy in the office of the opposite parties by enclosing the original Janata Personal Accident Insurance Policy on 23.04.1999 under claim No.47/87/98-99 and it was also acknowledged but the opposite parties have not settled the claim of the complainant. Hence, the complainant got issued a legal notice on 17.07.2004 through an advocate to the opposite parties 2 & 3 and they received the same but the opposite parties avoid the payment to the nominee on some pretext or other. The 2nd opposite party has finally repudiated the claim of the complainant in its letter dt.14.03.2005 on flimsy grounds. Thus there is deficiency in service on the part of the opposite parties in not settling the just claim of the complainant under the said Janata Personal Accident Insurance Policy. Hence, the opposite parties are liable to pay to the complainant sum insured under the Janata Personal Accident Insurance Policy of Rs.5,00,000/- with interest on the said amount from19.10.1998 to 13.03.2007 @ 18% p.a., Rs.7,55,500/- towards mental agony, Rs.20,000/- towards transporting expenses and Rs.20,000/- total sum of Rs.12,95,500/-. Hence, prayed this Forum to allow the complaint as prayed for in the complaint. 3. The 2nd opposite party filed counter and contended that the deceased was murder on 19.10.1998 but the claim form was submitted more than six months after the said incident. As per the policy conditions immediately after the injury/death the same is to be informed and it should be within the period of 30 days. Thus, the company has lost chance to investigate into the case immediately after the occurrence of the incident. The complainant has not submitted any authenticated documents in proof of her claim along with the claim form as required under the policy. The complainant failed to submit succession certificate in view of the claim made by A. Sreekanth who is also successor/legal heir of the deceased. Therefore, the complaint filed by the complainant is bad for non-joinder of the necessary party. The complaint filed by the complainant is barred by limitation. This opposite party denied the other averments mentioned in the complaint and contended that claim of the complainant for Rs.12,95,500/- under various heads is highly excessive and exaggerate and the complainant is not entitled for the same are any potion thereof. There is no deficiency in service on the part of the insurance company. Therefore, the complained filed by the complaint is not maintainable and that therefore, the is the same is liable to be dismissed with costs. 4. The opposite parties 1 & 3 filed memo adopting the counter filed by the 2nd opposite party in all material particulars. 5. Basing on the above pleadings the points that arise for consideration are:- 1. Whether the repudiation of the claim of the complainant by the opposite parties 1 to 3 is justified or not? 2. Whether the opposite parties insisting the complainant to submit succession certificate is justified or not? 3. Whether the complaint filed by the complainant is barred by limitation? 4. To what relief? 6. In order to prove the case of the complainant, the complainant has filed her evidence on affidavit in support of her case and Exs.A1 to A15 were marked basing on the evidence on affidavit of the complainant. On behalf of the opposite parties the 2nd opposite party has filed his evidence on affidavit in support of their claim and Ex.B1 to B7 were marked on the behalf of the opposite parties 1 to 3. 7. Heard both sides. 8. POINTS NO.1 and 2:- The counsel for the complainant contended that soon after the death of the deceased the complainant on 23.04.1999 under claim No.47/87/98-99 informed the opposite parties and claimed the amount of Rs.5,00,000/- under Janata Personal Accident Insurance Policy obtained by the deceased wherein the complainant is the nominee. The opposite parties without settling the claim on some pretext or other delayed the same without any reason and finally the 2nd opposite party repudiated the claim by letter dt.14.03.2005 which amounts to deficiency in service of the opposite parties. In support of his contention he placed reliance in the reported decisions (1) 2004 (5) ALD 692 The Manager, United India Insurance Company Limited Vs. Ummadi Shankunthala and others.(2) 2009 (4) ALD 21 Sheni Shetty Dhana Laxmi Vs. United India Insurance Company Limited, Chennai and others. 9. The counsel for the opposite parties contended that the cause of death of the deceased will not fall within the purview of the cover granted by the insurance company. The murder which is caused cannot be called as the incident and that the deceased suppressed the material facts and obtained insurance policy and the deceased intentionally hiked the income at the time submission of the proposal and obtained the cover for Rs.5,00,000/-. The husband of the complainant alleged to have involved in the murder as per the F.I.R. and hence beneficiaries and the alleged accused are one and the same, hence the complainant is not entitled to claim the amount. In support of his contention he placed reliance in the reported decision ACJ 2000 between Rita Devi and others Vs. New India Assurance Co. Ltd and another. He further contended that the deceased has left behind her son A.Sreekanth and daughter Smt. J,Madhavi Latha @ A.Madhavi Latha i.e., the complainant herein and that the deceased son A.Sreekanth also made a claim. Therefore, the opposite parties in order to avoid further litigation insisted the complainant to produce succession certificate but the complainant has not produced the same. Therefore, the opposite parties could not pay the insurance amount to the complainant and in said circumstances the opposite parties are justified in repudiating the claim of the complainant. Therefore, there is no deficiency in service of the opposite parties. Therefore, the complaint is liable to be dismissed with costs. 10. In the decision cited by the counsel for the complainant reported in 2004 (5) ALD 692 between The Manager, United India Insurance Company Limited Vs. Ummadi Shankunthala and others wherein it was held that:- “Murder, which is an unexpected event from the standpoint of victim, is an accident. In the instant case, it is not in dispute that the deceased was killed allegedly by group of persons belonging to other faction. Indisputably as the injuries being vital, the deceased died. Though it is on record that somebody attacked, the reasons are not known and further it is also very difficult to discern as to whether the intention of the person who attacked the deceased was only to cause injuries or to completely annihilate the deceased or for some other reason. Of course from the injuries caused it could be provisionally understood that the deceased was attacked to annihilate him. However, it would be totally a different subject, which has to be dealt with separately in the criminal adjudication. But when it comes to the purpose of contractual obligation by the insurance company under the policy, the death of the deceased should only be understood, as already discussed above, as an accident. The occurrence satisfies all the conditions laid under the policy and hence it is inescapable for this Court to hold that the murder of the deceased in the present case shall be treated as an accident for the purpose of awarding compensation under the Janata Personal Accidence Policy.(Para 28). The repudiation of the claim was on the ground that the deceased belong to a group of faction and involved in criminal cases. In fact this investigation ought to have been conducted before issuing the policy. No such enquiry was conducted earlier, nor the report, which discloses the alleged involvement of the insured in any criminal case and resulting in breach of any law with criminal intent, is made part of the record. Therefore, mere allegation subsequent to the death of the deceased, does not amount to violation of Clause 3 (e) of provisos to policy. Hence, the repudiation of the claim without any basis cannot be accepted”.(Para 30). In the decision reported in 2009 (4) ALD 21 between Sheni Shetty Dhana Laxmi Vs. United India Insurance Company Limited, Chennai and others wherein it was held that:- ‘Even according to the respondents, sub-clauses (a) to (d) of Clause (3) of the policy do not apply. Sub-clause (e) can be invoked, only when the death of the insured had arisen, or resulted from a breach of law committed by him, with criminal intent. In other words, if the death occurs in the course of commission of a crime, by the insured, the respondents cannot be compelled to pay the amount covered by the policy. In the instant case, the insured did not die, on account of any criminal act attributed to him. It is not even denied that, he was killed by a team of PWG Naxalites. While the undisputed fact is that he became the victim of an attack by extremists, an attempt was made, to present him not only as a criminal, but also a victim of his own crimes.(Para 13). Thought the orders of repudiation are cryptic and silent, as to the basis, the respondents pleaded in their counter-affidavits, that the deceased figured as accused in Crime No.84/99. The allegation against him was that he facilitated certain extremists in committing a crime of blasting a police station. This accusation was made on the basis on the basis of an alleged confession of one of the accused in Crime No.84/99. Assuming that there is an element of truth in the allegation against the deceased, it is just un-understable, as to how his death, on 14.09.2000 can be traced to his involvement, in Crime No.84/99. On the other hand, the basis pleaded by the respondents turns out to be a self-contradictory. The reason is that the deceased is portrayed as a person, supporting the Naxalites, and at the same time, it emerged that he was killed by those very persons. Be that as it may, as long as no criminal acts or omissions were attributed to the deceased, for the incident, that took place on 14.09.2000, and it is not alleged that the death of the deceased occurred on account of his own criminal acts, there would not be any occasion to press Clause (3) into service. The view taken by the respondents cannot be sustained in law”. (Para 14, 15). 11. In view of the principle laid down in the above decisions we have to consider whether the opposite parties have placed any materials to prove that the cause of death of the deceased will not fall within the preview of the cover granted by the Insurance Company. 12. The opposite parties have not placed any materials to prove that the death of the deceased will not fall within the purview of the cover of the policy Ex.A1, that the deceased has suppressed the material facts and obtained insurance policy and the deceased intentionally hiked the income at the time submission of the proposal and obtained the cover for Rs.5,00,000/- and that the husband of the complainant alleged to have involved in the murder as per the F.I.R., hence beneficiaries and the alleged accused are one and the same, hence the complainant is not entitled to claim any amount. Therefore, in the absence of material proof their oral contentions cannot be accepted. On the other hand Ex.A13, F.I.R. clearly goes to prove the fact that the deceased was murdered on 19.10.1998 at about 11.15 P.M. As seen from Ex.A14, it goes to shows that Post Mortem and Doctor has opined that the death of the deceased due to shock due to multiple head injury. In the decision cited by the Counsel for the opposite party reported in ACJ 2000 between Rita Devi and others Vs. New India Assurance Co. Ltd and another wherein it was held that ‘Murder is a felonious act where death is caused with intent and the perpetrators of that act normally have a motive against the victim for such killing.” Ex.A15 is Charge Sheet disposal report, it goes to shows that police referred the case as un-detectable and submitted final report to the Court requesting the Honorable Magistrate to treat the case as un-detectable and to issue court proceedings accordingly. Thus, it clearly goes to shows that the deceased was murdered by un-known persons. Therefore, the murder of the deceased which is an unexpected event from the standpoint victim is an accident. Hence, the above decision does not help to the case of the opposite parties. 13. It is an admitted fact that the deceased obtained Janata Personal Accident Insurance Policy bearing No.051004/400/47/56/10/1/49348/96 commencing from 09.12.1996 to 08.12.1997 wherein the complainant is the nominee. The evidence on affidavit filed by the complainant goes to prove the fact that the deceased was murdered in a robbery by unknown offenders on 19.10.1998 at about 11.15 p.m. at her residence. Ex.A1 is the Janata Personal Accident Insurance Policy obtained by Smt. A.Frank Rachel from the opposite parties for a sum of Rs.5,00,000/- and the said policy commence from 09.12.1996 to 08.12.2007. Under Ex.A1 the nominee is mentioned as Smt. J,Madhavi Latha @ A.Madhavi Latha (daughter) i.e., the complainant herein. Ex.A2 is the claim form submitted by the complainant on 23.04.1999 to the opposite parties claiming the insurance amount for the death of the deceased on 19.10.1998 on the ground that the deceased died due to injuries and murder. Ex.A3 is the letter sent by the opposite parties to the complainant on 22.09.1999 on the ground that the claim is kept pending for final investigation report and succession certificate. Ex.A4 is the letter dt.02.09.2003 addressed by the opposite parties to the complainant requesting to submit succession certificate from the court for their taking further action in the matter. Ex.A5 is the letter addressed by the complainant to the opposite parties 1 to 3 informing them that the question of obtaining a succession certificate when insured amount is claiming by the nominee registered in the policy does not arise and requested the opposite parties to consider her case in view of the provision of Section 39 of Insurance Act and settle her claim urgently by paying to the nominee. Ex.A6 is the letter addressed by the opposite party on 21.06.2004 that they have taken up the matter concerned DO, Anantapur and they will inform the latest position on hearing from them and regretted for inconvenience caused to her. Ex.A7 is the letter sent by the complainant through her advocate to the opposite parties on 17.07.2004 to pay the insurance amount of Rs.5,00,000/- with interest @ 18% p.a. from 01.08.2008 till the date of payment within one month from the date of receipt of the notice otherwise the complainant will be constrained to take appropriate legal action to recover of the aforesaid amount with damages for the mental agony and suffering caused to the complainant. Ex.A10 is the letter addressed by the opposite parties to the counsel for the complainant on 13.08.2004 again asking to submit succession certificate and also informed that her brother is also making claim on the J.P.A.police proceeds in connection with the murder of his mother i.e., the deceased. Ex.A11 is the letter dt. 14.03.2005 addressed by the opposite parties to the complainant wherein repudiated the claim of the complainant on the grounds mentioned. 14. In Ex.A1 insurance policy obtained by the deceased, the nominee name is mentioned as Smt. J,Madhavi Latha @ A.Madhavi Latha (daughter) i.e., the complainant. It is the bounden duty of the opposite parties to pay the insurance claim amount to the nominee when the nominee submits an application on the ground that the insured was murdered by unknown offenders at her residence on 19.10.98 at 11.15.p.m.while committing robbery. The opposite parties can only stop payment of the insured amount to the nominee when there is a stay order by the competent Court. The opposite parties cannot insist the nominee to produce succession certificate of the deceased. Therefore, the opposite parties No.1 to3 are liable to pay to the complainant a sum of Rs.5,00,000/- under Ex.A1 policy with interest @9%p.a. from 23.07.99 i.e., after three months from the date of Ex.A2 dt.23.04.99 till the date of payment. Since the complainant is granted interest on the said amount, hence, the complainant is not entitled for the claim under mental agony and transportation expenses. 15. Therefore, on considering the said facts and circumstances we hold that the conduct of the opposite parties repudiating the claim of the complainant under Ex.A11 and insisting the complainant to produce the succession certificate is not justified, which amounts to deficiency in service of opposite parties. Accordingly Points No.1 and 2 are answered. 16. POINT NO.3:- The Counsel for the complainant contended that the opposite parties repudiated the claim of the complainant under Ex.A11 dt.14.03.2005 and the complainant has filed this complaint before this Forum on 13.03.2007 i.e., within two years from the date of Ex.A11 repudiation and the complaint filed by the complainant is within time as per section 24 (A) of Consumer Protection Act, 1986. 17. The counsel for the opposite parties contended that the deceased died on 19.10.98 whereas the complainant has filed this complaint on 13.03.2007 which beyond two years from the date of the death of the deceased. Therefore, the complaint filed by the complainant is barred by limitation in view of section 24(A) of Consumer Protection Act, 1986. 18. It is well settled principle of law that the limitation as per Section 24(A) of Consumer Protection Act, the limitation period starts from the date of repudiation of the claim. The repudiation of the claim of the complainant by the opposite parties as per Ex.A11 is on 14.03.2005 and the complainant has filed this complaint on 13.03.2007 which is within two years from the date of repudiation by the opposite parties. Therefore, the complaint filed by the complainant is not barred by limitation. Accordingly Point No.4 is answered 19. POINT NO.4:- In the result the complaint is allowed and opposite No.1 to 3 are jointly severally liable to pay to the complainant a sum of Rs.5,00,000/- with interest at 9%p.a. from 23.07.99 till the date of realization with costs of Rs.5000/-.One month time is granted for payment of the said amount. Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 3rd day of February, 2010. Sd/- Sd/- Sd/- LADY MEMBER MALE MEMBER PRESIDENT DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM ANANTAPUR ANANTAPUR ANANTAPUR APPENDIX OF EVIDENCE WITNESSES EXAMINED ON BEHALF OF THE COMPLAINANT: ON BEHALF OF THE OPPOISITE PARITES -NIL - - NIL EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT 1. Ex.A1 - Xerox copy Janata Personal Accident Insurance Policy issued by the1st opposite party in the name of deceased A.Frank Rachel. 2. Ex.A2 – Xerox copy of claim form dt.23-04-1999 submitted by the complainant to the opposite parties. 3. Ex.A3 - Xerox copy of letter dt.22-09-1999 of the 2nd opposite party sent to the complainant. 4. Ex.A4 – Xerox copy of letter dt.02-09-2003 of the opposite parties sent to the complainant. 5. Ex.A5 – Xerox copy of the letter of the complainant sent to the opposite parties 2 & 3. 6. Ex.A6 - Xerox copy of the letter dt.21-06-2004 of the 3rd opposite party sent to the complainant. 7. Ex.A7 - Office copy of legal notice dt.17-07-2004 got issued by the complainant to opposite parties 2 & 3. 8. Ex.A8 - Postal Receipts dt.28-05-2004. 9. Ex.A9 - Postal acknowledgement signed by the 2nd opposite party. 10. Ex.A10 – Xerox copy of letter dt.13-08-2004 sent by the 2nd opposite party to the counsel for the complainant. 11. Ex.A11 – Repudiation letter dt.14-03-2005 sent by the 1st opposite party to the complainant. 12. Ex.A12 – Order of the Hon’ble High Court of A.P. dt.14-12-2004 in Writ Petition No.23103/2004. 13. Ex.A13 - Attested copy of F.I.R. in Cr.No.243/98 issued by the Station House Officer, I Town Police Station, Anantapur. 14. Ex.A14 – Attested copy of Postmortem Report relating to deceased A.Frank Rachel. 15. Ex.A15 – Attested copy of Charge Sheet in Cr.No.243/98 of I Town Police Station, Anantapur. EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTIES 1. Ex.B1 - Xerox copy Janata Personal Accident Insurance Policy issued by the 1st opposite party in the name of deceased A.Frank Rachel. 2. Ex.B2 – Xerox copy of claim form dt.23-04-1999 submitted by the complainant to the opposite parties. 3. Ex.B3 - Xerox copy of letter dt.22-09-1999 of the 2nd opposite party sent to the complainant. 4. Ex.B4 - Copy of the letter dt.11-07-2001 of the 1st opposite party sent to the complainant. 5. Ex.B5 - Xerox copy of letter dt.13-08-2004 sent by the 2nd opposite party to the counsel for the complainant. 6. Ex.B6 - Xerox copy of Certificate of Death dt.14-11-98 relating to deceased A.Frank Rachel issued by the Sub-Registrar of Births & Deaths Anantapur Municipality. 7. Ex.B7 - Endorsement dt.25-11-1998 of the Mandal Revenue Officer, Anantapur relating to family members of the deceased A.Frank Rachel. Sd/- Sd/- Sd/- LADY MEMBER MALE MEMBER PRESIDENT DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM ANANTAPUR ANANTAPUR ANANTAPUR
......................Smt.S.Lalitha
......................Sri S.Niranjan Babu
......................Sri. C.Thyagaraja Naidu | | 
