BEFORE THE DISTRICT CONSUMER FORUM AT NALGONDA
PRESENT: SRI D.SINGARA CHARY, B.A., LL.B.,
PRESIDENT.
SMT.CH.A.LATHA KUMARI, M.A.,M.Sc.,LL.M.,
FEMALE MEMBER.
. . .
MONDAY, THE SIXTH DAY OF JANUARY, 2014
CONSUMER COMPLAINT No. 20 OF 2013
Date of filing: 18-03-2013
Date of Disposal: 06-01-2014
Between:
- Prathikantam Shailaja W/o Late P.Satyanarayana Raju,
Aged: 30 years, Occ: Household,
- P.Manikumar Raju S/o Late P.Satyanarayana Raju,
Aged: 12 years, Occ: Student,
- P.Sindhu Bhavani D/o Late P.Satyanarayana Raju,
Aged: 8 years, Occ: Student,
- P.Vijaya Laxmi W/o Pullam Raju, Aged: 56 years,
Occ: Housewife,
- P.Pullam Raju S/o P.Narasimha Raju, Aged: 63 years,
Occ: Nil,
All are R/o H.No.9-120, Seetharampuram, Miryalguda Town
and Mandal, Nalgonda District.
…COMPLAINANTS.
AND
1. The Zonal Manager, United India Insurance Company Limited,
Whites Road, Chennai.
2. The Manager, United India Insurance Company Limited,
Branch-Miryalguda, 1 Floor, Paidimarri Complex, Reddy Colony,
Miryalguda-508 207.
…OPPOSITE PARTIES.
This complaint coming on before us for final hearing on this day, in the presence of Sri P.Narsimha, Advocate for the Complainants, and Sri K.Yadaiah, Advocate for the Opposite Parties, and on perusing the material papers on record, and having stood over for consideration till this day, the Forum passed the following:
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ORDER OF THE FORUM DELIVERED
BY SRI D.SINGARA CHARY, PRESIDENT
1. The Complainant No.1, the wife, the Complainants No.2 and 3, the children and the Complainants No.4 and 5, the parents of late Prathikantam Sathyanarayana Raju have filed this complaint complaint U/S 12 of the Consumer Protection Act, 1986 to direct the Opposite Parties to pay a sum of Rs.2,00,000/- under the two different accident policies marked as Exs.B-1 and B-2.
2. The facts of the case as disclosed from the complaint are as follows:
The deceased P.Sathyanarayana Raju obtained individual Janatha Personal Accident Policy for a sum of Rs.1,00,000/- which was valid from 18-12-2009 to 17-12-2012. He also obtained Personal Accident Policy for a sum of Rs.1,00,000/- with validity from 13-01-2011 to 12-01-2012. While so, on 04-02-2011 when he was returning to Miryalguda from Nalgonda on a motorcycle bearing No.AP-24R-1901 with due care and caution by observing traffic rules, a car bearing No.AP-24R-6939 came in his opposite direction in a rash and negligent manner when he reached near Anishetty Duppalapally and dashed against him, due to which he received injuries. He died on his way to District Head Quarters Hospital, Nalgonda. The accidental death is attributable to the rash driving of the said car. On complaint, the Police, Thipparthy registered a case in Cr.No.16/2011, conducted inquest on the dead body of the deceased, sent it for post mortem and chargesheeted the driver of the car. The Complainant No.1
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submitted the claim forms to the Opposite Parties, but they repudiated the same on the ground that at the time of the accident when the deceased was driving the two-wheeler, he had no driving licence. The Complainants state that at the time of the accident his mobile phone, personal ATM cards and Driving Licence were lost. The repudiation is illegal.
3. The Opposite Party No.2 filed a written version which was adopted by the Opposite Party No.1. It is alleged in the said written version as follows:
The Opposite Parties admit the issuance of policies Exs.B-1 and B-2. They exhibited ignorance about the deceased dieing in a road accident and put the Complainants to strict proof of the same. It is admitted that the Complainant No.1 lodged the claim and the Opposite Parties repudiated it by letters, dated 02-11-2011 under Exs.B-3 and B-4 since the deceased was not having driving licence and that he has committed breach of law when he had driving the two-wheeler at the time of his death. The repudiation is on proper lines and as such the complaint is liable to be dismissed.
4. The parties filed their respective proof affidavits. The Complainants marked Exs.A-1 to A-5 and the Opposite Parties marked Exs.B-1 to B-5.
5. The point for consideration is:
Whether the repudiation made by the Opposite Parties
is tenable?
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6. POINT:
The factum of the Opposite Parties issuing individual Janatha Personal Accident Policy under Ex.B-1 and the individual Personal Accident Policy under Ex.B-2 and their validity as on the date of the accidental death of the deceased is not disputed. Even though the Opposite Parties exhibited volte-face as to the accidental death of the deceased, a consideration of F.I.R. in Cr.No.16/2011 of PS.Thipparthy marked as Ex.A-2, the inquest report Ex.A-3, post mortem report Ex.A-4 and the charge sheet Ex.A-5 show that while the deceased was returning from Nalgonda to Miryalguda on his two-wheeler bearing No.AP-24R-1901 on 04-02-2011, a car bearing No.AP-24R-6939 came in the opposite direction being driven by one Manchukonda Ashok in a rash and negligent manner and dashed against the deceased and that the deceased on his way to Government Head Quarters Hospital, Nalgonda. No material is produced to rebut the same. Therefore, the accidental death of the deceased is established beyond doubt.
7. The only ground on which the repudiation rests is that the deceased did not have driving licence to drive two-wheeler. Certain exclusions are made in the policies and fourth proviso is pressed into service to repudiate the claims. The same is to the effect that the sum assured is not payable in case of intentional self injury or suicide, the death occurring while under the extraordinary influence of intoxicating liquor or drug, while racing on two-wheelers, hunting, shooting, mountaineering etc., death caused by direct or indirect insanity and above all if the injured committed breach of any law with criminal intent. Among all the sub-heads, the one which is in relation to the breach of law with
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criminal intent is very much pressed to repudiate the claims. The breach of law according to the learned counsel for the Opposite Parties is that the deceased in driving the two-wheeler at the time of the accident without licence, had violated the provisions of Motor Vehicles Act and had thus committed breach of law. It may be that the deceased may not be having the driving licence and thereby committed contravention of Motor Vehicles Act. The mere commission of breach of law does not by itself entitles the Opposite Parties to repudiate the policies since proviso-(iv) under which much dwelling is sought, shows that such breach of law must be attended by criminal intent. Driving of two-wheeler without driving licence, ipso facto does not lead to a conclusion that the deceased had “criminal intent”. The criminal intent can be said to have been established if the Opposite Parties prove that the driver of a vehicle not possessing licence drives it after committing offence like murder, theft, robbery, rape etc. Such types of driving can be classified as one to commit breach of law with criminal intent. This is a case where the accused was driving the two-wheeler without driving licence and at the relevant time he was going on business trip. Accidental death had not occurred on account of his fault, but due to dash of a car, coming in the opposite direction. When no criminal intent is alleged and proved, it must be held that even if there is any breach of law for non-possession of driving licence, it is not with criminal intent so as to attract the exclusionary clause to repudiate the claim.
7. The learned counsel for the Opposite Parties relied on a decision reported in Oriental Insurance Co.Ltd., Vs.Prema ( I (2008) CPJ 194 ) rendered by the Karnataka State Consumer Disputes Redressal
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Commission, Bangalore, in support of his contention. The facts of the said case show that the deceased was the owner of a two-wheeler bearing No.KA-25V-8526 and while driving the said two-wheeler, he met with an accident and died. The said vehicle was insured with the Oriental Insurance Company Limited. On the death of the deceased, his wife intended to enforce the policy in so far as it relates to personal accident to owner-cum-driver. The policy sought to be enforced was issued under the provisions of the Motor Vehicles Act, where a condition precedent under the policy was that it should be driven by a licenced driver. Here, the policies are personal accident policies. In this case, the policies issued under Motor Vehicles Act for the vehicle which the deceased was driving are not being enforced. The specific allegation is that due to the rash and negligent driving of the car by one Manchukonda Ashok, the accident had occurred, resulting in the death of the deceased. The charge sheet Ex.A-5 also shows that the deceased had not contributed anything for his death while driving the two-wheeler and it was only on account of the negligent driving of the car, the accident had occurred. The decision rendered by the Karnataka State Commission, dealing the policy issued under Motor Vehicles Act, is not applicable to this case while enforcing the policies issued under Personal Accidents and Janatha Personal Accidents. Therefore, the decision relied on by the learned counsel for the Opposite Parties is not applicable.
8. Since no other ground is raised, the Opposite Parties are liable to pay the amounts covered by Exs.B-1 and B-2. In repudiating the claims, the Opposite Parties committed deficiency of services.
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In the result, the complaint is allowed and the Opposite Parties are directed to deposit in this Forum, a sum of Rs.2,00,000/- (Rupees Two lakhs only) in enforcement of Exs.B-1 and B-2 with interest at the rate of 9% p.a. from the date of the complaint till realization and a sum of Rs.5,000/- (Rupees Five thousand only) towards deficiency of services and Rs.2,000/- (Rupees Two thousand only) towards costs. Time for compliance one month. On deposit, the amount shall be paid to the Complainant No.1.
Dictated to Steno-Typist, transcribed by him, corrected and pronounced by us in the open Forum on this 06th day of January, 2014.
FEMALE MEMBER PRESIDENT
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
For Complainants: For Opposite Parties:
Affidavit of the Complainant No.1. Sri P.Kanaka Ratnam, Senior
Branch Manager, United India
Insurance Co.Ltd. BO,
Miryalguda, filed his affidavit on
behalf of the Opposite Parties.
EXHIBITS MARKED
For Complainants:
Ex.A-1 Dt.02-11-2011 Copy of Repudiation Letter.
Ex.A-2 Dt.04-02-2011 Xerox copy of F.I.R. in Cr.No.16/2011 of
PS.Thipparthy.
Ex.A-3 Dt.05-02-2011 Xerox copy of Inquest Report.
Ex.A-4 Dt.05-02-2011 Xerox copy of Post Mortem Report.
Ex.A-5 Dt.28-02-2011 Xerox copy of Chargesheet.
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For Opposite Parties:
Ex.B-1 Dt.18-12-2009 Certified true copy of Policy along with
terms and conditions.
Ex.B-2 Dt.13-01-2011 Certified true copy of Policy along with
terms and conditions.
Ex.B-3 Dt.02-11-2011 Repudiation Letter.
Ex.B-4 Dt.02-11-2011 Repudiation Letter.
Ex.B-5 Dt.28-02-2011 Attested copy of Chargesheet.
PRESIDENT
DISTRICT CONSUMER FORUM
NALGONDA
TO
1). Sri P.Narsimha,
Advocate for the Complainants.
2). Sri K.Yadaiah,
Advocate for the Opposite Parties.
