BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABAD.



FA.IA.No.607/2009 & FA.(SR).No.7097/2008 against C.D.No30/2006, District Forum, Warangal.



Between:



The United India Insurance Co. Ltd.,

Being rep. by its Divisional Manager,

M.G.Road, Warangal District. .. Petitioner/Appellant/

Opp.party No.1

And



1. Sanga Rajaiah, S/o.Komariah

Aged 50 years, Occ:Agriculture.



2. Sanga Kethamma, W/o.Rajaiah,

Aged 40 years, Occ:Household,

Both R/o.H.No.2-1-58, Saraswathinagar,

Gopalapur Road, Vidhyaranyapuri,

KUC, Hanmakonda, Warangal District. ..Respondents/Complainants.



3. M/s.Himayala Hire Purchase & Finance

Rep. by its Manager,

H.No.2-2-426, Sunitha Complex, 2nd floor,

Kishanpura, Hanamkonda. Respondent/Opp.party No.2





Counsel for the Petitioner Sri Ramachandra Reddy.



Counsel for the Respondents.- Admission Stage.



QUORUM:THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT.

AND

SRI K.SATYANAND, MEMBER.



WEDNESDAY, THE THIRD DAY OF JUNE,

TWO THOUSAND NINE



ORAL ORDER: (Per Hon’ble Sri K.Satyanand, Hon'ble Member.)

***



This is an appeal filed by the insurance company challenging the order of the District Forum along with an I.A. to condone the delay of 107 days in filing the appeal. Heard the counsel for the appellant. We are of the opinion that this is a fit case where the unnumbered appeal itself could be disposed of at the stage of admission on merits which in turn would be decisive of the fate of the condone delay petition, the merits of which, however, shall be considered for appreciation once again after the discussion on the merits in the appeal.

The facts of the case are briefly as follows:

The complainants are the parents of the insured by name, Sanga Ravi @ Ravinder who obtained the policy from the opposite party No.1 through opposite party No.2 valid with effect from 22-4-1999 till 01-4-2000 for an assured amount of Rs.3,00,000/- under Janatha Personal Accident Scheme. The said Ravi died on 27-7-1999 as a result of an accident which he met with on 03-7-1999. The deceased was treated as an inpatient at Laxmi Hospital, Lion’s Gate Hospital from 3-7-1999 to 20-7-1999. As the condition deteriorated, he was shifted to their house where ultimately he succumbed to the injuries on 27-7-1999. Thereupon the complainants had filed the claim with opposite party No.1 for the insured amount. Opposite party No.1 procrastinated for quite some time and ultimately repudiated the claim. Aggrieved by the said repudiation, the complainant filed the complaint.

Opposite party No.1, the appellant herein, resisted the complaint contending that the deceased met with an accident even before issuing the policy and he had obtained the policy suppressing the said fact and the death was a result of the accident that occurred on 30-3-1999 before obtaining the policy. They relied upon various circumstances including the factum of the deceased having been an inpatient in Rohini Hospital from 30-3-1999 to 02-4-1999. They discussed the probabilities calculated to rule out the accident between 3-7-1999 to 27-7-1999 and finally submitted that all these facts had come to light in the investigation report. It was ultimately urged that the complaint was liable to be dismissed.

As these rival pleadings threw up a consumer dispute, the District Forum posted the matter for enquiry. In the enquiry, the complainant No.1 filed affidavit and relied upon Exs.A1 to A11. Opposite party No.1 on the other hand also filed affidavit and relied upon Exs.B1 to B3.

On a consideration of the evidence adduced on either side, the District Forum came to a firm conclusion that the repudiation was bad as the insurance company miserably failed to prove its theory that the insurance was obtained after some accident and the death was the result of such accident. It also observed that it does not lie in the mouth of the opposite party to say that the insured was a minor as per Ex.B2 as it had issued the insurance policy with its eyes wide open. The District Forum ultimately granted the relief prayed for with interest at the rate of 7.5% p.a. from the date of filing of the complaint till the date of deposit; along side awarding Rs.500/- by way of costs.

Aggrieved by the said order, opposite party No.1 preferred the present appeal contending inter alia that the District Forum wrongly ignored the investigation report of Mr.K.David Vijay Kumar digging out the facts calculated to establish that the deceased remained absent for Science and Social Studies examinations on 31-3-1999 and 3-4-1999 thereby probabilising the accident prior to the procurement of the policy. The District Forum failed to rely upon Ex.B2 showing the deceased being a minor by the date of taking the insurance. It failed to take into account Ex.B1, furnishing the proof of treatment taken by the deceased for an accident on 30-3-1999 and questioned the award as untenable.

Heard the counsel for the appellant.

The only life support for the appellant to justify the repudiation of the insurance claim is a combined effect of two proved facts namely the accident having occurred on 30-3-1999 few days prior to the taking of the policy and the said accident having resulted in the death that activated the claim by the parents of the deceased. For the purpose of proving that the accident had occurred even before he obtained the insurance policy, he relied upon Ex.B1 and B1 only. B1 is in the nature of a self serving document, the report of the surveyor, appointed by the opposite party No1. The said surveyor alluded to the treatment obtained by the deceased in some Rohini Hospital but we are at a loss to understand as to what prevented the surveyor from obtaining those records from the said hospital. On the other hand, the counsel for the appellant tried to put the blame on the District Forum for not summoning the record from Rohini Hospital, while admitting that its own counsel in the District Forum had given wrong particulars in the said petition. It is urged that an inference should be drawn to the effect that if really the surveyor had no access to those records, he could not have issued such a report. When it is reasonable to draw such an inference from Ex.B1, it is also equally reasonable to say that opposite party No.1 did not take any pains to obtain the said record from the said hospital. Even otherwise, opposite party No.1, may be through its agent, processed the policy and issued the policy in favour of the deceased with its eyes wide open. If really the deceased was bed ridden by the date of taking the policy, as the appellant intended to show that the death was the result of the accident that occurred on 30-3-1999, the appellant would have done well to show circumstances making it possible for such a person on the death bed successfully obtaining the insurance policy that was issued by no other than the opposite party itself. In other words a person on the death bed could have obtained an insurance policy only by playing some fraud. It was not the case of the opposite party that any such fraud was played by the deceased or by anybody of his folks. No doubt the opposite party No.1 made a fleeting remark that the local agent had colluded with the parties. If that is so, it might have some grievance against the local agent with which we are not concerned. But in the absence of any concrete evidence against the deceased, the insured or his nominees cannot be victimized for the fault of anybody including opposite party No.1 or its agent. Thus we do not see any merits in the appeal and the appeal is therefore liable to be dismissed.

The I.A. to condone delay has to be conformably dismissed as

infructuous as the appeal itself has been dismissed. Apart from it, the condone delay petition lacks any merits as it heavily relied upon its own red-tapism which we are not inclined to patronize. Accordingly this application fails and is accordingly dismissed.

Accordingly the appeal is dismissed but without costs in the circumstances of the case. The appellant is granted six weeks time from the date of receipt of this order to comply with the order of the District Forum.





PRESIDENT



MEMBER.

Dt.03-6-2009.