BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM ::
KADAPA Y.S.R DISTRICT
PRESENT SRI V.C. GUNNAIAH, B.Com., M.L., PRESIDENT
SMT. K. SIREESHA, LADY MEMBER
SRI M.V.R. SHARMA, MEMBER
Thursday, 18th February 2016
CONSUMER COMPLAINT No. 84 / 2015
1. Nukanaboena Gurramma, W/o Late N. Lakshumaiah, aged 60 years.
2. Nukanaboena Ganga Raju, S/o Late N. Lakshumaiah, aged 40 years.
3. Nukanaboena Gayathri, D/o Late N. Lakshumaiah, aged 28 years.
All are R/at D.No. 1/40, U. Venkatapuram, Urutur Village,
Veerapunayunipalle Mandal, YSR District. ….. Complainant.
Vs.
1. Andhra Pragathi Grameena Bank, Rep. by its
Branch Manager, Veerapunayunipalli Branch,
Veerapunayunipalle Mandal, YSR District.
2. Andhra Pragathi Grameena Bank, Rep. by its
Regional Manager, Nagarajupeta,
Kadapa YSR District – 516 001.
3. United India Insurance Co. Ltd., Rep. by its
Divisional Manager, Division Office, 2/194-2,
Near Murali Theatre, Kadapa – 516 001. ….. Respondents
This complaint coming on this day for final hearing on 10-2-2016 in the presence of Sri V. Dharma Kumar, Advocate for complainant and Sri G. Ramachandra Reddy, Advocate for R1 & R2 and Sri K. Rama Kondiah, Advocate for R3 and upon perusing the material papers on record, the Forum made the following:-
O R D E R
(Per Smt. K. Sireesha, Member),
1. Complaint filed under section 12 of C.P. Act 1986.
2. The brief facts of the complaint are as follows:- It is submitted that the complainants No. 2 & 3 are children of complainant No. 1. The husband of 1st complainant who is the father of 2nd and 3rd complainants had bank S.B. Account bearing No. 10688 from the 1st respondent bank. The 2nd respondent is the head office of the 1st respondent. The 1st respondent bank has tie up with R3 insurance company to their account holders. The R1 has provided accidental insurance claim to their account holders. Likewise, the respondent No.1 has deducted required premiums from 1st complainant deceased husband N. Lakshumaiah and provided accidental insurance coverage for ₹ 1,50,000/- under two kisan credit card (KCC) A/c Nos. 9104678833 and KCC No. 19185525381. Accordingly, the R3 issued two group insurance policies bearing Nos. 050900/47/14/43/000000008 and 050900/47/14/61/000000001. The husband of 1st complainant was also covered under these policies. The 1st complainant is shown as nominee to these policies. As per the terms of the policy, in case of accidental death of insured the nominee will be paid with ₹ 1,50,000/- towards accidental coverage.
3. While so, the husband of 1st complainant deceased N. Lakshumaiah died on 9-11-2014 in an road accident occurred on Kommaddi – Urutur road near U. Venkatapuram village of V.N. Palli Mandal, the said incident was registered in Cr. No. 156/2014 under section 304 (A), Section 14 (a) (b) R/w 187 of M.V. Act after the death of deceased N. Lakshumaiah, being the nominee and legal heirs the complainants made an accidental claim with the respondents. Their claim was received by the R1 & R2.
4. It is submitted that to their utter surprise, the complainants received two letters dt. 14-7-2015 from R3 which was addressed to R2, in which it was stated that the claim of the complainants was repudiated on the ground that as per Aadhar card, as on the date of accident, the deceased N. Lakshumaiah was aged 71 years and policy covers KCC A/c holders to the utter age stipulation of below 70 years. At this juncture it is important to mention here that the deceased N. lakshumaiah was an illiterate and he knew only to sign his signature. As per the voter identity card bearing No. AP/23/159/324311 issued by the election commission of India and household card bearing No. WAP112301400160 issued by the MRO Veerapunayunipalle Mandal, he was below the age of 70 as on the date of accident. As per the police records in FIR, Inquest, Post mortem and charge sheet also the age of the deceased is mentioned as 65 years. But, due to oversight and his illiteracy, the date of birth of deceased i.e. Nukanaboena Lakshumaiah was mentioned as 1943 in his Aadhar card No. 659592863183. The dame was not corrected by him due to his innocence and illiteracy. Though there is ample evidence by way of Election Identity card and Ration card, that the age of deceased was below 70 as on the date of accident 9-11-2014, the R3 without application of mind has repudiated genuine claim of the complainants. Even the premium for the said insurance policies has been deducted from the SB account of the deceased. Under these circumstances, the respondents are not liable to repudiate the claim of the complainants. The negligent acts of the respondents caused mental agony and physical strain to the complainants. The services of the respondents are deficient in nature. Hence, this complaint.
5. It is therefore, prayed that the Hon’ble forum may be pleased to allow the complaint and pass orders in favour of the complainant and directing the respondents (a) to pay the amount of ₹ 1,50,000/- towards accidental insurance coverage under the two polices bearing Nos. 050900/47/14/43/000000008 and 050900/47/14/61/000000001with 24% p.a. from the date of death of deceased i.e. 9-11-2014 till the date of realization, (b) to pay compensation of ₹ 30,000/- towards compensation for causing physical strain and mental agony and (c) to pay ₹ 3,000/- towards the cost of the complaint and other reliefs as the Hon’ble forum deems fit and proper in the circumstances of the case.
6. Counter field by R2 and the same was adopted by R1. The petition filed on behalf for the petitioner is not maintainable either in law or on facts. The petitioner is put to strict proof of all the allegations mentioned in the petition except those which are admitted herein.
7. It is fact that deceased N. Lakshumaiah had account in R1 branch. The deceased has paid premium to cover the risk of death claim of ₹ 1,50,000/- under the scheme KCC and SB covering PAC Master policy. The deceased has submitted house hold card as evidence to open his account about 10 years back. As per the house hold card the age of the deceased was 65 years at the time of sending the amount to R3 as such this respondent sent the premium amount to R3. This respondent submits that the premium amount was received by R3. Hence, the policy covered under the scheme to the deceased. The complainants have submitted all relevant documents to this respondent to claim the assured amount of ₹ 1,50,000/-. This respondent immediately forwarded the documents submitted by the complainant to the R3 for payment of compensation of ₹ 1.50,000/- to the claimants.
8. The R3 repudiated the claim of the complainant on the ground that deceased was 71 years age at the time of the accident as per Aadar card. The complainant submitted that all other documents i.e. P.M. certificate, inquest, Election card etc., showing the age. This respondent denied the allegations in para – 3 of the complaint that the negligent act of the respondent caused mental agony and physical strain to the complainant is false. This respondent has discharged his duty in proper method and in time. Hence, there is no deficiency of service on the part of this respondent at any point of time. This respondent is not liable to pay any compensation to the complainants. This respondent therefore pray that the Hon’ble forum may be pleased to dismiss the petition against this respondent in the interest of justice.
9. R3 file counter that the complainant filed by the complaint is neither just nor maintainable either in law or on facts of the case. The complainant is put to strict proof of all the allegations mentioned, except those which are specially admitted herein by this respondent.
10. United India insurance company Ltd., is a General Insurance Company registered under the company’s act 1956 and carrying insurance business as licensed by IRDA under the provisions of the insurance Act 1938 and it is an undertaken by the Government of India.
11. In the course of the said business the company offers Personnel Accidental Policy for S.B. A/c Holder in APG Bank, for coverage of accidental risk to S.B. Account holders in APG banks in accordance with the provisions of the insurance Act. The said PA Policy covers policy holders, who have attained age of 10 years and the upper age stipulation of below 70 years. This policy condition is well known to the bankers, who propose their account holders for coverage of the PA policy and also the account holders, who ever covers under this policy.
12. That the Insurance contract is a contract of “Utmost Good Faith” where in the proponent is duty bound to disclose everything concerning his age, and other related matters which are within his knowledge at the time of making the proposal, failing which the insurer has every right to repudiate the claim. It is submitted that this respondent company issued the said PA Policy for the S.B. Account holders in APG Bank VN Palli Branch. The deceased N. Lakshumaiah was also one of the account holders in the said bank. The said policies were in force at the time of the death of N. Lakshumaiah.
13. Further it is submitted that the petitioners claimed compensation through the respondents 1 & 2 to this respondent stating that on 9-11-2015 the said N. Lakshumaiah met with a road accident and died. The petitioners stated in their claim that the deceased N. Lakshumaiah had two KCC accounts in APGP bank and that he covers under two PA policies and that they submitted that relevant documents for settlement of the claim. It is further submitted that after verifying the documents submitted by the petitioners this respondent come to know that the deceased was aged about 71 years at the time of the alleged said accident. After that this respondent company clearly intimated to the petitioners that the company is unable to settle the claim, in view of the above said fact and repudiate the claim of the petitioners according to the policy conditions.
14. It is submitted that the R3 clearly stated in its reply notices to the petitioners that why they are unable to settle the claim of the petitioners so there is no deficiency of service on the part of R3. The contents of the prayer clause are denied intoto. The claim was repudiated as per the terms and conditions of the policy documents which is the evidence of the insurance contract and there is no contractual obligation on the part of the R3 to pay any amount of whatsoever nature to the complainant. The complainant is not eligible for ₹ 1,50,000/- towards the claim amount along with 24% interest towards claim amount, ₹ 30,000/- towards mental agony and he is not eligible to get costs of the complaint and legal expenses or any other amount of whatsoever nature amount or otherwise. There is no deficiency in service carelessness or unfair trade practice on the part of R3. Hence, the complaint is not maintainable against the R3 and should be dismissed with exemplary costs.
15. On the basis of the above pleadings the following points are settled for determination.
- Whether the complainants are eligible for compensation as prayed by them or not?
ii. Whether there is negligence or deficiency of service on the
part of the Respondents or not?
iii. To what relief?
16. On behalf of complainant Exs. A1 to A11 were marked and on behalf of the respondent No. 3 Exs. B1 & B2 were marked.
17. Point Nos. 1 & 2. It is very clear from the averments, complaint and counter that the deceased N. Lakshumaiah had S.B. account with R1 bank under Ex. A1, which covers accidental insurance coverage under KCC scheme. After that the deceased husband of the complainant met with an accident on 9-11-2014 the same was registered as Cr. No. 156/2014 of G.R. Palli police station. Exs. A2 to A6 clearly proves the same. As per Ex. A7 family member’s certificate issued by the Revenue department, the complainants are the legal heirs of the deceased Lakshumaiah. As per Ex. A8 the age of the deceased as on 1-1-1995 is 45 years. As per Ex. A9 the age of the deceased was 60 years i.e. house hold card. As per Exs. A2 to A5 the age of the deceased was 65 years. Ex. A10 which is aadar card showing that the date of birth is 1943 of the deceased. But it is not the exact proof to shows the age of the deceased. Ex. A2 to A6 are relevant documents to prove the age of the deceased. As per Ex. A2 to A8 the age of the deceased at the time of death was 65 years only. In these circumstances the complainants are eligible for compensation as prayed by them two policies i.e. KCC card for account No. 9104678833 and KCC No. 19185525381, the insurance policy bearing Nos. 050900/47/14/43/000000008 and 050900/47/14/61/000000001. Ex. A2 clearly proves that the death of the deceased was accidental. So the deceased covers under these two policies. Under these circumstances the complainants 1 to 3 are eligible for compensation as claimed by the nominees of the deceased Lakshumaiah, at the same there is deficiency of service on the part of the respondents 1 to 3.
18. Point No. 3. In the result, the complaint is allowed directing the respondents 1 to 3 jointly and severally liable to pay ₹ 1,50,000/- (Rupees one lakh fifty thousand only) towards accidental insurance coverage, pay ₹ 5,000/- (Rupees five thousand only) towards mental agony and pay ₹ 3,000/- (Rupees three thousand only) towards costs of the complaint, within 45 days of date of receipt of orders to the complainant.
Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, this the 18th February 2016.
MEMBER MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant : NIL For Respondents : NIL
Exhibits marked for Complainant: -
Ex: A1 P/c of Pass book bearing khata no.10688 issued by the 1st respondent in
Favour of the deceased N.Lakshumaiah.
Ex: A2 P/c of F.I.R. No. 156/2014 of G.R.Palli P.S.,
Ex: A3 P/c of inquest report in FIR No.156/2014 of G.R. Palli. P.S.,
Ex: A4 P/c of Post-Mortem certificate in FIR No.156/2014 of G.R. Palli. P.S.,
Ex: A5 P/c of chargesheet in FIR No.156/2014 of G.R. Palli. P.S.,
Ex: A6 P/c of Death Certificate of deceased N.Lakshumaiah issued by the Kadapa
Municipal Corporation, Kadapa.
Ex: A7 P/c of Family member certificate of deceased N.Lakshumaiah issued by the
Revenue Department.
Ex: A8 P/c of Voter Identity card pertaining to the deceased N.Lakshumaiah bearing no.AP/23/159/324311 Issued by the Election Commission of India.
Ex: A9 P/c of Household card bearing no.WAP112301400160 issued by the M.R.O. Veerapunayunipalli Mandal in favor of deceased N.Lakshumaiah.
Ex: A10 P/c of AADHAR Card No.659592863183 pertaining to deceased
N.Lakshumaiah.
Ex: A11 P/c of Repudiation letters dated 14-07-2015 (two in numbers) issued by the 3rd respondent.
Exhibits marked on behalf of the Respondents : -
Ex. B1 P/c of Group Janatha Personal Accident policy
No. 050900/47/14/61/000000001
Ex. B2 P/c of aadar card of the deceased i.e. N. Lakshumaiah.
MEMBER MEMBER PRESIDENT
Copy to :-
- Sri V. Dharma Kumar, Advocate for complainant.
- Sri G. Ramachandra Reddy, Advocate for R1 & R2.
- Sri K. Ramakondiah, Advocate for R3.
B.V.P.
