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, B.L., LADY MEMBER
SRI M.V.R. SHARMA, MEMBER
Monday, 6th June 2016
CONSUMER COMPLAINT No. 88 / 2015
1. Nukanaboyina Ravi Sankar,
S/o Late N. Obulesu,
aged 38 years, R/a 1/64, Veldulthy,
Veerapunayunipalli Mandal, YSR District.
2. Nukanaboyina Lakshmi Devi @ Gangadevi lakshmi Devi,
D/o Late N. Obulesu, W/o G. Venkata Ramana,
aged 46 years, R/at D.No. 10/96-3-28-308,
Vittal Kalyan Apartments,
Near Yadav Colony, PVN Colony,
Hyderabad – 500 047. ….. Complainants.
Vs.
1. Andhra Pragathi Grameena Bank, Rep. by its
Branch Manager, Yerraguntla Branch, Yerraguntla Mandal,
YSR Distract.
2. Andhra Pragathi Grameena Bank, Rep. by its
Regional manager, Nagharajupeta, 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 – 516001. …..Respondents.
This complaint coming for final hearing on 01-6-2016 in the presence of Sri V. Dharma Kumar, Advocate for Complainant and Sri A. Raja Reddy, Advocate for R1 and R2 and Sri K. Rama kondaiah, Advocate for R3 and upon perusing the material papers on record, the Forum made the following:-
O R D E R
(Per V.C. Gunnaiah, President),
1. The complainant filed this complaint under section 12 of Consumer Protection Act 1986 (for short herein after called as C.P. Act) praying this forum to direct the Respondents to pay an amount of Rs. 1,50,000/- towards accidental insurance coverage under two policies with interest @ 24% p.a. from the date of death of the deceased, to pay Rs. 30,000/- towards compensation for mental agony and Rs. 3,000/- towards costs of the complaint.
2. The averments of complaint in brevity are that the Complainants 1 & 2 are children of one Nukanaboyina Obulesu, who had S.B. Account bearing No. 1336 in R1 bank. R2 is the Head office of R1 and R3 is the insurance company who has tie-up with R1 bank to their account holders to provide accidental insurance. The R1 bank has provided accidental insurance claim to their account holders and deducted required premiums from the Complainant’s deceased father Nukanaboyina Obulesu and provided accidental insurance coverage for Rs. 1,50,000/- under two Kisan Credit card (KCC) account Nos. 19068129857 & 19068002488. Respondent No. 3 issued two group insurance policy bearing Nos. 050900/47/13/43/00000022 and 050900/47/13/61/000000001. The Complainants father was covered under these two policies. The mother of the Complainants was shown as nominee of these policies. As per terms and conditions of the policy, in case of accidental death of insured the nominee will be paid Rs. 1,50,000/- towards accidental coverage. While so on 10-9-2013 the Complainants father Nukanaboyina Obulesu died in rail accident in between upline and down line tracks at 204/03-04 posts in between Pullampeta – Rajampet Railway stations by falling from train and died. A case in Cr. No. 83/2013 under section 174 Cr.P.C was registered by Renigunta Railway Police Stations with regard accident and death of the deceased. After the death of the deceased / insured his wife who is nominee also died due to ill-health on 17-6-2014. The Complainants who are legal heirs of deceased / insured made accidental claim to the Respondents 1 & 2 and the same was forwarded to R3 along with certified copies of FIR, Post mortem report, death certificate, family members certificate and other criminal case record. But the Complainants received two letters dt. 14-7-2015 from R34 which was addressed to R2 stating that their claim was repudiated on the ground that he deceased was more than 70 years old as on the date of loss and upper age stipulation of age is below 70 years. So the claim was not admitted. The deceased was illiterate. As per household card issued by Mandal Revenue Officer of V.N. Palli mandal he was below 70 years on the date of accident. But in Aadar card it is mentioned that his birth year was 1936 and the same was not correct and the same occurred due to innocence and illiteracy of the deceased. But the deceased was 67 years only on the date of accident. On 10-9-2013 the same has also been shown in FIR, which is genuine and R3 without application of mind had repudiated the claim of Complainants, though the premium was collected and deducted from S.B. Account of the deceased. Thus there is negligent act on the part of the respondents and deficiency in service. Hence, the complaint for the above reliefs.
3. Respondent No. 1 filed counter and the same has been adopted by respondent No. 2 by filing memo. R1 admitted in his counter that the deceased opened S.B. Account No. 1336 and was operating the same during his life time and insurance contract had with R3 Company and insurance facility was provided in respect of accidental insurance coverage and two KCC accounts for an amount of Rs. 1,50,000/- as pleaded by the Complainant. He also admits the premium was remitted to R3 Company for the policy for accidental death. It is further admitted in their counter that after the death of the deceased on 10-9-2013 the Complainants submitted claim forms along with FIR, inquest report, Post mortem report of their deceased father and in turn they were forwarded to R3 Company for settlement as per terms and conditions of the policy. But R3 Company did not settle the claim as the deceased was crossed the age of 70 years and repudiated the claim. So the R1 bank is nothing to do with the same. The Complainants have to prove the correct age of the deceased for insurance benefit. No negligence on the part of this respondent and no deficiency of service on their part. Hence, the complaint is liable to be dismissed.
4. Respondent No. 3 filed counter denying the allegations for the Complainants. However, admitted the tie-up with R1 bank for coverage of accidental risk for S.B Account holders in accordance with the provisions of insurance Act. It is further contended the upper age stipulated to cover the policy is below 70 years. The deceased Nukanaboyina Obulesu was also one of the account holder in A.P.G. Bank also covers under the said policies which was in force at the time of death of the deceased. The Complainants claimed compensation through R1 & R2 by submitting all relevant documents for settlement of the claim.
5. After verifying the documents submitted by the Complainants this respondent came to know that the deceased was aged 77 years at the time of his death and intimated the claimants that the company is unable to settle the claim and repudiated the same as the deceased was more than 70 years. Thus there is no deficiency of service on the part of this Respondent. The claim was repudiated as per terms and conditions of the policy and the Complainants not eligible for Rs. 1,50,000/- towards claim with interest and also for mental agony Rs. 30,000/- with costs. Hence, the complaint is liable to be dismissed with costs.
6. On the basis of the above pleadings the following points are settled for determination.
- Whether the repudiation of the claim by R3 is correct?
- Whether there is deficiency in service on the part of the Respondent?
- Whether the complainants are entitled for the reliefs as prayed for from the Respondents?
- To what relief?
7. No oral evidence has been let in by the parties. But on behalf of complainants Exs. A1 to A10 documents are marked. On behalf of Respondents Exs. B1 to B6 documents are marked.
8. Heard arguments on both sides and carefully considered the documentary evidence filed by the parties.
9. Point No. 1. Learned counsel for R3 contended that the claim of Complainants was repudiated as per Ex. A9 by giving reasons as the insured / deceased Nukanaboyina Obulesu was aged 77 years as on the date of accident. As per Aadar card Ex. A6 & B4 his year of birth is 1936 and the policy applies only to the policy holder below 70 years at the time of death and since the deceased more than 70 years at the time of his death the Complainants are not entitled for the claim though the premium was collected for his policies.
10. On the other hand learned counsel for Complainants contended that the birth of year was wrongly mentioned as 1936 in Ex. A6 & B4 by the authorities, as the deceased was illiterate and innocence. As per house hold card Ex. A5 the date of birth of the deceased which was issued on 10-8-2006 shows that he was aged 60 years and the said age is correct one as Ex. A5 being earlier document the same has to be taken in to consideration for determining the age of deceased / insured by 10-9-2013. The age of the deceased was not more than 67 years. Therefore, R3 cannot repudiate the claim on the ground that the deceased was more than 70 years. Respondents 1 & 2 contended that they have no role to play regarding the age of the deceased and they simply forwarded the claim along with necessary documents to the R3 and thus they have no deficiency in service.
11. The facts pleaded by the Complainants in this case regarding death of the deceased in Rail accident and was having accounts in KCC with R1 and paid insurance premiums to the R3 for the above two policies during his life time and the Complainants are legal heirs of the deceased. The only dispute for repudiation of claim of the Complainants is that as per stipulation of terms and conditions of the policy for paying insurance claim the deceased shall be below 70 years at the time of his death and since the deceased was more than 70 years at the time of his death, as per Ex. A6 Aadar card his claim was repudiated. According, to Complainants the same was not genuine as the deceased was illiterate and innocent and he was below 70 years at the time of his death as per Ex. A5 house hold card issued by Mandal Revenue Officer, V.N. Palli Mandal to the deceased in the year 2006.
12. In this case there are two documents one is Ex. A5 house hold card and other is Ex. B4 which is equivalent to Ex. A6 Aadar card of deceased showing his age. A perusal of Ex. A6 & B4 shows that the year of birth of the deceased was in the year 1936. A perusal of Ex. A5 original house hold card which was issued on 10-8-2006 shows that the deceased was aged 60 years. Ex. A5 was issued by Mandal Revenue Officer, V.N. Palli, Kadapa District. Whereas Ex. A6 & B4 was issued by Government of India recently i.e. in the year 2013, which is electronically generated letter. The document Ex. A6 which is not authenticated document to determine the age taking in to consideration to prove the age of the deceased as 77 years as the year of birth of the deceased was not verified physically and personally. Whereas Ex. A5 was issued by Mandal Revenue Office by taking photos of the family members and noting the age of family members. This house hold card Ex. A5 is more authenticated document with regard to age of the deceased than Ex. A6 & B4 Aadar card. Therefore, we have taken in to consideration Ex. A5 house hold card to determine the age of the deceased N. Obulesu and his age at the time of death as 67 years i.e. below 70 years. If such is the case R3 who is the insurer who collected the premium from the deceased for the policies KCC account Nos. 19068129857 and 19068002488 under group insurance policy Nos. 050900/47/13/43/00000022 and 050900/47/13/61/000000001 cannot repudiate the claim of Complainants on the sole ground that the deceased N. Obulesu was more than 70 years at the time of his death. Therefore, we clearly hold the repudiation of the claim by R3 is not correct and R3 is liable to pay the claim of the Complainants. Accordingly point No. 1 is answered.
13. Point No. 2. Respondents 1 & 2 have forwarded the claims submitted by the Complainants to R3 for settlement of the claim as per the terms and conditions of the policy. There was no delay on their part. It is for R3 only to settle the claim. Therefore, there was no deficiency in service on the part of the Respondent 1 & 2 and are not liable for any relief claimed by the Complainants, hence Complaint against them is liable to be dismissed.
14. In point No. 1 above we discussed at length and held that R3 is liable to pay insurance claim of the Complainants, but repudiated the same. Therefore, we hold there is deficiency in service on the part of R3 in settling the claim of Complainants in respect of their deceased / insured father N. Obulesu. Accordingly, this point is answered against R3.
15. Point No. 3. The Respondents have not denied the accidental insurance coverage of two group insurance policy bearing Nos. 050900/47/13/43/00000022 and 050900/47/13/61/000000001 at Rs. 1,50,000/-. Therefore, the Complainants are entitled for Rs. 1,50,000/- towards accident insurance coverage under two policies bearing Nos. 050900/47/13/43/00000022 and 050900/47/13/61/000000001 with interest at 12% p.a. from the date of filing of this complaint i.e. 19-10-2015 and Rs. 2,000/- towards compensation for mental agony and Rs. 3,000/- for costs of the complaint. Accordingly, this point is answered.
16. Point No. 4. In the result the complaint is allowed, directing the Respondent No. 3 (United India Insurance Co. Ltd.,) to pay Rs. 1,50,000/- (Rupees one lakh fifty thousand only) towards accidental insurance coverage under two policies bearing Nos. 050900/47/13/43/00000022 and 050900/47/13/61/000000001 along with interest @ 12 % p.a from the date of filing this complaint i.e. 19-10-2015 till realization and shall also pay Rs. 2,000/- (Rupees two thousand only) towards mental agony and Rs. 3,000/- (Rupees three thousand only) towards costs of the complaint to the Complainants, within 45 days from the date of receipt of this order. The complaint against Respondents 1 & 2 is dismissed without costs.
Dictated to the Stenographer, typed my dictation by Stenographer, corrected and pronounced by us in the open forum, this the 6th June 2016
MEMBER MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant: NIL For Respondents : NIL
Exhibits marked for Complainant : -
Ex. A1 original pass book bearing khata No.1336 issued by R1 in favour of the
deceased N. Obulesu.
Ex. A2 P/c of FIR No. 83/2013 of Renigunta P.S.
Ex. A3 P/c of death certificate of deceased N. Obulesu issued by Panchayat Office
of Pullampeta Mandal, YSR District.
Ex. A4 P/c of family member certificate of deceased N. Obulesu issued by revenue
department.
Ex. A5 Original house hold card bearing No. WAP112301300206 issued by the
M.R.O, V.N. Palli Mandal in favour of the deceased N. Obulesu.
Ex. A6 P/c of Aadhar card No. 326161545213 pertaining to Complainant to
N. Obulesu.
Ex. A7 P/c of Aadhar card No. 987342573316 pertaining to Complainant No. 1.
Ex. A8 P/c of Aadhar card No. 471806316688 pertaining to Complainant No. 2.
Ex. A9 P/c of repudiation letters dt. 14-7-2015 (2 numbers) issued by R3.
Ex. A10 Death certificate of wife of deceased by name N. Narasamma, issued by
Panchayat Secretary, Veldurthy, YSR District.
Exhibits marked on behalf of the Respondents:-
Ex. B1 Policy with memorandum of understanding
Ex. B2 Postmortem certificate.
Ex. B3 Final report.
Ex. B4 Aadhar card of the deceased.
Ex. B5 P/c of Aadhar card.
Ex. B6 P/c of statement.
MEMBER MEMBER PRESIDENT
Copy to :-
1) Sri V. Dharma Kumar, Advocate for Complainant.
2) Sri A. Raja Reddy, Advocate for R1 & R2.
- Sri K. Ramakondaiah, Advocate for R3.
B.V.P
