Date of filing: 28-4-2017 Date of order : 23-10-2017
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
Monday, 23rd day of October, 2017
CONSUMER COMPLAINT No. 30 / 2017
G. Venkata Rama Subba Reddy,
S/o late Venkata Siva Reddy,
R/o Gorigenuru Village,
Jammalamadugu Mandal,
Kadapa District. … Complainant.
Vs.
Life Insurance Corporation of India,
Rep. by its Senior Divisional Manager,
Divisional Office, Government Arts College Road,
Near New Collectorate, Kadapa City. ….. Opposite party.
This complaint coming for final hearing on 11-10-2017 in the presence of Sri D. Pratap Kumar Reddy, Advocate for Complainant and Sri G. Trivikram Singh, Advocate for Opposite party and upon perusing the material papers on record, the Forum made the following
O R D E R
(Per Smt. K. Sireesha, Member),
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 Opposite party to pay Rs. 4,83,772 together with interest accrued thereon and thereby settle the claim of the complainant, to pay a sum of Rs.10,000 as compensation for causing mental agony, and to pay Rs.5,000 towards costs of the complaint.
2. The averments of the complaint in brevity are as follows. The Complainant father namely Venkata Siva Reddy took insurance policy vide policy No.653379855 from the opposite party for a sum assured of Rs.1,00,000 under Jeevan Mitra (Triple Cover) Plan. The terms of policy is 20 years which commenced on 28-2-2004 . The father of the complainant was murdered on 7-3-2004 in their village and the same was register as Crime No.18/2004. The complainant is also included as accused in the said crime. After trial the complainant was acquitted by the Hon’ble Sessions Judge Court, Kadapa.
3. After that the complainant made claim of the above policy and the same was repudiated by the opposite party on 3-11-2006. The complainant approached Insurance Ombudsman on 8-4-2008 the same was dismissed as it was barred by limitation. After that the complainant approached Hon’ble High Court of A.P. and filed Writ Petition No.8417/2010. Wherein the Hon’ble High Court of A.P. directed Insurance Ombudsman to deal with the matter by condoning the delay and dispose the same on merits in accordance with law. After the order of the Hon’ble High Court the Insurance Ombudsman enquired into the matter and on hearing both sides passed an award bearing No.IO/HYD/A/LI/02003/2015-2016 Dt. 31-3-2016 directing the opposite party to settle the claim in full along with all riders benefits and interest for delayed settlement.
4. The complainant sought for the relief of sum assured plus Interest 24percent plus Rs.50,000 damages plus Rs.5,000 legal charges. Since the complaint was allowed the opposite party was under obligation to comply with the award passed by the insurance ombudsman. According to the award the amount payable by the opposite party was Rs.7,20,000. But the opposite party an amount of Rs.5,62,695/- only instead of Rs.7,20,000. Thus the opposite party is still due of Rs.4,83,772 and subsequent interest. On 19-10-2016, the complainant addressed a letter to the opposite party claiming remaining amount. On 20-10-2016 the opposite party repudiated the claim of the complainant vide reference letter MKTG/CLAIMS which Dt.20-10-2016 in spite of repeated demands, the opposite party declined to settle the claim and caused mental agony to the complainant.
5. The repudiation of the opposite party amounts to deficiency of service under the Consumer Protection Act. Therefore the complainant approached the Hon’ble Forum praying to pay remaining claim amount of RS.4,83,772/- together with interest, to pay Rs.10,000 towards mental agony and to pay Rs.5,000/- towards costs of the complaint.
6. Counter filed on behalf of the opposite party, the complainant filed by the complaint is not maintainable either in law or on fact of the case. The complainant is put to strict proof of all the allegations which are not expressly admitted herein by the opposite party. The opposite party takes preliminary objections with regard to maintainability before the Hon’ble Forum, kadapa. The complainants grievance is that the O.P. has not complied the orders of the Insurance Ombudsman, dt. 31-3-2016 passed against it. The person has to approach appropriate authority and not the Hon’ble Forum. The Claim of the complainant was repudiated under a letter, dt. 31-3-2016 by the O.P. on the ground that life assured was insane for the last 4 years and he was treated at RUIA Hospital, Tiruapthi and Yerragadda Hospital, Tirupathi. Towards compliance of the insurance ombudsman order the O.P. has calculated the amount as mentioned hereunder;
Sum Assured Rs.1,00,000
Additional Sum assured Rs.2,00,000
Bonus Rs.5,900
and Interest from 31-3-2016 to 8-7-2016 is Rs.2,85,328 totaling to amount of Rs.5,62,695,
7. Out of the total amount an amount of rs.5,62,695 was paid to the complainant through NEFT on 8-7-2016 to his bank account No.91071943886 of APGB Jammalamadugu Branch and remaining amount of Rs.28,533/- was paid to the complainant by way of Cheque bearing No.266285 dt. 19-7-2016 and the same was encashed by him on 4-8-2016. The rate of interest calculated as 9% p.a. from the date of repudiation i.e. 31-3-2016 to the date of claim payment i.e., 8-7-2016. The complainant accepted to receive the said amount and discharge voucher dt.8-7-2016 towards full and final satisfaction was given by the complainant. The opposite party fully complied the award of the Honble Ombudsman by paying interest @ 9% as per norms of the corporation from the date of repudiation. The circular reference ACTL/PS/2224/4 Dt. 18-4-2016 regarding rate of interest applicable for delayed payment is herewith filed for kind perusal of the Hon’ble Forum.
7. Hence, the additional amount being claimed by the complainant is not sustainable as it is excessive and not maintainable as it is not part of the award. The same was informed to the complainant vide letter Dt. 20-10-2016, Having been received calculated amount of Rs.5,91,228 from the O.P. by executing discharge voucher, dt. 8-7-2016 towards full and final satisfaction, the complainant is barred to raise any further claims.
8. Hence, there is no deficiency of service on the part of the opposite party in not settling excessive claim and complaint is not maintainable under Consumer Protection Act and there is no cause of action before the Hon’ble Forum award passed by the Insurance Ombudsman, Hyderabad dt. 31-3-2016. It is therefore prayed that the Hon’ble Forum may dismiss the complaint with exemplary costs.
9. Ex.A1 to Ex.A6 filed by the complainant and Ex.B1 to Ex.B9 filed on behalf of the Opposite party. From the above averments these points were taken for consideration
- Whether the complainant is eligible for compensation for as prayed by him or not
- Whether there is negligence or deficiency of service on behalf of the opposite party or not
- To what relief ?
10. Point No.1 & 2 It is very clear from Ex. A1 that the complainant’s father had taken a policy bearing No.653379855 from the O.P. dt. 28-2-2014 and after the death of his father the complainant approached the Insurance Ombudsman and the award passed by the Insurance Ombudsman under Ex. A2. Ex. B3 is order passed by the Insurance Ombudsman, Hyderabad. Ex.B5 is the award of the Ombudsman dt. 31-3-2016. The complainant approached Hon’ble Insurance Ombudsman for relief of settlement of the bonus death claim and the same Ombudsman awarded the claim dt. 31-3-2016 and the complainant had also discharged a voucher dt.8-7-2016 i.e, Ex.B6, as full and final satisfaction of his claim. When the complainant approached Ombudsman and he had received claim amount from the O.P. and again he approached the Hon’ble Forum for other reliefs. When once he approached the Ombudsman again he has to approach the Insurance Ombudsman for further execution or if any. This is not the right forum for his claim. Hence the complainant is not eligible for any compensation as prayed by him. At the same time there is no deficiency of service on the part of the opposite party.
11. Point No.3. In the result, the complaint is dismissed without costs.
Dictated to the Typist, transcribed by him, corrected and pronounced by us in the open forum, this the 23 day of October, 2017
MEMBER PRESIDENT
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant: NIL For Opposite party : NIL
Exhibits marked for Complainant : -
Ex. A1 Copy of Insurance Policy bearing No.653379855, DT.28-2-2004.
Ex. A2 Copy of Award bearing No.IO/Hyd/A/LI/OP203/2015-2016 passed by
the Insurance Ombudsman.
Ex. A3 Copy of letter dated 19-10-2016 addressed to the opposite party by
the complainant.
Ex. A4 Copy of repudiation dated 20-10-2016.
Ex. A5 Office copy of legal notice dated 27-12-2016 issued by the
Complainant to the O.P.
Ex. A6 Copy of reply notice dt. 31-12-2016 issued by the opposite party to
the complainant.
Exhibits marked on behalf of the Opposite party : -
Ex. B1 Letter dt.7-4-2006 issued by the O.P. to the complainant.
Ex. B2 Letter Dt. 3-11-2006 issued by the O.P. to the complainant.
Ex. B3 Order Dt. 18-7-2008 passed by Hon’ble Insurance Ombudsman, Hyd.
Ex. B4 Order Dt. 4-11-15 passed by Hon’ble High Court of A.P. Hyd. in
W.P. No.8417 of 2010.
Ex. B5 Ombudsman Award Dt. 31-3-2016.
Ex. B6 Original discharge voucher dt.8-7-2016 executed by the complainant
in favour of the O.P. towards full and final satisfaction of his claim.
Ex. B7 Circular Ref. Acti/PS/2224/4, Dt.18-4-2016 regarding rate of interest
applicable.
Ex. B8 Letter Dt. 20-10-2016 issued by the O.P. to the complainant.
Ex. B9 Reply dt.31-12-2016 addressed to complainant counsel by the O.P.
MEMBER PRESIDENT
Copy to :-
1) Sri D. Pratap Kumar Reddy, Advocate for Complainant.
2) Sri G. Trivikram Singh, Advocate for opposite party.
P.R.
