State Consumer Disputes Redressal Commission
Smt. Tirumalasetty Vijaya Lakshmi vs The Branch Manager,The New India ... on 19 May, 2010
FA1389 of 2007.html BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD. F.A. 1389/2007 against C.C. 71/2006, Dist. Forum, Kadapa Between: Smt. Tirumalasetty Vijaya Lakshmi W/o. Late T. Subbarayudu R/o. 14/407, Sangampeta Kadapa Town & Dist. *** Appellant/ Complainant. And The Branch Manager The New India Assurance Company Ltd. 40/526-12, 1st Floor, HDCP Complex R.S. Road , Kurnool Town & Dist. *** Respondent/ Opposite Party. Counsel for the Petitioner: M/s. Allur Manjunath. Counsel for the Respondent: Mr. K.N.V. Radhakrishna. CORAM: HONBLE SRI JUSTICE D.APPA RAO, PRESIDENT. & SMT.M.SHREESHA, LADY MEMBER.
WEDNESDAY, THIS THE NINETEENTH DAY OF MAY TWO THOUSAND TEN ORAL ORDER: (Per Honble Sri Justice D.Appa Rao, President.) ***
1) This is an appeal preferred by the complainant aggrieved by the order of the Dist. Forum in declining accidental benefit under the policy while granting only the sum assured (under the policy).
2) The case of the complainant in brief is that her husband late T. Subbarayudu worked as a constable in Prohibition & Excise, Rajempeta, Kadapa. During his life time, he had taken Janata Personal Accident Insurance Policy commencing from 17.11.1998 to 16.11.2013 for Rs. 5 lakhs on payment of signle premium of Rs. 1,400/-. She was the nominee under the policy. While so, he met with accident on 18.1.2004 and sustained injuries. Based on the report the police registered a case in crime No. 4/2004 While taking treatment in CMC Hospital, Vellore he died on 11.2.2004. She informed the said fact to the insurance company along with documents, however there was no response. Despite the fact that she approached various authorities her claim was not settled.
Therefore she sought an amount of Rs. 5 lakhs together with interest, compensation and costs.
3) The insurance company resisted the case. It alleged that Prohibition & Excise Department had taken Group Janata Personal Accident Policy wherein the complainants husband was also one of the assured persons. The policy was issued in the name of Deputy Commissioner of Excise, Kurnool, and not in the name of any individual. There was no contract between it and the deceased. The Dy. Commissioner of Excise wrote a letter Dt. 6.2.2003 to retain premium for Rs. 1 lakh for the sum assured and return the balance premium amount Therefore it had cancelled the policy by retaining premium of Rs. 240/- for each of the employee covering the sum assured for Rs. 1 lakh covering the period from 31.1.2003 to 30.1.2008 and balance of Rs. 73,912/- was refunded to the Dy.
Commissioner of Excise which he has received. In case of accidental death FIR, inquest, post-mortem examination report etc. had to be filed. However, the complainant cannot file the complaint on her own.
It has to be filed by the Dy Commissioner of Excise the assured. When the complainant intimated about the death it has categorically informed that long term group JPA policy was cancelled and a premium of Rs. 240/- was retained for Rs. 1 lakh policy the amount of which she is entitled. There was no deficiency in service on its part. Therefore it prayed for dismissal of the complaint with costs.
4) The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A11 marked while the insurance company filed Exs. B1 to B5.
5) The Dist. Forum after considering the evidence placed on record opined that originally the long term Group Janata Personal Accident Policy was cancelled as per the terms and conditions and later converted into a five year policy commencing from 31.1.2003 to 30.1.2008 agreeing to pay Rs. 1 lakh in case of death in accident retaining the premium of Rs. 240/- only. The balance amount taken towards premium was refunded to the Dy. Commissioner of Excise, Kurnool. Therefore she was entitled to an amount of Rs. 1 lakh under the policy. Accordingly the insurance company was directed to pay Rs. 1 lakh together with interest @ 9% p.a., from 11.2.2004 besides compensation of Rs. 8,000/- and costs of Rs. 2,000/-.
6) Aggrieved by the said decision, the complainant preferred the appeal contending that the Dist. Forum did not appreciate either the facts or law in correct perspective. It ought to have seen that the insurance company has no jurisdiction to cancel the long term JPA policy on the instructions of higher officials without giving any notice to the individuals. It has failed to follow the principles of natural justice while canceling the policy. Therefore she prayed that the entire amount of Rs. 5 lakhs originally assured under the policy be paid.
7) The point that arises for consideration is whether the complainant was entitled to the assured amount originally stipulated under the long term Group Janata Personal Accident policy?
8) It is an undisputed fact that the complainant is the wife of late T. Subbarayudu a constable in Excise & Prohibition, Rajampet, Kadapa Initially Dy. Commissioner of Excise, Kurnool took long term Janata Personal Accident Policy for Rs. 5 lakhs commencing from 17.11.1998 to 16.11.2013 evidenced under Ex. B1. Name of the assured is mentioned as Prohibition & Excise Employees, O/o. Deputy Commissioner of Excise, Kurnool and various beneficiaries. Later the said policy was cancelled and in its place a five year term policy was taken commencing from 31.1.2003 to 30.1.2008. Later at the instance of Dy.
Commissioner of Excise the said policy was cancelled and the sum assured was restricted to Rs. 1 lakh. The extra premium that was taken was refunded vide letters Ex. B2 & B3. The fact that extra premium was sent through cheque in favour of Dy. Commissioner of Excise is evidenced under premium refund voucher Ex. B4 Dt. 17.2.2003 besides statement of account maintained by Andhra Bank pertaining to the insurance company marked as Ex. B5.
9) It is not in dispute that its employee late T. Subbarayudu died in an accident during the subsistence of the policy on 11.2.2004 evidenced under FIR, Ex. A1, copy of the inquest Ex. A2, death certificate Ex. A3 while taking treatment in the hospital. As a nominee she claimed Rs. 5 lakhs under original policy Ex. A7, without taking cognizance of change in the policy.
10) The Honble Supreme Court in The General Assurance Society Ltd. Vs. Chandmull Jain reported in 1966 ACJ 267 held that where the parties agreed upon certain terms which were to regulate their relationship, it was not for the court to make a new contract, however reasonable, if parties had not made it for themselves. This was an answer to the contention that the policy gave a mutual right to the parties to cancel the policy at any time was so unreasonable that it should not be allowed to stand. Their Lordships opined that the right to terminate cannot by reason of any circumstances be read as a right to terminate for a reasonable cause. No reasons need be assigned for cancellation.
11) When the insurance company in its counter pleaded that at the instance of assured Dy. Commissioner of Excise, Kurnool earlier policy was cancelled and later a policy for five years for assured sum of Rs. 1 lakh was taken it was not denied by the complainant in her affidavit evidence.
In fact she could have approached the Dy. Commissioner of Excise to find out as to why the terms and conditions of the policy were changed. Equally she did not allege that such a cancellation by the assured was wrong. When the office of the Deputy Commissioner of Excise had taken the policy covering the risk of various employees and when the very assured intends to get the conditions changed by invoking the terms, the insurance company has no other go than to change the terms as stipulated by the assured. The question of giving notice to each of the employees will not arise, in view of the fact that the very assured is the Dy. Commissioner of Excise, the Head of the Department of their employees. When she alleges that Dy. Commissioner of Excise has no power to alter or change the terms of the policy against the interests of the employees she could have impleaded him or taken action against him on the ground that she had suffered loss of amount. The premium that was collected for the period was refunded and subsequently fresh policy was given limiting the period to five years as well as the sum assured. The complainant claimed the amount as though the first policy was still subsisting. What all she was entitled to is the assured amount covered under the policy together with interest in case if there was delay in settlement of the claim. The Dist. Forum even awarded compensation for whatever deficiency in service that could be attributed to the insurance company together with costs. It cannot be said that the Dist. Forum did not appreciate either the facts or law in correct perspective. The complainant is not entitled to the amount under the cancelled first policy by the very employer. We do not see any mis-appreciation of fact or law by the Dist. Forum in this regard.
We do not see any merits in the appeal.
12) In the result the appeal is dismissed. No costs.
1) _______________________________ PRESIDENT
2) ________________________________ MEMBER Dt. 19.
05. 2010.
*pnr UP LOAD O.K.