State Consumer Disputes Redressal Commission
Reliance General Insurance Anil ... vs Chennaboina Venkatamma on 6 November, 2017
Cause Title/Judgement-Entry STATE CONSUMER DISPUTES REDRESSAL FORUM Telangana First Appeal No. FA/242/2014 (Arisen out of Order Dated in Case No. of District State Commission) 1. Reliance General Insurance Anil Dhirubhai Ambani Group Rep by its Authorised Signatory 570 Naigaum Croos Road Next to Royal Industrial Estate Wadala Mumbai ...........Appellant(s) Versus 1. Chennaboina Venkatamma Wife of Venkataiah aged 41 years, Agriculture 2. 2 Chennaboina Shankar Son of Venkataiah age 15 years student akk are Residing at Narasapuram village of Damaracherla Mandal Nalgonda District 3. 3 Chennaboina Madhu Son of Venkataiah, age 10 years occupation student all are residing narasapuram village of Damaracherla Mandal Nalgonda District 4. 4 Golden Multi Services Rep by its Branch Manager 1st floor sanghamithra Bhavan Prakasham Bazar Nalgonda 508 001 ...........Respondent(s) BEFORE: HON'BLE MR. JUSTICE B. N. RAO NALLA PRESIDENT HON'BLE MR. Sri. PATIL VITHAL RAO JUDICIAL MEMBER For the Appellant: For the Respondent: Dated : 06 Nov 2017 Final Order / Judgement STATE CONSUMER DISPUTES REDRESSAL COMMISSION OF TELANGANA : At HYDERABAD FA 242 OF 2014 AGAINST CC 15 OF 2013, DISTRICT FORUM, NALGONDA Between : Reliance General Insurance ( Anil Dhirubhai Ambani Group), Represented by its authorised Signatory, 570, Naigaum Cross Road, Next to Royal Industrial Estate, Wadala (W), Mumbai - 400 031 ... Appellant/Op.1 And Chennaboina Venkatamma, W/o Venkataiah, Age : 41 years, Occ : Agriculture. Chennaboina Shankar, S/o Venkataiah, Age : 15 years, Occ : student Chennaboina Madhu, S/o Venkataiah, Age : 10 years, Occ : Student All are R/o Narsapuram village of Damaracherla Mandal, Nalgonda District. ............ Respondents/ complainants 1 to 3 Golden Multi Services, represented by its Branch Manager, 1st floor, Sanghamithra Bhavan, Prakasam Bazar Nalgonda - 508 001 ...Respondent/ OP.2 Counsel for the Appellant : Sri N. Mohan Krishna Counsel for the Respondents : Sri V. Narasimha Rao for R1 to R3 M/s. M. Haribabu for R-4. Coram : Honble Sri Justice B. N. Rao Nalla ... President And Sri Patil Vithal Rao ... Member
Monday, the Sixth Day of November Two Thousand Seventeen Oral order : ( per Hon' ble Sri Justice B.N.Rao Nalla, Hon'ble President ) ***
1) This is an appeal filed under Section 15 of the Consumer Protection Act by the first opposite party praying this Commission to set aside the impugned order dated 23.08.2013 made in CC 15/2013 on the file of the DISTRICT FORUM, Nalgonda and allow the appeal.
2) For the sake of convenience, the parties are described as arrayed in the complaint before the District Forum.
3). The case of the complainants, in brief, is that they are the legal heirs of late Chennaboina Venkataiah, who, assured his life with the first opposite party and obtained Group Personal Accident Insurance Policy bearing No. 1503312914000115 for an assured sum of Rs.1,00,000/- through the second opposite party agent of 1st opposite party, by paying a sum of Rs.166/- for the period from 04.06.2011 to 10.06.2012. The insured got injuries by bullock hit while he was trying to catch hold of the escaping bullock and sustained severe injuries on his legs and back side of his head on 16.5.2012. while shifting to Miryalaguda Hospital for treatment he lost his last breath near Guduru Village at 6.00pm on the same day. The claim submitted by the complainant no.1 to the first opposite party through the second opposite party with all relevant documents was repudiated on 30.06.2012 on the ground that animal hit is not covered under the policy, which, amounts to deficiency in service. Hence the complaint to direct the opposite parties 1 and 2 to pay a sum of Rs.1,00,000/- towards the sum assured along with interest @ 12% pa , Rs.50,000/- towards compensation for mental agony and costs of Rs.5,000/-.
4) The first opposite party opposed the above complaint by way of written version while admitting issuance of policy in question and the policy was in force on the date of the death of the deceased and staunchly supported their earlier stand of repudiation on the ground that as per exclusion clause ii (g) of the policy, death due to snake bite, dog bite, insect bite, drowning or animal hit, the insurance company is not liable to pay any amount and hence prayed to dismiss the complaint.
5) The second opposite party argued by way of written version stating that they are the corporate agents of first opposite party, they have forwarded claim papers submitted by the first complainant to the first opposite party immediately on 28.05.2012, there is no deficiency in service on their part and hence prayed to dismiss the complaint against it.
6) During the course of enquiry before the District Forum, in order to prove his case, the complainant filed his evidence affidavit and got marked Ex.A1 to A-7 and the 1st opposite party filed evidence affidavit by reiterating the contents of the written version and also got marked Ex. B1. The second opposite party did not mark any document. Heard both sides.
7) The District Forum, after considering the material available on record, allowed the complaint in part and directed the first opposite party to deposit in the Forum a sum of Rs.1,00,000/- towards the sum assured under the policy in question, Rs.5,000/- towards deficiency in service with interest @ 9% pa from the date of filing of the complaint till realization and costs of Rs.2,000/- within one month, while dismissing the claim against second opposite party.
8) Aggrieved by the said order, the 1st opposite party preferred this appeal before this Commission.
9) Both sides have advanced their arguments reiterating the contents in the appeal grounds, rebuttal thereof. . Counsel for the respondents/complainants 1 to 3 and respondent no. 4 filed written arguments. Heard both sides 10) The points that arise for consideration are, (i) Whether the impugned order as passed by the District Forum suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with, in any manner? (ii) To what relief ? 11). Point No.1 :
There is no dispute that the deceased had obtained Insurance policy in question for an assured sum of Rs.1,00,000/-, he died of injuries sustained due to bullock hit and the policy was in force as on the date of death of the deceased on 16.05.2012 which was supported by Ex.A-4, FIR, Ex.A-5 Inquest report and Ex.A-6 post-mortem report and Ex.A-7 charge sheet.
12) The contention of the appellant/1st opposite party is that the District Forum failed to see that as per " exclusion II (g)" of the policy, death due to snake bite, dog bite, insect bite, drowning or animal hit is not covered under the policy and admittedly the policy holder died of animal hit and hence the claim was rightly repudiated. The District Forum relying on the decision of the Hon'ble Apex Court in 1 (2000) CPJ 1 (SC) between M/s. Modern Insulators Limited Vs. Oriental Insurance Co.Ltd, opined that since the appellant did not supply the terms and conditions and exclusion clauses to the insured while filing proposal form at the time of accepting the premium vide Ex.A-2, held that the insurance company cannot claim benefit of said exclusion clause. Further, the District Forum also relied on the decision of the Hon'ble National Commission in 1 (2006) CPJ 21, wherein, it was held that step down by a cow leading severe injuries to the insured is an accidental death and hence came to the conclusion that there is deficiency in service on the part of the appellant in repudiating the claim and respondents/ complainants are entitled to the sum assured. As the Hon'ble National Commission opined that death due to hit by a cow is an accidental death and since the death in the present case also due to hit by bullock hit, we are of the opinion that the principle laid down by the Hon'ble National Commission is applicable to the facts of the case on hand and hence the respondents/complainants are entitled to the sum assured for an amount of Rs.1,00,000/-.
13) Counsel for respondent no.4 argued that the respondent has acted as facilitator in obtaining the Insurance Policy and it has no role in settlement of the claim of the respondents/complainants, it had forwarded the claim forms submitted by the respondents/complainants to the appellant/1st opposite party and hence there is no deficiency in service on their part. Both the respondents/complainants and the appellant/1st opposite party failed to prove that there is any negligence or deficiency in service on the part of respondent no. 4 and hence the District Forum rightly dismissed the claim against respondent no.4.
14). After considering the foregoing facts and circumstances and also having regard to the contentions raised on behalf of the appellant/1st opposite party and the respondents, this Commission is of the view that there is no infirmity or irregularity in the order passed by the District Forum. There are no merits in the appeal and hence the appeal is liable to be dismissed.
15). Point No. 2 :
In the result, the appeal is dismissed confirming the impugned order dated 23.08.2013 passed by the District Forum, Nalgonda in CC 15 of 2013. There shall be no order as to costs. Time for compliance four weeks.
PRESIDENT MEMBER Dated : 06.11.2017. [HON'BLE MR. JUSTICE B. N. RAO NALLA] PRESIDENT [HON'BLE MR. Sri. PATIL VITHAL RAO] JUDICIAL MEMBER