State Consumer Disputes Redressal Commission
Sahara India, Tagarapu Valas And One ... vs 01. Smt.Danthuluri Gayatri Devi,, ... on 16 October, 2012
A. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION : AT HYDERABAD FA 499/2011 against CC 302/2008 on the file of the District Consumer Forum II, Visakhapatnam. Between : 01. The Branch Manager, Sahara India Tagarapuvalasa branch Visakhapatnam District. 02. The Incharge Higher Authority, Sahara India, Commercial Corporation Ltd Command Office, Sahara India Bhavan-1, Kapurthala complex, Lucknow 226 024 .. Appellants/Ops 1 and 2 And 01. Smt.Danthuluri Gayatri Devi, W/o Late Danthuluri Jagannadha Raju Hindu, aged 53 years, Residing at Rajulatallavalasa village Chittivalasa, Bheemunipatnam mandal Visakhapatnam Village .. Respondent/complainant 02. The National Insurance Company ltd D.O-4, Jeevan Bhavan Phase -1,43, Hazarath Gunj Lucknow - Respondent/OP.3 Counsel for the Appellants : M/s. C. R. Vasantha Kumar Counsel for the Respondents : Ms. P. Shakunthala Devi for R-1 M/s. M. Ramgopal Reddy for R-2 FA 193/2012 against CC 302/2008 on the file of the District Consumer Forum II, Visakhapatnam. Between : 01. Smt.Danthuluri Gayatri Devi, W/o Late Danthuluri Jagannadha Raju Hindu, aged 53 years, Residing at Rajulatallavalasa village Chittivalasa, Bheemunipatnam mandal Visakhapatnam Village .. Appellant /complainant And 01. The Branch Manager, Sahara India Tagarapuvalasa branch Visakhapatnam District. .. 02. The Incharge Higher Authority, Sahara India, Commercial Corporation Ltd Command Office, Sahara India Bhavan-1, Kapurthala complex, Lucknow 226 024 Respondents/Ops 1 and 2 03. The National Insurance Company ltd D.O-4, Jeevan Bhavan Phase -1,43, Hazarath Gunj Lucknow - Respondent/OP.3 Counsel for the Appellants : Ms. P. Shakunthala Devi Counsel for the Respondents : M/s. K. Kalpana for R1 & R2 M/s. M. Ramgopal Reddy for R-3 Coram ; Sri R. Lakshminarasimha Rao Honble Member
And Sri T. Ashok Kumar .. Honble Member Tuesday, the Sixteenth Day of October Two Thousand Twelve Oral Order : ( As per Sri T. Ashok Kumar , Honble Member ) ****
01. The appeal and cross appeal are filed by the opposite parties and the complainant respectively assailing the order of the District Forum in C.C.302/2008 dt.31.3.2011. For convenience sake the parties as arrayed in the complaint are referred to here under : Since both the appeals arising out of same order, we intended to dispose of the same by common order.
02. The gist of the complaint is that one D.Janardhan Raju husband of the complainant joined in the scheme in the name and style Sahara Swarna Yozana floated by the opposite parties 1&2. The duration of the said scheme for 10 years. He paid total scheme amount of Rs.1,40,00/- on 15.12.2003 and the opposite parties 1&2 Provided printed documents containing terms and conditions,procedurial aspects etc. The complainant was nominated by her husband for the purpose of the said scheme. As per the terms of clause 18 of the Scheme in the event of accidental death after one year up to two years the opposite parties offered Rs.2.00 lakhs insurance benefit. While the things thus stood on 19.3.2005 the said Janardhan raju died in road accident and consequent to his death she made claim for maturity benefit and the accidental death benefit to the opposite parties 1 & 2 but they paid only maturity and did not pay the accidental benefit. As her husband died within two years of the scheme the complainant is entitled for the accidental benefit of Rs.2.00 lakhs and the opposite parties did not pay the same in spite of request and legal notice dt.18.1.2007 and they gave a reply dt.08.3.2007 with untenable grounds. Hence the complaint claiming Rs.2.00 lakhs towards accidental death benefit with 24% interest, Rs.1.00 lakh towards damages/compensation and costs of Rs.10,000/-.
03. The opposite parties 1&2 resisted the claim of the complainant denying the allegations made ion the complaint and contended that D.Janardhan Raju invested Rs.1,40,000/- under the Sylver Year Labh Yozna through the control number 22839201047 on 15.12.2003 nominating his wife as nominee under the said scheme. agreeing to abide by the said terms and conditions of the scheme. As per the terms there is an insurance coverage (5-65) age holders of the investor in case of accidental death benefit in addition to death benefit/maturity under the scheme and that the accidental insurance amount vary depending upon the joining period of the account holder in the scheme and that in case of the accidental death the nominee/holder has to make the claim as per the terms of the investment scheme as well as insurance policy. The insurance policy was obtained by the opposite parties 1&2 for the benefit of its employees agents and investors without collecting any consideration and therefore the complainant does not come under the definition of the consumer and as such the complaint is liable to be dismissed. The complaint is also barred by limitation as the accidental death of the husband of the complainant was on 19.3.2005 and was the complaint filed on 09-6-2008. As per the terms and conditions of the scheme for the insurance amount the claimant has to inform the death and make claim to opposite parties 1&2 and in turn they forward the same to insurance company for settlement as only facilitator and it is the insurance company (O.P.3) to settle the claim.
The claimant did not make the insurance claim after the death of her husband but made claim made for death maturity benefits and the same was paid even though the deceased suppressed his correct date of birth. On receipt of the notice from the complainant the same was informed to the O.P.No.3 insurance company and it repudiated the claim. There are no merits in the claim and thus prayed dismiss the complaint.
04 .O.P.No.3resisted the complaint by filing its written version denying the allegations made in the complaint and contended that it has issued the policy covering their depositors and the claim for the death of Janardhan Raju has been repudiated as the death intimation was received after 12 months which is in violation of the policy conditions. The said Janardhan Raju died on 19.3.2005 but intimation was received by the opposite parties 1&2 on 08.07.2008 and therefore rightly it repudiated the claim and that the complainant unnecessarily impleaded the opposite party No.3 and thus prayed to dismiss the complaint against it.
05. Both sides filed evidence affidavit re-iterating their respective contentions. Ex.A.1 to A.6 and B.1 to B.7were marked.
06. Having heard both side and considering the material on record the district forum allowed the complaint vide impugned orders directing the opposite parties 1&2 to pay Rs.2,00,000/- to the complainant together with costs of Rs.3,000/- giving one month time for comp0liance and the case against the opposite party No.3 was dismissed without costs.
07. Aggrieved with the said orders the opposite parties 1&2 filed fa 499/2011 and mainly contended that the complainant has simply informed about the death of investor only in the august 2005 and made claim for maturity amount and that the opposite parties 1&2 released death maturity amount along with the credit value and that did not make any claim for such accidental death benefit within 30 days from the date of the death and therefore the opposite parties 1&2 did not forward the insurance claim to the opposite party No.3. the complainant is not a consumer within the meaning of the Act and that the role of the opposite parties 1&2 Only that of a facilitator and liability of accidental claim if any lies with opposite partyNo.3. The opposite parties 1&2 deposited premium without charging any fee or consideration from the depositor and that the district forum did not consider the case of the opposite parties 1&2 in a right manner and arrived at wrong conclusion in directing the opposite parties 1&2 to pay Rs.2.00 lakhs as accidental death benefit and costs of Rs.3,000/-.
08. The complainant filed F.A. 193/2012 and contended that the forum awarded meager compensation and costs for the mental agony and costs and that erred in not awarding the interest and compensation and thus prayed to allow the appeal and enhance the compensation and costs as prayed for int the complaint and also award interest from the date of repudiation till payment.
09. Heard both sides with respect to their both side contentions.
10. Therefore, the point for consideration is whether the order of the district forum is vitiated either in facts on in law?:-
11. There is no dispute that the opposite parties 1&2 that D.Janaradhan Raju husband of the complainant joined in a scheme Sahara Swarna Yozana and that the said scheme was for 10 years and that the said investor paid Rs.1,40,000/- to opposite parties on 15.12.2003 and that as per the terms of the scheme in the event of accidental death after one year up to two years Rs.2.00 lakhs was offered towards insurance benefit and that on 19.3.2005 the said investor died in road accident and that as the complainant is the nominee of the deceased for the purpose of the said scheme. There is no dispute that after the death of the investor the complainant claimed the death maturity benefit and that the opposite parties 1&2 paid the same.
The contentions of the opposite parties as per the terms of the said scheme vide Ex.B.5 within 30 days of the death of the investor the nominee has to report about the death of the investor and put forth insurance claims and in the instant case the complainant did not do so. There is no dependable evidence from the complainants side that it was so claimed within the stipulated time. When she could claim the death maturity benefit she ought to have claimed the accidental death benefit claims of Rs.2.00 lakhs but she did not do so. The opposite parties `1&2 cited decision reported in 2012N.C.J1997(N.C) of National Commission between Ankhit Goel Vs Mew India Assurance Company. Where in it was held that the insurance claim can only be allowed within the terms of the insurance policy. In another decision reported in 2010 N.C.J 896 N.C between united India Insurance Company Ltd Vs M/S Sona Spices Pvt.Ltd., it was held that the terms and conditions of the insurance policy has to be construed with reference only to its stipulation contane3d in it and no artificial meaning can be given to the words appearing therein. In another decision reported 2012 N.C.J552(N.C) between M/S Aerolex india Pvt.Ltd.,Vs New India Assurance Company Ltd., it was held that the complainant is duty bound to inform the insurer regarding the incident. All the said decisions support s the case of the opposite parties to say that the complainant did not comply with the terms and conditions of the scheme and consequently he is not entitled for the said accidental death benefits from the opposite parties 1&2. Very specifically the opposite parties 1&2 pleaded in their written version that copy of the policy was given to the account holder at the time of opening and that the terms and conditions was fully explained to the nominee/complainant. The said aspect has been deposed in the evidence affidavit of the representative of the O.P.s 1&2 and the said accept has not been controverted by the complainant by filing re-joinder or additional affidavit and in such circumstances it has to be held that the complainant had knowledge about the terms and conditions of the policy, but she did not comply with the said terms in informing to the opposite parties about the said death within the stipulated time and also failed to put forth claim for such accidental death benefits for it she has to reap the consequences.
There is no dependable evidence from the complainant that the opposite parties 1&2 have charged the amount from the deceased for the coverage of the said insurance and there is acceptable force in the contention of the opposite parties 1&2 that they are only facilitators. According to the opposite parties it was only additional benefit provided to depositor on free of costs for which no liability can be raised against the opposite parties 1&2. It is a service rendered free of cost and therefore exempted and 2(o) of the C.P.Act. As rightly contended by the opposite parties they have no control in decision making i.e to accept the claim or to reject the same. Since the investor died on 19.3.2005 and the intimation was received by the opposite party no. 3 on 08.07.2008 the opposite party No.3 is also justified in repudiating the claim.
12. In view of the above discussion we are satisfied to hold that the order of the district forum against the opposite parties 1&2 not sustainable and therefore F.A.499/2011 filed by the opposite partiers is liable to be allowed setting aside the order of the district forum passed against the opposite parties 1&2. Consequently, the F.A.No 193/2012 filed the complainant is liable to be dismissed.
13. In the result, F.A.ANo.499/2011 is allowed setting aside the orders of the district forum passed against the opposite parties 1&2 without costs and thus the complaint filed by the complainant stands dismissed in total.
Consequently, F.A.No.193/2012 filed by the complainant is dismissed without costs.
MEMBER MEMBER DT.16-10-2012