State Consumer Disputes Redressal Commission
The Divisional Manager New India ... vs Challa Jayamma on 25 March, 2026
1
BEFORE THE TELANGANA STATE CONSUM ER DISPUTES
REDRESSAL COM M ISSION : HYDERABAD.
F.A.No. 106 OF 2024
AGAINST ORDERS IN C.C.12/2022
DISTRICT CONSUM ER COM M ISSION, NALGONDA
Between:
The Divisional Manager,
New India Assurance Company Ltd.,
Prakasham Bazar, Nalgonda Town,
and District- 508001.
...........Appellant/ Opposite Party
And:
Challa Jayamma,
W/o Venkataramanaiah,
Age 57 years, Occupation Housewife,
Yachavaram Village, Munubolu Mandal,
Nellore District-524405
.........Respondent/ Complainant
Counsel for the Appellant/Opposite Party : M/s. D.R.Kulkarni
Counsel for the Respondent/Complainant : Called absent.
HON'BLE SM T. JUSTICE DR.G.RADHA RANI, PRESIDENT
HON'BLE SM T. M EENA RAMANATHAN, M EMBER (NON-JUDICIAL)
HON'BLE SM T R.S. RAJESHREE- M EMBER (NON-JUDICIAL)
W EDNESDAY, THE 25 th DAY OF M ARCH
TW O THOUSAND TW ENTY SIX
*******
Order :
PER HON'BLE SMT. MEENA RAMANATHAN, MEMBER (NON-JUDICIAL)
1.The appeal is filed u/s 41 of Consumer Protection Act, 2019 by the Opposite Party, aggrieved by the order of District Consumer Commission, Nalgonda, dated 24.11.2023 in CC 12/2022, where under, the opposite party is directed to pay to the complainant an amount of Rs.4,25,000/- towards sum assured under Group Personal Accident Policy, Andhra Pradesh Transport Drivers and Non-Transport Drivers Social Security Scheme 2008, with interest @ 2 9% p.a. from the date of registration of the complaint i.e. 19.02.2022 till realization, Rs.10,000/- towards compensation for mental agony and Rs.5,000/- towards costs, within thirty days from the date of receipt of this order".
2. The parties are herein after referred to as they were arrayed before the District Commission, as complainant and opposite party.
3. a) The brief averments of the complaint are that the complainant is the mother and nominee of deceased Challa Rajendra, who was a Member of Andhra Pradesh Transport Drivers and Non-Transport Drivers Social Security Scheme 2008. The Union of India provided a Group Life Insurance for an amount of Rs.75,000/- to each Transport Driver and non-Transport Driver from the Life Insurance Corporation of India, through the Commissioner of Labour, Vijayawada. The Andhra Pradesh State Government has provided a group personal accident insurance scheme to the transport drivers and non-transport drivers from Commissioner of Labour, Vijayawada to the opposite party vide policy No.6104002160100000010, valid for the period 01.05.2016 to 30.04.2017. The opposite party had assured an amount of Rs.4,50,000/- to each transport and non-transport drivers.
b) On 28.07.2016 at about 06:30 p.m., son of the complainant - driver of the tipper bearing No.AP 26 TC 8429, was loading stones when there was heavy rain and was struck by a bolt of thunder and died instantaneously. The police Saidapuram, registered a case and took up the investigation. The complainant, an illiterate woman was in shock and submitted the claim form only on 13.03.2017. The claim was repudiated on the ground that there was delay in intimation.
c) The present complaint is filed for legal remedy against the opposite party stating that a genuine claim cannot be repudiated on the ground of delay in intimation. The opposite party also raised a plea before the Insurance Ombudsman that the deceased was not on the list with the Commissioner of Labour. The complainant has also 3 contended that LIC of India has settled the claim of Rs.75,000/- to the complainant but the opposite party has acted negligently and failed to settle the claim. The present complaint is raised claiming the entitled amount along with compensation and costs.
4. The opposite party filed their written version and it is denied that the deceased Challa Rajendra, was a member of Andhra Pradesh Transport Drivers and Non-Transport Drivers Social Security Scheme 2008, provided by the Union of India from Group Life Insurance Company for an amount of Rs.75,000/- to each Transport Driver and non-Transport Driver through the Commissioner of Labour, Vijayawada. It is also denied that the Government of Andhra Pradesh provided a group personal accident insurance scheme to the transport drivers and non-transport drivers for a sum of Rs.4.50 lakh through the Commissioner of Labour, Vijayawada. This opposite party does not admit that the deceased was the driver of the tipper bearing No.AP26TC8429 and died while loading stones at Saidapuram while it was raining heavily. No concerned documents were furnished to this opposite party and the delay in intimation of claim is abnormal. The collection of premium for GPA and forwarding is the responsibility of the Commissioner of Labour, Vijayawada and as such is a necessary party to the complaint. With the above submissions, they seek dismissal of the complaint with costs.
5. Before the Commission below, complainant filed evidence affidavit as PW1 and marked Ex. A1 & A2. One Smt.P.Padmaja, Deputy Manager of opposite party filed evidence affidavit as DW1 and got marked Ex.B1 & B2. Opposite Party has filed their written arguments.
6. Aggrieved by the above orders, the Opposite Party preferred this appeal contending that the Commission below failed to consider 4 the following grounds:
The Commission below erred in having considered Ex.A1 as repudiation. It ought to have seen that under Ex.A1 the claim was not entertained on the point of delay of 07 months in submitting claim.
The Commission below failed to see and appreciate that the deceased Challa Rajendra did not register his name with the Registering Authority (The Commissioner of Labour) as contemplated under Clause vi of the Ex.B1 consequently the deceased Challa Rajendra was not beneficiary under the policy No.610400421600000010 issued by the Appellant Insurance Company herein to Government of Andhra Pradesh, which was reiterated in Ex.A2 in Para 18(b) of the order dated 17.05.2019 of the Insurance Ombudsman.
The Commission below ought to have seen that the total registered transport drivers in unrecognized sector registered with Registering Authority (the Commissioner of labour) are 4.50 lakh and Challa Rajendra's name is not within the 4.50 lakh beneficiaries.
With these grounds and others that will be urged at the time of arguments, requested to set aside the order of the Commission below and to dismiss the complaint.
7. On 02.03.2026 heard the counsel for the appellant. There was no representation for respondent since the service of notice on 06.05.2024, hence the matter was reserved for orders.
8. The point that arises for consideration is whether the impugned order as passed by the District Commission suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with in any manner ? To what relief ?
9. POINT : The case of the complainant is that she is the mother and nominee of her deceased son Sri Challa Rajendra, who was a member of Andhra Pradesh Transport Drivers and Non-Transport Drivers Social Security Scheme 2008. The Union of India provided a Group Life Insurance for an amount of Rs.75,000/- to each 5 Transport Driver and non-Transport Driver through the Commissioner of Labour, Vijayawada and so also the Government of Andhra Pradesh provided a group personal accident insurance scheme to the transport drivers and non-transport drivers for a sum of Rs.4.50 lakh through the Commissioner of Labour, Vijayawada. Her son she claims is the driver of tipper bearing No.AP 26 TC 8429 and died on 28.07.2016.
10. The police Saidapuram registered a case in Cr. No.68/2016, u/s 174 of Cr.P.C. and took up the investigation. The complainant was in shock and could only submit her claim on 13.03.2017 along with relevant documents for claiming the group personal accident policy amount of Rs.4,25,000/-. After a gap of 01 year, the opposite party sent the letter of repudiation to the complainant and a copy to the Commissioner of Labour, Vijayawada - i.e. on 16.03.2018. The complainant approached the Insurance Ombudsman and her complaint was dismissed.
11. The complainant approached the District Commission for remedy and is relying on Ex.A1 - the letter dated 16.03.2018 - addressed by the opposite party to the Commissioner of Labour, Vijayawada. This is a letter regarding the AP Drivers claims list. They have stated that a list of claims are as per Memorandum of Understanding (MOU) and another list of claims which were not received within 03 months and the remaining list they are unable to process as it is not in their purview.
12. In the list that is attached, the name of the deceased Challa Rajendra is at Sl.No.26 and the claim is not payable because it was submitted with a delay of 07 months.
The proceedings before the Insurance Ombudsman is filed vide Ex.A2. The facts that emerge are that the deceased was covered under the group personal accident policy vide No. 610400421600000010, for the policy period 01.05.2016 to 30.04.2017 and the policy holder is M/s Commissioner of Labour, Department, Govt. of Andhra Pradesh.
613. The Ombudsman's order states that the opposite party erroneously listed the instant claim under delay in submission of claim documents, as there was a delay of 220 days but on further scrutiny of the list provided by the labour Commissioner, it was observed that the deceased had not registered himself with the labour Commissioner by paying the requisite fee for enrolment of his name under the policy. As his name was not appearing in the list provided by the insured, the claim was not admissible, apart from the delay grounds already taken by them.
14. To substantiate their defense, the opposite party has not filed the list of names as provided by the insured/Commissioner of Labour. As per Ex.B2 - Annexure I - the number of persons covered under this Group policy are 3,38,000 in the age group of 18-60 years. As per Ex.B1 - the MOU between the Government of Andhra Pradesh and the Insurance Company/opposite party - the beneficiaries have to submit an application as specified and furnish particulars like Aadhar Card, Phone Number and Bank Account. The total premium for 3.38 lakh transport drivers is Rs.2,58,24,822/-.
15. The policy is a social security measure, primarily to provide financial cover to the drivers in the unorganized se ctor. They are often the sole bread winners and the scheme is laudable as these transport drivers are exposed to continuous risks. The opposite party has repudiated the claim stating that the name of the deceased did not figure in the list of insured as provided by the Commissioner of Labour. Thus, having defended themselves they have failed to provide the list nor have they supported their contentions by filing a letter attested by the Commissioner of Labor that the deceased was not one among these 3.38 lakh transport drivers. The evidence affidavit of opposite party as DW1 discloses that the nominee of the deceased did not file any document to show that she is the nominee of the deceased and that the deceased was a member of the Non- Transport Auto Drivers Social Security Scheme. If that is the case, then the name of the deceased should not be reflected in the list of claims that were denied for delay in submission.
716. The opposite party is holding the details of names of drivers as the insured master policy holder/Commissioner of Labour provided them with the list. We seek to emphasize this by reproducing the relevant portion from the proceedings before the Ombudsman :-
" ................ But on further scrutiny of the list provided by the Labour Commissioner and also the claim forms submitted by the claimant it was observed that the deceased had not registered his name with labour Commissioner by paying required fee for enrolment of his name under the policy. His name was not appearing in the list provided by the insured.............".
17. The other reason for repudiating the claim is that there was delay of 07 months in submission. We refer to clause 14 of the MOU
- Ex.B1 :-
14. CLAIMS INTIMATION :
"Intimation of death of the beneficiary to be given immediately or within 90 days from the date of occurrence/incident. Delay may be condoned for sufficient reasons".
18. The nominee/mother of the deceased has pleaded that she was in shock after the death of her son and took some time to submit her claim. When the entire policy is meant to provide sustenance to the family, denying a genuine claim for the delay in submission is extremely unjust and unfair. Moreover, the Police Saidapuram registered a case in Crime Number Cr. No.68/2016, u/s 174 of Cr.P.C., and took up the investigation. Based on IRDAI guidelines, an Insurance Company cannot deny a claim solely for delay in intimation especially if a police case was registered promptly and the claim is otherwise genuine. The policy ultimately is a social security scheme and requires a liberal construction to protect the Consumer. The grounds urged have been dealt with in detail and we find no reason to interfere with the impugned order.
19. In the result, the appeal is dismissed without costs by confirming the impugned order, dated 24.11.2023 in CC 12/2022 passed by the District Consumer Commission, Nalgonda.
8The Respondent/Complainant is at liberty to withdraw the amount deposited by appellant/Opposite Party to the credit of this appeal along with accrued interest thereon, towards part satisfaction of the decretal amount after the lapse of appeal time.
Typed to my dictation by Stenographer on the System; corrected by me and pronounced by us in the Open Court on this the 25th day of March' 2026.
Sd/- Sd/- Sd/-
PRESIDENT M EM BER-NJ M EM BER-NJ
Dt: 25.03.2026
AD*