PULIVARTHI SAMBRAJYAM Vs. UNITED INDIA INSURANCE COMPANY LTD

JUDGEMENT

(1.) Aggrieved by the order in C.D.No.239/2004 on the file of District Forum, Guntur, the complainant preferred this appeal.

(2.) The brief facts as set out in the complaint are that the complainants husband during his life time insured his life with the opposite party under Janata Personal Accident Insurance Policy bearing No.150800/47/51/00187/97 by paying an amount of Rs.1250 under receipt No.17-11-1997 for a sum of Rs.5,00,000/- covering the risk for the period from 17-11-1997 to 16-11-2007. The complainant submitted that her husband died on 18-12-1999 due to fire accident on 06-12-1999 at mid night. The dying declaration of the insured was noted by the Magistrate and the Arundelpet P.S. has registered a case under Section 174 of Cr.P.C. The death of the insured was informed to the opposite party by the complainant in the month of January, 2000 personally as well as in writing and submitted all the required documents. It is the case of the complainant that the opposite party repudiated her claim without any grounds and therefore she filed a complaint before Insurance Ombudsman but the said Ombudsman by letter dated 17-3-2001 directed the complainant to make a representation to the Regional Office of the opposite party. Accordingly the complainant made a representation vide letter dated 12-4-2003 and 25-8-2003 to the Regional office but they did not take any steps to settle the claim. The complainant further submitted that the Ombudsman also sent another letter dated 5-1-2004 stating that the complainant applied for settlement of claim after a lapse of one year and five months. Thereafter also the complainant requested the opposite party to settle the claim but in vain. Hence the complainant approached the District Forum for a direction to the opposite party to pay Rs.5,00,000/- with interest and also Rs.20,000/- towards damages.

(3.) Opposite party filed written version stating that it had carefully verified the papers sent by the complainant by registered post along with letter dated 15-10-2001. The F.I.R. and the dying declaration revealed that the insured, P.Prasad, lit a match box to light a cigarette in the house than the kerosene stove on the almirah fell on him and that kerosene slipped on his body on 6-12-1999 resulting in burn injuries and subsequent death on 18-12-2009. They immediately sent a letter dated 19-10-2001 to the complainant stating that there was no accident caused by any outward violent and visible means and the accident appears to be an intentional self injury and the reason given for the injury is unbelievable and not convincing. Therefore they repudiated the claim of the complainant as per the terms and conditions of the policy by letter dated 19-10-2001. They further submitted that the complaint was filed in the year 2004 and hence barred by limitation and prayed for dismissal of the complaint.