BEFORE THE TELANGANA STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD.

F.A.No.144 OF 2020 AGAINST ORDERS IN C.C.34/2017, DATED 18.12.2019 DISTRICT CONSUMER COMMISSION, NALGONDA Between:

1. Smt. Govinda Rajula Radha Kumari, W/o Govinda Rajula Venkata Shobhan Chalapathi Rao, Aged about 53 years, Occ.: Housewife.

2. Govinda Rajula Venkata Sai Sree Keerthi, Govinda Rajula Venkata Shobhan Chalapathi Rao, Aged about 24 years, Occ.: Student, Both are R/o Srinagar Colony, Nalgonda Town, Nalgonda.

…….Appellants/Complainants And:

The United India Insurance Company Limited, Miryalaguda Branch, Miryalaguda Town, Nalgonda District-508 207, Rep. by its Branch Manager.

……..Respondent/Opposite Party Counsel for the Appellants/Complainants : M/s V.Gouri Sankara Rao.

Counsel for the Respondent /Opposite Party :

Sri Ramachandrareddy Gadi QUORUM :

HON’BLE SMT. MEENA RAMANATHAN, I/c PRESIDENT &

HON’BLE SRI. V.V.SESHUBABU, MEMBER – (JUDICIAL)

TUESDAY, THE 12th D AY OF NOVEMBER TWO THOUSAND TWENTY FOUR **********

Order : (PER HON’BLE SRI. V.V.SESHUBABU, MEMBER – JUDICIAL)

1. The appeal is filed u/s 15 of the Consumer Protection Act, 1986 by the unsuccessful complainants against the order dated 18.12.2019 in CC.No.34/2017 by the District Consumer Disputes Redressal Commission, Nalgonda, where under the complaint was dismissed without costs.

2. The brief averments of the complaint in CC 34/2017 are that the deceased GVS Chalapathi Rao, who is the husband of the complainant No.1 and the father of complainant No.2, obtained a policy, bearing No.0514024215P116228145 from the opposite party for a Personal Accidental which was valid from 28.03.2016 to 27.03.2017 for a sum of Rs.5,00,000/-; that the complainants are the nominees; that the insured died on 30.06.2016 in Rohini Super Speciality Hospitals, due to sudden heart attack, while he was being taken to the operation theatre for the purpose of Spinal Fusion Procedure operation at 08:00 A.M.; that the claim was submitted with the opposite party on 01.06.2017, basing on the Hon’ble National Consumer Disputes Redressal Commission, reported in CPJ 2007(4) NC 335; that the complainants got issued a legal notice on 20.07.2017 for the repudiation of claim; that despite receiving the same, the claim was not honoured; that sudden heart attach comes within four corners of an accidental death; hence, the complaint.

3. The brief averments of the written version of Opposite Party are that the scope of policy is death due to accident and an accident means “a sudden unforeseen and involuntary event caused by the external, visible and violent means”. It shows the policy does not cover “death due to mere heart attack”; that the insured admittedly died due to mere heart attack; that the order of the Honble National Consumer Disputes Redressal Commission, reported in CPJ 2007 (4) NC 335, is not applicable to the facts of the case, in view of the several case laws of the Hon’ble Supreme Court, reported in 2016 (3) SCC 49. With this requested to dismiss the complaint with costs.

4. Before the Commission below, complainant No.1, filed evidence affidavit as PW1 and marked Ex. A1 to A20. One Sri L.Amar Singh, Branch Manager of Opposite Party, filed evidence affidavit as RW1 and got marked Ex.B1 to B3.

5. The Commission below, settled the following points for discussion viz..:

 Whether there is any deficiency in service on the part of Opposite Party ?

 Whether complainants are entitled for the claims, they made in their complaint?

 If so, to what extent?

6. Having heard the contesting parties, the Commission below dismissed the complaint. Aggrieved by the same, the present appeal is filed by the complainants with the following grounds:

 The order of the Commission below is contrary to law, weight of evidence and probabilities of the case.

 The Commission below ought to have allowed the complaint as insured died due to sudden heart attack, which comes under the terms and conditions of the policy.

 The Commission below failed to observe E