BEFORE THE TELANGANA STATE CONSUMER DISPUTES REDRESSAL COMMISSION: HYDERABAD.

F.A. No. 562/2018 AGAINST ORDERS IN CC.No.207/2015 ON THE FILE OF DISTRICT CONSUMER COMMISSION,WARANGAL.

Between:

1.The Branch Manager, ICICI Lombard General Insurance Co.Ltd., Office at H.No.5-9-116 & 117, 5-9-121 & 126, Petrol Pump, Vaddiraju Complex, Green Square Plaza, Main Road, Hanamkonda,Warangal.

2. The Regional Manager/Regional Office, ICICI Lombard General Insurance Co.Ltd.

(Claims Section)

Office at ICICI Bank Towers, Plot no.12, Financial Dist.

Nanakramguda, Gachibowli, Hyderabad.

3. The Managing Director , ICICI Lombard House(Claims Section), 414, Veer Savarkar Marg, Near Siddi Vinayak Temple, Prabhadevi, Mumbai – 400 025.

Through Legal Manager, ICIC Lombard General Insurance Co.Ltd., Lumbini Jewel Mall, Banjarahills, Hyderabad. … Appellants/

Opposite parties

1 to 3.

And

1.Sutari Padmasri, W/o.late Balakrishna, Age:45 yrs., Occ:Household.

2. Sutari Nikhil, S/o.late Balakrishna, Age :21 yrs., Occ:Student.

3. Sutari Navya , D/o.Late Balakrishna, Age :19 yrs., Occ:Student.

All are R/o.H.No.2-5-257/T/5, Flat No.405, Saipuja Varadharaja Apt., Nakkalagutta, Hanmakonda, Warangal. …Respondents/

Complainants.

Counsel for the Appellants : Mr.Suri Sravan Kumar.

Counsel for the Respondents : Set exparte.

QUORUM: Hon’ble Sri K.Ranga Rao, Member-(J), &

Hon’ble Smt.R.S.Rajeshree, Member (N-J).

TUESDAY, THE FOURTH DAY OF JUNE, TWO THOUSAND TWENTY FOUR.

Order : (Per Hon’ble Smt.R.S.Rajeshree, Member-Non -

Judicial)

******

01). This appeal is filed u/s.15 of the Consumer Protection Act,1986 by the opposite parties being aggrieved by the order dt.31.8.2018 passed in C.C.No.207/2015 by District Consumer Commission, Warangal wherein the District Commission had passed the following orders:

 “ In the result this complaint is allowed directing the opposite parties jointly and severally liable to deposit in this forum a sum of Rs.5,12,210/-(Rs.Five Lakhs Twelve Thousand Two Hundred and ten only) with interest @ 7.5% p.a. from the date of death i.e. 25-05-2014 till the date or realization and to pay Rs.15,000/-(Rs.Fifteen thousand only) towards damages and to pay Rs.5,000/- (Rs.Five thousand only) towards costs within one month.

The complainants share the claim amount equally.”

02). For the sake of convenience, the parties are described as complainants and opposite parties as arrayed in the original complaint.

03). The case of the complainant is that her husband late Dr.Sutari Balakrsihna during his life time worked as Government doctor in Medical & Health Department and during the course of employment he had obtained an insurance policy from the opposite party under the name and style of “Home Safe Plus-Secure Mind Policy” for a period from 30.12.2011 to 29.12.2016 vide policy bearing no.44065/ICICI-HSP/2217615/00/000, the total sum assured was Rs.5,12,210/- and the premium payable was Rs.23,357/-; that her husband would regularly pay the premiums without any delay and while issuing the policy, the opposite parties have assured that in case of death, the family of the insured would be entitled for the death benefits as per the policy;

that her husband was hale and healthy, but on 25.5.2014 he died due to massive heart attack at Rohini Medicare Pvt. Ltd. Hospital and the doctors of said hospital have issued a certificate stating that Dr.Sutari Balakrishna died due to “aspiration pneumonia sudden cardiac arrest”; that her husband never suffered from any heart disease previously. This was the first and massive heart attack which led to his death; that after the death of her husband, she being the nominee had made a claim before the opposite party seeking the insurance amount, but however, the opposite party repudiated her claim by way of a letter dt.27.8.2014 on false and frivolous grounds. The complainant had made several e-mail messages to the opposite party requesting to pay the insurance amount but the opposite party failed to respond, as such the complainant got issued a legal notice on 7