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Thread: Life Insurance Corporation of India, Udaipur

  1. #1
    Sidhant's Avatar
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    Default Life Insurance Corporation of India, Udaipur

    APPEAL NO: 1325/2008


    1. Br. Manager,

    Life Insurance Corporation of India,

    Br.office, Banswara.

    2. Sr. Divisional Manager

    Life Insurance Corporation of India,

    Udaipur.


    through

    Manager ( Legal ) LIC of India,

    Divisional Office,

    Jeevan Prakash, Bhawani Singh Road,

    Jaipur .

    Opposite parties -appellants

    Vs.


    Smt. Rama w/o Lt. Shankar Lal Kumhar

    2-1-1, Housing Board,

    Banswara. Complainant-respondent


    Date of judgment 15.7.09


    Before:


    Mr.Justice Sunil Kumar Garg- President

    Mrs.Vimla Sethia-Member


    Mr.Ram Kalyan Sharma counsel for the appellants

    Mr. Hari Om counsel for the respondent

    JUDGMENT

    BY THE STATE COMMISSION, (PER HON. MR.JUSTICE SUNIL KUMAR GARG, PRESIDENT

    2


    This appeal has been filed by the appellants LIC against order dated 11.6.08 passed by the District Forum, Banswara in complaint no. 30/2007 by which the complaint of the complainant was allowed in the manner that the appellants were directed to pay within 60 days a sum of Rs. 50,000/- the amount of the LIC policy bearing no. 183605090 alongwith interest @ 6% p.a. from the date of filing of the complaint till the payment is made and if the payment was not made within 60 days, the rate of interest would be charged @ 9% p.a. and further to pay a sum of Rs. 2000/- as compensation for mental agony.


    2. It arises in the following circumstances-

    That the complainant respondent had filed a complaint before the District Forum, Banswara on 6.9.07 inter alia stating that her husband Shankar Lal, now deceased had taken a Life Insurance Policy for a sum of Rs. 50,000/- from the appellants bearing policy no. 183605090 and the date of commencement of the policy was 28.10.05 and the premium of Rs. 600/- was to be paid on quarterly basis. It was further stated in the complaint that the deceased had met with an accident on 22.5.07 and the complainant respondent was also with him and she had also received injuries and because of the injuries received in that accident the deceased had died on 5.6.07 and after the death of the deceased claim was preferred by the complainant respondent being the wife and nominee of the deceased before the office of the appellants but that claim was repudiated by the appellants through letter dated 16.8.07 on the ground that since the deceased had died on 5.6.07 and the date for payment of the quarterly premium

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    was 28.4.07 and if the grace period was allowed, the premium could be paid upto 28.5.07 and since the premium was not paid upto 28.5.07 , therefore on the date of death of he deceased i.e. 5.6.07 the policy was in a lapsed condition. It was further stated in the complaint that the complainant respondent had deposited a sum of Rs. 616/- the amount of the premium for the month of January 2007 on 26.5.07 and she also intended to deposit the next instalment before the office of the appellants but the same was not accepted by the appellants and since the deceased had died on 5.6.07, therefore, no fault could be attributed on the part of the complainant for making payment of the premium of second quarter and hence appellants have wrongly repudiated the claim of the complainant respondent through letter dated 16.8.07 and thereafter the present complaint was filed by the complainant.


    A reply was filed by the appellants before the District Forum, Banswara on 6.11.07 and in the reply they have taken the same pleas which were taken by them in the repudiation letter dated 16.8.07. It was further stated in the reply that since the second quarterly premium was due on 28.4.07 and the grace period was upto 28.5.07 and since no payment of premium was made before death of the deceased , therefore, the policy was in a lapsed condition on the date of death of the deceased i.e. 5.6.07 and it was prayed that claim was rightly repudiated by the appellants through letter dated 16.8.07 and it was prayed that complaint be dismissed.


    After hearing both the parties the District Forum,

    4


    Banswara through impugned order dated 11.6.08 had allowed the complaint inter alia holding that -



    (i) That the date for payment of the premium for second quarter no woubt was 28.4.07 and if grace period was allowed, the date of payment of the premium could be 28.5.07 but before that the since complainant and deceased both had met with an accident on 22.5.07 and because of sustaining injuries later on the deceased had died on 5.6.07 and he was also hospitalized therefore, in above circumstances if the premium was not paid, therefore, some sympathetic attitude should be taken and the policy could not be treated as lapsed one and thus it was held that on the date of death of the deceased i.e. 5.6.07 the policy was not in a lapsed condition.


    (ii) That the appellants were not justified in repudiating the claim of the complainant respondent and it had amounted to deficiency in service on the part of the appellants.


    Aggrieved from that order dated 11.6.08 passed by the District Forum, Banswara , this appeal has been filed by the appellants.


    3. In this appeal the main contention of the learned counsel for the appellants is that the premium which had become due on 28.4.07 was not deposited by the deceased even upto the grace period of one month i.e. 28.5.07 therefore, on the date of

    5


    death i.e. 5.6.07, the policy was in a lapsed condition and thus on that ground the claim of the complainant respondent was rightly repudiated by the appellants through letter dated 16.8.07 and the District Forum had committed serious error and illegality in decreeing the claim of the complainant respondent. Hence the impugned order could not be sustained and liable to be quashed and set aside and this appeal deserves to be allowed.


    4. On the other hand, the learned counsel appearing for the respondent has supported the impugned order of the District Forum .


    5. We have heard the learned counsel for the appellants as well as for the respondent and gone through the entire materials available on record.


    6. There is no dispute on the point that the deceased had taken

    a Life Insurance Policy for a sum of Rs. 50,000/- from the appellants bearing policy no. 183605090 and the date of commencement of the policy was 28.10.05 and the premium of Rs. 600/- was to be paid on quarterly basis.


    7. There is also no dispute on the point that deceased alongwith his wife had met with an accident on 22.5.07 and had died on 5.6.07 meaning thereby within two years of the sissuance of the policy.


    8. There is no dispute on the point that the claim of the above mentioned policy was repudiated by the appellants through letter dated 16.8.07 on the grounds mentioned therein.


    6


    9. There is no dispute on the point that the premium of second quarter was due on 28.4.07 and the grace period was upto 28.5.07, even then that was not paid by the deceased during his life time and since he had died on 5.6.07 and therefore, upto the date of death of the deceased the premium for the second quarter was not paid by the deceased or on his behalf.


    9. Thus, in the facts and circumstances just narrated above, the question for consideration is whether the repudiation of the claim of the complainant respondent by the appellants could be justified or not or whether the findings of the District Forum by which the

    claim of the complainant was decreed could be sustained or not.


    10. In our considered opinion the argument of the learned counsel for the appellants that on the date of death the policy was in a lapsed condition appears to be correct one as on the date of death i.e. 5.6.07, the premium for the month of April 2004 was not paid by the deceased upto 28.5.07 i.e. within grace period and thus, on the date of death of the deceased the policy was in a lapsed condition.


    11. It may be stated here that no doubt in this case the deceased had met with an accident on 22.5.07 and was hospitalized and ultimately he had died on 5.6.07 but that would not be a ground to treat the policy alive which had lapsed because of non-payment of the premium.


    12. The Hon'ble Supreme Court in the case of Life Insurance Corporation of India Vs. Mani Ram reported in III ( 2005) CPJ 31 (SC) has held that if the premium is not paid within grace period of one month, the policy would lapse and no exception could be

    7


    taken against that decision and further it is held that if the premium is not paid before expiry of the grace period, the policy had become lapsed one and when this being the position, in the present case on the date of death of the deceased i.e. 5.6.07 the policy was in a lapsed condition.


    13. For the reasons stated above, it is held that repudiation of claim of complainant respondent by the appellants through letter dated 16.8.07 on ground of lapsed policy was justified and no illegality or irregularity has been committed by the appellants in repudiating the claim of complainant respondent and in view of this, the findings of the District Forum decreeing the claim of the complainant respondent could not be sustained and the same are liable to quashed and set aside as they are wholly illegal, erroneous and perverse one and the appeal deserves to be allowed.


    14. During the course of arguments the learned counsel for the respondent has stated that in case the appeal of the appellants is going to be allowed, in such circumstances some amount of compensation as ex-gratia be allowed to the complainant respondent who is a widow and poor lady.


    On ex-gratia payment


    15. Ex-gratia payments are made as an act of grace, if the damage caused is outside the scope of the policy terms, or the liability under the policy is doubtful. In such cases the payment is made as an act of grace on humanitarian grounds. As a matter of fact, the loss or damage is outside the terms of the policy but the insurer takes a lenient view on humanitarian grounds. In such

    8


    cases, full amount to indemnify the damages is not made. Such payments do not place the insurer under an obligation to make such payments in similar circumstances in future.


    16. Further ex-gratia payment of claim would arise where there was no legal liability on the Life Insurance Corporation to make payment as in the case of repudiated claim or unconcluded contract. Such claims are paid to mitigate hardship to the claimants by way of equitable relief. The analysis, particularly of a repudiated claim for consideration of an ex-gratia payment, would be a skilful exercise on the part of the concerned officers of the opponent Life Insurance Corporation of India. Ex-gratia payment cannot be claimed as a matter of right. For that the law laid down by the Hon'ble National Commission in the case of LIC Vs. Shashi Gupta ( 1994) 2 CPR 622 (NC) ) may be referred to.


    17. Further the word 'ex-gratia' payment itself means a payment which is voluntarily and charitable in nature and since the C.P.Act,1986 is based on the principle of equity, therefore, hypertechnicalities could be ignored and equitable consideration should be kept in mind while deciding the matter.


    18. However, looking to the entire facts and circumstances of the case and looking to the fact the LIC policy was for a sum of Rs.50,000/- and looking to the fact that the complainant respondent is not only a widow lady but her husband had died in an accident and that death was a disaster one and because of the accident the deceased was not in a position to make the payment of the premium which had become due on 28.4.07 as he was hospatilized , therefore, in such circumstances and on humanitarian consideration, this Commission thinks it just and

    9


    proper to award ex-gratia amount of Rs.20,000/- in lumpsum to the complainant respondent.


    19. It is further made clear that ex-gratia payment to the tune of Rs.20,000/- in lumpsum is being given to the complainant respondent who is a widow, not as a matter of right but taken into consideration the facts and circumstances that the condition of a widow in India is not good and in the present case the complainant respondent is a widow lady.


    20. In view of the discussions made above, this appeal filed by the appellants is allowed and the impugned order dated 11.6.08 passed by the District Forum, Banswara is quashed and set aside and the complaint of the complainant respondent is dismissed. However, the appellants LIC would pay a sum of Rs.20,000/- in lumpsum as ex-gratia payment to the complainant respondent . It is further made clear that while preferring this appeal the appellants had deposited a sum of Rs. 25,000/- before the District Forum, Banswara and thus the District Forum, Banswara is directed to pay a sum of Rs. 20,000/- out of the amount deposited by the appellants to the complainant respondent and rest amount be returned to the appellants LIC.



    Member President

  2. #2
    ranveer menaria Guest

    Exclamation pament of s benifit due on29/4/12 po-no-180839103

    sir, me ranveer menaria s\o mangilal nenaria mere father ne mere jiwan pae 1 policy li thi uspar muje 18 yr pure hone per muje 26/4/10 me rs-10000 mile the kintu next time 28/4/12 mers-10000 abhi tak servial benifit prapt nahi huo karpaya shigra dilwaye r-menaria LIC OF INDIA BO-1 UDAIPUR DEHLIGAT UDAIPUR RAJ.

  3. #3
    radheshyam vaishnav Guest

    Post Money back not recived amount

    Dear Sir,
    mera 15 Fe.2013 ko money back paisa aa jana chahiye vo abh tak nahi aaya hai,
    lekin aapke requirment ke anusar 14/03/2013 (speed post) jo bhi ID manga hai vo sab document bhej diya hai.
    lekin abhi tak mera 15000/- money back ka paisa bank me jama nahi huva hai.

    so aap se meri request hai ki Sir, mera money-back ka paisa SBI (Sosyo Circle Br.) me bhejne ki krupa karave.
    aapke Customer
    radheshyam Vaishnav

    Bank Details:-
    STATE BANK OF INDIA
    sOSYO CIRCLE BRANCH.SURAT (GUJARAT)
    ACCOUNT NUMBER - 32216517198
    IFS CODE-SBIN0010993
    MICR CODE-395002037
    MOBILE-9173675406, 8511198397
    Email - radheshyamvaishnav22@yahoo.com

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