BEFORE THE CONSUMER DISPUTES REDRESSAL COMMISSION, RAJASTHAN, JAIPUR


APPEAL NO: 2222/2006


1. Life Insurance Corporation of India,

through Sr.Divisional Manager,

Jaipur.

2. Br.Manager, LIC of India,

Br.office, Bharatpur.

Opposite parties -appellants


Vs.


Sh.Ramnath Mittal,

r/o Kotwali Road, Bharatpur.

Complainant-respondent


Date of judgment 30.3.09


Before:


Mr.Justice Sunil Kumar Garg- President

Mrs.Vimla Sethia-Member


Mr.Ram Kalyan Sharma counsel for the appellants

Mr. Puneet Sharma counsel for the respondent

JUDGMENT


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


This appeal has been filed by the appellants LIC against

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order dated 9.11.06 passed by the District Forum, Bharatpur in complaint no. 527/2003 by which the complaint of the complainant was allowed in the manner that the appellants were directed to pay a sum of Rs. 50,000/- , the amount of the LIC policy alongwith interest @ 9% p.a. w.e.f. 18.11.03 the date on which the complaint was filed and further to pay Rs.2000/- as amount of compensation for mental agony and Rs.1000/- as costs.


2. It arises in the following circumstances-

That the complainant respondent had filed a complaint before the District Forum, Bharatpur on 18.11.03 inter alia stating that his son Rinku Mittal, now deceased had taken a life insurance policy with accidental benefit for a sum of Rs. 50,000/- from the appellants bearing policy no.193830420 on 14.8.01 and the maturity date was 14.8.2016. It was further stated in the complaint that the premium was to be deposited half yearly. It was further stated in the complaint that on 6.10.02 the deceased had met with an accident and thereafter he had died on 9.10.02 and this fact is not in dispute.


Note- In this case so far as the amount of the policy to the tune of Rs.50,000/- is concerned, that had been paid by the appellants LIC to the complainant respondent and the dispute remains to the amount of accidental benefit and since the claim of accidental benefit was not paid by the appellants LIC, the present complaint was filed.


A reply was filed by the appellants on 19.12.03 and the case of the appellants was that since the policy in

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question was taken by the deceased on 14.8.01 and the instalment of the premium was to be paid six monthly and thus the next premium had become due on 14.2.02 and the same was deposited by the deceased but he had not deposited the next half yearly premium which was due on 14.8.02, even within the grace period of 30 days with the result on the date of accident i.e. on 6.10.02 the policy was not in force. It was further stated in the reply that the premium which was due on 14.8.02 was deposited on behalf of the deceased on 9.10.02 and taken into consideration that the policy had become revived one, the principal amount of the policy was paid to the complainant respondent but on point of accidental benefit the case of the appellants was that since on the date of accident i.e. on 6.10.02 the policy was in a lapsed condition and therefore, the complainant respondent was not entitled to the amount of accidental benefit and it was prayed that complaint be dismissed.


After hearing the parties the District Forum, Bharatpur through impugned order dated 9.11.06 had allowed the complaint inter alia holding that -


(i) That since the premium was deposited on behalf of the deceased on 9.10.02 in the office of the appellants and taken into consideration that the policy was not in a lapsed condition, the amount of the policy was paid by the appellants to the respondents and since the main amount of the policy had been paid by the


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appellants, therefore, the appellants had no right to deny the accidental benefit to the complainant respondent.


Aggrieved from that order dated 9.11.06 passed by the District Forum, Bharatpur , this appeal has been filed by the appellants.


3. In this appeal the main contention of the learned counsel for the appellants is that since on the date of accident i.e. on 6.10.02 the policy was in a lapsed condition, therefore, if principal amount of the policy had been paid by the appellants to the complainant respondent, it does not mean that the complainant was entitled to the amount of accidental benefit 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 with accidental benefit for a sum of Rs. 50,000/- from the appellants bearing policy no.193830420 on 14.8.01 and the maturity date was 14.8.2016.

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7. There is also no dispute on the point that deceased had died on 9.10.02 meaning thereby within two years of the issuance of the policy.


8. In our considered opinion when the payment of the main policy was paid by the appellants to the complainant respondent and that could only be possible when the policy in question was found lapsed one and therefore, the appellants could not take the different stand for giving accidental benefit.


9. It may be stated here that no doubt in the present case the accident had taken place on 6.10.02 and the amount in question was paid on behalf of the deceased on 9.10.02 and when the policy in question was found in force by the appellants LIC, therefore, they are under obligation to extend the accidental benefit also as the fact that the deceased had died in an accident is not in dispute.


10. The learned counsel for the appellants has placed reliance on condition no. 8 of the policy which reads as follows-


" Accident Benefit- If at any time when this policy is in full force, the life assured before the expiry of the period for which the premium is payable is involved in an accident resulting in either permanent disability as hereafter defined or death and the same is proved to the satisfaction of the corporation, the Corporation agrees in the case of -


(a) Disability to the life assured..........................

(b) Death to the life assured- To pay an additional sum equal to the sum assured under the policy, if the life assured

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shall sustain any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means and such injury shall within 180 days of its occurance solely, directly and independently of all other causes result in the death of the life assured.

....................................."


11. In our considered opinion, no doubt on the date of accident i.e. on 6.10.02, the policy might be lapsed one but since thereafter the premium was accepted by the appellants LIC on 9.10.02 and taken into consideration that the policy was not in a lapsed condition and the payment of the main amount of the policy had been made to the complainant respondent, therefore, for giving the accidental benefit the appellants LIC could not take the different stand and thus condition no. 8 of the policy would not come to help to the appellants.


12. For the reasons stated above, the appellants were not justified in rejecting the claim of accidental benefit to the complainant respondent and the findings of the District Forum decreeing the claim of the complainant respondent are based on correct appreciation of entire materials and evidence available on record and they do not suffer from any basic infirmity or illegality or perversity and hence, no interference is called for with the same and this appeal deserves to be dismissed.


Accordingly, the appeal filed by the appellants is dismissed.



Member President