Petitioner/complainant’s husband was the employee of State Bank of India, respondent no.2 herein. He took a housing loan of Rs.6,25,000/- from respondent no.2 and also took the insurance from the insurance company (respondent no.1) to cover the risk of outstanding loan amount in case of his death. Insured died due to illness on 12.09.2004. Respondent No.2 deposited the GPF and
-2- gratuity amount in the loan account of the deceased insured. Complainant lodged the claim with the respondent no.1 which was repudiated on the ground that since the insured had died within 45 days of taking the policy as per rules the claim was not payable; that the claim could be paid only if the deceased had died after 45 days of the commencement of the policy. Being aggrieved, petitioner filed the complaint before the District Forum. District Forum dismissed the complaint, aggrieved against which the petitioner filed the appeal before the State Commission. State Commission dismissed the appeal by the impugned order by observing thus: “It was a case where life assured died within 45 days of his insurance by respondent the SBI Life Insurance Co. Ltd. Insurance was issued under a home loan insurance master policy obtained by respondent no.2 bank for its loanee employees from the respondent no.1 SBI Life Insurance Co. Ltd. As per certificate of the insurance the said master policy was made effective from 31.07.2004 whereas the insured died on 12.09.2004 i.e. within 45 days of the commencement of the policy. As per policy condition no claim was payable, if the life assured died within 45 days of the commencement of the policy. In fact, -3- the proposal for the policy and payment of premium were made on 31.07.2004 and it was from this date itself that the policy was made effective. Under the circumstances, the respondent insurance company was justified in repudiating the appellant’s claim and the complaint has been rightly dismissed by the Forum below.” In the present case, the policy commenced on 31.07.2004 and the insured died on 12.09.2004, i.e. within 45 days of the commencement of the policy. as per policy condition, no claim was payable if the assured died within 45 days of the commencement of the policy unless the assured died as a result of accident which is not the case in the present case. Parties are bound by the terms and conditions of the policy. We do not find any infirmity in the order passed by the fora below. Dismissed. However, respondent no.1 insurance company (respondent no.1) is directed to refund the premium amount of Rs.61,230/- to the petitioner within eight weeks from today, if not already refunded, failing which the insurance company shall be liable to pay interest -4- @ 9% p.a. on the amount of premium from the date of deposit till realization. |