Orissa

Cuttak

CC/123/2014

Satyabrata Prasad - Complainant(s)

Versus

Senior Branch Manager, Life Insurance Corporation Of India - Opp.Party(s)

A K Samal

24 Apr 2017

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL FORUM,CUTTACK.

                                                                                    C.C. No.123/2014

                Satyabrata Prasad,

S/O:Late Prahallad Behera,

At:Goud Sahi,PO:Mashra,

Via:Binjharpur,Dist:Jajpur..                                                                            … Complainant.

 

                Vrs.

 

1.         Senior Branch Manager,

Life Insurance Corporation of India,

District Branch Office,

At:Link Road,PO:Arunodaya Market,

Town/Dist:Cuttack.

 

2.         Senior Divisional Manager,

Life Insurance Corporation of India,

Cuttack Divisional Office,

At:Nuapatna,PO:Buxibazar,

Town/Dist:Cuttack.                                                                                 … Opp. Parties.

 

 

Present:               Sri Dhruba Charan Barik,LL.B. President.

Sri Bichitra Nanda Tripathy, Member.

 

Date of filing:   09.05.2014

Date of Order: 24.04.2017.

 

For the complainant:               Sri A.K.Samal,Adv. & Associates.

For Opp.Parties.    :                  Sri R.K.Pattnaik,Adv. & Associates.

 

 

Sri Dhruba Charan Barik,President.

                The complainant has filed this case alleging deficiency in service on the part of the O.Ps and seeking appropriate relief in terms of his prayer in the complaint.

1. The brief facts of the case of the complainant are that his father Late Prahallad Behera during his life time had obtained a Life Insurance Policy from the O.P,Insurance Company bearing policy No.598463858.  This policy was for 15 years and the sum assured was Rs.1,20,000/-.  The date of maturity of the policy was on 22.7.2026 and the annual premium to be paid was fixed at Rs.10,985/-.  The complainant being the son of the policy holder was cited as the nominee in the said policy.  The first premium was paid by the policy holder on 22.7.11 and thereafter policy bond was issued to him.  The copy of the said policy bond has been filed and marked as Aannexure-1. 
2. On 10.5.12, the policy holder met with an accident on his way to the Block Chhak for purchase of some grocery articles.  A motorcycle coming at high speed from behind dashed against him for which he fell down and sustained serious injuries on the vital portion of his body.  He was admitted to Sreemaa Nursing home on the next date i.e. 11.5.12 and subsequently was referred to District Headquarter Hospital,Jajpur.  His condition became more critical.  He was again referred to S.C.B.Medical College & Hospital,Cuttack where he expired on 29.9.12 due to Cardiac Respiratory failure while undergoing treatment.
3. On 24.7.12 F.I.R was lodged at Binjharpur P.S and copy of the said FIR has been filed and marked as Annexure-2.  Lastly police submitted final report in that case stating that the “fact is true but no clue”.  Copy of the said final report submitted to the Court of the SDJM,Jajpur which has been duly accepted ,has been filed and marked as Annexure-3.
4. The complainant has intimated this fact to the O.ps and submitted all the required documents such as policy bond, medical certificate, death certificate issued by the competent authority etc to the O.P No.1 and lodged a valid claim.  Annexure-4 series are the copies of the above documents submitted to O.P No.1.
5. The O.P, Insurance Company vide their letter dt.11.3.13 intimated the complainant about the repudiation of his death claim on the ground that the said policy had already lapsed by the time of death of the policy holder because of non-payment of the premium.  Annexure-5 is the copy of the said repudiation letter.
6. It is also revealed from the complaint that first premium was paid on 22.7.11 but the second annual premium which was due for payment on22.7.12 could not be paid because of pre-occupation of the complainant in the treatment of his ailing father.  It is also stated that the second premium could not be paid even after expiry of the grace period of one month.
7. It is specifically stated that the accident of the policy holder took place on 10.5.12 and subsequently the injuries caused to the policy holder by such accident led to his death.  So the cause of action which led to his death started from the date of accident itself, when the said policy was on force.  The O.Ps failed to take note of this fact before repudiating the claim.  That apart it is stated that even on humanitarian ground, the O.Ps should have allowed the death claim lodged by the complainant.  As such the O.Ps have committed deficiency in service in repudiating the death claim made by the complainant which has caused undue harassment and serious mental agony to him.
8. Accordingly it is prayed that the O.Ps may be directed to pay the insurance claim of Rs.1.,20,000/- to the complainant towards the death claim together with interest @ 18% per annum and they also be directed to pay Rs.50,000/- towards compensation together with the cost and other reliefs as deemed fit in the interest of justice.
9. The O.Ps in the written version of their case have categorically challenged the maintainability of the case on the ground that there was no deficiency in service on their part in any manner as alleged by the complainant.  The repudiation of the claim vide Annexure-B is strictly according to the terms and conditions of the policy.  Exhibit-A is the copy of the policy bond issued in               favour of the policy holder.  It is specifically stated that even after expiry of the 30 days grace period the second premium was not paid for which the death claim made by the complainant was repudiated.  It has been specifically stated that the complainant is also not entitled to any accidental benefit under the policy since at the time of relevant accident; the policy was not in force due to non-payment of the premium.  It is accordingly prayed that the case may be dismissed.
10. We have heard the learned counsel for both the parties and gone through the annexures filed by them respectively.
11. It is an admitted fat that when the accident took place or the death of the deceased occurred the said policy was not in force.  It had lapsed due to non-payment of premium even after expiry of 30 days of grace period.  The only submission made by the learned counsel for the complainant that some consideration should be made by us on humanitarian ground to grant some relief to the complainant.  As against it the learned counsel for the O.P has relied upon a decision of the Hon’ble Apex Court reported in III (2005) CPJ-31(SC) (Life Insurance Corporation of India Vrs. Mani Ram).  It has been held by their lordships that insurance policy would lapse because of non-payment of premium even after expiry of 30 days of the grace period and in such an event the insurance company is wholly justified in rejecting the claim of the complainant.  Keeping in view the facts and circumstances of the case and the ratio of the decisions cited above, the prayer of the complainant does not merit consideration.  Hence ordered;

                                                                                      ORDER

The case of the complainant is dismissed on contest against the O.Ps.

Typed to dictation, corrected and pronounced by the Hon’ble President in the Open Court on this the 24^th  day of April, 2017 under the seal and signature of this Forum.

                                                                                                                                                  

    (   Sri D.C.Barik )

                                                                                                                        President.

                                                                                                                   (Sri B.N.Tripathy )

                                                                                                                            Member.