IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Monday the 30th day of January, 2017
Filed on 01.02.2016
Present
- Smt. Elizabeth George (President)
2.Smt.Jasmine.D. (Member)
in
C.C.No.38/2016
between
Complainant:- Opposite Party:-
Sri. Johnson. M.A. The Chief Manager
Manichira LIC of India
Andhakaranazhy P.O. Cherthala
Cherthala (By Adv. P.K. Mathew)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
The case of the complainant is as follows:-
The complainant has taken a policy in the name of his minor son from the opposite party under Bhima Gold Plan for a term of 20 years and the sum assured is Rs.1 lakh. The quarterly premium for the policy is Rs.854/-. As per the conditions in the said policy when the minor son became major, he applied for the double accident benefit, on 21.2.2011 by remitting Rs.50/-. Thereafter he continued to remit the premium and on 7.8.2015 his son died in an accident. On 30.11.2015 complainant received the sum assured amount of Rs.1 lakh. But the opposite party so far not paid the double accident benefit. His claim for the double accident benefit was rejected by the opposite party. Alleging deficiency in service the part of the opposite party, the complaint is filed.
2. The policy No.393319673 was issued on the life of late Jijimon M.J. with date of commencement 28.3.2006 under Bhima Gold Plan (Plan 174) for a term of 20 years and sum assured Rs.1 lakh. The quarterly premium for the policy is Rs.854/-. The life assured was a minor at the time of issuance of policy and hence the policy was issued without accident benefit. The life assured expired on 7.8.2015 and the opposite party has promptly settled the death claim for Rs.1 lakh on 30.11.2015 being the basic sum assured under the policy, as has been admitted by the complainant. The inclusion of accident benefit is not automatic. It has to be requested for and has to be effected with payment of additional premium over and above the quarterly premium of Rs.854/-. The amount of Rs.50/- was paid towards premium for accident benefit, but towards alteration fees. The life assured did not submit any request for inclusion of accident benefit or remit any additional premium. As such the quarterly premium continued to be @ Rs.854/- without any incremental change without any incremental benefit and the policy does not cover any accident benefit. The complainant is estopped from making any further claim under the policy. There is no deficiency in service on the part of the opposite party.
3. The complainant was examined as PW1. One document produced marked as Ext.A1. The opposite party produced documents marked as Exts.B1 to B3.
4. The points came up for considerations are:-
- Whether there is any deficiency in service on the part of the opposite party?
- Whether the complainant is entitled to get relief and cost?
5. It is an admitted fact that opposite party issued a policy on the life of late Jijimon under Bhima Gold Plan for a term of 20 years and since the life assured expired on 7.8.2015. Opposite party has settled the death claim for Rs.1 lakh. According to the complainant when his son became major, as per the policy conditions he applied for the double accident benefit on 21.2.2011 by remitting Rs.50/-. In the version filed by the opposite party, they admitted that the amount of Rs.50/- was paid towards alteration fees. According to the opposite party the life assured did not submit any request for inclusion of accident benefit or remit any additional premium. It is pertinent to notice that when the complainant takes the policy of his son, he was a minor and when he became major as per the terms and conditions, he applied for the double accident benefit and remitted Rs.50/-. Even though it was considered by the opposite party as alteration fees there is no documents produced by the opposite party to prove that they have effected alteration and demanded the complainant additional premium for the double accident benefit. At the same time they continued to accept Rs.854/- without any change from the complainant. While cross examining the complainant to the question put by the learned counsel of the opposite party, “ additionalquarterly Rs.854/- double accident benefit ?” He answered that, “ ” Since the opposite party accepted Rs.50/- towards alteration fees, then it is the bounden duty of the opposite party to make alteration in the policy and also to claim additional premium from the complainant. The failure from the part of the opposite party in informing the complainant his liability to pay additional premium after the change of policy and the conduct of the opposite party in continue to receive the premium at the earlier rate, which culminated in the repudiation of the policy amounts to serious lapse and deficiency in service from the part of the opposite party. In the light of the above facts and circumstances of the case, the Forum is of the view that it will be just and equitable to allow the complainant to remit the additional premium entitling the complainant for double accident benefit.
In the result, complaint is allowed. The opposite party is directed to pay Rs.1,00,000/- (Rupees one lakh only) towards the double accident benefit after receiving the additional premium amount due to the opposite party. Since the primary relief is granted no further amount as to cost and compensation. The order shall be complied within one month from the date of receipt of this order.
Dictated to the Confidential Assistant transcribed by her corrected by me and pronounced in open Forum on this the 30th day of January, 2017. Sd/- Smt.Elizabeth George (President) :
Sd/- Smt.Jasmine.D. (Member) :
Appendix:-
Evidence of the complainant:-
PW1 - Johnson (Witness)
Ext.A1 - Original receipt
Evidence of the opposite party:-
Ext.B1 - Death claim paid form
Ext.B2 - Policy schedule
Ext.B3 - Letter dated 7.12.2015
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite party/S.F.
Typed by:- pr/-
Compared by:-
