Per M.P.KASAR MEMBER,

1. It is stated that, complainants husband suddenly died in a road accident on 5/11/12.The complainant is nominee of deceased in the said life insurance policy lodge a claim with opposite party with all documents.  It is stated that opposite party called various documents from the year 2013 to the year 2015 but it is alleged that opposite party did not settled the claim. It is stated that, complainant had received the renewal notice for payment of premium on 02/01/2012 even after intimating them that policy holder was expired on 05/11/2012.  It is stated that, complainant’s claim repudiated as No Payment History for the Policy.  Admittedly cause of action arisen on 18/06/2013 when claim was closed but according to complainant the decision of opposite party was arbitrary and unjust. It is stated that, complainant is an illiterate widow of the original insured and at all aware of the legal procedure and time limit for filing claim and according to the complainant claim is still on. Hence considering the letter of repudiation only there is delay of around 4 year 264 days in filing the present complaint. Complainant seeks to condone the said delay as it caused due to certain unavoidable circumstances and irresponsible and negligent handling of the issue by the opposite party.
2. Opposite party appeared filed say stating in that, the policy holder under policy No.884042386 died on 05/11/2012 and the complainant has not submitted any claim papers after the death of policy holder so delay is inordinate of more than 6 years & this is negligence and carelessness and dereliction on the part of the complainant. Claim is after thought.  It is denied that various other documents were called from the year 2013 to the year 2015.  Policy commenced on 25/10/2011.  The mode of premium was ECS monthly, and policy holder paid premium of Rs.842/- only up to month of August 2012.  Death occurred on 05/11/2012 i.e. after one month and 10 days. The ECS payment for the month Sep.2012 was dishonoured. With the reason balance insufficient. Accident claim under said policy is not payable because for accident claim one of the condition needed is that the policy should have been in force as on the death of accident as well as on the time of death. It is stated that, complainant is falsely contended that the delay is that of 4 years and 264 days it is false and fabricated statement of complainant. Delay is not justified. Hence delay condonation application be rejected with cost of Rs.10000/-.
3. Heard Adv.Gaur for complainant and Adv.Damale of opposite party on 22/07/2022. Perused application and written say filed by the opposite party also peruse case law filed by opposite party. To decide application on merit and in order to that, we frame issue as follows:-

          Findings :-

4. As to issue No.1 & 2 :-           From the perusal of written say filed by the opposite party it has been noted that, the policy holder i.e. husband of complainant under policy No.884042386 died on 05/11/2012.  It is also noted that, the risk under policy No.884042386 commenced on 25/10/11.It is also noted that, the mode of premium payment was ECS monthly. And policy holder i.e. Naval Kishor Zha paid premiums of Rs.842/- only up to the month of August 2012 & for month September 2012 premium has not paid & ECS mode grace period is 15 days and there after payment for September 2012 was not received by LIC.  According to opposite party accident claim under said policy is not payable because for accident claim one of the condition needed is that the policy should have been in force as on the date of accident as well as on the time of death and policy has not acquired paid up value as minimum three years premium not receive.

However it has been observing that, LIC’s Jeevan Saral (with profits) policy No. 884042386maturity date is 25/10/2027 age of life assured at the time of issuance said policy was 38 years.Though monthly premium for the month of September 2012 is unpaid however premium for the month of August 2012 has be paid.

Complainant is wife and nominee of deceased who admittedly died on 5/11/12.According to the complainant she has filed claim and according to opposite party the claim was not lodge at all.Considering all this contentions and whether opposite party is liable to pay claim or not will have to be decided on merit admittedly portion of premium towards policy has been received by the opposite party .There is no dispute of opposite party in regard complainant is illiterate and not at all aware of legal procedure. So considering judgement passed by Hon’ble State Commission in First Appeal No.FA 15/623 vide dated 03/04/18  Smt.Kamalavati Suryakant Rane v/s National Insurance Company and otrs  in  regard condonation of delay  that ,issues related to insurance claim not get to complainant and issues raised by the opposite party can be decide on merit  so delay caused to file present complaint we are of the opinion that, is condonable in view  of circumstances of complainant & principle of natural justice  and we are of the opinion that, below section 6992) of consumer protection Act 2019 complainant had sufficient cause for not filing the complaint within limitation mentioned in  section 69(1) from the date of cause of action aroused. So we pass order in view of issue No.2 as follows:-

6698606.  ORDER

1. MA No.21/25  Is hereby allowed and  delay of 4 years & 264 days is hereby condoned  below section 69(2) of Consumer Protection Act 2019 in filing present complaint No.CC -21/219
2. No order as to cost.