STATE CONSUMER DISPUTES REDRESSAL COMMISSION OF TELANGANA :
At HYDERABAD
FA 384 of 2014
AGAINST
CC NO.36 of 2013, DISTRICT FORUM, NALGONDA
Between :
The Senior Manager ( Claims)
Authorised Signatory,
SBI Life Insurance Co. Ltd
8th floor, Parishrama Bhavan,
Basheerbagh, Hyderabad ..Appellant/opp. party no. 2
And
- Gundaboine Mallamma,
W/o Late China Saidulu,
Aged 50 years, Occ : Household
- Gundaboine Venkaiah,
S/o Late China Saidulu,
Aged 34 years, occ : Agriculture,
Both are R/o Thettekunta,
H/o Alvala Anmula Mandal,
Nalgodna District .. Respondents/complainants
- The Branch Manager,
State Bank of Hyderabad,
A.D. B., Miryalaguda Branch
Nalgonda District .Respondent/opp. party no.1
Counsel for the Appellants/2nd opp. party : M/s. Gosala Srinivasa Rao
Counsel for the Respondent 1& 2/
complainants : M/s. V. Gourisankara Rao for R1&R2
Sri P.K. Arjun for R-3.
Coram :
Honble Sri Justice B. N. Rao Nalla … President
And
Sri Patil Vithal Rao … Member
Monday, the Nineth Day of October
Two Thousand Seventeen
Oral order : ( per Hon’ ble Sri Justice B.N.Rao Nalla, Hon’ble President )
***
1) This is an appeal filed under Section 15 of the Consumer Protection Act by the 2nd opposite party to set aside the impugned order dated 23.12.2013 made in CC No. 36 of 2013 on the file of the District Forum, Nalgonda and allow the appeal.
2) For the sake of convenience, the parties are described as arrayed in the complaint before the District Forum.
3). The case of the complainant, in brief, is that the husband of 1st complainant and father of the 2nd complainant, during his life time, is the Account holder bearing No., 52141918831 of the 1st opposite party under Swadhan Scheme and obtained Ex.A-1 policy under Swadesh Group Insurance for a sum of Rs.1,00,000/- valid for the period from 01.12.2006 to 01.12.2016 after paying premium amount of Rs.3,642/-. During the subsistence of policy, he died on 03.02.2009 in course of normal death. The first complainant submitted claim with all relevant documents to the second opposite party but it did not pay the same. She also got issued legal notice on 03.02.2011. But the second opposite party did not settle the claim amount. Hence the complaint to direct the opposite parties 1 and 2 to pay the insurance claim of Rs. One lakh, Rs.20,000/- towards mental agony and costs of Rs.10,000/-.
4). The 1st opposite party while admitting the issuance of policy in question contended that he is only a felicitator and it has no liability to pay the insured amount and it is the duty of the second opposite party to settle the amount. The first complainant has submitted incomplete and unfilled claim form and it was informed to her but she did not furnish required details. Admitted receipt of legal notice from the complainants. Hence prayed to dismiss the complaint against it.
5). The 2nd opposite party opposed the complaint by way of written version while admitting the issuance of insurance policy and contended that the complaint is barred by limitation. It has not received claim forms etc nor the information about the death of the deceased. The OP has not received the renewal premium due on 01.12.2008 and the insurance cover lapsed with effect from 01.12.2008. The date of death was 03.02.2009. Thus, nothing is payable under the insurance coverage as the insurance cover was in lapsed condition as on the date of death.
6) During the course of enquiry before the District Forum, in order to prove their case, the complainants filed evidence affidavit and got marked Ex.A1 to A-6 and the opposite parties marked Ex. B-1 to B-5. Heard the counsel on both sides.
7) The District Forum, after considering the material available on record, directed the second opposite party to deposit a sum of Rs. One lakh with interest @ 9% pa from 06.05.2013, the date on which the delay was condoned, till realization along with a sum of R.5,000/- towards deficiency of services and Rs.2,000/- towards costs within one month while dismissing the complaint as against first opposite party.
8) Aggrieved by the said order, the 2nd opposite party preferred this appeal before this Commission.
9) Both sides have advanced their arguments reiterating the contents in the appeal grounds, rebuttal thereof along with written arguments by appellant and R1 and R2. Heard both sides.
10) The points that arise for consideration are,
(i) Whether the impugned order as passed by the District Forum suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with, in any manner?
(ii) To what relief ?
11). Point No.1 :
There is no dispute that the deceased husband of the first respondent/1st complainant and father of the second respondent/2nd complainant obtained insurance policy during his life time vide Ex.A-1 for a sum of Rs. One lakh and for the period from 01.12.2006 to 01.12.2016 and the premium amount is Rs.3,642/- per annum. There is also no dispute that the deceased died on 03.02.2009 in course of natural death. There is no dispute that the complainants are the legal heirs of the deceased policy holder.
12). The main contention of the appellant insurance company is that the policy was not in force as on the date of the death of the insured on 03.02.2009 since the required premiums payable on the policy which are due on 01.12.2008 were not paid. Ex.A-6 statement of Account issued by the 3rd respondent Bank reveals that yearly premiums were debited from the account of the deceased policy holder on 15.11.2006, 18.12.2007 and two premiums on 14.03.2008, and from the above it would be inferred that the policy was in force on the date of the death of the policy holder. Even otherwise, the features of the group Insurance Scheme speaks that “ a grace period of 30 days is allowed for the payment of premium for each Member. If the premium is not paid on or before the expiry of the grace period, insurance cover for that Member will automatically lapse. However, revival of cover will be allowed as specified in clause 8. It further reveals that , “ if any death occurs within the grace period and before the payment of the premium then due and the death claim is admitted, the claim will be settled only after deduction of premiums then due.. Even after filing of the complaint also they can release the amount to disprove that there is deficiency in service on their part, but, they did not do so. In view of the above conditions, non-payment of the claim by the appellant insurance company amounts to deficiency in service
13) The further contention of the appellant insurance company is that the respondents 1 and 2/complainants failed to submit their claims with valid documents within the stipulated time. Ex.5 letter along with postal receipt and postal acknowledgement shows that she has written a letter to the SBH. ADB, Miryalaguda on 7.6.2011 and it was posted on 08.06.2011. Hence the contention of the appellant insurance company that they did not receive claim within the time cannot be accepted. It is not the case of the appellant Insurance company that the deceased policy holder suppressed material facts etc and he is not entitled for the insurance claim, but, contending that the claim was not submitted within the stipulated time. The first respondent/complainant is a poor and illiterate widow. Technicalities cannot be taken into account and they have to be brushed aside in helping the poor to keep them alive. It appears that there is no role of the third respondent Bank in settlement of the claim.
14). After considering the foregoing facts and circumstances and also having regard to the contentions raised on behalf of the appellant/2nd opposite party and the respondents, this Commission is of the view there are no irregularities or infirmities in the order passed by the District Forum. There are no merits in the appeal and hence the appeal is liable to be dismissed.
15). Point No. 2 :
In the result, the appeal is dismissed confirming the impugned order passed by the District Forum. There shall be no order as to costs. Time for compliance four weeks.
PRESIDENT MEMBER Dated : 09.10.2017.
