CONSUMER DISPUTES REDRESSAL FORUM, KOTTAYAM Present. Sri.Santhosh Kesavanath.P. President Smt.Bindhu M.Thomas Member Sri.K.N.Radhakrishnan Member.
CC.No.78/08 Monday, the day of 16th, November, 2009.
Petitioner. Smt.Saji Anil Thazhaniyil house Vellilappally Ramapuram Bazar.P.O. (Adv.K.S.Ambily) Vs. Opposite parties. 1. Branch Manager LIC of India Edaparambil buildings Main Road, Pala. (Adv.G.Jayasanker) 2. Divisional Manager LIC of India Kottayam Division. O R D E R Smt.Bindhu M.Thomas, Member.
The crux of the complaint is as follows. Complainant was the wife of Anilkumar.T.K. who was killed in a road traffic accident on 3/4/07 at about 3.30 p.m. as per the police records. On 28/3/06, Mr.Anilkumar had taken a Bhima Gold policy vide number 393353900 for an amount of Rs. 2 lakhs. On 28/3/2006 he remitted Rs.2,025/- as the first premimum and on 26/3/07 he remitted third premium for the month of 9/06 and on 8/4/07 the fourth instalment of the premium Rs.2200/- was also remitted. On 3/4/07 at 11 a.m, the deceased gave Rs.2200/- to his staff Mr.K.P.Rajeev to remit the 4th premium at the Ist opposite party's office. After that Mr.Anikumar along with Mr.K.P.Rajeev had gone to pala by his bike and dropped Mr.Rajeev near KSRTC bus stand for remitting the premium in the first -2- opposite party's office. Mr.Rajeev remitted the said premium at 3.19 p.m. and Mr.Anilkumar met with an accident near Lallam Palam, Ettumanoor road at 2 p.m. He was taken to Govt. Hospital Pala and was referred to Medical College Hospital Kottayam and he died at 3.30 p.m. The complainant submitted claimant's statement, policy, police records and post mortum certificate before the Ist opposite party on 23/10/07 and the same was repudiated by the second opposite party vide letter dated 5/2/07 stating the reason that ''the policy was not in force at the time of accident and death''. The complainant alleged that the act of opposite parties amounted to deficiency in service. Hence the complainant filed this complaint praying to direct the opposite parties to give Rs.4,00,000/- covered by the Bhima Gold Policy with interest @ 12% from the date of claim till realisation, compensation for mental agony and Rs.2000/- as litigation cost. The opposite parties entered appearance and filed version with the following main contentions. (i) The complaint is not maintainable because it is not coming under S.2(1) (c) of the Consumer Protection Act. (ii) The petition is bad for non-jointer of necessary parties.
(iii)The premium due was remitted at the first opposite party's
branch office on 3-4-07 at 3.19 pm ie. after the death of the life assured. (iv)It is evident from the police records that time of death was 3.30 pm and therefore the opposite parties repudiated the claim. (v) At the time of accident there was no valid policy subsisting in favour of deceased. The policy was lapsed due to non-payment of premium amount. (vi)After the death of life assured somebody with a malafide intention in order to get the claim amount, remitted premium -3- amount at 3.19 pm on 3-4-08, after the death.
(vii)The relief claimed in the petition is not allowable in any manner.
Hence the opposite parties prayed to dismiss the petition with costs to them. Points for considerations are: (i)Whether there is any deficiency in service or unfair trade practice on the part of opposite parties. (ii) Reliefs and costs.
Heard the counsels for both parties and perused the documents. The policy is produced and marked as exhibit B2. The policy stated that the date of commencement was 28/3/06 and the date of maturity would be 28/3/26 as it was for a period of 20 years. The opposite party's counsel submitted that the third premium was due on 28/9/06 and was remitted on 26/3/07. If 28/9/06 was the due date for the payment of premium, as per condition 2 of exhibit B2, grace period of one month was available to the insured and payment ought to have been made by October 28, 2006. But the said premium was paid only by March 26, 2007. As per clause 2 of Ext. B2, the policy ought to have lapsed due to the non payment of third quarterly premium on time. But according to the opposite party the policy was lapsed from 28-12-2006 due to the non payment of the fourth premium due on 28/12/2006 within the grace period of one month. It is not in dispute that the unpaid third and fourth premium instalments were paid later on with late fee. It was further submitted by the learned counsel for the opposite party that the insured was not alive at the time of remittance of fourth premium and therefore as per clause 3 of the policy the said payment could not have the effect of reviving the policy. Where as the complainant's counsel contented that the fourth premium was remitted at 3.19 pm on 3/4/07 and the insured's death occurred at 3.30 pm on the same day. Both parties produced documents to prove the time of death. The counsel for the complainant further contented that as the fourth premium was paid prior -4- to the insured's death, the complainant was entitled to get the insured amount. It was next submitted by the complainant's counsel that as per clause 10(b) of the policy if the life assured who had opted for accident benefit dies due to an accident, the nominee will get an additional sum equal to the accident benefit sum assured along with the sum assured under basic plan. The counsel for the opposite party took defense that as the policy is lapsed no claim amount is payable as per the conditions of the policy. The repudiation letter is produced and marked as exhibit A5. As per ext. A5, the policy was repudiated on the ground that at the time of death of the insured the policy was not in force. According to the opposite party's counsel the policy lapsed from 28/12/2006. Though 28/12/2006 is the due date, still it was open for the insured to pay the premium within the grace period. If the insured fails to pay the premium even after the expiry of the grace period under section 50 of the Insurance Act, 1938, the Insurance company is required to intimate whether the policy was lapsed or not. In this instant case there is no such intimation by the opposite party. If that is so, it is clear the Insurance company kept the policy alive as on the date of death of the insured. Taking this fact in to consideration we feel that this complaint is to be allowed. The act of opposite party in not sending notice as per S.50 of the Insurance Act 1938 to the assured on the lapsing of a policy and repudiation of the claim on the ground of lapsing of policy is a clear case of deficiency in service. In our opinion, the complainant, the nominee of the said policy is entitled to get four lakh rupees as per 'clause 10(b) of the policy. Point No.1 is found accordingly. Point No.2. In view of the findings in point No.1, the complaint is allowed. The opposite party is ordered to pay R.4,00,000/- with interest @ 9% p.a. from the date of repudiation till realisation to the complainant. As interest is allowed no compensation is ordered. The opposite party is also ordered to pay Rs.1500/- as the cost of litigation to the complainant. -5- This order will be complied with within one month of receipt of its copy. Smt.Bindhu M.Thomas Member Sd/- Sri.Santhosh Kesavanath.P. President Sd/- Sri.K.N.Radhakrishnan Member. Sd/- APPENDIX Ext.A1 Copy of policy particulars Ext.A2 Original renewal premium receipt dt.26/3/07. Ext.A3 Original renewal premium receipt dt. 3/4/07 Ext.A4 Copy of claimnt's statement Ext.A5 Copy of repudiation letter Ext.A6 Copy of post-mortum certificate Ext.A7 Copy of FIR. Ext.A8 Copy of affidavit by K.P.Rajeev. Ext.A9 Copy of certificate of identity and Documents of the opposite party. Ext.B1 Document showing time of remittance of premium Ext.B1(a) Document showing time of remittance of premium. Ext B2 Original policy schedule Ext.B3 Document showing delegation of powers under Regulation No.45. Ext.B4 Copy of FIR Ext.B5 Copy of Inquest report Ext B6 Copy of post-mortum report. By Orders,
Senior Superintendent. Kgr/5 copies.
......................Bindhu M Thomas
......................Santhosh Kesava Nath P | | 
