BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE.
DATED THIS THE 8th DAY OF JULY 2021
PRESENT
MR. RAVISHANKAR : JUDICIAL MEMBER
MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
APPEAL NO. 378/2021
1. | The Branch Manager, LIC of India, Sakaleshpura Branch Office, Hassan Dist. | ……Appellant/s |
2. | The Zonal Manager, LIC of India, Customer Relation Manager, South Central Zonal Office, Jeevan Bhagya, Saifabad, Hyderabad 560 063. Both the appellants are represented by Sri K. Bheemsen Rao, Secretary, Legal Cell, LIC of India, Bangalore. (By Sri KPM Varghese) | |
V/s
1. | Sri C.D. Sanjay, (33 years), S/o Doddaiah, | …Respondent/s |
2. | Master. C.S. Diganth, ( 13 years ), S/o C.D. Sanjay, | |
3. | Master C.S. Deekshith, ( 11 years ), S/o C.D. Sanjay, (Appellant Nos. 2 & 3 are minors), Rep. by their Father/ Natural Guardian i.e., C.D. Sanjay, All are resident of Chikkandoor Village, Doddakondoor Post, Yesalur Hobli, Sakaleshpura Tq 573 134, Hassan District. | |
ORDER ON ADMISSION
BY SRI RAVISHANKAR, JUDICIAL MEMBER
1. The appellants/Opposite Parties have preferred this appeal being aggrieved by the Order dt.26.02.2021 passed in CC.No.193/2019 on the file of District Consumer Disputes Redressal Commission, Hassan which directed them to pay accident benefit of Rs. 1,00,000/- along with interest at 6% p.a. and Rs.15,000/- towards compensation for deficiency in service.
2. The facts leading to the appeal are as hereunder;
It is the case of the complainant that the wife of complainant No.1 Smt. B.S. Soumya took Jeevan Saral Policy from the Opposite Party insurance company for an assured amount of Rs.1,00,000/- and for accidental benefit for Rs.1,00,000/- vide policy bearing No.725524825 which commences from 23.12.2011 and the term of the policy is 15 years and premium payable is half yearly at Rs.251/-. The complainant had paid the premium towards the policy up to 2017 and the premium due was 23.06.2018 and the grace period was 30 days from the date of due, but, the premium was not paid during that grace period. Such being the case, on 25.09.2018 the policy holder Smt. B.S. Soumya unfortunately drowns in water while returning to house from her agricultural field and body was found in the river. Subsequently, the complainants 1 to 3 being the LRs of the deceased/assured have claimed for compensation by virtue of the policy. After considering the claim and considering the special features of Jeevan Saral Policy, the Opposite Party Company have settled the assured amount to the tune of Rs.1,00,000/- and denied to pay the accidental benefit of Rs.1,00,000/- as the policy is in lapsed condition for which the complainants approached the District Commission alleging deficiency in service. After trial, the District Commission directed the Opposite Party Company to pay the accidental benefit to the complainants along with accrued interest.
3. Aggrieved by the said Order, the appellants/ Opposite Parties are in appeal. Heard the arguments.
4. There is no dispute that the insurance policy obtained in the year 2011 and the insured was paying the premium regularly till 2017. It is an admitted fact that the insured had not paid the premium which is due on 23.06.2018 even after the grace period of 30 days thus policy stood in lapsed condition. During that time, the life insured died due to accidental slip in the river while going to her home after completion of her agricultural work. The Opposite Party has considered and settled the claim to the tune of Rs.1,00,000/-, but, denied to settle the accidental benefit. The reason for denial of the accidental benefit to the complainant’s wife is that the policy was not renewed well within time and it is in a lapsed condition, but, the repudiation is not acceptable because there is a provision in the terms and conditions of the policy that any lapsed policy can be revived within certain period from the date of lapse. As such, total rejection under the ground of lapse is not acceptable and amounts to deficiency in service. Once they have settled the claim by considering the eligibility, they cannot deny the accidental benefit. The District Commission has rightly awarded the amount after considering the terms and conditions of the policy. Hence, we found no valid grounds to admit the appeal. Hence, the following;
ORDER
The appeal is dismissed at the stage of admission.
The amount in deposit shall be transmitted to the District Commission for disbursement of the same to the complainant/s.
Forward free copies to both parties.
MEMBER JUDICIAL MEMBER
KCS*
