NCDRC

NCDRC

RP/843/2011

SUDESH GUPTA - Complainant(s)

Versus

ICICI PRUDENTIAL LIFE INSURANCE CO. LTD. & ANR. - Opp.Party(s)

MR. AJAY PAL

13 May 2011

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 843 OF 2011
 
(Against the Order dated 10/01/2011 in Appeal No. 123/2008 of the State Commission Haryana)
1. SUDESH GUPTA
Resident of House No. 406, Sector 8, Urban Estate
Karnal
Haryana
...........Petitioner(s)
Versus 
1. ICICI PRUDENTIAL LIFE INSURANCE CO. LTD. & ANR.
ICICI Prulife Towers 1089, Appasaheb Marathe Marg, Prabhadevi
Mumbai - 400025
Maharashtra
2. ICICI PRUDENTIAL LIFE INSURANCE COMPANY LIMITED
Plot No. 225-226, Ist and IInd Floor, Sector 12, Urban Estate
Karnal
Haryana
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE R. C. JAIN, PRESIDING MEMBER
 HON'BLE MR. S. K. NAIK, MEMBER

For the Petitioner :
Mr. Prashant Shukla, Advocate.
For the Respondent :NEMO

Dated : 13 May 2011
ORDER

This Revision Petition seeks to challenge the order dated 10.01.2011 passed by the State Consumer Disputes Redressal Commission, Haryana Panchkula (State Commission for short). Relief/award given by the District Consumer Disputes Redressal Forum Karnal (District Forum for short) vide its order dated 06.12.2007 in favour of the Petitioner/Complainant has been set aside in this order of the State Commission thereby dismissing the complaint. Aggrieved against this reversal order, the Complainant has filed this Revision Petition. Facts of the case in brief are that the Petitioner/Complainant husband had purchased a life insurance policy for a sum of Rs. 5 lakhs allegedly with accidental benefit from the Respondent Life Insurance Company Ltd. During the subsistence of the policy, however, the life assured died in a motor vehicle accident. When the Petitioner being the nominee under the policy made a claim of Rs. 10 lakhs, the Respondent Insurance Company Ltd. paid her only a sum of Rs. 5 lakhs on the ground that the life assured had not opted for accident and disability benefit and as such under the terms of the policy no such benefit could be extended to her. Contending that under the terms of the policy she was entitled to the accidental benefit which has been wrongly denied by the Respondent which amounted to deficiency in service she approached the District Forum by filing a consumer complaint. The complaint was resisted by the Respondent/OP. On appraisal of the evidence adduced by either side before it, the District Forum accepted the complaint and directed the Respondent/OP to pay Rs. 5 lakhs on account of accidental benefit to the complainant within a period of 30 days failing which it was to carry interest @ 10% per annum from the date of the order till its payment. The OPs were aggrieved against this finding of the District Forum and filed an appeal resulting in the setting aside of the District Forum order and consequently dismissal of the complaint. It is under these circumstances that the Complainant who is the aggrieved party has filed this Revision Petition. We have heard the Ld. Counsel for the Petitioner. According to him the Ld. State Commission has failed to appreciate that the definition of nsured coveras given in the definition clause of the insurance policy makes it clear that it included accident and disability benefit as well. He has further referred to the explanation of accidental benefit given in Condition A under head ccident and disability benefitin the annexure enclosed with the policy document and contends that the mention of upplementary benefits applicable if opted forwould not ipso facto unsuit the Complainant from receiving the accidental benefit as the General Condition No. 4 did not specifically exclude the accidental benefit. We have noted the submissions made by the Ld. Counsel only to be rejected for the simple reason that the life assured in the proposal form in response to question No. 39(2), under the head articulars of Plan Applied forhad responded only for a um proposed/death benefitof Rs. 5 lakhs. As clearly observed by the State Commission, the life assured did not add any iderto avail any supplementary benefits. No extra premium to avail any additional benefit had been paid by him. It has also been clearly brought out that the life assured having not represented against any deficiency in terms and condition of the policy within the period of 15 days prescribed by the Insurance Regulatory and Development Authority, it can only be said that he was not clearly entitled to any accidental benefit. It is only an afterthought and the arguments advanced by the Ld. Counsel will cut no ice. The terms and conditions in an insurance policy being in the nature of a contract between the parties, the rights and obligations have to be governed by the terms as incorporated and in construing the terms of the insurance policy the words used therein must be given paramount importance and it is not open for any fora to add, delete or substitute any word. The law on this point is now very well settled and we may respectfully draw support from the Judgement of the Supreme Court in the case of Suraj Mal Ram Niwas Oil Mills (P) Ltd. Versus United India Insurance Co. Ltd. & Anr., 2011 CTJ 11 (Supreme Court) (CP). As discussed, we do not find any illegality, material irregularity or jurisdictional error in the order passed by the State Commission and the Revision Petition is, therefore, dismissed in limine.

 
......................J
R. C. JAIN
PRESIDING MEMBER
......................
S. K. NAIK
MEMBER

Consumer Court Lawyer

Best Law Firm for all your Consumer Court related cases.

Bhanu Pratap

Featured Recomended
Highly recommended!
5.0 (615)

Bhanu Pratap

Featured Recomended
Highly recommended!

Experties

Consumer Court | Cheque Bounce | Civil Cases | Criminal Cases | Matrimonial Disputes

Phone Number

7982270319

Dedicated team of best lawyers for all your legal queries. Our lawyers can help you for you Consumer Court related cases at very affordable fee.