Sri.D.Krishnappa,<br /> President<br /> <br /> 1. The grievance of the complainant who has approached this Forum against the Opposite parties is that his wife Renuka had taken ING Vysya Life Insurance Policy from the Opposite parties on her life for a period of 10 years with annual premium of Rs.4,040/- and that policy came into effect on 20.09.2006. That his wife on 20.09.2000 has paid the first premium of Rs.4,040/- to the Opposite parties, but on 10.11.2006 his wife died due to heart failure and the same was informed to the Opposite parties and made a claim for payment of the insurance amount. But, the Opposite parties repudiated his claim on the ground that the insured has died within 1 year from the inception of the policy and thus attributing deficiency to the Opposite parties has prayed for a direction to the Opposite parties to pay the assured amount of Rs.36,601/- with interest at 18% p.a. and also to award damages of Rs.20,000/- for his mental agony.<br /> 2. The Opposite parties contending that there is no 2nd Opposite party like in their establishment and they are being one and the same, they have filed their version admitting the issue of a policy on the life of the deceased Renuka and the policy came into effect with the risk on 20.09.2006. Further contended that condition 12 of the policy do not empower the insured or the beneficiary to claim the insurance amount as the company has a lien over any and all the benefits accruing under the policy during the initial period of 3 months except in case of accidental death and therefore contended that the complainant is only entitled for Rs.4,000/- received from the assured and despite informing the complainant to give a discharge memo and receive the premium amount has not responded and thereby denying any deficiency at their end have prayed for dismissal of the complaint.<br /> 3. The complainant and on behalf of Opposite parties one Manjunath have filed their affidavit evidence reiterating the contention they have raised in their respective complaint and version. The complainant has produced copies of policy conditions and a copy of the legal notice he got issued to the Opposite parties. Heard the counsel for both the parties and perused the records. <br /> 4. On the above contentions, following points for determination arise.<br /> 1. Whether the Complainant proves that the Opposite parties are liable to pay the assured amount under the policy due to the deceased, but have failed to pay that assured amount to him and thereby have caused deficiency in their service?<br /> 2. To what relief, the complainant is entitled to?<br /> 5. Our findings are as under:-<br /> Point no.1 : In the Negative.<br /> Point no.2 : See the final order.<br /> <br /> REASONS<br /> <br /> 6. Point no. 1:- The claim of the complainant that his wife Smt.Renuka took a life insurance policy on her life for an assured amount of Rs.36,601/- maturable in 10 years on an annual premium of Rs.4,040/- has not been disputed by the Opposite parties. On the other hand, the Opposite parties have also admitted the issuance of policy in favour of Late Renuka not only in their version but also in their affidavit evidence, but as against the claim of the complainant, the annual premium of Rs.4,040/- the Opposite parties have stated that the annual premium was fixed at Rs.4,000/-. On perusal of the particulars of the policy also we find that annual premium payable was Rs.4,000/- and not Rs.4,040/- as put forth by the complainant. Except this difference we do not find any dispute between the parties on this aspect.<br /> 7. Admittedly the insured died on 10.11.2006 within 3 months from the date of inception of the policy, it is therefore the Opposite parties have repudiated the claim on the ground that the insured had died within 1 year of the policy and therefore has stated that the beneficiary the complainant is not entitled for the insured amount. The Opposite parties and their counsel have invited our attention to condition no.12 of the policy, which reads as under:- <br /> “Lien clearly mentions that – The company shall have a lien over any and all of the Benefits payable under this policy during the initial period of three months from the date of Risk Commencement under this policy (initial period). Except in the case of Life Assured’s death by accident as defined in this policy in the initial period, no Benefits shall be payable to the policy holder and / or beneficiaries during the said initial period and premiums paid to the company during the said initial period shall be returned by the company to the policy holder.”<br /> Further on perusal of the other conditions of the policy, none of the conditions entitles either the insured or the beneficiary for the insured amount in the event of death of the insured before the maturity date of the policy. But there is a provision under condition no.3 for paying the sum assured with other benefits under the policy to the nominee or beneficiaries of the insured in the event of the death of the insured due to accident after the commencement of the risk. Even condition no.12 referred to above reads that the Opposite parties have a lien over any and all the benefits payable under the policy during the initial period of 3 months from the date of commencement of the risk in the initial period, which is 3 months except in the case of death of the assured due to accident. In other case the insured or the beneficiaries would be entitled to the return of the premiums paid. In the case on hand, the insured admittedly died during the initial period that is 3 months from the date of commencement of the policy. As the death of the insured was not accidental one, his nominee the complainant will not be entitled to the assured amount with other benefits, but is only entitled to the premium that the deceased had paid. <br /> 8. The Opposite parties as could be seen, had offered to pay the premium amount paid by the deceased requesting the complainant to execute a discharge memo, but the complainant did not do so, but rushed to this Forum with this complaint. Therefore, the offer of the Opposite parties for payment of the premium as provided under condition no.12 of the condition of policy has not been availed. Thus, under these circumstances, the complainant in our view is not entitled for the entire assured amount with other benefits and we find not merits in the grievance of the complainant. However, the complainant since is entitled to return of the premium amount and the same since has been offered by the Opposite parties, we dispose of this complaint by negativing point no.1 and directing the Opposite parties to return the premium amount to the complainant. As the result, we pass the following order:- <br /> ORDER<br /> <br /> 1. The Complaint is allowed in part.<br /> 2. The Opposite parties jointly or severally shall return Rs.4,000/- the premium amount to the complainant within 30 days from the date of this order, failing which they shall pay interest at 9% p.a. from the date of this order till the date of payment.<br /> 3. Under the circumstances of the case, both the parties are directed to bear their own costs.<br /> 4. Give a copy of this order to each party according to Rules.<br /> <br />