Haryana

Karnal

CC/206/2015

Manoj Kumar S/o Roshan Lal - Complainant(s)

Versus

Life Insurance Corporation Of India - Opp.Party(s)

Joginder Singh

11 Jul 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                               Complaint No. 206 of 2015

                                                             Date of instt.07.09.2015

                                                               Date of decision 11.07.2016

 

Manoj Kumar son of late Sh. Roshan Lal resident of village Katlaheri District Karnal.

 

                                                                                      ……..Complainant.

                                      Versus.

LIC of India, Post Box no.106, Jevvan Parkash, 489 Model town, Karnal through its Senior Divisional Manager.

 

                                                                              …Opposite Party.

                     Complaint u/s 12  of the Consumer Protection Act.

 

Before                   Sh.K.C.Sharma……….President.

                   Sh.Anil Sharma…….Member.

 

Present:      Sh. Joginder Singh Advocate for complainant.

                   Sh. Mohit Sachdeva Advocate for opposite party.

 

 ORDER:

 

                   This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that his father  Shri Roshan Lal (the deceased life assured) obtained insurance policy no.171402747 under money back policy with profits + accident benefit of opposite party, which came into existence in the year 1997. The deceased life assured expired in a roadside accident on 30.9.2008 and First Information Report no.391 was registered in Police Station Sadar Karnal regarding the said accident. The post mortem on the dead body of the deceased life assured was also got conducted on the same day. He was not aware of the said policy, therefore, no claim could be lodged with the opposite party, immediately after the death of the deceased life assured.  In the year 2012 a letter was received from the opposite party about maturity of the policy and then he came to know about the policy of his father and lodged death claim with the opposite party. He submitted all the required documents, but the opposite party released maturity amount to the tune of Rs.50,000/- + bonus only on 8.8.2013, but death accident benefit and other benefits were not paid intentionally. He met the opposite party a number of times for payment of accident benefits and other benefits, but he was asked to submit driving licence of the deceased life assured, which was not available with him, as the same might have lost in the accident. Not making payment of the accident benefit and other benefits amounted to deficiency in service on the part of the opposite party, which caused him harassment and humiliation apart from financial loss.

2.                Notice of the complaint was given to opposite party, who put into appearance and filed written statement disputing the claim of the complainant. Objections have been raised that the complaint is not maintainable in the present form; that the complaint is time barred; that the complainant has not approached this forum with clean hands and that the complainant has no locus standi and cause of action to file the complaint.

                   On merits, it has been submitted that death claim under the policy to the tune of Rs.69550/-inclusive of the sum assured+ vested bonus as full and final settlement of the claim was paid to the complainant. As per First Information Report, the deceased life assured had died due to accident, while he was driving splendor motorcycle. As per condition no.10.2(b) of plan no.74( Money Back Plan) driving licence of the deceased life assured was required to consider the claim of the complainant for accident benefit, but the same was not furnished by him. Therefore, additional sum equal to the sum assured was not payable, because the deceased life assured committed breach of law i.e. of section 3 of the Motor Vehicles Act, 1988 by not having any driving licence to drive motorcycle on the date of accident. The other allegations made in the complaint have not been admitted.

3.                In evidence of the complainant, his affidavit Ex.CW1/A and documents Ex.C1 to C8 have been tendered.

4.                On the other hand, in evidence of the opposite parties, affidavit of Balihar Singh Manager  Ex.OP1/A and document Ex.O1 have been tendered.

5.                We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.                There is no dispute between the parties that the deceased life assured had obtained insurance policy money back plan from opposite party and he died on 30.9.2008 during subsistence of the policy, due to an accident and First Information Report regarding that accident was registered in Police Station Sadar Karnal. Post Mortem on the dead body of the deceased life assured was also got conducted. It is also not in dispute that usual benefits under the policy to the tune of Rs.69,654/- have been paid to the complainant. However, the claim of the complainant regarding accident benefit and other benefits under the scheme has been denied on the ground that deceased life assured was not having driving licence on the date of accident.

7.                Learned counsel for the opposite party laid emphasis on the contention that the deceased life assured was not having any driving licence to drive the motorcycle on the date of accident. The complainant could not produce driving licence in favour of deceased life assured despite repeatedly asking him. In this way, the deceased life assured committed breach of law i.e. of Section 3 of the Motor Vehicles Act, by not having driving licence while driving the motorcycle which met with an accident resulting into his death. Therefore as per clause 10.2(b) of the policy the insurance company is not liable to pay any accident benefit. In support of his contention he placed reliance upon Mohan Lal Tiwari Versus Life Insurance Corporation of India and Anr.2009(1) CPJ 209 wherein the insured obtained life insurance policy with accident benefit and he died in motor accident while driving car. He was not having any driving licence. Under those circumstances, it was held by the Hon’ble National Commission that claim regarding accident benefit was rightly repudiated by the insurance company. Learned counsel for the opposite party also referred to the order dated 18.11.2010 passed by Hon’ble State Consumer Disputes Redressal Commission, Maharashtra Mumbai in first appeal no.A/09/1141 @ M.A.No.09/1422 titled as Life Insurance Corporation of India Versus Smt. Sangeeta Sadhu Gorad  wherein the life assured had taken insurance policy and he died due to accidental injury. Double accident benefit claim was repudiated by Life Insurance Corporation on the ground that the deceased was not having any driving licence. Under those circumstances, it was held that Life Insurance Corporation was within its right to repudiate the claim of double accident benefit as per condition no.10.2(b) of the policy.

8.                On the other hand learned counsel for the complainant submitted that the deceased life assured was having valid driving licence, but the same was lost in the accident and could not be traced by the complainant and other family members and for that reason could not be produced, but the fact remains that the deceased life assured had died due to accident while driving motorcycle, therefore, the opposite party was not legally justified to deny the accident benefit under the policy.

9.                The proposition of law laid down in the afore discussed authorities cited on behalf of the opposite party applies on all fours of the present case. The deceased life assured was driving the motorcycle and the said motorcycle met with an accident, as a result of which he died. However, no driving licence of the deceased life assured could be produced by the complainant though repeatedly asked by the opposite party to produce the driving licence of the deceased, if any.  Therefore, in the absence of production of the driving licence of the deceased life assured by the complainant adverse inference is to be drawn that the deceased life assured was not having any driving licence to drive the motorcycle. To drive the vehicle without having valid driving licence certainly amounts to breach of law under section 3 of the Motor Vehicle Act. Therefore, in view of condition no. 10.2(b) of the policy, the insurance company is not liable to pay accident benefit to the complainant and other legal heirs of the deceased life assured. Consequently, the opposite party was legally justified to deny the accident benefit to the complainant regarding death of the deceased life assured in an accident and as such there was no deficiency in service on its part.

10.              As a sequel to the foregoing reasons, we do not find any merit in the present complaint. Therefore, the same is hereby dismissed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 11.07 .2016

                                                                                      (K.C.Sharma)

                                                                                         President,

                                                                             District Consumer Disputes

                                                                             Redressal Forum, Karnal.

                             (Anil Sharma)

                               Member