KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD, THIRUVANANTHAPURAM
FIRST APPEAL 7/2011
JUDGMENT DATED: 20..7..2011
PRESENT
SRI.M.V.VISWANATHAN : JUDICIAL MEMBER
SRI.M.K.ABDULLA SONA : MEMBER
1. Smt.Remachandrika aged 39 years, : APPELLANTS
W/o late N.Dasan, residing at
Manapazhinji, DR Square Cottage,
Uchakkada, Karode Village,
Neyyattinkara.
2. Dilin Das, aged 15 years(minor)
S/o late N.Dasan, rep.by
Smt.Remachandrika,
-do-do-
3. Rejin Das aged 14 years(minor),
S/o late N.Dasan, rep.by
Smt.Remachandrika,
-do-do-
(By Adv.A.Yarshad)
Vs.
1. The Managing Director, : RESPONDENTS
SBI Life Insurance, State Bank of India,
Local Head Office, SS Kovil Road,
Thampanoor, Tvpm.
(By Adv.B.S.Deepthi Bhagavathi)
2. The Branch Manager,
State Bank of Travancore,
Poovar Branch,
Thiruvananthapuram.
JUDGMENT
SRI.M.V.VISWANATHAN : JUDICIAL MEMBER
The appellants are the complainants and respondents are the opposite parties in CC.No.108/08 on the file of CDRF, Thiruvananthapuram. The complaint therein was filed alleging deficiency in service on the part of the opposite parties 1 and 2 in repudiating the claim under the SBI life insurance scheme with respect to the loanee Dasan.N, the husband of the 1st complainant and father of complainants 2 and 3. The opposite parties entered appearance before the Forum below and filed written version denying the alleged deficiency in service. They took the contention that the policy holder Dasan.N committed suicide within one year of the SBI life insurance policy and so complainants are not entitled to get the benefit under the said SBI life insurance scheme. Thus, the opposite parties prayed for dismissal of the complaint.
Before the Forum below the 1st complainant was examined as PW1; Exts.P1 to P6 documents were marked on the side of the complainants. On the side of the opposite parties DWs 1 and 2 were examined. Ext.D1 to D14 were also marked on their side. On an appreciation of the evidence on record, the Forum below passed the impugned order dated 31.5.2010 dismissing the complaint in CC.108/08. Hence the present appeal by the complainants therein.
We heard the counsel for the appellants/complainants. The learned counsel for the appellants submitted his arguments based on the grounds urged in the memorandum of the present appeal. He argued for the position that the insurance policy certificate marked as Ext.P2 does not disclose any such condition regarding the inability to get the benefit under the certificate of insurance in the event of death by suicide within one year of the policy. It is submitted that there is no such condition incorporated in Ext.P2 certificate of insurance issued by the 1st opposite party to the insured Dasan.N. It is further submitted that there is no documents forthcoming from the side of the opposite parties to show that the conditions incorporated in the master policy were served on the insured Dasan.N. Thus, the appellants prayed for setting aside the impugned order passed by the Forum below and to allow the complaint in CC.108/08. On the other hand, the learned counsel for the respondents/opposite parties supported the impugned order passed by the Forum below. He relied on the terms and conditions incorporated in D1 master policy. He much relied on clause 2 of the general conditions of SBI life insurance viz, home loan insurance –master policy. Thus, the respondents prayed for dismissal of the present appeal.
There is no dispute that the appellants/complainants are the legal heirs of the life assured/policy holder Dasan.N. It is also admitted that the policy holder Dasan paid premium amount of Rs.24822/- on 5.5.06 and the 1st respondent/1st opposite party SBI life insurance issued a certificate of insurance(Ext.P2). As per Ext.P2 certificate of insurance Dasan was the policy holder who availed house loan as borrower from SBT home branch. The aforesaid policy commenced on 5.5.06, the date on which the premium for policy was paid. P2 certificate of insurance would make it abundantly clear that the said certificate of insurance was issued subject to the terms and conditions incorporated in the master policy. It is further stated in P2 certificate of insurance that what are stated in Ext.P2 certificate of insurance are only the summary of terms and conditions of the scheme. It is also made clear that the full text of the terms and conditions are contained in the master policy issued by SBI life in the name of the group administrator. The policy holder was also given the contact number for obtaining the details of the policy with respect to the terms and conditions of the master policy. It can very safely be concluded that Ext.P2 certificate of insurance was issued to the policy holder Dasan subject to the terms and conditions of the master policy issued by SBI life insurance. So, the case of the appellants/complainants that they were not aware of the master policy and the terms and conditions of the master policy cannot be accepted as such.
Moreover, there is no case for the appellants/complainants that the policy holder Dasan.N was not aware of the terms and conditions of the master policy. It is to be noted that the policy holder Dasan.N was an educated person working as Sub Engineer in KSEB. There is nothing on record to show that the policy holder Dasan.N was not aware of the terms and conditions of the policy during his life time. It is further to be noted that Ext.P2 certificate of insurance was issued with effect from 5.5..06. The policy holder Dasan committed suicide in September 2006. It is hard to believe that the policy holder was not aware of the terms and conditions of the master policy. It is to be borne in mind that Ext.P2 certificate of insurance was issued to the policy holder under the home loan insurance-master policy introduced by SBI life. It is also to be noted that the aforesaid master policy was introduced on 21st March 2003. Thus, the master policy was effective from 21.3.03 and that the policy holder Dasan.N took the said policy under the aforesaid master policy which is marked as Ext.D1. In all respects, the policy holder was bound by the terms and conditions incorporated in the master policy.
Condition No.2 of general conditions of Ext.D1 master policy is as follows “The Company shall not be liable for payment of any sum assured in terms of para 5 of schedule II of this policy in respect of a Member, if such a Member commits suicide during the 1st year of his admission to the cover.
The aforesaid condition No.2 would make it abundantly clear that a member who has been issued a policy under the master policy commits suicide during the 1st year of his admission to the cover is not entitled to get the benefit under the policy which was issued subject to the terms and conditions of the master policy. In the present case on hand, the policy holder Dasan.N was admitted to the cover on 5.5.06 and he committed suicide in November, 2006. Thus, the suicidal death of the policy holder occurred within one year of the policy. If that be so, the appellants/complainants being the legal heirs of the policy holder are not entitled to get the benefit under Ext.P2 certificate of insurance.
There is no dispute that the policy holder Dasan committed suicide. The documentary evidence adduced from the side of the opposite parties would also make it clear that the policy holder Dasan committed suicide on 16.11.2006. If that be so, the respondents/opposite parties can be justified in repudiating the insurance claim preferred by the appellants/complainants. The Forum below has rightly dismissed the complaint in CC.108/08. This State Commission is pleased to dismiss the present appeal preferred by the complainants in CC.108/08.
In the result the appeal is dismissed. The impugned order dated 31.5.2010 passed by CDRF, Thiruvananthapuram in CC.108/08 is confirmed. As far as the appeal is concerned, parties are directed to suffer their respective costs.
M.V.VISWANATHAN : JUDICIAL MEMBER
M.K.ABDULLA SONA : MEMBER
ps
