FA.No.1447/2008 against CC.No.55/2007 District Consumer Forum, Kurnool.

Between:

1.Smt.E.Lalitha, W/o.late Eswar Goud,

   Aged about 35 years, Occ: Housewife,

2.Kum.E.Shireesha, D/o.late Eswar Goud,

   Aged about 13 years, Minor rep. by her natural

3.Mr.E.Naveen Kumar Goud,

   S/o.late E.Eswar

   Minor, rep. by his natural guardian Mother,

All are residents of Door No.69/505, Joharapuram,

Kurnool.

…Appellants/Complainants.

And

1.Life Insurance Corporation of India,

   Rep. by its Divisional Manager,

   2.The Branch Manager,

   Life Insurance Corporation of India,

   Kurnool Branch, Kurnool.

…Respondents/Opp.Parties.

Counsel for the Appellants       : Mr.M.C.AdimurthyCounsel for the Respondents   : Dr.G.Shyamala.

QUORUM: THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT,

AND

SMT.M.SHREESHA, HON’BLE MEMBER.

FRIDAY, THE SIXTH DAY OF AUGUST,

TWO THOUSAND TEN.

Oral Order (Per Hon’ble Sri Justice D.Appa Rao, President)

*******   

1.         This is an appeal preferred by the complainants against the inadequacy of the amount granted by the District Forum.

2.         The case of the complainants in brief is that the first complainant is the wife and complainants 2 and 3 are the children of late Eswar Goud who took policy for Rs.50,000/- from the opposite parties-Life Insurance Corporation of India covering the period from 28.1.1998 to 29.1.2008.  While so, on 29^th /30^th April, 2001 he met with an accident and admitted into Government General Hospital, in a state of Coma.  The family members could pay premium upto January, 2004.  However, they could not pay the premium for the year 2005.  He died on 10.12.2005.  Thereupon a claim was made enclosing all the documents showing they are the nominees of the deceased.  The Insurance Company repudiated the claim on the ground that the policy was not in force by the date of death of the insured.  Therefore, the complainants filed the complaint for the amount covered under the insurance policy.

3.         The Insurance Company resisted the case.  However, it admitted the issuance of policy and the fact that he received injuries and admitted in the hospital and ultimately died on 10.12.2005.  The premiums were paid only upto 1/2004.  The duration between the unpaid premium and the date of death of the life assured was 1 year 5 months.  The policy has been lapsed by the date of death.  By virtue of condition No.10.2 of the policy, the nominees would be entitled to the amount paid but not the accident benefit.  Since the policy is money back policy under table and term 75-20, survival benefit of 20% of sum assured i.e Rs.10  The complainants were entitled to the prorate amount of Rs.26  The death was not proximate to the accident and therefore prayed for dismissal of the complaint.

4.         The complainant in proof of their case filed affidavit evidence and got the documents marked as Exs.A.1 to A.9 and X.1 and X.2, while the opposite parties filed affidavit evidence and filed Ex.B.1.

5.         The District Forum after considering the evidence placed on record opined that either the deceased or the complainants did not pay the premium due for the year 2005.  The last premium that was paid was in January, 2004.  In fact the survival benefit of Rs.10  The prorate amount of Rs.26  Accordingly, the District Forum directed the Insurance Company to pay Rs.26,950/- together with interest at 9% per annum from the date of death i.e. 10.12.2005 till realization besides costs of Rs.2,000/-. 

6.         Aggrieved by the said order, the complainants preferred this appeal contending that since the deceased was in coma although and died on 10.12.2005.  The Insurance Company ought to have paid the entire amount covered under the policy.

7.         The point for consideration is whether the amount awarded by the District Forum needs modification, and if so to what extent?

8.         It is an undisputed fact that the deceased having taken a policy covering the period from 28.1.1998 to 29.1.2008 for Rs.50th/30^th April, 2001 and ultimately succumbed to death on 10.1.2005 while taking treatment in Govt. General Hospital.  The last premium that was paid was in January, 2004.  Admittedly, neither the assured nor the family members had paid the premium due for 2005.  By the date of death on 10.12.2005 the policy was in lapsed condition.  It is not in dispute that the Insurance Company had paid Rs.10  viz. 20% of the sum assured towards survival benefit on 10.1.2003.  Since the policy is for Rs.50,000/- after calculating the proportionate paid up value of Rs.16,250/- and vested bonus of Rs.19,800.- the total of which comes to Rs.36,050/, the Insurance Company arrived at Rs.26,050/- after deducting survival benefit of Rs.10,000/-.  The Insurance Company has agreed to pay the amount of Rs.26  In fact the District Forum directed the said amount to be paid together with interest at 9% per annum together with costs of Rs.2000/-.  The Insurance Company did not prefer any appeal against the said order.  The complainants contend that in view of the death of the deceased in road accident, they would be entitled to the said benefit. Admittedly by the date of death of the deceased i.e. on 10.12.2005 the policy was in lapsed condition.  Therefore, the complainants would not be entitled to accident benefit covered under the policy.  We do not see any mis-appreciation of fact in this regard.

9.         In the result, the appeal is dismissed, however without costs.

PRESIDENT                   MEMBER

DtVvr.           

PRESIDENT

MEMBER

DtVvr.