KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD THIRUVANANTHAPURAM APPEAL NO.20/2010 JUDGMENT DATED 2.6.2010 PRESENTSMT.VALSALA SARANGADHARAN -- MEMBER SRI.M.V.VISWANATHAN -- JUDICIAL MEMBER S.CHANDRAMOHAN NAIR -- MEMBER 1. The Branch Manager Life Insurance Corporation of India, Edaparambil Building, Main Road, Pala. 2. The Divisional Manager, -- APPELLANTS Life Insurance Corporation of India Divisional Office, Jeevan Prakash Building, Nagampadom, Kottayam. (By Adv.G.S.Kalkura) Vs. Smt.Saji Anil, Thazhaniyil House, -- RESPONDENT Velliappally, Ramapuram Bazar P.O, Kottayam. (By Adv.P.K.Vijayamohan & Ors.) JUDGMENT SRI.M.V.VISWANATHAN,JUDICIAL MEMBER The appellants were the opposite parties 1 and 2 and the respondent was the complainant in CC.No.78/08. The complaint therein was filed alleging deficiency in service on the part of the opposite parties in repudiating the insurance claim made by the complainant with respect to the policy issued by the opposite party/LIC of India in the name of the complainant’s husband late Anilkumar. The opposite parties entered appearance and justified their action in repudiating the insurance claim by the repudiation letter dated 5.12.07. They contended that the policy issued in the name of late Sri.Anilkumar.T.K. was not in force at the time of death of the life assured, that the premium for the policy was effected at 3.19 pm on 3.4.07, but the policy holder Sri. Anilkumar died at 2.40 pm on 3.4.07. Thus, the opposite parties prayed for dismissal of the complaint in CC.78/08. 2. Before the Forum below the complainant was examined as PW1 and Exts.A1 to A9 documents were marked on the side of the complainant. The authorized officer of the opposite party LIC of India filed counter affidavit in support of the case of the opposite parties. Exts.B1 to B6 documents were also marked on the side of the opposite parties. After hearing both parties, the Forum below passed the impugned order dated 16th November 2009 directing the opposite parties to pay the insured sum of Rs.4 lakhs with interest at the rate of 9% per annum from the date of repudiation till realization and cost of Rs.1500/-. Hence the present appeal by the opposite parties therein. 3. We heard both sides. The learned counsel for the appellants/opposite parties much relied on B5 inquest report and submitted that the life assured died on 3.4.07 at 2.40 PM that the premium for the policy was remitted only at 3.19 pm on 3.4.07and there was no policy in existence at the time of death of the life assured Anilkumar T.K. It is also submitted that the provisions of Section 50 of the Insurance Act have no application in the present case because of the fact that all the details regarding the payment of premium are set forth in the policy itself. He also pointed out the details regarding the payment of premiums in B2 Insurance policy. It is further submitted that the complainant has not taken any such case regarding the right available to the life assured under the provisions of Section 50 of the Insurance Act. Thus, the appellants/opposite parties prayed for setting aside the impugned order passed by the Forum below. On the other hand, the learned counsel for the respondent/complainant supported the impugned order passed by the Forum below. She much relied on A7 FIR in Crime No.218/07 of the Police Station, Pala and submitted that the death of the life assured Anilkumar occurred at about 3.30 pm on 3.4.07 and argued for the position that the premium for the policy was accepted by the opposite party/LIC of India at 3.19 pm on 3.4.07. Thus, the respondent prayed for dismissal of the present appeal. 4. Points that arise for consideration are:- 1. Whether the appellants/opposite parties can be justified in repudiating the insurance claim by virtue of the repudiation letter dated 5.12.07 (Ext.A5)? 2. What was the actual time of death of the life assured Anilkumar T.K? 3. At what time the premium for the Life Insurance Policy which was issued in the name of Anilkumar was remitted to get the lapsed policy revived? 4. Whether the respondent/complainant is entitled to get the benefit of Section 50 of the Insurance Act as opined by the Forum below? 5. Is there any legally sustainable ground to interfere with the impugned order dated 16.11.09 passed by CDRF, Kollam in CC78/08? For the sake of convenience, we will consider these points together as these points are inter related and inter connected. 5. Admittedly, the respondent’s late husband Sri.Anilkumar.T.K was holder of Bhima Gold Policy with Policy No.393353900 for an amount of Rs.2 lakhs with double accident benefits. Ext. B2 is the policy with the policy schedule. It would show that the aforesaid policy was commenced on 28.3.06 and the risk commenced on 31.3.06. The date of maturity is shown as 28.3.26. The due date of premium is prescribed as 28th quarterly. It is also specified that the stipulated due date for payment of premiums are shown as March, June, September and December. The name of the life assured is shown as Anilkumar T.K with his wife Saji Anil (complainant) as the nominee. Thus, B2 policy of Insurance with the policy conditions would make it clear that all the details regarding the said life insurance policy were included in the policy itself especially, the details regarding payment of premiums. If that be so, Section 50 of the Insurance Act, 1938 cannot be made applicable in the present case. Section 50 of the Insurance Act reads as follows:- “Notice of options available to the assured on the lapsing of a policy - An insurer shall, before the expiry of 3 months from the date on which the premiums in respect of a policy of life insurance were payable but not paid, give notice to the policy-holder informing him of the options available to him unless these are set forth in the policy” 6. The details given in B2 policy would make it clear that the details regarding the options available to the policy holder were given in the policy itself. If that be so, the provisions of Section 50 of the Insurance Act cannot be made applicable in the present case on hand. More over, the respondent/complainant had no such case that there was lapse on the part of the LIC of India to give notice under Section 50 of the Insurance Act. The life assured had no such complaint regarding the failure on the part of the LIC of India to issue intimation under Section 50 of the Insurance Act. Thus, in all respects, the Forum below cannot be justified in finding fault with the opposite parties for not giving notice as stipulated under Section 50 of the Insurance Act. It is also to be noted that the Forum below allowed the complaint in CC 78/08 on the sole ground that the opposite parties failed to give notice to the life assured as contemplated under Section 50 of the Insurance Act, 1938. The above said finding and conclusion of the Forum below cannot be upheld. There is no dispute that the Life Insurance Policy issued in the name of Anilkumar T.K had lapsed for non payment of premium within the stipulated time. The premium ought to have been paid on 28.12.06. The life assured had one month grace period to pay the premium. The grace period was also over by 28.1.07. It is at the request of the life assured permission was granted to pay the premium to get the lapsed policy revived. But, the life assured permitted the premium to get the policy revived only on 3.4.07 at 3.19 pm. Ext.A3 receipt for payment of renewal premium would make it clear that the said premium was remitted only on 3.4.07 at 3.19pm. The definite case of the appellants/opposite parties is that the life assured died at 2.40pm on 3.4.07. In other words, at the time of death of the life assured, the Life Insurance Policy was not in force. There can be no doubt about the fact that the lapsed policy could be revived only on remittance of the renewal premium. But in the present case, the renewal premium was paid only on 3.4.07 at 3.19 pm. If the case of the appellants is accepted as true and correct, then there was no policy in force in the name of the life assured Anilkumar T.K at the time of his death. The case of the respondent/complainant is that the life assured Anilkumar T.K died only at 3.30 pm on 3.4.07. Ext.A7 FIR (B4) would show that Anilkumar T.K died at 3.30 pm on 3.4.07 while he was in the treatment at Medical College Hospital, Kottayam. It is to be noted that the aforesaid FIR was lodged based on the first information furnished by one Sabu son of Damodharan. A perusal of the first information furnished by the first informant Sabu was only ear say information. It would show that the first informant Sabu was not present at the place of accident nor at the time when the injured Anilkumar died at Medical college Hospital Kottayam. So, much reliance cannot be placed on A7 FIR in coming to the definite finding and conclusion that Anilkumar T.K died at 3.30 pm on 3.4.07. No other document is forthcoming from the side of the complainant to support her case that her husband Anilkumar died at 3.30pm on 3.4.07. Ext.B5 Inquest report prepared by the Police in the aforesaid Crime No.218/07 of the Police Station Pala would show that the insured Anilkumar died at 2.40 pm on 3.4.07 at Medical College Hospital, Kottayam. It is to be noted that the life assured Anilkumar met with the motor accident on 3.4.07 at about 2 pm and he sustained serious injuries including head injury. He was brought to the General Hospital, Pala and thereafter to Medical College Hospital, Kottayam. The death of Anilkumar occurred while he was in the casualty of Medical College Hospital, Kottayam. The inquest was prepared at Medical College Hospital, Kottayam. Thus, the statement in B5 inquest is more reliable and acceptable than the statement in A7 FIR. The complainant was examined before the Forum below as PW1. She was not in a position to give a definite answer to the question as to the actual time of death of her husband. A definite suggestion was put to PW1 that the death of her husband occurred at 2.40 pm on 3.4.07. But to the said suggestion, PW1 could not give a definite answer. But, she gave an evasive answer that she got the information that the death occurred in an accident. In effect, the complainant could not adduce any reliable evidence to substantiate her case that at the time of death of the life assured, the Insurance policy was in force. The appellants/opposite parties filed an interlocutory application as IA.539/10 to receive additional documents in this appeal. The documents sought to be produced are the letter dated 13.6.07 issued by the opposite party/LIC of India to the complainant requesting her to produce the FIR Police Inquest Report, Postmortem report and the Claim Forms, A, B, B1 and C. The other documents are the medical attendance certificate and certificate of hospital treatment. The appellant on this day has also produced photocopy of the case record maintained in Medical College Hospital, Kottayam. It is submitted that the Medical attendance Certificate and certificate of Hospital treatment are issued based on the case records maintained by the medical authority at Medical College Hospital, Kottayam. The aforesaid Medical attendance certificate and certificate of hospital treatment and the case record maintained in Medical College Hospital, Kottayam would reveal the fact that the injured Anilkumar (life assured) died at 2.40 pm on 3.4.07 while he was in Medical College Hospital, Kottayam. The aforesaid documents could not be filed by the by the appellants before the Forum below. The respondent/complainant has filed objection to this IA.539/10. But the acceptance of these documents maintained by the public authority could not cause any material prejudice to the respondent/complainant. It is also to be noted that the time of death of the life assured is an important point to be considered for a just and proper disposal of this appeal. In effect, the interest of Justice demands acceptance of these documents produced at the appellate stage. So, this Commission is pleased to accept these documents produced along with IA.539/10 for rendering substantial justice to the parties in this appeal. The documents now produced from the side of the appellants/opposite parties would also make it crystal clear tat the life assured Anilkumar T.K died at 2.40 pm on 3.4.07. We do not find any reason or ground to doubt the genuineness and correctness of the certificate of hospital treatment and medical attendance certificate issued by the Doctor attached to Medical College Hospital, Kottayam. It is also to be noted that the respondent/complainant has not disputed the genuineness and correctness of these documents and the entry made in these documents. Thus, it can very safely be concluded that the life assured Anilkumar T.K. died at 2.40 pm on 3.4.07. If that be so, the remittance of renewal premium was effected only after the death of the life assured. In effect, there was no Life Insurance Policy in force at the time of death of the life assured. The appellants/opposite parties are justified in issuing A5 repudiation letter dishonoring the Insurance claim preferred by the respondent/complainant. The forgoing discussions and findings thereon would make it clear that the Insurance claim preferred by the respondent/complainant is not legally sustainable. The Forum below cannot be justified in directing the opposite parties to pay the insurance amount under the lapsed policy. So, the impugned order is liable to be set aside. Hence we do so. Before parting with this appeal, we would like to draw the attention of the LIC of India to invoke the provisions of granting ex-gratia payment to the complainant, the nominee of the life assured. It is also to be noted that as per A3 receipt, the life assured had remitted a total of Rs.2065.50 by way of renewal premium. The aforesaid payment was effected on 34.07. It is understood that the aforesaid amount is still in the possession and enjoyment of LIC of India. They have not taken any steps to refund the said amount with interest accrued thereon. So, the LIC of India can very well think over the pathetic situation of the widow of the life assured. We expect that the reputed institution, the LIC of India will consider this matter in a deserving manner by showing sympathy towards the complainant, the widow of the life assured. It is also to be borne in mind that the benefit of 4 lakhs was snatched away from the hands of the complainant by the mere lapse of few minutes, otherwise the complainant being the nominee ought to have been benefited by getting the policy amount of Rs.4 lakh with the necessary other benefits. So, once again we are pleased to request the LIC of India to consider the case of the respondent/complainant in a sympathetic way. In the result, the appeal is allowed. The impugned order passed by the Forum below is set aside. There will be no order as to costs. M.V.VISWANATHAN -- JUDICIAL MEMBER VALSALA SARANGADHARAN -- MEMBER CHANDRAMOHAN NAIR -- MEMBER | 
