THE KARNATAKA STATE CONSUMER DISPUTES

REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)

DATED THIS THE 19^th DAY OF JULY, 2022

PRESENT

SRI RAVI SHANKAR – JUDICIAL MEMBER

SMT. SUNITA C.BAGEWADI - MEMBER

APPEAL NO. 379/2013

1. The General Manager,

SBI Life Insurance,

Regd. Office,

State Bank Bhavan, Madame,

Cama Road, Nariman Point,

Mumbai-400021 with

Corporate office,

Turner Morrison

Building GN Vaidhaya Marg Fort,

Represented by

The Head – Processing Centre,

SBI Life Insurance Co. Ltd,

23, Yamuna Complex,

II Floor, 7^th Cross,

Bangalore-560 003

……….Appellant/s.

(By Shri/Smt. R.Rajagopalan, Adv.,)
                                   

                                          -Versus-

1. Smt.Geetabai,

W/o Mahadappa Nalgire,

Aged about 32 years,

Occ: Household,

R/o. Katti Tugaon Taluk Balki,

Bidar District -585328

2. The Manager,

State Bank of India,

Branch: Chitguppa,

Taluk Humnabad,

District Bidar-585412

………Respondent/s.

(R1-By Shri/Smt.M.R.Hiremathad, Adv.)

(R2-By Shri/Smt.Brijesh Chander Guru, Adv.)

:ORDER:

BY SRI.RAVI SHANKAR  -  JUDICIAL MEMBER

         The Opposite Party in Complaint No.43/2012 before the Bidar District Consumer Commission preferred an appeal against the order passed by the District Commission is directed to pay the loan availed from the Opposite Party no.2 bank along with Rs.2,000-00 as litigation expenses .

2.       The brief fact of the complaint is that, the complainant obtained master policy through 2^nd respondent covering risk of personal loans the policy is a group insurance and complainant’s Sri.Mahadappa Nalgire took out a life insurance policy from the appellant’s insurance company under SBI Dhana Raksha Plus PLLT bearing No.93000001404 and his member ship was no.931253347.

3.       After issuance of policy, this appellant has under took to cover the risk of the outstanding loan availed by the any members from the 2^nd respondent. The policy commenced from 21-1-2011, the husband of the complainant had availed a loan to the tune of Rs.2,50,000-00 he is regularly paying the EMI to the said loan such being the case on 4-2-2011 the husband of the complainant died. The complainant being the nominee and LRs of the said deceased she claimed for clearance of the loan by this appellant/Opposite Party, but the said Opposite Party instead of clearing the loan of the deceased husband of the complainant had repudiated the claim for which filed the complaint alleging the deficiency of service.

4.       After trial, the District Commission allowed the complaint and directed the appellant /Opposite Party no.2 to pay the entire loan amount to the bank/respondent no.2.

5.       Aggrieved by the said order, the appellants came before this Commission.

6.       Heard from both parties.

7.      On going through the memorandum of appeal, certified copy of the order and other documents produced  before  District Commission, there is no dispute that the complainant being an account holder in respondent no.2 bank  had availed loan to the tune of Rs.2,50,000-00  and insured the said loan amount with this appellant and paid the premium of Rs.1574-00, after issuance of policy, the complainant’s husband died on 4-2-2011being a nominee the complainant claimed for clearing the loan as per the policy issued by the appellant company but the appellant company has repudiated the claim made by the complainant for the reasons that the husband of the complainant was died within 45 days from the commencement of the risk, hence they are not liable to pay any claim and submits no deficiency of service.

8.       The District Commission after trail allowed the complaint and directed to this appellant to clear the loan but the District Commission failed to appreciate the terms and conditions of the policy issued by the Opposite Party bank. Clause 8 of the terms and conditions of the policy is clear that whoever died within 45 days of the commencement of the policy they are not liable to pay any claim. The terms and conditions are binding on the party. The District Commission made an error in not appreciating the terms and conditions of the policy. Exclusion clause 8 of the policy clearly discloses that “45 days exclusion: During the first 45 days from the date of commencement of cover for an insured member, the company shall not be liable to pay any claim amount except for a claim arising out of death to accident.”  And also provide if any death occurred due to accident the risk is going to the covered. Here the death of the husband of the complainant is natural death, the death was not caused due to any accident, hence the claim made by the complainant is not in accordance with the terms and conditions of the policy. We found there is no any deficiency of service on the part of the Opposite Party, the repudiation made by the appellant is justifiable but the District Commission made an error in allowing the complaint. Hence, the order has to be set aside and accordingly the appeal is allowed and the complaint is dismissed. Consequently, we proceed to pass the following:

:ORDER:

The appeal No.379/2013 filed by the Appellant/Opposite Party is allowed.  Consequently, the complaint filed by the complainant is dismissed.

The amount deposited in appeal No.379/2013 shall be transmitted to the concerned District Commission to pay the same to the appellant/Opposite Party. 

Send a copy of this order to both parties as well as concerned District Commission.

Member.                                                                     Judicial Member.