Life Insurance Corporation of India, who was the opposite party before the District Forum, has filed the present Revision Petition. Briefly stated the facts are that the deceased husband of the complainant/respondent had taken an insurance policy on 1.1.2005 from the petitioner insurance company for a sum of Rs.5 lakh. He died on 13.2.2005 in an accident. Respondent filed her claim with the insurance company, which was repudiated on the ground that her husband had committed suicide. Aggrieved by this, respondent filed complaint before the District Forum. District Forum allowed the complaint and directed the petitioner to pay a sum of Rs.5 lakh within 30 days from the passing of the order. Rs.1,000/- were awarded by way of costs. Respondent /complainant accepted the order and did not file any appeal. Petitioner insurance company carried an appeal before the State Commission, which has been dismissed by the impugned order. State Commission, while maintaining the order of the District Forum, in addition granted accidental benefit as may be available to the respondent on the insurance policy taken by her husband. Petitioner, being aggrieved, filed the Revision Petition and confined its claim regarding the direction given by the State Commission to give the accidental benefit as well on the twin grounds that (i) as per the policy, accidental benefit was not to be given to the respondent and (ii) in the appeal filed by the petitioner, the additional benefit to the respondent could not be given in the absence of any appeal filed by her. Limited Notice was issued with regard to the award of accidental benefit. Shri Pradeep Kumar, Advocate has put in appearance on behalf of the respondent. He has drawn our attention to the proposal form where the respondent had proposed to take coverage under the accidental benefit as well. But the same is not reflected in the policy. The contract between the parties comes in existence as per terms of the concluded contract of policy. Anything mentioned in the proposal form remains a proposal only, unless the same is accepted by the insurer. The terms between the parties have to be determined as per the clause of the insurance policy and not on the basis of what has been stated in the proposal form, especially when the respondent had the benefit of seeing the policy for 11 months and no objection was taken by her. It has also not been show that the premium paid included the premium for accident benefit as well. This apart, the respondent had accepted the decision of the District Forum and did not carry any further appeal. In the appeal filed by the insurance company, the additional benefit could not be given to the respondent. Such a benefit could have been given only if the respondent had filed the appeal, which she did not do. Learned counsel for the respondent then contended that direction issued to award interest on the insured amount of Rs.5 lakh, as the District Forum has not awarded any interest. If the respondent was aggrieved for non-grant of interest, then she should have filed an appeal before the State Commission. In the absence of any such appeal, State Commission could not have awarded any interest. Moreover, the respondent has not filed any Revision Petition against the order of the State Commission. In the absence of Revision Petition, such a prayer cannot be accepted. In the aforementioned circumstances, the order of the State Commission granting accidental benefit is set aside. Rest of the order is maintained. Revision Petition stands disposed of in above terms.
......................JASHOK BHANPRESIDENT ......................B.K. TAIMNIMEMBER | |