JUSTICE AJIT BHARIHOKE, PRESIDING MEMBER

            This revision is directed against the order of the State Commission dated 29.03.2012 whereby the State Commission West Bengal dismissed the revisional application No. SC Case No.RC/97/2011.

2.         Briefly stated the facts relevant for the disposal of this revision petition are that Late Alok Kumar Dass, husband of the respondent / complainant, obtained Home Equity Loan of Rs.5,22,135/- from M/s GE Money Financial Services which was to be paid in monthly instalments of Rs.9383/- w.e.f. July 2005.  The said loan was covered by SBI Life Insurance Policy obtained by MS GE Money Financial Services under Group Insurance Scheme.  Husband of the complainant unfortunately died before he could discharge the aforesaid loan.  The respondent / complainant being nominee under the insurance policy filed the insurance claim which was repudiated by the petitioner / insurance company on the ground that late husband of the complainant was not covered under the Group Insurance Scheme as per the confirmation received from GE Money Financial Services.  Being aggrieved of repudiation of the insurance claim, the respondent /  complainant filed consumer complaint in District Forum 24 Pgs, Barasat.  The complaint was resisted by the opposite parties.  The District Forum on consideration of the pleadings of the parties and the evidence allowed the complaint and directed thus:

“The opposite parties are jointly and severally directed to pay the insured sum with interest at the rate of 9% p.a. w.e.f. the date of filing P.O.C. till realization after making an adjustment with the outstanding amount there from within 2 months from the date of this order.  O.Ps are further directed to pay sum of Rs.10,000/- towards compensation to the complainant.  OPs are further directed to pay the sum of Rs.5000/- towards the cost of litigation within two months from the date of this order.”

3.         The above order of the District Forum was not challenged in appeal and it has become final.  As the order was not complied with, the respondent / complainant filed an Execution Petition being Execution Case No. 66/2011 in the District Forum concerned.  The petitioner JD No.2 in response to the notice of the Execution Petition appeared before the Executing Court and took the plea that he has complied with the order by liquidating the house building loan of late husband of the complainant by paying Rs.6,59,980- to JD No.1 Finance Company and has also paid Rs.12000/- by cheque to the respondent / decree holder towards compensation and cost of litigation.

4.         The aforesaid plea of the petitioner / JD No.2 was rejected by the District Forum by observing that JD No.2 has not fully satisfied the order because he has failed to pay the balance insurance amount after adjusting the loan account of late insured.

5.         Being aggrieved of the order of the Executing Court, the petitioner approached the State Commission and the State Commission vide the impugned order dismissed the revision application preferred by the petitioner with following observations:

“We have carefully gone through the impugned order and find that the Ld. District Forum has rightly observed that SBI Life Insurance Co. Ltd. issued the insurance certificate in favour of the deceased insured and as such, question of exonerating the OP/Revisionist does not arise at all at the very initial stage of the execution proceeding without going into the merit of the same. In this connection, we find much merit in the submissions so put forward on behalf of the OP/Complainant, according to whom, only a part pecuniary liability has been discharged at the instance of the OP/Revisionist and the real controversy between the parties can only be properly adjudicated at the time of hearing of the execution case. Having considered the present Revisional Application in the light of above discussion we are of the considered opinion that the application for exonerating the Revisional Petitioner appears to have been made prematurely and the Ld. District Forum having rejected the same has not committed any illegality or irregularity and as such, we are not inclined to interfere with the impugned order, which stands confirmed. In the result, the Revisional Application fails.”

6.         No one appeared on behalf of respondent no.1 / complainant.  As such the revision was heard ex parte against respondent no.1 / complainant.  Counsel for respondent no.2 has contended that dispute in this revision does not concern respondent no.2.  As such she has nothing to argue.

7.         Mr. Rakesh Malhotra, Advocate for the petitioner has  taken us through condition no.1 (a)  in Schedule-I of the terms and conditions of the insurance policy and contended that as per this condition, the PPI cover extended to the life assured was lower of the outstanding amount of loan or Rs.7,50,000/-. Learned counsel has contended that foras below have failed to appreciate that entire outstanding loan with interest have been liquidated by the petitioner / opposite party.  Therefore, now there is no liability on the part of the petitioner in respect of the order under execution.

8.         In order to appreciate the contention of the petitioner, it is necessary to have a look on the relevant condition no.1 detailed in Schedule – I of the terms and conditions of the insurance which is reproduced as under:

“Schedule – I

            Sum Assured, Premium Rates and Advance Premium Amount

1.         Sum Assured means:

            (a)       In the case of PPI Cover ( “PPI Sum Assured”) : -

                        the lower of :

                        (i)         the Amount Outstanding for that Member; and

                        (ii)        Rs.7,50,000/- (Rupees Seven lakhs Fifty Thousand only)

And

(b)       In the case of PA Cover (“ PA Sum Assured”);- an amount of Rs.5 lakhs (Rupees Five Lakhs only) for cases done before October 31, 2004

( c )                  The PA cover would be Rs.7.5 lakhs for cases done beyond November 2004.”

9.         On reading of the above, it is seen that in case of Premium Payable Insurance Cover PPI), the liability of the insurance company is either the amount outstanding in the loan account of the insured or Rs.7,50,000/- whichever is less.  However, condition No. 1 ( c) provides that personal accident cover would be Rs.7,50,000/- for the cases done beyond November 2004.  From the consumer complaint filed by respondent no.1, it appears that respondent no. 1 has set up the case to the fact that her late husband was having personal accident cover.  There is nothing on the record to suggest that late husband of respondent no.1 died an accidental death.  Only pleading before the consumer complaint was that husband of the petitioner expired on 30.12.2006 without mentioning the cause of death.  This imply that respondent / complainant had failed to establish that her late husband died because of some accident.  That being the case, the sum assured qua the insurance policy has to be under clause 1 (a ) of Schedule – I which provides that insurance cover in case of PPI cover would be lesser of Rs.7,50,000/- or the loan amount outstanding against the member to the group insurance policy.  Admittedly, the outstanding loan of the deceased has been liquidated by the petitioner. Therefore, in our view, the petitioner has complied with the order of the District Forum under execution.  It may also be pointed out that order of the District Forum under execution is vague to the extent that it does not mention the exact sum payable by the petitioner.

10.       In view of the discussion above, it is obvious that impugned orders of the foras below are violative of terms and conditions of the contract, as such not sustainable.  Revision petition is, therefore allowed and impugned orders are set aside.