J U D G E M E N T
1. The complainant filed the complaint against the OPs U/Sec.12 of the Consumer Protection Act, 1986.
2. The complaint in brief is that, the complainant’s father Mareppa had obtained a Life Insurance Policy from OP’s insurance corporation on 28.10.2009 for Rs.50,000/- for which yearly premium payable was Rs.3,276/- and maturity of the said policy was on 28.10.2026. Due to illness, he could not pay the second premium amount. The complainant’s father died on 17.4.2011. The complainant was the nominee under the said policy obtained by his father. Hence, the complainant made claim with the OP’s insurance corporation to pay the amount assured under the policy. But the OP’s insurance corporation refused to pay the same. This act of the OP’s insurance company amounts to deficiency in service. Therefore, the complaint seeking reliefs as prayed for.
3. The OP’s insurance corporation filed written version stating that, all the allegations made in the complaint, except those which are expressly admitted are denied as false. The life assured had paid only first yearly premium on 28.10.2009. He was issued with policy bond in which it was clearly printed that, life assured has to pay yearly premiums in the month of October every year. However, the life assured has not paid the due for the month of October-2010 to OP’s insurance corporation to keep his policy in force and allowed the policy to lapse as on the date of death. Hence, the OP’s insurance corporation has rejected the claim of the complainant. If the said premium due was not paid even before the expiry of grace period, then the policy lapses. A lapsed policy is devoid of all benefits. The complainant himself has admitted that the yearly premium due on 10/2010 has not been paid till the death of life assured on 17.4.2011. The complainant himself has admitted that, the yearly premium due on 10/2010 has not been paid till the death of life assured on 17.4.2011. The complainant himself being the nominee under the policy has been informed that since the policy is in lapsed condition for non-payment of 10/2010 yearly premium, he was not eligible for any claim under the policy. The OP has acted as per the policy conditions, hence, there is no deficiency of service. It is false to state that, the OP has assured to consider the admission of claim. Since, there is no deficiency of service, the complaint may be dismissed with costs.
4. The complainant to prove his case, as his evidence, filed his affidavit, which is marked as PW-1 and got marked 05 documents as Exh.P-1 to P-5. The OP as his evidence, filed one affidavit, which is marked as RW-1 and got marked 04 documents as Exh.R-1 to R-4.
5. Heard the oral arguments on both sides.
6. The points that arise for our consideration are;
1) Whether the complainant has proved deficiency in service on the part of the OP towards him, as alleged in the complaint?
2) Whether the complainant is entitled for the reliefs prayed for in the complaint?
3) What order?
7. The findings on the above points are as under;
1) In the negative.
2) In the negative.
3) As per final order for the following;
REASONS
8. POINT NO.1 :-
The complainant himself in the complaint admitted that his father deceased life assured could not pay the 2nd installment of the premium due on October-2010 due to his illness. The OP contended that the life assured had paid only initial one premium while taking the policy and it is clearly printed on the policy bond that life assured had to pay his yearly premium in October-2010 every year and it is the responsibility of the life assured to pay the premiums regularly whenever it falls due and the life assured has not paid the premium due for October-2010 to keep the policy in force and thereby the policy was in lapsed condition as on the date of the death on 17-04-2011. It is the further contention of the OP that policy condition No-2 deals with the payment of premium and as per the said condition a grace period of one month but not less then thirty days is allowed for the payment of premium and if death occurs within this grace period and before the payment of premium due, the policy will be still be valid and death claim will be paid after deduction of the said unpaid premium and if premium is not paid before the expiry of grace period then the policy lapses. Perused the policy condition No.2 and it reads thus:
Payment of premium:- A grace period of one month but not less then 30 days will be allowed for payment of yearly, half yearly or quarterly premium and 15 days for monthly premium. If death occurs within this period the policy will be still valid and the sum assured paid after deduction of the said premium as also the unpaid premium’s falling due before the next anniversary of the policy. If the premium is not paid before the expiry of the days of grace the policy lapses.
9. It is not at all the case of the complainant that the premium due on October-2010 was subsequently paid within 30 days of the grace period allotted as per Condition No-2. So as on the date of death of the deceased life assured on 17-04-2011 the policy was in lapsed condition. Under such circumstances the complainant cannot claim the amount assured under the said policy. Therefore the repudiation of the claim of the complainant by the OP is proper and legal. Therefore deficiency in service cannot be attributed against the OP. Accordingly this point is answered in the Negative.
10. POINT NO.2:-
As the complainant has failed to prove his case and deficiency in service on the part of OP, he is not entitled for any reliefs prayed for in the complaint. Accordingly this point is answered in the Negative.
11. POINT NO.3:-
As per order below
ORDER
The complaint filed by the complainant is dismissed.
There is no order as to cost.
Intimate the parties accordingly.
(Dictated to the Stenographer, transcribed by him, corrected by me and then pronounced in the open Court on this the 1st day of February 2014)
