SRI.K. VIJAYAKUMARAN, PRESIDENT.

 Complainant filed this complaint for realization of insurance amount, compensation and costs etc.

          The averments in the complaint can be  briefly summarized as follows:

          Complainant’s husband was employed in gulf.  While so he has joined a Group Janatha Personal Accident Policy sponsored by the opp.parties on 29.1.1999The policy save card issued under the above scheme bearing No.125536 was issued to the complainant’s husband.   As per the condition in the policy in case policy holder died during the subsistence of the policy within 10 years  in accident. the nominee will kept Rs.5,00,000/-.  The complainant’s husband sustained injury in   an accident in July  2004 at gulf.   After that on 27.7.2004  he was brought home for further treatment  attempted in the Thiruvananthapuram Medical College were he succumbed in the injury on 17.8.2004.   The complainant is the regal heir  and nominee as per the above policy and as such she is entitled to get Rs.5,00,000/-  as per the conditions in the policy.   The complainant produced the death certificate and claim form before the first opp.party   But her claim was repudiated on 14.10.2004.  Hence the complaint.

          The Opp.parties filed a joint version contending, interalia, that the complaint is not maintainable either in law or on facts.    There is no privity of contract between the complainant and opp.party  and therefore there is no consumer relationship between the complainant and this opp.party.  The opp.party has entered into a contract of Insurancef with M/s. Dollars India Card Ltd., Chennai and accordingly a mater policy bearing No.4771060000846 dt. 29.1.1999 was issued  to the card holder from time to time under the Long Term Janata Personal Accident Policy.  The cardholders of the Janata Personal Accident Policy were enrolled by the said Dollara India Card Ltd  and the complainant’s husband was Sri. Reghunathan .  It is a Group Personal Accident Policy and not an individual policy to respective cardholders.  The period of policy was 10 years with death cover only.  On the basis of the Agreement entered between Dollars India Card and as per the Master Policy the insurer has insured  in the beneficiaries  and issued individual Janatha Personal Accident Policy certificate.  As per the policy certificate  was issued the complainant the sum assured was Rs.5,00,000/- .    For that a nominal  sum of Rs.280/- was only received towards premium. The policy had validity from 29.1.1999 to 28.1.2009 as per the clause 5 of the condition of policy, the insured has every right to cancel the policy without assigning reason and in such case to refund the pro rata  premium of the un expired portion of the risk.  Due to the operational constrains and risk, the Regional Office of the opp.party  asked all the branches to cancel the Janata Personal Accident Policy with effect from 1.5.2003 and to refund the pro-rata premium  of the unexpired portion of the risk.   Accordingly the Janata Personal Accident Policy  was issued  to the complainant’s husband  was also cancelled and pro-rata premium for the unexpired period was  refunded  and the same was acknowledged by the complainant.    The insurer has every right to cancel the policy by canceling the policy  the complainant received this refunded premium without out protest or in objection.  Now  the complainant lhas approached the Hon’ble Forum  alleging deficiency of service and unfair trade practice.  For which the complainant has no  right  under condition number of the policy .  This opp.party  has rightly cancelled the policy  and they have acted  only in accordance with the  conditions challenging the conditions of the policy is not at all a consumer dispute within the purview of Consumer Protection Act. The prayer of the complainant to disburse the insurance policy does not arise such policy is already cancelled.   The policy was cancelled   as early as 1.15.2003 whereas the subject risk  here in  case taken place  on 17.8.2004.  The complainant  is not entitled to get the  any benefits under the policy which was no longer in the existence as on the date of incident.  There is no deficiency in service on the part of the opp.party   The complaint is bad for non-jonder of necessary parties M/s. Dollars India Card Ltd  is not made a party with whom only this opp.party has privity of contract.  Hence the opp.parties prays to dismiss the complaint. With their costs.

Points that would arise for consideration are:

1.     Whether there is deficiency in service on the part of the opp.parties

2.     Reliefs and costs.

For the complainant PW.1 is examined Ext. P1 to P4 are marked.

For the opp.party DW.1 is examined.  Ext. D1 to D5 are marked.

Points

          There is no dispute that then there was a contract of Insurance between the 1^st opp.party and the complainant’s husband Reghunathan.  It was a Janatha Personal Accident Policy and the term of the policy was 10 years from 29.1.99 to 28.1.09.  According to the 1^st opp.party the contract of insurance was between opp.party 1 and M/s. Dollars India Card Ltd. and a Master policy bearing No.4771060000846 dt. 29.1.99 was issued to the card holders lwhich is not an individual policy but a giving Insurance Policy and that the complainant’s husband was a subscriber of the said policy.  It is the further case  of the  1^st opp.party that the policy had certain conditions and under condition.   NO.5 of the said policy the insurance company reserved their right to cancel the policy at any time without assigning any reason after paying the prorate premium for the unexpired portion of the risk and in exercise of that right  they cancelled the above Janatha Personal Accident Policy with effect from 1.5.2003 and the policy in respect of the complainant’s husband was also cancelled.

          The contention of the learned counsel for the complainant is that the 1^st opp.party has no right to cancel the policy unilaterally without giving notice to the policy holders.  It is further argued that copies of condition was not given to the policy holders nor they were informed about the conditions and as such unilateral cancellation of policy is unsustainable.

          Now the question is whether or not the cancellation of the policy is valid .   The definite contention of the 1^st opp.party is that they have every right to cancel the Janatha Personal Accident Policy at any time invoking condition NO.V after giving notice  to the policy holders and that they have given due notice to the policy holders and also given the prorate premium for the unexpired portion.   Every policy will have terms and conditions and the policies are accompanied with conditions.  It cannot be believed that in the p[olicy of the complainant’s husband the terms and condition were not annexed condition No.V  of Ext. D1 policy  is an follows:  “ The company may at any time by notice in  writing cancel this policy, provided that the company shall in that case return to the insured the then last paid premium less a pro-rata part thereof for the portion of the current insurance period which shall have expired ……”  Ext. D3 series shows that the opp.party has send a notice under certificate of posting in the address of the insured furnished in the policy.   A notice which is correctly addressed and properly stamped can be presumed to be delivered Ext.P4 also would establish that the notice and the cheque  for prorate premium have been received  by the insured.   So in our view the cancellation of the policy by the 1^st opp.party invoking condition V  is valid and proper

          Now the question is whether the complainant is entitled to get the policy amount after cancellation of the policy or not.   Though the policy was cancelled with effect from 1.5.2003 the insured did not challenge the same during his life true.   After one year land 3 months after the cancellation when the insured died the complainant lwho is the wife of the insured is challenging the cancellation and claiming the insurance amount when once the contract of insurance is cancelled the insured ceased to be a consumer of the 1^st opp.party and the 1^st opp.party is lno longer bound to entertain the claim.   As argued by the learned counsel for 1^st opp.party when the risk occurred on 17.81.2004  the policy was not subsisting and therefore the insured cannot be said to be a consumer and reliance can be drawn from the decision of National Commission reported in 2008 [1] CPJ 384.  Therefore we hold that the complainant is not entitled to get the policy amount.   There is no deficiency in service on the part of the opp.party.  Point found accordingly.

          In the result the complaint fails land the same is hereby dismissed.  No costs.

            Dated this the 19^th day of March, 2009.

I n d e x

List of witnesses for the complainant