Sri. M.C. Devakumar, Member

1. The complainant Smt. Kusuma Bai has filed this complaint under Section 12 of the C.P. Act, 1986 against the opposite party Insurance Company alleging deficiency in service and seeking a direction to pay double accident benefit under the policy of Rs.5,02,252/- alongwith interest at the rate of 25% p.a. on the assured sum for the period of 6 months i.e. from the date of single assure amount credited to the complainant and to pay Rs.1,00,000/- towards mental agony, inconvenience and deficiency in service and also to pay litigation expenses of Rs.20,000/- with such other reliefs.

2. The complainant’s husband Late Shyam Singh obtained a Life Insurance Policy from LIC of India under LIC’s Jeevn Saral (with profit) policy on 18.01.2012 with life risk coverage and double accident benefit.  The yearly Premium of the policy was divided into 12 EMI’s and the same was paid monthly through ECS without fail till his death on 22.06.2018. After the death of the insured, the complainant, being the whole nominee of the said policy had claimed the policy benefit with OP by submitting relevant documents. The OP considering the documents unilaterally credited single policy amount of Rs.5,02,252/- to the complainant’s account through NEFT on 12.09.2018 by receiving the original policy document.  However the OP has not paid the double accident benefit as agreed in the policy.  As such another request was made to OP to pay the double accident benefit. But the OP repudiated the claim. Hence alleged deficiency and filed the complaint seeking reliefs.

3. The OP appeared through their counsel has filed version and denied the allegations as false and submit the complaint is not maintainable.

4. Further the OP admits that the Sri Shyam Singh has taken the insurance policy and has agreed to pay the premium amount on monthly basis through ECS. However failed to pay the 2 monthly premium EMI amount i.e. for the month of May and June-2018. On the date of his death i.e. 22.06.2018 the complainant policy was not in force as the premium was made only up to April-2018.  The complainant’s claim was rejected considering the lapsed status of the policy on the date of death of the Life assured.

5. Thereby considering the policy terms and conditions they have credited the amount to the complainant’s bank account through NEFT. Hence there is no deficiency in service by them to the complainant.  As such. prays for dismissal of the complaint as not maintainable.   
6. Both side parties have filed their affidavit evidence by way of examination in chief along with several documents to establish their contentions.
7. Both side counsels have filed written argument and also made the oral submissions and the matter is set down for orders.
8. The following points arose for our consideration.

1. Whether the complainant establishes this deficiency in    service by the OP and thereby she is entitled for the reliefs?

­­­­­2. What order?

9.  Our findings on the aforesaid point is as follows:

                    Point no.1: In the Negative.

                   Point no.2: As per final order for the following

REASONS

10. Point No.1:- It is true that, the complainant’s husband late Sri Shyam Singh has obtained a Life Insurance policy from LIC of India under LIC’s Jeevan Saral (with profit) policy on 18.01.2012 with life risk coverage and double accident benefit. The yearly premium policy was divided into 12 EMI’s and were paid through ECS without fail till April 2018 . However the premium for the months May and June-2018 was not paid.  Thereby the policy was not inforce as on the date of death of the insured (Sri Shyam Singh) on 22.06.2018.  Considering the documents furnished by the complainant a total   sum of Rs.5,02,252/- has been credited to the complainant’s account through NEFT on 12.09.2018 by the OP. However the complainant aggrieved that the non payment of double accident benefit under the policy has made another request to OP to pay the double accident benefit, the same was rejected by the OP by quoting the policy terms and conditions under clause 4(b).  Thereby it is found that the OP has paid the amount in accordance with the policy terms and conditions. As such the allegations of deficiency in service by the OP is not justified. Considering the above facts this commission is of the opinion that there is no deficiency in service by the OP and the complainant is not entitled for any reliefs of double accident benefit. Accordingly, the point No.1 is answered in “Negative’’.

11.  Point No.2:- In view of the discussion in point No.1 the complaint filed by Smt. Kusuma Bai deserves to dismissed. Hence the following:

:: ORDER ::

1. The complaint is hereby dismissed.
2. Furnish the copy of this order to the parties, at free of cost

(Dictated to the Stenographer transcribed, typed by her, transcript corrected

by us and then pronounced in open court on this the 30^th  September 2021)