Passed  by Shri Atul D. Alsi, Hon’ble President.

1.         The complainant filed complaint against partial disbursement of insurance claim. Amounted to Rs.2,03,413/- against the sum assured amount of  Rs.4,00,000/-for the loan insured amount and thereby claiming remaining insurance amount of Rs.1,96,587/-alongwith interest and compensation of Rs.1,50,000/- with cost.

Facts of the case, in nutshell, are as under.

2.         The husband of complainant Ratan Mohare has obtained tractor loan amount to Rs.4,00,000/- from the O.P. No.3, The State Bank of India, to purchase tractor on dated 14.7.2008. To secure loan amount, the complainant has to purchase one SBI Life Sureksha Policy bearing No. 83001003610 from O.P. No.3 for the sum assured of Rs.4,00,000/-against one time premium of Rs.16,917/- for the period valid till 19.11.2008. The husband of the complainant being laymen could not understand the language and terms and conditions contained in master policy. Signed the documents as per direction of O.P. No.3. The complainant husband has died on dated 08.08.2015. The complainant had filed insurance claim along with relevant documents on 21.7.2016 but the O.P. has sanctioned Rs.1,95,185/- on dated 29.7.2016 and thereafter Rs.8,228/- on dated 18.11.2016 as a difference amount towards insurance policy but failed to pay Rs.4,00,000/- the sum assured. Therefore complainant through counsel issued legal notice on dated 09.01.2017 but for the non-compliance of the notice the complainant has filed the present complaint.

3.         After filing of complainant notices were issued to the O.P. No.1 to 3. The O.P. No.1 and  2  has appeared through their counsel and filed their written statement. The case is proceeded exparte against the O.P. No.3 as per order dated 12.9.2018.

4.         The O.P. No.1 and 2 had denied allegation of complainant and submitted that the complaint is not maintainable for want of territorial jurisdiction. The insurance cover to the insured was issued in the months of November-2008 but the complaint is filed in month of March 2017 without any application u/s 24-A of Consumer Protection Act, 1986, therefore complaint is liable to be dismissed at outset.  The O.P. No.1 and 2 further submitted that O.P. has already settled the death claim under insurance cover, of loan account bearing-30427245025 under master policy bearing-83001003610 as per terms and conditions of policy. As per outstanding loan amount on the date of death and as per original repayment schedule by disbursing the amount of Rs.1,98,185+8,228=2,03,413/-. Therefore O.P. has discharged their contractual obligation and the complaint is infructuous , hence not maintainable.  In the event of death the insured tractor loan borrower due to any cause the same assured become payable to group administrator and the sum assured equivalent balance to outstanding loan amount including interest as per original EMI schedule.  The complainant falsely claiming entire loan amount Rs.4,00,000/- On the date of death of insured there was no outstanding loan amount.  However O.P. has paid Rs.2,03,413/- calculating outstanding loan amount as per original EMI schedule. Therefore the case is liable to be dismissed with cost.

5.         The counsel for complaint argued that inspite of service of legal notice the insurance claim of sum assured has not been disbursed for the insurance policy for loan. Therefore partial disbursement of  Rs.2,03,413/- is unfair trade practice on the part of O.P. 

6.         The counsel for O.P. No.1 and 2 argued that the O.P. No.1 and 2 disburse the insured amount as per terms and condition of insurance policy which is filed on record as annexure no.1 with condition No.6.  The sum assured means the amount outstanding in the tractor loan account including interest as per original repayment schedule to the amount outstanding in the loan account on the date of death. The minimum sum assured is Rs.10,000/- and maximum sum assured is Rs.5,00,000/-. The insured has signed the loan agreement along with terms and conditions of policy and accordingly the insurance claim the O.P. has disbursed the amount of Rs. 2,03,413/- towards outstanding amount of loan as on date of death therefore there is no unfair trade practice on the part of O. P

Reasoning

7.         The complainant had filed insurance claim with O.P.No.1 and 2 on 21.7.2016. The O.P. as per on the date of death and as per death certificate filed on record as document No.5 with list of document dated 13.2.2017 disbursed the amount of Rs.2,03,413/- by issuing two cheques of Rs.1,95,185/-, dated 29.7.2016 and Rs.8,228/-, dated 18.11.2016, which is filed on record vide document no. 10 as per list of document dated 13.2.2017. As per terms and condition of policy filed by O.P. No.1 and 2 as annexure no. “A”  at exhibit No.9 and as per list of documents dated 4.7.2017 in respect of the term sum assured would be the amount of outstanding in the loan account as per original repayment schedule. The terms and conditions of loan agreement and insurance policy are binding on the parties equally.  The O.P. have disbursed the insurance claim to the complainant as per terms and conditions of policy as per disbursement of sum assured. Therefore total claim of sum assured Rs.4,00,000/-is not payable. There is no negligence of service on the part of O.P.No.1 to 3.  Therefore there is no merit in the present case. Hence case is dismissed as per following order. 

O R D E R

i.          Complaint is dismissed.

ii.         No order as to cost.

iii.        Copy of order be furnished to both parties, free of cost.