State Consumer Disputes Redressal Commission
Lic Of India vs Madhu Bala on 29 October, 2010
H
H.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
SHIMLA-9.
FIRST APPEAL No.157/2010.
DECIDED ON : 29.10.2010.
In
the matter of:
Life
Insurance Corporation of India, through its Divisional Manager,
Block No.14 & 15, SDA Complex, Kasumpti, Shimla-171 009.
Appellant.
Versus
Smt. Madhu Bala wife of Shri Sanjay Kumar, Resident
of Village Tholuwa, Post Office Thakur Mathi, Tehsil Salooni, District Chamba,
Himachal Pradesh.
.. Respondent.
.
For the Appellant: Mr.
G.D. Sharma, Advocate.
For the Respondent: Mr. Pankaj Negi, Advocate vice
Mr.
Vijay Chaudhary, Advocate.
..
Honble Mrs. Saroj Sharma, Presiding
Member.
Honble Mr. Chander Shekhar Sharma, Member.
Whether approved for reporting?
O R D E R:
( Per Mr. Chander Shekhar Sharma, Member).
This appeal is directed against the order of District Forum, Chamba, Himachal Pradesh passed in Consumer Complaint No.51/2008, dated 25.02.2010, whereby the complaint of the respondent was partly allowed and the appellant was directed to pay accidental benefits due under the policy to the tune of Rs.2,50,000/-, to all the legal heirs of deceased in equal shares within 30 days after receipt of copy of order and it was further directed that in case the payment is not made within said period, then the interest @ 9% per annum from the date of complaint till its final payment and compensation amounting to Rs.5,000/- was also awarded for mental agony, harassment and litigation cost was assessed at Rs.2,000/-.
2. Facts of the case as they emerge from the record are that the respondent who is wife of deceased Sanjay Kumar being nominee in LIC policy bearing No.152148505 which was for a sum of Rs.2,50,000/- plus Rs.2,50,000/- (Total Rs.5,00,000/-) only being a double accidental policy. After death of her husband Shri Sanjay Kumar, who had died in a vehicular accident on 11.07.2007, she had lodged insurance claim with the appellant. Appellant had only paid an amount of Rs.2,50,000/- to the respondent and rest of the claim had been repudiated which she was entitled as per insurance policy and as such there was deficiency in service on the part of the appellant.
3. In this background complaint under Section 12 of Consumer Protection Act, 1986 was filed for deficiency of service against the appellant, wherein the appellant had claimed balance amount of Rs.2,50,000/- alongwith interest @ 12 % from the date of death of the insured and also compensation to the tune of Rs.50,000/- and litigation cost of Rs.1,000/- was also claimed.
4. Appellant had contested and resisted the complaint and its main plea was that the respondent had not produced driving licence of the life assured and as per investigation life assured was not having a driving licence, as such the appellant was not liable to pay the accidental benefit and there is no delay on the part of appellant in making payment of the sum assured and basic sum assured amounting to Rs.2,50,000/- had already been paid to the respondent on 30.11.2007.
5. Appellant in support of its case has filed affidavit of Shri Vishwa Nath Sharma Manager (Legal) of Divisional Office, Shimla Annexure OPW-1 and placed reliance upon document Annexure OP-1 which is letter dated 04.03.2008 sent to the respondent by the appellant.
6. Respondent in support of her case filed her own affidavit and placed reliance upon various documents Annexures C-1 to C-7, which are insurance policy, receipt of insurance premium, letters dated 04.03.2008 and 18.07.2008 sent to the respondent by the appellant, copy of FIR, post-mortem report, inquest report and abstract of Parivar Register of concerned Gram Panchayat.
7. We have heard leaned counsel appearing for the parties and have also gone through the record of the case minutely.
8. Mr. G.D. Sharma, learned counsel for the appellant argued that since the respondent had no submitted the driving licence of deceased Shri Sanjay Kumar despite writing of letters to him and there was a breach of terms and conditions of insurance policy especially clause 17, as such double benefit amounting to Rs.2,50,000/- was not paid to the respondent and basic sum of Rs.2,50,000/- was rightly paid to the respondent, and thus there is no deficiency of service on the part of appellant in the present case. He had also placed reliance upon the decision of National Commission in the case of Mohan Lal Tiwari versus Life Insurance Corporation of India and another 2009 (1) CPC 563, wherein it was held that in the absence of driving licence of the deceased, no accident benefits can be granted.
9. Mr. Pankaj Negi, learned vice counsel appearing on behalf of the respondent argued that since the husband of respondent Shri Sanjay Kumar life assured had died in a vehicular accident and as such he was entitled for the double accidental benefits as per terms and conditions of insurance policy which were rightly allowed to the respondent in the present case. He had supported the order of the District Forum below.
10. After hearing learned counsel for the parties and going through the entire record of the case, we are of the considered view that there is no merit in the present appeal and it deserves to be dismissed. Reason being that in the present case there is no iota of evidence placed on record to the effect by the insurance company that the husband of respondent Shri Sanjay Kumar life assured was not having any valid and effective driving licence at the time of accident. Even in the FIR lodged with the police, it is only stated that the later-on it came to light that name of driver of motorcycle bearing registration No.HP-44-0714 was Shri Sanjay Kumar and as such identity of Shri Sanjay Kumar regarding driving of motorcycle in question at the relevant time is also not very clear. In this case this fact is amply proved on record from the post-mortem report that the deceased had died due to severe head injuries and the inquest report also depicts that is an accidental death and as such the respondent being the nominee of deceased Shri Sanjay Kumar was entitled for the double accidental benefits in the present case and the District Forum below had rightly held the appellant liable for payment of accidental benefits under the policy to the tune of Rs.2,50,000/- to the legal heirs of deceased Shri Sanjay Kumar and there appears to be ample justification for awarding the compensation, as well as cost to the respondent in view of facts and circumstance of the case.
11. Even document Annexure C-1 which is policy terms and conditions, clause No.17 upon which reliance had been placed by learned counsel for the appellant is only a very thin print which is not readable and there is no cogent evidence on record that there was any violation of terms and conditions of policy in the present case as argued by learned counsel for the appellant.
12. Decision of National Commission relied upon by learned counsel for the appellant in case of Mohan Lal Tiwari versus Life Insurance Corporation of India and another (supra) is not applicable in the present case since in this case there is no iota of evidence placed on record by the insurance company to the effect that Shri Sanjay Kumar deceased husband of respondent was not having any licence at the time of accident.
13. No other point was urged.
14. In view of above discussion and facts and circumstances of the case, we hereby dismiss the present appeal and confirm the order of District Forum, Chamba, Himachal Pradesh passed in Consumer Complaint No.51/2008, dated 25.02.2010.
15. No costs.
16. Office is directed to send a certified copy of this order to the parties, free of cost as per rules.
SHIMLA 29.10.2010 ( Saroj Sharma ) Presiding Member.
(Chander Shekhar Sharma) Member.
/dinesh/