State Consumer Disputes Redressal Commission
Lic vs Smt. Ratan Kanwar on 13 November, 2009
jkT; miHkksDrk fookn izfrrks"k vk;ksx] jktLFkku] t;iqj vihy l[;k% 1857@2005 1. Branch Manager, Life Insurance Corporation of India Vivekanand Nagar Sumerpur, District-Pali.(RaJ.) 2. The Senior Divisional Manager, L.I.C. Of India , Divisional office , Jeevan Prakash, Circuit House Road, Jodhpur.Raj. 3. Zonal Manager, Life Insurance Corporation of India, Northern Zone, Jeevan Bharati, 124, Connought Circus, New Delhi. 4. Life Insurance Corporation of india, Central Office, Yogakshema, Jeevan Bima Marg, Mumbai.400001. THROUGh The Manager (Legal & HPF.), L.I.C. Of India , Divisional Office, Jeevan Prakash Bhawani Singh Road, jaipur.302005. Appellants--Opposite Parties Versus Smt. Ratan Kanwar W/o Late Shri Kanakdan Aadha,Resident of Sumerpur, Tehsil-Sumerpur, District -Pali Raj. Respondent--complainant
fnukad 13@11@2009 le{k% ekuuh;
U;k;kf/kifr Jh lquhy dqekj xxZ&v/;{k ekuuh;k Jherh foeyk lsfB;k&lnL;k mifLFkr% vihykaV~l&L.I.C. dh vksj ls Jh jkedY;k.k 'kekZ] vf/koDrk A jsLiksMsaV&ifjokfn;k dh vksj ls Jh ch-,l-pUnzkor] vf/koDrkA jkT;
vk;ksx }kjk 1- ;g vihy vihykaV~l&L.I.C. tks fd ewy ifjokn esa foi{khx.k Fks] us ftyk eap ikyh ds vkns'k fnukad 26-9-2005 tks mUgksusa ifjokn la[;k 25@2004 esa fuEu :i esa vihykaVl&L.I.C. ds fo:) vkns'k ikfjr fd;k gS%& ^^vr% vkns'k gS fd vizkFkhZx.k ifjokfnuh dks nks ekg ds Hkhrj ikWfylh la- ,l&182066748 rFkk ,l&101959088 ds chek/kku dh jkf'k;ka ,oa mu ij ns; leLr ifjykHk vnk djs] lkFk gh ifjokfnuh ds ifr dh e`R;q 17-8-2001 dks gqbZ gS mlds rhu ekg 2 i'pkr~ vFkkZr fnukad 17-11-2001 ls vnk;xh rd ewy chek /kujkf'k ij 9 izfr'kr okf"kZd dh nj ls C;kt Hkh vnk djsA ifjokn O;; 500@&:i;s rFkk gtkZuk jkf'k 500@&:i;s Hkh vnk djsA** ds fo:) is'k dh xbZ gSaA 2- ;g bu ifjfLFkfr;ksa esa lkeus vk;k gS fd jsLiksMsaV&ifjokfn;k us ,d ifjokn vihykaV~l&L.I.C. ds fo:) ftyk eap] ikyh esa fnukad 3-3-2004 dks ;g dgdj is'k fd;k Fkk fd mlds Lo- ifr Jh dudnku ftldks Hkfo"; esa e`rd ds uke ls lEcksf/kr fd;k tk;sxk] us vius thoudky esa fuEu nks ikWfyfl;ka yh Fkh%& dze la-
ikWfylh la[;k fnukad chek jkf'k 1- ,l&182066748 12-2-1999 87000@& 2- ,l&101959088 28-12-2000 25000@& mldk ;g Hkh dguk gS fd e`rd uxj ikfydk lqesjiqj ftyk&ikyh esa ukdsnkj ds in ij dk;Zjr Fkk ftldh fnukad 17-8-2001 dks g`n; xfr :d tkus ds dkj.k e`R;q gks xbZ Fkh mlds ckn jsLiksMsaV&ifjokfn;k us cgSfl;r iRuh o uksfeuh vihykaVl~&L.I.C ds ;gka Dyse is'k fd;kA ftl Dyse dks vihykaVl&L.I.C us vius jsiqfM;s'ku i=k fnukad 30-3-2002 ds }kjk ;g dgdj jn~n dj fn;k fd%& ^^pwafd e`rd }kjk izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 16-2-99 ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 30-12-2000 dks dgk Fkk fd mlds dksbZ chekjh ugha gS vkSj uk gh mlus fdlh vLirky esa HkrhZ jgdj fdlh chekjh dk bZykt djok;k gS ysfdu vihykaVl&L.I.C ds ikl bl ckr ds iq[rk lcwr gS fd mijksDr ikWfyfl;ksa ds fy;s izLrko djus ds yxHkx rhu o"kZ iwoZ ls og ikbZYl vkSj yhoj dh chekjh ls ihfMr jgk Fkk ftlds fy;s mlus fpfdRld ls ijke'kZ fd;k Fkk vkSj mlls bZykt djk;k Fkk og ,d vLirky esa Fkk vkSj fnukad 3 2-11-96 ls 31-1-97 rd 91 fnu vLoLFkrk vodk'k ij jgk Fkk ysfdu e`rd us bu rF;ksa dks vius izLrko i=k&O;fDrxr izdFku esa izdV ugha fd;k mlds LFkku ij vlR; mRrj fn;s A ** fQj ;g ifjokn is'k fd;k x;kA 3- vihykaVl~&L.I.C us ftyk eap esa viuk tokc fnukad 27-5-2004 dks fn;k vkSj vius tokc esa eq[; :i ls oks gh pleas yh tks mUgksaus vius jsiwfM;s'ku i=k fnukad 30-3-2002 esa yh FkhA blds vykok mudk ;g Hkh dguk gS fd e`rd us ikbZYl ds vkWijs'ku o yhoj dh [kjkch ds dkj.k vius dk;kZy; ls fnukad 2-11-1996 ls 31-1-1997 rd dqy 91 fnu rd fpfdRlk vodk'k fy;k Fkk tcfd mDr rF; vius Kku esa gksrs gq, Hkh tkucw>dj /kks[kk nsus ds mn~ns'; ls e`rd us izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 16-2-99 dks ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 30-12-2000 dks mDr rF;ksa dks Nqik;k Fkk blfy;s vihykaVl&L.I.C }kjk vius jsiwfM;s'ku i=k fnukad 30-3-2002 ds }kjk tks Dyse jsLiksMsaV&ifjokfn;k dk jn~n fd;k x;k gS og lgh jn~n fd;k x;k FkkA ;g chekjh Nqikus dk ekeyk FkkA ifjokn [kkfjt fd;s tkus dk fuosnu fd;kA 4- ftyk eap] ikyh us vius vkns'k fnukad 26-9-2005 ds }kjk jsLiksMsaV&ifjokfn;k dk ifjokn ;g ekurs gq, Lohdkj dj fy;k fd%& 1- vizkFkhZx.k ;g lkfcr djus esa lQy ugha jgs gS fd dudnku dh e`R;q cokflj ds jksx ds dkj.k ;k yhoj dh fdlh chekjh ds dkj.k gqbZ gSA 2- vizkFkhZx.k }kjk izLrqr lk{; ls e`rd dh e`R;q ,oa mlds }kjk izLrko i=kksa esa izdV ugha fd;s x;s jksx dk laca/k fdlh izdkj ls LFkkfir ugha gksrk gSA 5- mDr vkns'k fnukad 26-9-2005 ls vlarq"V gksdj vihykaV~l&L.I.C. dh vksj ls ;g vihy is'k dh gSA 6- fo}ku odhy vihykaVl&L.I.C dk nkSjkus cgl eq[; :i ls eqn~nk ;g jgk gS fd pwafd e`rd }kjk izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le;
4fnukad 16-2-99 ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 30-12-2000 dks dgk Fkk fd mlds dksbZ chekjh ugha gS vkSj uk gh mlus fdlh vLirky esa HkrhZ jgdj fdlh chekjh dk bZykt djok;k gS ysfdu vihykaVl&L.I.C ds ikl bl ckr ds iq[rk lcwr gS fd mijksDr ikWfyfl;ksa ds fy;s izLrko djus ds yxHkx rhu o"kZ iwoZ ls og ikbZYl vkSj yhoj dh chekjh ls ihfMr jgk Fkk ftlds fy;s mlus fpfdRld ls ijke'kZ fd;k Fkk vkSj mlls bZykt djk;k Fkk og ,d vLirky esa Fkk vkSj fnukad 2-11-96 ls 31-1-97 rd 91 fnu vLoLFkrk vodk'k ij jgk Fkk ysfdu e`rd us bu rF;ksa dks vius izLrko i=k&O;fDrxr izdFku esa izdV ugha fd;k mlds LFkku ij vlR; mRrj fn;s bfly;s ftyk eap dh QkbZfMax fnukad 26-9-2005 xyr gS ftls vikLr fd;k tkdj vihykaVl&L.I.C dh vihy Lohdkj fd;s tkus dk fuosnu fd;kA 7- blds foifjr fo}ku vf/koDrk jsLiksMsaV&ifjokfn;k us ftyk eap ds vkns'k fnukad 26-9-2005 dks lgh crk;k vkSj vihykaVl&L.I.C. dh vihy [kkfjt fd;s tkus dk fuosnu fd;kA 8- bl lUnHkZ esa fopkj fd;k x;k vkSj i=kkoyh ij miyC/k fjdkMZ ns[kk x;kA 1- bl dsl esa blesa dksbZ fookn ugha gS fd e`rd }kjk izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 16-2-99 ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 30-12-2000 dks dgk Fkk fd mlds dksbZ chekjh ugha gS vkSj uk gh mlus fdlh vLirky esa HkrhZ jgdj fdlh chekjh dk bZykt djok;k gS 2- bl dsl esa blesa Hkh dksbZ fookn ugha gS fd e`rd dh e`R;q izFke ikWfylh la[;k% ,l&182066748 ysus dh fnukad 16-2-99 ds nks lky ckn ;kfu fnukad 17-8-01 dks ,oa f}rh; ikWfylh la[;k ,l&101959088 ysus dh fnukad 5 30-12-2000 ds nks lky ds vUnj ;kfu fnukad 17-8-2001 dks gqbZ FkhA 3- bl dsl esa blesa Hkh dksbZ fookn ugha gS fd vihykaVl&L.I.C. }kjk vius jsiwfM;s'ku i=k fnukad 30-3-2002 ds }kjk jsLiksMsaV&ifjokfn;k dk Dyse mlesa of.kZr dkj.kksa ds vk/kkj ij jn~n dj fn;k FkkA 4- i=kkoyh ij miyC/k fjdkMZ ds vuqlkj e`rd loZizFke fnukad 5-8-96 ls fnukad 21-8-96 rd viuh chekjh ds dkj.k vius dk;ZLFky ls vodk'k ij jgk FkkA 5- i=kkoyh ij miyC/k fjdkMZ ds vuqlkj e`rd us ikbZYl o yhoj [kjkc gksus ds dkj.k viuk bZykt Mk-,p-,l-x<oh esfMdy vkWfQlj] ikyuiqj ls djok;k Fkk vkSj vius dk;ZLFky ls fuEu izdkj ls vodk'k fy;s Fks%& fnukad 02-11-96 ls 02-12-96 rd 31 fnu fnukad 03-12-96 ls 17-12-96 rd 15 fnu fnukad 18-12-96 ls 01-01-97 rd 15 fnu fnukad 02-1-97 ls 31-01-97 rd 30 fnu dqy 91 fnu 6- i=kkoyh ij miyC/k fjdkMZ ds vuqlkj e`rd us blds i'pkr~ fnukad 7-09-97 o fnukad 23-9-97 dqy 2 fnu dk vodk'k Hkh fy;k FkkA 7- i=kkoyh ij miyC/k fjdkMZ ds vuqlkj Mk-,p-,l-x<oh esfMdy vkfQlj ] tkyksrjk us fnukad 21-12-97 dks ,d izek.k i=k fn;k gS ftlesa ;g dgk x;k gS fd e`rd fnukad 2-11-96 ls 2-12-96 rd ikbZYl dh otg ls vks-ih-Mh-esa ejht FkkA 9- vc gesa ;g ns[kuk gS fd mijksDr ifjfLFkfr;ksa esa ftyk eap dh QkbZfMax fnukafdr 26-9-2005 lgh gS vFkok ugha ;k 6 vihykaVl&L.I.C }kjk vius jsiwfM;s'ku i=k fnukad 30-3-2002 ds }kjk jn~n fd;k x;k jsLiksMsaV&ifjokfn;k dk Dyse lgh Fkk ;k ughaA 10- i=kkoyh ij miyC/k e`rd ds NqfV~V;ksa ds fjdkMZ] vLirky dk fjdkMZ ,oa MkaDVj }kjk fn;s x;s izek.k i=k ¼ftudk mij foospu fd;k tk pqdk gS½ ls ;g lkfcr gks tkrk gS fd e`rd izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 16-2-99 ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 30-12-2000 ls dkQh le; iwoZ ls ikbZYl ,oa yhoj dh chekjh ls xzLr Fkk vkSj mDr chekfj;ksa dk bZykt e`rd }kjk fy;k tk jgk Fkk vkSj mDr chekfj;ksa ds bZykt ds fy;s e`rd us vius dk;ZLFky ls esfMdy ds vk/kkj ij NqfV~V;k Hkh yh Fkh ysfdu mij of.kZr nksuksa ikWfyfl;ksa ds fy;s izLrko i=k Hkjrs le; ,oa LokLF; dk ijh{k.k nsrs le; dze'k fnukad 16-2-99 ,oa 30-12-2000 dks LokLF; ds lEcU/k esa iwNs x;s iz'uksa ds e`rd }kjk udkjkRed tokc fn;s Fks] tcfd e`rd ds Lo;a dh chekfj;ksa ds rF; tkudkjh esa Fks] blds ckotwn mlds }kjk iwNs x;s iz'uksa ds udkjkRed tokc fn;s x;sA blfy;s ;g ekeyk Li"V :i ls chekjh Nqikus dk jgk gSA 11- tgka rd jsLiksMsaV&ifjokfn;k dk ;g dFku fd ikbZYl ,oa yhoj dh chekjh dk e`rd dh e`R;q ls dksbZ lEcU/k ugha jgk gS] Hkh pyus ;ksX; ugha gS D;ksafd ;gka fuDll dk bZ';w ugha gS cfYd b';w ;g gS fd e`rd us mijksDr of.kZr nksuksa ikfyfl;ksa ysus ,oa LokLF; dk ijh{k.k dze'k fnukad 16-2-99 ,oa 30-12-2000 dks nsus ls iwoZ e`rd fdlh chekjh ls xzLr Fkk vFkok ugha vkSj ml chekjh ds bZykt ds fy;s e`rd }kjk bZykt fy;k x;k Fkk vFkok ugha vkSj bl dsl esa ;g c[kwch lkfcr gS fd e`rd us mijksDr nksuksa ikWfyfl;ka ysus ,oa LokLF; dk ijh{k.k dze'k fnukad 16-2-99 ,oa 30-12-2000 dks nsus ls iwoZ e`rd ikbZYl ,oa yhoj dh chekjh ls xzLr Fkk ftudk mlds }kjk bZykt fy;k tk jgk Fkk A vr% ;g ekeyk Li"V :i ls chekjh Nqikus dk gSA 12- blds vykok tgka rd vihykaV&ifjokfn;k dk ;g eqn~nk fd izFke ikWfylh la[;k% ,l&182066748 ysus ,oa LokLF; dk ijh{k.k nsus dh fnukad 16-2-99 ds nks lky ckn ;kfu fnukad 17-8-01 dks e`rd dh e`R;q gqbZ gS blfy;s vihykaV&ifjokfn;k 7 /kkjk 45 bU';ksjsal ,DV dk Qk;nk izkIr djus dh vf/kdkjh gS] Hkh gekjh jk; esa pyus ;ksX; ugha gS D;ksafd i=kkoyh esa layXu fjdkMZ ls ;g Li"V gks tkrk gS fd e`rd us mDr ikWfylh ysus ,oa LokLF; dk ijh{k.k nsus dh fnukad 16-2-99 ls iwoZ esfMdy ds vk/kkj ij vius dk;ZLFky ls ckj&ckj NqfV~V;k yh Fkh vkSj vLirky esa HkrhZ jgdj viuh chekjh dk bZykt djok;k Fkk vkSj mDr rF;ksa dks e`rd }kjk ikWfylh ysus ,oa LokLF; ijh{k.k dh fnukad 16-2-99 dks tkucw>dj Nqik;k x;k FkkA blfy;s vihykaV&ifjokfn;k }kjk 45 bU';ksjsal ,DV dk Qk;nk izkIr djus dh vf/kdkjh ugha gSA 13- bl izdkj i=kkoyh esa layXu fjdkMZ ls ;g Li"V gks pqdk gS fd e`rd izFke ikWfylh la[;k% ,l&182066748 ysrs le; ,oa LokLF; dk ijh{k.k nsrs le; fnukad 16-2-99 ,oa f}rh; ikWfylh la[;k ,l&101959088 ysrs le; ,oa LokLF; dk ijh{k.k fnukad 30-12-2000 dks nsus ls iwoZ e`rd ikbZYl ,oa yhoj dh chekjh ls xzLr Fkk vkSj mDr chekfj;ksa ds rF;ksa dks tkucw>dj Nqikdj e`rd }kjk mijksDr nksuksa ikWfyfl;ka yh xbZ Fkh blfy;s ;g ekeyk chekjh Nqikus dh ifjHkk"kk esa vkrk gS bl dkj.k ftyk eap] ikyh dk vkns'k fnukad 26-9-2005 dkfcys iqf"V ugha gS D;ksafd og rF;ksa ij vk/kkfjr ugha gS] tcfd vihykaVl&L.I.C ds }kjk jsLiksMsaV&ifjokfn;k dk vius jsiwfM;s'ku i=k fnukad 30-3-2002 ds }kjk jn~n fd;k x;k Dyse lgh Fkk vkSj vihykaVl&L.I.C dh ;g vihy Lohdkj dh tkus ;ksX; gS vkSj jsLiksMsaV&ifjokfn;k dk ifjokn [kkfjt fd;s tkus ;ksX; gSA 14- cgl ds nkSjku fo}ku odhy jsLiksMsaV&ifjokfn;k us tkfgj fd;k gS fd ;fn fdlh otg ls vihykaVl&L.I.C dh vihy Lohdkj dh tkrh gS rks jsLiksMsaV&ifjokfn;k tks fd e`rd dh iRuh gS mldks ex-gratia payment ds :i esa dqN jkf'k fnyok;h tkosA On ex-gratia payment
15. Ex-gratia payments are made as an act of grace, if the damage caused is outside the scope of the policy terms, or the liability under the policy is doubtful. In such cases the payment is made as an act of grace on humanitarian grounds. As a matter of fact, the loss or damage is outside the terms of the policy but the insurer takes a lenient view on humanitarian grounds. In such cases, full amount to indemnify the 8 damages is not made.Such payments do not place the insurer under an obligation to make such payments in similar circumstances in future.
16. Further ex-gratia payment of claim would arise where there was no legal liability on the lifeinsurance corportation to make payment as in the case of repudiated claim or unconcluded contract. Such claims are paid to mitigate hardship to the claimants by way of equitable relief. The analysis, particularly of a repudiated claim for consideration of an ex-gratia payment, would be a skilful exercise on the part of the concerned officers of the opponent life insurance corporation of india. Ex-gratia payment cannot be claimed as a matter of right. For that the law laid down by the Hon'ble National Commission in the case of LIC Vs. Shashi Gupta (1994) 2CPR 622 (NC) may be referred to.
17. Further the word 'ex-gratia' payment itself means a payment which is voluntarily and charitable in nature and since the C.P.Act, 1986 is based on the principle of equity, therefore, hypertechnicalities could be ignored and equitable consideration should be kept in mind while deciding the matter.
18- bu rF;ksa dks ns[krs gq, fd pwafd jsLiksMsaV&ifjokfn;k ,d fo/kok L=kh gS vkSj fo/kok dh fLFkfr fgUnwLrku esa vPNh ugha gS vkSj blds vykok e`rd }kjk ,d ikWfylh 87000@&:i;s dh ,oa nwljh ikWfylh 25000@&:i;s dh yh xbZ Fkh vkSj igyh ikWfylh ysus ,oa LokLF; dk ijh{k.k nsus dh fnukad 16-2-99 ds nks lky ckn fnukad 17-8-01 dks e`rd dh e`R;q gqbZ Fkh blfy, jsLiksMsaV&ifjokfn;k dks vihykaVl&L.I.C ls yele esa 25000@&:i;s ex-gratia payment ds :i esa fnyok;k tkuk mfpr izrhr gksrk gS vkSj ;g jde gj n`f"Vdks.k ls mfpr izrhr gksrh gSA ;gka ;g dguk mfpr gksx fd ftyk eap] ikyh ds fookfnr vkns'k fnukad 26-9-2005 dh ikyuk esa vihykaVl&L.I.C 9 dh vksj ls ftyk eap esa tks jkf'k tek djokbZ xbZ gS ml jkf'k esa ls yele esa 25000@&:i;s ex-gratia payment ds :i esa jsLiksMsaV&ifjokfn;k dks ,oa 'ks"k jkf'k ml ij Accrue gq, C;kt lfgr vihykaVl&L.I.C dks ykSVkbZ tk;sxhA mijksDr dkj.kksa ds dkj.k vihykaVl&L.I.C dh ;g vihy Lohdkj dh tkrh gS rFkk ftyk eap] ikyh ds vkns'k fnukad 26-9-2005 dks vikLr fd;k tkrk gS ,oa jsLiksMsaV&ifjokfn;k dk ifjokn [kkfjt fd;k tkrk gS ysfdu lkFk gh vkns'k fn;k tkrk gS fd ftyk eap] ikyh ds fookfnr vkns'k fnukad 26-9-2005 dh ikyuk esa vihykaVl&L.I.C dh vksj ls ftyk eap esa tks jkf'k tek djokbZ xbZ gS ml jkf'k esa ls yele esa 25000@&:i;s ¼v{kjs iPphl gtkj :i;s½ ex-gratia payment ds :i esa jsLiksMsaV&ifjokfn;k dks ns fn;s tkos ,oa 'ks"k jkf'k ml ij Accrue gq, C;kt lfgr vihykaVl&L.I.C dks ykSVk nh tkosA ¼Jherh foeyk lsfB;k½ ¼ U;k;kf/kifr Jh lquhy dqekj xxZ½ lnL;k v/;{k ^^lat;**