National Consumer Disputes Redressal
Rajendra Singh vs Lic Of India & Anr. on 19 March, 2014
NATIONAL
CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
REVISION PETITION NO. 2215 OF 2013
(From order dated 22.02.2013 in First
Appeal No. 36 of 2013 of the
Haryana State Consumer Disputes
Redressal Commission, Panchkula)
Rajendra Singh
R/o Chiranjeev Colony
Bhiwani, Tehsil and District Bhawani
Haryana Petitioner
Versus
1. Life Insurance
Corporation of India
Regional Office at Jeewan Prakash
489, Model Town, Karnal (Haryana)
Through Divisional Manager
2. Branch Manager
Life Insurance Corporation Of India
Bhiwani Respondents
BEFORE:
HONBLE MR. JUSTICE J.M.MALIK,
PRESIDING MEMBER
HONBLE DR. S.M. KANTIKAR, MEMBER
For the Petitioner :
Mr. Madhurendra Kumar, Advocate
For the Respondents : Mr. Anoop K. Kaushal, Advocate
PRONOUNCED ON 19th MARCH, 2014
ORDER
PER DR. S.M. KANTIKAR, MEMBER
1. The present Revision Petition is directed against the Impugned Order dated 22.02.2013, whereby the Honble State Consumer Disputes Redressal Commission (in short, State Commission), Haryana at Panchkula, wherein it has erroneously accepted the First Appeal filed by the Respondents herein and consequently set aside the order dated 01.02.2010 passed by the District Consumer Disputes Redressal Forum, (in short, District Forum) and dismissed the complaint filed by the Petitioner herein.
2. The brief relevant facts herein are that, the Petitioner/Complainant, Rajendra Singh, got insured his son, Pawan Kumar, a minor, with the Life Insurance Corporation of India Respondents/ OPs vide Policy No. 174209252 for Rs.70,000/- commencing from 28.11.2004 to 31.03.2005. Unfortunately, Pawan Kumar, died on 15.03.2007. On submitting the claim by the Complainant, with respect to the above said policy, the OPs refunded an amount of Rs.8295/- only to the Complainant, because as per the terms and conditions of the policy, only premium paid before deferred dates was refunded. The complainant challenged the action of the OPs, by filing complaint before District Consumer Disputes Redressal Forum (in short, District Forum), Bhiwani and prayed for direction to the OPs to pay the insured amount of Rs.70,000/- with interest and litigation expenses.
3. The District Forum allowed the said complaint on 01.07.2010, and directed the OPs to pay full insured value along with other benefits and interest @ 12% per annum, from the date of death of life assured, till its realization and also Rs.2,200/- as litigation charges.
4. Being aggrieved with the order passed by the Ld. District Forum, OPs filed First Appeal No. 36 of 2013 before the State Commission, Haryana.
5. The State Commission allowed the Appeal on the premise that the insurance policy was to commence till the child attained the age of 7 years as per the policy, and dismissed the Complaint.
6. Against the impugned order of State Commission, this revision petition filed by the Complainant.
7. We have heard the Counsel for the both parties and perused the Terms and Condition of the insurance policy.
8. The Counsel for the Complainant vehemently argued that the District Forum had wrongly observed that the claim of the Petitioner in Special Provisions-B, Clause-2, is not applicable in the instant case, as the said terms have neither been read over to the Petitioner nor there is any evidence that these terms have been brought to the notice of the Petitioner. Mere mentioning such terms in the policy is not sufficient to decline the claim of the Petitioner. Therefore, it is a proved case of deficiency in service, committed by the Respondents. The Petitioner had been paying the premium, regularly, with effect from 18.11.2004 and his son expired, on 15.03.2007. Hence, the OP cannot wriggle out of contractual obligation as the said contract became complete on the date of issuance of insurance policy, in the name of the deceased.
9. The Ld. Counsel for the OP argued that it was a valid repudiation, as per the terms and conditions of the said policy. We have perused the Policy No.174209252, the date of commencement is 28.11.2004 and the Deferred Date mentioned in it is 28.11.2007. We have also perused the Special Provisions A and B of the said policy, which are more confusing. Hence, we sought clarification from the Counsel for OP as to why there are different dates, causing confusion. He was also not in a position to clarify it. Accordingly, we ordered on 4/2/2014, Learned counsel for the respondent wants to take instructions why the deferred date mentioned in the schedule is so confusing. The matter is adjourned to 24.2.2014.
10. On 24.2.2014, the Counsel for OP was unable to specify the correctness of applicability of Deferred Date. He has placed reliance upon the Judgment of Honble Delhi High Court, in LIC of India Vs. Rajiv Khosla 186 (2012) DLT266, DB, relating to the point of Deferred Date. Counsel for the complainant relied upon the judgment of this Commission in the case Murali Agro Products Vs. Oriental Insurance Co. I(2005)CPJ 1 (NC), wherein it was held in paras 22 to 24, as follows:
Para 22: Contact of Insurance is based upon good faith. It is the duty of insurers and their agents to disclose all material facts in their knowledge since obligation of good faith applies them equally with the assured.
Para 23: Secondly, if the contract is vague, benefit should be given to the insured. The exclusion term of insurance policy must be read down so as to serve the main purpose of policy t5hat is to indemnify the damage caused due to fire.
Para 24 : Finally, it is so to state that the Insurance Company to have terms clearly defined in insurance policy with reasonable clarity and not to continue with the old forms which terms are vague.
11. In another case, Devi alias Rita Gupta Vs. National Insurance Co. Ltd. 2008 (1) CLT Page 70 it has been held that in case of insurance claim, when two reasonable interpretations of the terms of the policy are possible, the interpretation which favors the insured is to be accepted and not the interpretation which favors the insurer.
12. Therefore, we are of considered view that, in the instant case, the OPs miserably failed to point out that any such terms and conditions were explained to the Complainant who represented the insured. It is deficiency in service by the OP. Accordingly, we set aside the order passed by the State Commission. We allow this revision petition and restore the order of District Forum.
13. The OP is directed to comply with the order of District Forum, within 90 days, from the date of receipt of this order, otherwise, it will carry further interest @ 9% p.a., till its realization. Parties, to bear their own costs.
...
(J. M. MALIK, J.) PRESIDING MEMBER ...
(S. M. KANTIKAR) MEMBER Mss/8