State Consumer Disputes Redressal Commission
Branch Manager, Life Corporation Of ... vs Mrs. Jyoti Manjari Sahu on 5 July, 2022
Cause Title/Judgement-Entry IN THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION ODISHA, CUTTACK Appeal Execution Application No. A/194/2006 ( Date of Filing : 09 Mar 2006 ) (Arisen out of Order Dated 25/01/2006 in Case No. CC/13/2005 of District Sambalpur) 1. Branch Manager, Life Corporation of India Sambalpur Branch-I, Jeevan Prakash, Ainthapalli, Sambalpur- 768004 ...........Appellant(s) Versus 1. Mrs. Jyoti Manjari Sahu W/o: Late Panchanan Sahu, Resident of Goutamtikra, P.O: Gourpali, P.S: Jamankira, Dist: Sambalpur-768112 ...........Respondent(s) BEFORE: HON'BLE MR. JUSTICE Dr. D.P. Choudhury PRESIDENT HON'BLE MR. Pramode Kumar Prusty. MEMBER HON'BLE MS. Sudihralaxmi Pattnaik MEMBER PRESENT: Mr. S.K. Mohanty, Advocate for the Appellant 1 Dated : 05 Jul 2022 Final Order / Judgement
Heard the learned counsel for the appellant. None appears for the respondent.
2. This appeal is filed U/S-15 of erstwhile Consumer Protection Act, 1986(herein-after called the Act). Parties to this appeal shall be referred to with reference to their respective status before the learned District Forum.
3. The case of the complainant in nutshell is that complainant's husband had purchased a policy for sum assured of Rs.50,000/- from the OP since 1.8.1999. It is alleged inter-alia that the policy holder met an accident on 9.2.2002 while coming on bicycle. Thereafter he was treated in the hospital. The complainant alleged that the policy holder after having met accident died on 29.03.2003. The complainant being the nominee made claim application to the OP but it was rejected because the policy has lapsed. Challenging the deficiency in service on the part of the OP, the complaint was filed.
4. The OP filed the written version stating that the policy holder has failed to pay the premium regularly even within the grace period. According to the OP, the policy holder has already expired after the month from the date when policy holder is required to pay the premium. Even if, the policy has already lapsed, no premium has been deposited at the belated stage. Thus, the policy holder has violated the policy condition for which they have repudiated the claim and there is no wrong committed on their part.
5. After hearing both the parties, learned District Forum passed the following order:-
Xxxxx xxxxxxxx xxxxxx "The complaint petition is allowed. We direct the OP to settle the claim of the petitioner without any further delay and to extend her the benefits covered under the policy alongwith admissible interest as per rules within a month of receipt of this order failing which the OP is liable to pay interest at the rate of 18 (eighteen) per cent per annum on the claim amount. With this observation, we dispose of this case leaving the parties to bear their own costs."
6. Learned counsel for the appellant submitted that learned District Forum has committed error in law by not considering the written version with proper perspectives. According to him on 9.2.2002 the complainant met accident but he has died on 29.03.2003. Learned District Forum ought to have considered such fact whether there is gap between the accident and death of the policy holder. Learned counsel for the appellant further submitted that learned District Forum should have applied judicial mind to the fact that the policy holder has not paid the premium even within the grace period during his life time. Learned District Forum thus has not exercised the judicial mind by allowing the complaint. So, he submitted to set-aside the impugned order by allowing the appeal.
7. Considered the submission of learned counsel for appellant, perused the DFR and impugned order.
8. It is admitted fact the policy holder has purchased the policy from the OP. It is also not in dispute that the payment is made on 01.02.2002 but the policy holder met accident on 9.2.2002. It is admitted fact that the policy holder expired on 29.03.2003. It is only found that whether during grace period the complainant had deposited the premium or not. It is to be also seen whether death of policy holder is connected with the accident.
9. We have gone through the policy in question. It appears from the policy that the premium is payable on 1.2.2002 but the deceased policy holder met accident on 9.2.2002. There is no any document filed by the complainant to the OP to show that from 92.2002 to 29.03.2003 the policy holder was unwell so that the sympathy would come down to connect the accident with the date of death. We have gone through the entire materials and it appears that the policy holder has met accident but discharged on 12.05.2002. Therefore there is no any document available to show whether he was treated continuously till 29.3.2003 when the policy holder died. Learned District Forum has lost sight of this aspect and only observed that during his ailment he has not been able to deposit the premium within grace period.
10. In view of above, we are of the view that after being cured the policy holder has not deposited the premium till his death 29.03.2003. Since, the premium has not been paid even within grace period, the policy as per payment schedule of the policy has expired much before the death. Therefore, the repudiation of claim by the OP cannot be said illegal. Learned Dist. Forum has not gone through this aspect. Hence, we are not inclined to concur the impugned order. Hence, the impugned order is set-aside.
Appeal stands allowed. No cost.
Free copy of the order be supplied to the respective parties or they may download same from the CONFONET or website of this Commission to treat same as copy of order received from this Commission.
DFR be sent back forthwith.
Statutory amount be refunded. [HON'BLE MR. JUSTICE Dr. D.P. Choudhury] PRESIDENT [HON'BLE MR. Pramode Kumar Prusty.] MEMBER [HON'BLE MS. Sudihralaxmi Pattnaik] MEMBER