State Consumer Disputes Redressal Commission
1.M/S. Shriram Life Insurance Co. Ltd., vs Thirukovalluri Sree Sai Poojitha on 23 June, 2022
1
Before the State Consumer Disputes Redressal Commission
(under Consumer Protection Act, 1986) of Telangana,
Eruvaka Building, Khairathabad, Hyderabad 500 004
FANO.88 OF 2019 AGAINST CC NO.67 OF 2016
ON THE FILE OF DISTRICT FORUM, KHAMMAM
Between:
1) M/s Shriram Life Insurance Co., Ltd.,
Rep. by its Authorized Person,
Regd. Office: H.No.3-6-478, 3rd Floor,
Anand Estate, Liberty Road,
Opp: Indian Bank, Himayath Nagar,
Hyderabad, presently having its
Corporate Office at Plot No.31 & 32 part,
5th Floor, Ramky Selemium, Financial District,
Near Andhra Bank Training Centre,
Gachibowli, Hyderabad.
2) M/s Shriram Life Insurance Co., Ltd.,
Rep. by its Divisional Manager,
3rd Floor, Gayathri Complex,
Sai Nagar, near Benz Circle,
Eluru Road, Vijayawada.
3) M/s Shriram Life Insurance Co., Ltd.,
Represented by its Collection Manager,
Collection Centre, R/o U.B. Road,
Bhadrachalam Town & Mandal,
Bhadradri Kothagudem district.
..Appellants/Opposite parties
And
Thirukovalluri Sree Sai Poojitha
D/o late Rama Krishna,
aged 13 years, Occ: Student,
R/o Medical Colony, Bhadrachalam
Town & Mandal, Khammam district.
Complainant being minor, rep. by her
mother and natural guardian by name
Thirukovalluri Vijaya Laxmi
W/o late Rama Krishna, aged 30 years,
Occ: Household, R/o Medical Colony,
Bhadrachalam Town & Mandal,
Khammam district.
.Respondent/Complainant
Counsel for the Appellants M/s KRR Associates
Counsel for the Respondent Paper publication filed
Coram
Hon'ble Sri Justice MSK Jaiswal President
and
Smt Meena Ramanathan Member
Thursday, the Twenty Third day of June Two Thousand Twenty Two Oral Order *** Opposite parties in cc No.67 of 2016 on the file of District Consumer Forum, Khammam preferred this appeal feeling aggrieved by the orders dated 14.11.2018 in allowing the complaint in part and directing the Opposite parties jointly and severally to pay the sum assured and vested bonus of Rs.1,59,100/- to the Complainant, within 30 days from the receipt of the order, failing which, the amount shall carry interest 9% per annum from the date of complaint i.e., 30.01.2017 and further directed to pay Rs.1,00,000/- at the time of maturity and to pay monthly amount of Rs.1,000/- from the date of death of the life assured i.e., 21.12.2014 till date of maturity i.e., 19.10.2022 to the mother of Complainant. The Complainant being minor, the awarded amount of Rs.1,60,100/- is ordered to be kept in fixed deposit until the Complainant attains majority.
2) For the sake of convenience, the parties are referred to as arrayed in the complaint.
3) The case of the Complainant, in brief, is that she is the daughter of Ramakrishna, who died on 21.12.2014. During lifetime of her father, he obtained Shri Vivah Insurance policy bearing No.NP100700156588 for Rs.1,00,000/ from Opposite party No.1, covering the period from 19.10.2007 to 19.10.2022. After the death of life assured, she being nominee, made the claim with Opposite parties who postponed the payment of death benefits from time to time. Hence, she got issued the notice dated 20.01.2016, to which, the Opposite parties gave reply on 26.02.2016 stating that the policy instalments were not cleared and there is a due for the last month instalment.
4) Having shown the false calculation, the Opposite parties sent a cheque for Rs.62,614/- with a mala fide intention to cheat the Complainant. After waiting for considerable period, the Complainant has knocked the doors of the Forum with a prayer to direct the Opposite parties to pay Rs.2,90,187/- towards the sum assured, together with damages for mental agony and costs of the complaint.
5) Opposite party No.1 filed its written version contending that the quarterly premium of Rs.2,08 1/- was paid regularly until 19.07.2014 by the policy holder. The 4th quarter, which was due on 19.10.2014 was not paid even after reminders, as such, the policy was in lapsed condition at the time of death of the insured. As per the terms of the policy, in case the premium is not paid even after the grace period, the benefits will not be payable. If the premium is discontinued after a minimum of three years from the commencement of the policy, the policy will not be fully void but will acquire a paid-up value and the life protection will continue to the extent of paid-up value until the end of the policy term.
6) After receipt of the death intimation of the life assured, they paid the sum of Rs.62,614/- through cheque dated 17.03.2015 but the Complainant failed to collect the same and instead got issued the legal notice, to which they got issued suitable reply along with revalidated cheque dated 17.02.2016, which was in full and final payment. Hence, there is no deficiency of service on their part and accordingly prayed to dismiss the complaint.
7) During the course of enquiry before the District Forum, in order to prove her case, the Complainant got filed the affidavit evidence of her mothr Vijaya Laxmi as PW1 and got marked the documents Ex.Al to A7 and on behalf of Opposite parties, they got marked the document Ex.B1.
8) The District Forum after considering the material available on record, allowed the complaint bearing CC No.67 of 2016 by orders dated 14.11.2018, as stated supra, at paragraph No. 1.
9) Aggrieved by the above orders, the Appellants/Opposite parties preferred this appeal contending that the forum below failed to consider the fact that except paid-up value, nothing is payable as the policy was in lapsed condition as on the date of death of the life assured. It passed the orders on mere assumptions and presumptions. It failed to consider the terms contained in the brochure Ex.B1 and came to an erroneous conclusion. Hence, prayed to allow the appeal by setting aside the orders impugned.
410) The point that arises for consideration is whether the impugned order as passed by the District Forum suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with, in any manner? To what relief ?
11) The admitted facts are that the father of the Respondent/ Complainant by name Ramakrishna has obtained the insurance policy from the Appellants insurance company which was effective from 19.10.2007 for a sum assured of Rs.1,00,000/- agreeing to pay quarterly premium of Rs.2,500/- for a period of 15 years. The life assured has paid the quarterly premium regularly for the period ending July, 2014 The next premium payable was due on 19.10.2014, that premium was not paid. On 21.12.2014, the life assured died.
12) According to the insurance company, the policy was in a lapsed condition and thereíore the nominee of the life assured is not entitled to the sum assured. As per the covenants of the insurance contract, which is evident from Ex.B1, it is mentioned as under
"PAID UP VALUE f the payment of premium is discontinued after a minimum of three years, premiums are paid and three years have elapsed from the date of commencement, the policy will not be filly void, but will acquire a paid up value and the life insurance protection will continue to the extent of the paid up value until the end of the policy term.
The paid-up value will be equal to, the sum assured (amount ofpremiums paid/ total amount of premiums payable).
A policy that becomes paid up will not participate in future profits, but any Bonuses already vested will be added in full to the paid up vahue determined as above. The paid up value shall be paid at the end of the policy term or death of the life assured whichever is earlier."
13) What is manifest from the above is that since admittedly the policy was in lapsed condition since the premia was not paid even after the grace period which also expired by 19.11.2014, even though the life assured was alive for more than a month after the expiry of the grace period, the policy is certainly under lapsed condition. What is the amount that can be paid to the nominee of the life assured in that scenario has to be considered. If we carefully analyse the extracted 5 manifest is that if the premia is paid continuously portion above, what is and if it is discontinued thereafter, the policy for a period of three years life instead it acquires a paid-up value and the will not be fully void but value extent of the pad-up i n s u r a n c e provisions will continue to the on the date when he stopped the policy term. Theresore, until the end of s a m e 1or nearly of the premia after having paid the making the payment will work-out to the paid-up value of the insurance policy seven years, entitled to the nominee is also about Rs.46,667/-. In addition to that, interest.
amounts to Rs.15,700/-and Rs.247/- the vested bonus which the total s u m entitled to the above amounts but not The nominee is also assured.
amounts erred in calculating the
14) The forum below has completely covenants of the contract of insurance.
which a r e contrary to the to has accepted their liability
15) The Appellant insurance company sent the s a m e by way a matter of fact has the extent stated above and a s 17.02.2016 to the Rs.62,604/- on of a cheque for The Respondent/Complainant vide Ex.A6.
Respondent/Complainant and instead filed the has not deposited the cheque and encashed it her disinclination to accept original cheque before the forum expressing have no the said amounts. In view of the foregoing discussion, we below cannot be hesitation in holding that the order of the forum therein a r e contrary to the terms sustained since the calculations made Instead, it is held that the Appellant insurance of the agreement.
with interest thereon @ 6% company is liable to pay Rs.62,614/- together 17.02.2016 till the payment is made together with costs per a n n u m from of Rs.5,000/-.
In the result, the appeal is allowed and the impugned order is set
16) aside. The Appellant insurance company is directed to pay Rs.62,614/-
17.02.2016 till the togetherwith interest thereon@6% per a n n u m from payment is made together with costs of Rs.5,000/-.