National Consumer Disputes Redressal
Life Insurance Corporation Of India vs T. Balaiah Chodari on 16 December, 2003
Equivalent citations: I(2004)CPJ67(NC)
ORDER
Rajyalakshmi Rao, Member
1. This Revision Petition is filed against the order dated 18.6.2003 passed in Appeal No. 440/2002 by State Commission, Karnataka. Brief facts of the case are :
The respondent/complainant, Shri T. Balaiah Chodari purchased a Jeevan Kishore Policy with profits for his minor daughter, Kumari T. Divya (the life assured) aged 11 years for a sum assured of Rs. 2,00,000/- from the Revision Petitioner - Life Insurance Corporation of India vide policy No. 612379109. Shri Chodari made a proposal for purchasing the said policy in the name of his daughter which commenced w.e.f. 16.3.1999 (terms and conditions in Annexure-A) and is to mature on 28.3.2018. The insured Kumari Divya unfortunately died in a motor vehicle accident on 16.4.1999 in Tamil Nadu State.
2. Shri Chodari made a claim with LIC for settlement of the amount covered by the insurance policy by providing the necessary documents. But LIC repudiated the claim vide their letter dated 11.12.1999 on the ground that the policy was issued on Jeevan Kishore Plan and risk under the policy did not commence as on the date of death of the insured and asked Shri Chodari to receive the premium paid by him from its branch. Aggrieved by this action of LIC after issuing notice to them, the respondent approached the District Forum, Bangalore with a complaint claiming a sum of Rs. 2 lakhs with interest and other reliefs. District Forum allowed his Complaint No. 384/ 2001 and directed LIC to pay a sum of Rs. 2 lakhs with interest at 9% p.a. from 26.11.2000 till payment along with Rs. 10,000/- as costs. The appeal preferred by LIC was dismissed by the State Commission, Karnataka. Hence, this present petition is filed here. To appreciate the facts in light of the terms of the policy we place the relevant portion as below :
Crucial issues identified in the arguments of learned Counsel for the petitioner are :
3. It is argued by the petitioner that in the present policy the special provision with regard to deferment of date for coverage of risk is such that petitioner is neither entitled to nor can claim the full sum assured from the petitioner since the Jeevan Kishore Policy is taken in the name of the minor the policy shall automatically vest in the life assured as soon as he/she attains majority. In view of the special provisions underlying the said policy, the coverage of risk on the life of the assured is deferred as per the terms and conditions. In the instant case there was no coverage of risk as on the date of death of life assured. The date of commencement of risk, in the instance case, was one year after the commencement of the policy. Therefore, said contention on behalf of LIC is in consonance with Clause II of the special provision of the Jeevan Kishore Policy which is reproduced below for ready reference :
"This policy shall stand cancelled in case the life assured shall die before the deferred date and in such event provided the policy is then in full force, a sum of money equal to all the premiums paid without any deduction whatsoever, shall become payable to the person entitled to the policy moneys."
4. It is also submitted by LIC that the claim was repudiated on the ground that the policy was issued under Jeevan Kishore Plan and risk under the said policy did not commence as on the date of death of the life assured i.e. on 19.4.1999. It is contended by the petitioner that the respondent cannot take undue advantage of non-mentioning of the deferred date in policy on account of clerical mistake/typographical error on the part of the petitioner. Since the petitioner repudiated the claim in terms of the special provision of the policy there is no deficiency in service and that the respondent is taking undue advantage of this clerical mistake. The main question here is whether the liability can be fastened on Insurance Company for clerical mistake/typographical error which resulted in non-mentioning of the deferred date on the policy due to inadvertence or oversight. It is also submitted that at the time of convassing the Jeevan Kishore Policy, the respondent was aware of the highlights of the policy and terms and conditions therein including "commencement of risk" through a pamphlet/ brochure titled "Jeevan Kishor" and printed and published by the petitioner Corporation was also given. Since the pamphlet/brochure contained salient features of the Jeevan Kishore Policy it is erroneous on the part of both District Forum and State Commission to take a view that there is deficiency in service on their part. We perused the documents on record and heard the petitioner and perused the judgment of both the Fora carefully. No doubt the brochure referred to the salient features of the policy which refers to the commencement of the risk as argued by the petitioner. According to us, the insured is normally guided by the promises and assurances given by the agents or field officer of the petitioner in the normal course of insurance business. Therefore, the brochure cannot be treated as an offer and it also cannot be said that the policy in question was obtained by agreeing to the terms stated in the brochure. For example in spite of the brochure the policy document some time has certain conditions which deferred from the brochure after the discussion with the policy holder in many cases. Policy document assumes ultimate finality. We are only guided by the terms and conditions mentioned in the policy. Although the brochure indicates that date of commencement of risk (deferred date) is different for different age groups, in the policy itself the deferred date has not been mentioned. It has been left blank. When it is left blank whether it is typographical error/ inadvertent mistake by the petitioner/Insurance Company the advantage has to go to the respondent. The petitioner/Insurance Company claim always advances an argument that the insurance policy represents the contract between the insurer and insured and the conditions governing the policy binding on both the parties. Petitioner cannot now claim that in the present case these special provisions are all applicable and that the brochure overrides the policy in question. The petitioner cannot contradict their own views on the question of what is binding on them, whether a brochure or the policy. In our view terms and conditions of the policy are final.
5. In view of the above discussion, we find that the orders of the District Forum and the State Commission are correct in holding the petitioner's deficiency in service. There is no legal infirmity or jurisdictional error for us to interfere under Section 21(b) of Consumer Protection Act, 1986. Revision Petition is dismissed with cost of Rs. 5,000/- to be paid to the respondent.