Entitlement to claim settlement under insurance policies based on an agreement between the parties.

Mr. Justice S.A. Kader, President—The appeal is directed against the order of the District Consumer Disputes Redressal Forum, Cuddalore, dated 19.8.93 in O.P. 96/92. The first opposite party is the appellant.

2. The complainant’s husband late K. Venu who was employed under the second opposite party had taken three policies of insurance under the Salary deduction scheme. The first policy is No. 61977999 for Rs. 3,000/- the second policy is No. 710372736 for Rs. 15,000/- and the third policy is No. 71037383 for Rs. 10,000/-. Under these policies, the monthly premier has to be deducted from the salary of Venu by the second opposite party and paid to the Insurance Company. The complainant’s husband died on 18.5.89 and the complainant claimed these amounts. The first opposite party settled the first policy by payment of Rs. 3,632.70 and the second policy by payment of Rs. 17,117/-. It repudiated the third policy. According to the complainant, the payment made for these policies were also not proper and the repudiation of the claim in respect of third policy is illegal and hence the complaint.

3. The first opposite party insurer contended that the complainant’s husband failed to pay the premium from March 1989 for all the three policies. After deducting the sum of Rs. 73.50 towards the premium, the claim was settled in respect of the first policy by payment of Rs. 3,632.70, in respect of second policy an ex-gratia settlement was made by payment of Rs. 17,117/- and the third policy was repudiated. There was no deficiency of service.

4. The second opposite party contended that due to financial constraints the premier could not be paid, but subsequently there was an agreement between the first and the second opposite party on 11.9.90 under—which the arrears of premia were agreed to be paid by the second opposite party and the first opposite party agreed to keep alive the policies.

5. The District Forum found that there was deficiency of service on the part of the first opposite party and directed it to pay to the complainant, the sum of Rs. 73.50 being the premia deducted in respect of the first policy, to pay the balance in respect of the second policy and to pay the full amount in respect of the third policy. No order was passed against the second opposite party. Aggrieved by this order, the first opposite party has preferred this appeal. The complainant has not preferred any appeal against the reduction of the claim against the second opposite party.

6. Exh. B5 is the agreement entered into between the first and the second opposite parties under which the second opposite party has agreed to pay the arrears of premia in respect of 5 em : ployees and in respect of their policies mentioned therein and the first opposite party has agreed to breat policies as inforce. The complainant’s husband is one of the persons mentioned therein and the two policies mentioned are policies 2 & 3. The first policy finds no place in this agreement.

7. The opposite party No. l has settled the first policy at Rs. 3,632.70 after deducting the premia arrears. As this policy was not covered by agreement, under Exh. B-5 no objection can be taken to the settlement of claim at Rs. 3,632.70. The complainant’s claim in respect of first policy must fail.

8. Policies 2 & 3 are covered by Exh.B-5 agreement. According to the second opposite party in accordance with this agreement, it has paid all the arrears of premia in respect of these two policies and this is not disputed by the first opposite party/appellant. It is however contended that this agreement will come into force only if the second opposite party pays the arrears of premia in respect of all the 5 persons mentioned therein. Hence, the mere fact that the second opposite party has paid the arrears of premia in respect of the complainant’s husband only cannot entitle the complainant to claim the benefit of this agreement. We are unable to accept this contention. There is nothing in Exh. B-5 to show that only