Back
2012(1) CPR 22
CHHATTISGARH STATE CONSUMER DISPUTES REDRESSAL COMMISSION, RAIPUR
S.C. Vyas, President; Smt. Veena Misra and V.K. Patil, Members
The Competent Authority (Claim/OMKAR), H.D.F.C. Standard Life Insurance Co. Ltd. & Ors. —Appellants
versus
Smt. Kamla Jain —Respondent
Appeal No. 86/2011
Decided on 21.10.2011
IMPORTANT POINT
It cannot be concluded that in all life insurance policies period of grace should be one month and not than 30 days in case of yearly payable premiums.
Headnote:Consumer Protection Act, 1986—Sections 15 and 17—Insurance—HDFC Children Double Benefit Plan Policy—Death of child in accident—District Forum awarded full amount together with accident benefit and interest—There was no request from life assured, for issuing policy from a back date—Normally in matters where death occurs prior to date of insurance of policy though coverage of risk is provided from a back date, insurer usually comes forward with plea that as the person had died prior to issuance of policy, policy cannot be said to be effective at the time of death of insured—Such double standards cannot be allowed—Insured had paid premium for continuous period of 3 years but he died prior to paying due premium marginally after grace period—In such a case insurer ought to have made ex gratia payment of at least half of amount payable on death of policy-holder—Impugned order set aside. (Paras 11 to 15)
Smt. Veena Misra, Member—This is an appeal filed by the OPs insurer against dated17.1.2011 passed in Complaint Case No. 416/2009 by the District Consumer Disputes Redressal Forum, Raipur (hereinafter called “District Forum” for short), whereby the complaint was allowed and the OPs were directed to pay to the mother of the deceased insured, the insured sum as well as accident benefit aggregating to Rs.1,47,462 and also to pay interest @ 6% p.a. from the date of complaint together with Rs.1,000 towards cost of litigation.
2. The facts of the case before the District Forum are that the complainant’s son, Shri Ashish Jain had obtained HDFC Children Double Beenefit Plan Policy bearing No. 10405812 dated 21.10.2005 for a sum of Rs. 73,731 with equal sum under accident benefit, yearly premium was Rs.5,000 and the policy was to mature on 21.10.2009. It was averred in the complaint that the complainant had regularly paid premium for 3 complete years and on 15.11.2008 he met with an accident near Nalghar Chowk, Raipur and died. The accident was reported to the police. The complainant gave intimation to the insurer and laid claim. However, the OPs had sent a discharge voucher dated 16.12.2008 without mentioning payable amount. Thereupon the complainant contacted the Officer and by way of letter dated 19.12.2008 she demanded full payment of the assured sum together with accident benefit. OPs sent cheque No.336353 for a sum of Rs. 18,893 with covering letter dated 20.3.2009. The complainant refused to accept the check and returned it to OP No.1 as the amount paid was insufficient. The complainant’s son had paid premium continuously for 3 years, though the premium for 4th year could not be paid before the due date and later on the insured died in accident after merely a few days. So the complainant filed complaint before the District Forum for getting the insured sum and accident benefit together with interest and cost etc. She also filed documents and affidavit in support of the complaint.
3. In joint written version, the OPs took the plea that the complainant’s soil had made a proposal to OPs and thereupon the policy was sent to him with terms and conditions with clear mention of a grace period of 15 days. It was to be returned in case the insured did not accept the terms and conditions mentioned therein. As the policy was not returned, the terms and conditions had become binding on the insured as well as the nominee. In the policy it was mentioned that yearly premium was to be paid on 21st October every year till 2019. Further period of 15 days grace period was also provided. In the instant case after calculating the grace period, the premium was to be paid by 5th November, but as the insured had not paid the premium by 5.11.2008, so the policy was in lapsed condition, when the policyholder died on 15.11.2008. The amount payable to the nominee was calculated according to the terms of the policy and cheque of a sum of Rs. 18,893 was sent to the complainant, which was returned by her. The said cheque was again sent to the complainant on 13.5.2009, which was again returned by her. It was averred that the complainant only wishes to get sympathy of the Forum though actually she is not entitled to any relief claimed under the complaint.
4. On the basis of material placed before it, the District Forum came to the conclusion that the complainant was entitled to get full amount together with accident benefit and interest on the said amount @ 6% p.a. from the dale of complaint and Rs. 1,000 towards cost.
5. The 0Ps aggrieved by the impugned order had filed appeal on the ground that the District Forum has failed to consider the terms and condition mentioned in the policy, though the said conditions were accepted by the insured as the policy was not returned within a period of 15 days. The District Forum has also failed to appreciate the fact that premium was due on 21.10.2008, but the insured failed to pay the premium either on the due date or wit
