IMPORTANT POINT
However, LIC cannot be made to provide accidental benefit when there was no provision for the same in insurance policy.

Dr. B.C. Gupta, Presiding Member—This revision petition has been filed under section 21(b) of the Consumer Protection Act, 1986 against the order dated 13.04.2010, passed by the Chhattisgarh State Consumer Disputes Redressal Commission (hereinafter referred to as ‘the State Commission’) in First Appeal No. 619/2009, “Life Insurance Corporation of India versus Shivmangal Ram Baghel & Anr.”, vide which, while dismissing the said appeal, the order dated 22.09.2009, passed by the District Forum Sarguja, Ambikapur allowing the consumer complaint No.124/2007, filed by the present respondent/complainant, was upheld.

2. Briefly stated, the facts of the case are that the complainants/respondents are the parents of their deceased son Dinesh Kumar Bhagel, who is stated to have died in a road accident on 04.02.2006. The deceased Dinesh Kumar Bhagel had obtained an insurance policy on 25.03.2005, called Limited Payment Endowment Policy with Profits from the Opposite Party (OP) Life Insurance Corporation of India (LIC) for a sum of Rs.1 lakh. The case of the complainant is that under the Policy, the respondent LIC had agreed to pay, apart from the sum insured, an accidental benefit of Rs.1 lakh under the terms and conditions of the policy. The complainants submitted claim with the LIC after the death of the said Dinesh Kumar Bhagel, but the same was repudiated by the LIC on the ground that the deceased policy holder was driving motor cycle under the influence of liquor and that he had no driving licence. Alleging deficiency in service on the part of the LIC, the complainants filed the consumer complaint in question, seeking directions to them to pay a sum of Rs.2 lakh and a compensation of Rs.25,000/- alongwith interest @12% p.a. on the aforesaid sums from the date of filing the complaint till realisation.

3. The complaint was resisted by the OP LIC by filing a written statement before the District Forum, in which they stated that the deceased was in the habit of consuming liquor in excess, but he concealed this fact from the Insurance Company, while filling the proposal forum. Moreover, the policy holder died in an accident within 10 months of taking the policy by driving his motor cycle in a rash and negligent manner under the influence of liquor. Hence, the LIC had got investigation into the matter conducted, treating it as an early death claim. Based on the said investigation, the claim had been repudiated.

4. The District Forum after considering the averments of the parties, directed the OP LIC to pay a sum of Rs.2 lakhs alongwith interest @9% p.a. from the date of repudiation of the claim till realisation and also Rs.2,000/- as compensation for mental agony and Rs.1,000/- as litigation cost. Being aggrieved against the said order of the District Forum, the LIC challenged the same by way of an appeal before the State Commission and the said appeal having been dismissed, the LIC is before this Commission by way of the present revision petition. While dismissing the appeal, the State Commission observed that clause 10.1 to 10.6 and 11 had been made applicable for the Insurance Policy.

5. The LIC have taken the stand that at the time of issuance of the policy, the life assured was a minor being only 17 years of age, having been born on 26.01.1988. The proposal form filed by him did not contain a clause for accident benefit and was specifically excluded from the policy in question. The life assured could have been covered under the accidental benefit, upon his becoming a major, subject to the condition that he opted for the said benefit and paid the premium for the same. At the time of his death, he was just a few days over 18 years of age. The learned counsel for the LIC has drawn attention to a copy of the Insurance Policy on record and stated that the conditions 10.1 to 10.6 and 11 were not applicable to the policy issued to the deceased and hence, the State Commission had wrongly observed that such conditions were applicable. Further,