Insurance claims can be repudiated based on Exclusion Clauses when circumstances of death fall within defined exceptions.

1. The present Appeal has been filed by the Appellant against the order dated 16.9.2014 of the Chhattisgarh State Consumer Disputes Redressal Commission, Pandri, Raipur (hereinafter referred to as "the State Commission") in CC No. 14/2006.

2. Case of the Complainant is that the Complainant had taken a housing loan from OP No. 2,with her husband as the co - borrower. Complainant took an Insurance Policy from OP No. 1 for personal accident benefit of Rs.34,00,000 and the Policy was valid upto 12.6.2028. The Policy also insured the aforesaid loan in case of death of the insured. The Complainant's husband, who was also the co - borrower died due to Naxalite attack on 25.5.2013. The matter was reported to the Police Station. As per the Complainant, in case of death of the Complainant or her husband, the insured amount was to be adjusted against the loan obtained by the Complainant from Op No. 2 Bank. The claim of the Complainant was repudiated on the ground that it fell under the Exclusion Clause of the Policy. Since the claim of the Complainant was repudiated, a Complaint was filed in the State Commission with the following prayer:
"A. That the OP No. 1 may be directed to pay the amount of Rs.34,00,000 along with interest to the complainant.
B. That the OP No. 2 may be directed to discharge the complainant from paying the home loan and for which the OP No. 2 will be liable,.
C. That on the claim amount of Rs.34,00,000 the interest @ 18% may be awarded from date of filing of the complaint till the payment.
D. That the complainant from 11.6.2013 and after that on various dates has paid the installment of home loan of Rs.3,41,275 from the OPs. The OPs may be direct to pay the said amount jointly or severally.
E. Any other relief which the Hon'ble Commission deems fit may also be granted against OPs"

3. The Complaint was contested by the OP No. 1 / Insurance Company stated that the Complainant's husband died due to naxalite attack and by virtue of the Insurance Policy's Exclusion Clause, the Complainant was not entitled to get the insured amount from OP No. 1 and therefore, the claim was rightly repudiated. OP No. 2 / Bank stated that since the claim of the Complainant was repudiated by OP No. 1, the Complainant is liable to deposit the loan amount with the OP No. 2. The dispute was between the Complainant and the Insurance Company, and was not related to OP No. 2 and therefore, Complaint against OP No. 2 was liable to be dismissed.

4. The State Commission after hearing both the parties and perusing the record of the case, passed the following directions:
"Therefore, the complaint filed by the complainant against the OPs, is liable to be dismissed, hence the same is dismissed. Parties shall bear their own cost."

5. Aggrieved by the order of the State Commission, the Complainant preferred the present Appeal.

6. Heard the learned Counsels for the Parties and carefully perused the record. Brief facts of the case are that the Complainant purchased a Plot bearing No. 14 situated at Avani Pride, Daldalseoni Road, Mowa, Raipur by obtaining a loan from OP No. 2 for an amount of Rs.25,00,000. The husband of the Complainant was the co - borrower. The Complainant insured the loan by obtaining an Insurance Policy which was valid upto 12.6.2028. The husband of the Complainant, who was also the co - borrower, died on 25.5.2013 at Jhiram Ghati due to Naxalite attack. The matter was reported to the Police Station, Darbha, Jagdalpur. The Complainant made a claim before OP No 1. The claim, however, was repudiated on the ground that the said incident and death of Complainant's husband was not payable as per the terms and conditions of the