BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MAHARASHTRA (Arisen out of order dated 20.08.2015 in Consumer complaint no.CC/2013/99 of District Forum, Satara)

SBI Life Insurance Co.Ltd. Through Branch Manager

287/1, Deeplakshmi Powai Naka, Satara. ...........Appellant(s)

Versus Smt.Vaishali Suryakant Duduskar R/o. Mauje Morewadi, Dare Khurd, Taluka & Dist. Satara. ............Respondent(s)

BEFORE:

Hon’ble Mr.Justice S.P. Tavade, President Hon’ble Mr.Vijay C. Premchandani, Member For the Appellant :

Adv.Sachin Daga a/w. Adv.Shreyashi Panda For the Respondent/s:

Adv.Balasaheb Deshmukh

ORAL ORDER

Per Hon’ble Member Mr.Vijay C. Premchandani (1) Present appeal is filed by the appellant insurance company/original opponent being aggrieved and dissatisfied by the impugned order dated 20.08.2015 passed in consumer complaint no.CC/2013/99 by the learned District Consumer Disputes Redressal Commission, Satara.

Brief facts of the appeal :-

i. The appellant has contended that the Deceased Life Assured, Mr. Suryakant Vasant Duduskar (hereinafter referred to as DLA) had applied for Shield Plan -A Policy through proposal no.162887624 dated 13.01.2010 along with an initial proposal deposit of Rs. 1070/- and accordingly a policy bearing no. 16016132902 was issued with date of commencement of policy as 16.01.2010 for a Level Cover of Rs.5, 00,000/- and with Accidental Death and permanent disability rider of Rs. 4, 00,000/-, for a term of 20 years. The frequency of premium was semi-annual [that is, Half-yearly] and the installment premium payable was Rs. 1085/-.

ii. The date of commencement of the policy was on 16.01.2010 and as the frequency of premium payment was semi-annual the next premiums due were on 16.07.2010, 16.01.2011, 16.07.2011...........The premiums dues till 16.01.2011 were received by SBI Life Insurance Co. Ltd and the premium due on 16.07.2011 was not received by SBI Life Insurance Co. Ltd and as a result, the policy lapsed with effect from 16.07.2011.

iii. As per the clause no.2, Premium Payments of Schedule III, Terms and Conditions of the policy, "A grace period of 30 days will be allowed for payment of quarterly/half-yearly/yearly premiums and 15 days for payment of monthly premiums. If the premium is not paid before the expiry of the days of grace, the policy will automatically lapse. ........." In the instant case, the premium due on 16.07.2011 was not received even within the grace period, i.e. within 16.08.2011, and hence the risk cover on the life of Sri Suryakant Vasant Duduskar and all the benefits under the policy ceased with effect from 16.07.2011.

iv. The DLA, Mr. Suryakant Vasant Duduskar is reported to have died on 24.08.2011. It is submitted that the renewal premium due on 16.07.2011 was not received by SBI Life Insurance Co. Ltd. Thus the risk cover given to Mr. Suryakant Vasant Duduskar was in lapsed status as on the date of his death, i.e. on 24.08.2011 and nothing was payable under the said insurance policy. Hence the death claim was repudiated by SBI Life Insurance Co. Ltd.

(2) The Respondent/complainant had filed the complaint bearing no. 99/2013 before Hon'ble District Forum, Satara against the repudiation action of Appellant and the Hon'ble Forum has pronounced the impugned order dated 20.08.2015 against which the present appeal is filed.

(3) Learned District Commission, Satara has allowed the consumer complaint by directing the appellant to pay claim amount with accident benefit of Rs.20,00,000/- with interest @9% p.a. and also directed to pay costs of the litigation.

(4) Being aggrieved by the impugned order, present appellant has preferred this appeal on following grounds :-

Grounds of Appeal :

i. That the Ld. Forum erred in concluding that claim amount payable under the policy no. 16016132902 is Rs. 20,00,000/- (Rupees Twenty Lacs only) based on complainant/Respondent prayer clause. That as per the policy documents, the DLA was covered for basic sum assured of Rs. 5,00,000/- (Rupees Five Lacs only)