Bhoomavva v. Life Insurance Co of India

This complaint is filed under Sec 12 of C.P.Act, 1986 praying this Forum to direct the opposite party to pay a sum of Rs.100,000/- towards accident benefit on the life assured (LA) with 12% interest on it from the date of death of life assured till realization and to award costs and any other relief as deemed fit and proper in the circumstances of the case. The brief averments of the complaint are:

1. The complainant is the mother of the deceased son who took a policy bearing no. 684087731 when he was minor in the year 2004. On 12.09.2010 the life assured/deceased met with an accident and died in the early hrs of 13.09.2010 near Lakudaram village on the high way road to Hyderabad. It is also submitted that the complainant was paid Basic Sum Assured Plus bonus 2i.e., 100,000/- + Rs.29,300/-, but the LIC agent/G.Mallesham assured accident benefit at the time of making the policy and the same was not paid by the opposite party. In this regard the counsel also sent a legal notice Dt: 23.12.2013 but the opposite party repudiated the claim through his letter Dt: 26.12.2013 on flimsy ground, that the life assured was not covered with accident benefit.

2. The opposite party in his written version stated that the opposite party issued Endowment Assurance Policy with profit on the life of Mogulla Mallesham/deceased/LA, when he was a minor, carrying no accident benefit. He further avered that on receipt of intimation of death of life assured. The LIC Company/opposite party admitted death claim for basic sum assured along with eligible bonus and paid Rs.1,34,100/- on 15.03.2011 vide cheque no.4017737. Finally he submits that as per the rules of the Corporation Accident benefit cover is not allowed to minor lives. Therefore, there was neither delay nor deficiency in service on the part of opposite party and humbly prayed to dismiss the complaint with costs.

3. The complainant through evidence affidavit got marked the documents as Ex.A1 to A7. Similarly the opposite party led evidence with Ex.B1 to B4. Heard both the counsels.

4. The point for consideration is, whether there is any deficiency of service on the part of opposite party? If so? To what relief? POINT`:

5. This is a simple case of life insurance policy related to a minor. The learned counsel for the complainant strongly emphasized that the accident claim was not paid to the deceased/life assured. Otherside the opposite party also resisted by revealing the fact that the said policy is an Endowment Assurance Policy on the life of a minor which do not carry Accident benefit. However the entitled benefits amounting to Rs.1,34,100/- were already paid to the complainant on 15.03.2011 itself.

36. On scrutiny of the Ex.A1/B1 policy copy it is confirmed that the said policy is an Endowment Assurance Policy with profits and age of the life assured was 15 years only and Ex.B4 reveals death claim paid. The Ex.A3 to A5 are related to accidental death of the deceased. Hence the point is not cause of death, whether accident claim benefit is covered in the said policy or not. From the documentary evidence it is perused that the policy does not include provision for accident claim benefit.

7. The contention of the learned counsel for complainant is that the opposite party never gave any intimation to the complainant that an extra premium amount is to be paid after the life assured attains majority does not have any connotation on the said policy.

8. The learned counsel of opposite party relied on the order Dt: 02.12.2010 in R.P.No.3232/2006; Rajendra Kumar Partogi Vs LIC of India; it was held:

The minor on attaining the majority could opt for the accidental benefit on payment of requisite amount of premium. As no such option was exercised, the insurance company was not liable to pay the Accident benefit

In the circumstances, the complainant cannot demand as she has not paid requisite amount of premium and not exercised such option (Accident Benefit). Hence the point is answered against the complainant.

9. In the result the complaint is dismissed with no costs. Typed to my dictation by Stenographer (DUR) and after correction, the orders pronounced by us in the open court this the 29th day of July, 2015. Sd/- Sd/- MEMBER PRESIDENT(FAC) NO ORAL EVIDENCE HAS BEEN ADDUCED ON EITHER SIDE FOR COMPLAINANT:

1. Ex.A1 is the photo copy of Policy Schedule issued by the opposite party in favour of Mogulla Mallesham Dt: 05.07.2004 for an Assured Sum of Rs.1,00,000/-.

2. Ex.A2 is the photo copy of Status Report in respect of policy no.684087731 Dt: 08.12.2010.

43. Ex.A3 is the photo copy of FIR in Cr.No.166/2010 Dt: 13.09.2010 issued by PS, Kuknoorpally.

4. Ex.A4 is the photo copy of Postmortem Examination Report conducted on Mogulla Mallesham Dt:13.09.2010 issued by Area Hospital, Siddipet.

5. Ex.A5 is the photo copy of Death Certificate of Mogulla Mallesham issued by Panchayat Secretary, Lakudaram Village, Kondapaka Mandal Dt: 24.09.2010 (DOD 13.09.2010).

6. Ex.A6 is the original copy of repudiation letter from opposite party addressed to counsel for complainant Dt: 26.12.2013.

7. Ex.A7 is the office copy of Legal Notice issued by counsel for complainant addressed to opposite party Dt: 23.12.2013. FOR OPPOSITE PARTY:

1. Ex.B1 is the original copy of Ex.A1.

2. Ex.B2 is the original copy of proposal for insurance issued by Karimnagar Division of opposite party Dt: 28.06.2009.

3. Ex.B3 is the original copy of Summary Status Report (death claim-paid) issued by opposite party in respect of policy no. 684087731.

4. Ex.B4 is the original copy of Status Report issued by opposite party in respect of policy no. 684087731 Dt: 17.07.2014. Sd/- Sd/- MEMBER PRESIDENT(FAC)