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Chedde Mahesh v/s Birla Sun Life Insurance Co. Ltd & Another


    FA No. 113 of 2017

    Decided On, 29 January 2020

    At, Andhra Pradesh State Consumer Disputes Redressal Commission Hyderabad

    By, THE HONOURABLE MR. JUSTICE T. SUNIL CHOWDARY
    By, PRESIDENT & THE HONOURABLE MR. P. MUTYALA NAIDU
    By, MEMBER

    For the Appellant: J. Narayana Swamy, Advocate. For the Respondents: M/s. CRS Associates.



Judgment Text


(Andhra Pradesh State Consumer Disputes Redressal Commission, Vijayawada)

T. Sunil Chowdary, President

Oral Order:

This appeal is filed, under Section 15 of the Consumer Protection Act, 1986, assailing the Order dated 09.02.2017, passed in CC No. 60 of 2016 on the file of the District Consumer Disputes Redressal Forum (herein after referred to as District Forum), Ananthapuram, wherein the complaint filed by the complainant was dismissed.

2. The parties herein after will be referred to as they were arrayed before the District Forum for the sake of convenience. .

3. The facts leading to filing of this appeal in brief are as follows:

One C. Chennakesava (herein after referred) to as 'life assured'.had obtained a policy bearing No. 005970685 from the opposite parties with effect from 26.02.2013 to 26.02.2079 for a sum assured of Rs.20,00,000/- on payment of monthly premium of Rs.9,270-39 ps.. The life assured paid the premiums up to July, 2013. The life assured died on 15.03.2015 due to heart attack. The Government Hospital, Chennai issued a post mortem certificate on 16.03.2015. The complainant, who is the nominee under the policy, submitted a claim application to the opposite parties for settlement of the insurance claim. The opposite parties repudiated the claim of the complainant on untenable grounds. Hence, the complaint.

4. The opposite parties filed written version admitting the issuance of the policy bearing No. 005970685 in favour of the life assured for a sum assured of Rs.20,00,000/-, inter alia, contending that the life assured did not pay the premium instalments as per the schedule. The opposite parties issued lapsed notice on 05.10.2013, to the life assured.

After receipt of the claim application, the opposite parties addressed a letter dated 26.05.2015 informing the complainant that the policy stands lapsed with effect from 26.08.2013. Hence, the complaint is liable to be dismissed.

5. Before the District Forum, both parties filed evidence affidavits in support of their respective stands. On behalf of the complainant, Exs.A-1 to A-16 were marked. On behalf of the opposite parties, Exs.B-1 and B-2 were marked.

6. Basing on the pleadings, evidence affidavits, documentary evidence and other material available on record, the District Forum arrived at a conclusion that there was no deficiency in service on the part of the opposite parties, consequently dismissed the complaint.

7. Feeling aggrieved with the impugned order dated 09.02.2017, passed in CC No. 60 of 2016, the unsuccessful complainant preferred the appeal.

8. The learned counsel for the complainant (appellant) submitted that the finding recorded by the District Forum that the policy was lapsed on 26.08.2013, is factually incorrect. He further submitted that the findings recorded by the District Forum are perverse, therefore, it is a fit case to set aside the impugned order and allow the appeal.

9. Per contra, the learned counsel for the opposite parties (respondents) submitted that the life assured did not pay the premium instalments as per the schedule, therefore, the policy was lapsed on 26.08.2013. He further submitted that the complaint itself is not maintainable in view of the lapse of the policy. He further submitted that the findings recorded by the District are supported by the documentary evidence produced by both parties, therefore, it is a fit case to dismiss the appeal.

10. Basing on the rival contentions, the points that arise for consideration are:

1. Whether the opposite parties are justified in repudiating the claim of the complainant; and

2. Whether there are any grounds to set aside the impugned order.

11. POINTS 1 AND 2:- Both points are intertwined with each other, hence, we address both the points simultaneously in order to avoid recapitulation of facts and evidence.

12. Before adverting to the findings of the District Forum, it is not out of place to refer the admitted facts of the case. The life assured submitted a proposal form, Ex.A-1 to the opposite parties for issuance of an insurance policy. Basing on Ex.A-1, proposal form submitted by the life assured, the opposite parties issued a policy bearing No. 005970685, Ex.A-3 with effect from 26.02.2013 to 26.02.2079 for a sum assured of Rs.20,00,000/- on payment of monthly premium of Rs.9,270-39 ps.. The life assured paid the first premium under Ex.A-2 on 26.02.2013. The life assured died on 15.03.2015 due to heart attack. Ex.A-4, is the post mortem certificate. The complainant, who is the nominee under Ex.A-3 policy, submitted a claim application, Ex.A- 8, to the opposite parties for settlement of insurance claim. Ex.A-10 is the acknowledgement issued by the opposite parties. The opposite parties repudiated the claim of the complainant vide its letter, dated 19.11.2015, Ex.A-7. Thereafter, the complainant submitted an application to the Grievance Redressal Committee to reconsider his case, who in turn rejected the claim of the complainant vide its letter, dated 21.01.2016, Ex.A-9. Exs.A-4, A-5, A-6, A-11 to A-16, B-1 and B- 2 are not relevant so far as the lis involved in the complaint. Hence, there is no need to consider these documents.

13. Suffice it to say, after lapse of the policy, the life assured has to submit an application to the Insurance Company for renewal of the policy. No one is entitled to make insurance claim basing on the lapsed policy. In the instant case, the life assured had obtained Ex.A-3 policy on 26.02.2013. The life assured paid the first premium on 26.02.2013. Ex.A-2 is the premium receipt. As per the testimony of RW-1, the life assured paid the total premium of Rs. 55,622/ -. It is an admitted fact that the life assured paid six instalments of premium, i.e., up to 26.07.2013. The policy was lapsed on 26.08.2013. The opposite parties have taken a specific stand in the written version that in spite of notice, the life assured did not choose to renew the policy bearing No. 005970685. It is not the case of the complainant that the opposite parties renewed the policy during the life time of the life assured. Admittedly, the life assure did not pay the monthly premiums with effect from 26.08.2013 till his death, i.e., 15.03.2015. The material placed before this Commission clinchingly establishes that the policy was lapsed in the month of August, 2013 itself. The nominee of the life assured is not entitled to submit a claim application basing on the lapsed policy. Basing on the material available on record, we are of the considered view that the complainant is n

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ot entitled to claim any amount under the policy bearing No. 005970685, which was lapsed in the month of August, 2013. 14. The District Forum considered the various documents filed by both parties and arrived at a conclusion that the opposite parties are justified in rejecting the claim of the complainant. The District Forum has assigned reasons much less cogent and valid reasons to its findings. We are fully endorsing with the findings recorded by the District Forum. There is no illegality or irregularity in the impugned order, which warrants interference of this Commission. Viewed from any angle, the appeal is liable to be dismissed. 15. In the result, the appeal is dismissed. No costs. Appeal dismissed.
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