Judgment:
Per Smt. S.P. Lale, Honble Member
1. This appeal filed by original O.Ps is directed against the order dated 15/10/2008 passed by District Consumer Forum, Sangli in consumer complaint no.1115/2007 Shri Laxmibai Ramchandra Shinde v/s. Branch Manager, Life Insurance Corporation of India and another, whereby Forum below directed O.P. to pay Rs.1 lakh sum assured together with interest @ 9% p.a. from 28/1/2007 till realization to the complainant. Forum below further directed O.P. to pay Rs.3000/- towards cost of the proceedings to the complainant. Being aggrieved by the said order, LIC of India has filed the present appeal.
2. Life assured was having Jeevan Anand policy bearing no.942697473 of the O.P. Date of proposal was 31/12/2003 and the date of commencement was 28/12/2003 and sum assured was Rs.1 lakh. Life assured was also covered for certain critical illness by paying certain amount towards Critical Illness rider. Life assured expired on 10/12/2006. Father of the life assured lodged a claim with the O.P. O.P. paid the basic claim to the complainant and repudiated the claim towards the critical illness for the treatment of kidney ailment. Claim was repudiated towards the critical illness benefit, since policy in question was lapsed on the date of diagnosis i.e.09/8/2006. According to complainant premium for the policy was due for June 2006 and he paid the premium on 14/8/2006. O.P. accepted the premium with fine and therefore policy was revived and was not in lapse condition as on the date of diagnosis. Therefore complainant filed consumer complaint before the Forum below for deficiency in service.
3. O.P. filed written statement and contested the claim of the complainant. It pleaded that the premium was due on June 2006 and was unpaid till 14/8/2006 and hence said policy was in lapse condition as on date of diagnosis. Policy was revived subsequently. Therefore as per terms and conditions of the policy, complainant is not eligible for the critical illness benefit and finally, prayed for dismissal of complaint.
4. After considering affidavits and documents placed before it, Ld. District Consumer Forum allowed the complaint and passed impugned order.
5. Heard Mr.A.S.Vidyarthi-Advocate for the appellants and Mr.H.R.Patil-Advocate for respondent/org.complainant.
6. Life insured had taken policy from the appellant. Due date of payment of the premium was 28/6/2006. Life assured paid the premium on 14/8/2006 with penalty. It is the contention of the respondent that the life assured had critical illness of kidney failure and the policy was not lapsed on the date of death of the life assured i.e.10/12/2006. Appellant had contended that the policy was in lapse condition when the life assured died. Therefore appellant has rightly repudiated the claim of the respondent for the illness of kidney failure. Ld.Advocate for the appellant Mr.Vidyarthi argued that non forfeiture regulations as contended in the Conditions and Privileges as mentioned in the main policy documents will not apply to the Critical Illness rider. However when the appellant had accepted the premium on 14/8/2006 with penalty for renewal of the policy and issued renewed policy, it is not a fresh policy. As such, the period of six months referred by the appellant relating to non-forfeiture regulations, which relates back to date of issue of the original policy, being already over and consumed, said premium is not now available to the insurance company to repudiate the claim. Therefore, contention of the appellant is not acceptable to us. We are finding appeal is devoid of any substance. We find no reason to interfere with the order passed by the Forum below. Order passed by the Forum below is just and proper and sustainable in law. Appeal is devoid of any substance. Hence we pass following order;-
Order:
1. Appeal stands dismissed.
2. Misc. application stands disposed of.
3. Copies of the order be furnished to the parties.