NATIONAL INSURANCE COMPANY LTD. vs LAXMI DEVI JAIN BARDIA & 2 ORS

The certified copy of the impugned order was delivered to the petitioner on 13.05.2016. The revision petition having been filed on 16.08.2016 and 13 to 15 August 2016 being th th holidays in this Commission, there may be a delay of one or two days in filing the revision petition. The said delay is condoned. The application stands disposed of.

RP/2400/2016 Late Sh. Nischal Jain S/o the complainant deposited a sum of Rs.7,000/- with respondent no.2 & 3 in a scheme in which investment was made by the deceased namely Sahara Rajat Silver Year Labh Yojna. As per the terms and conditions of the scheme issued by respondent no.2 & 3 to the deceased, in a case of accidental death after four years, he was entitled to insurance compensation of Rs.2,00,000/-. In order to provide the benefit of compensation in terms of its scheme, respondent no. 2 & 3 obtained a Group Personal Accident Policy from the petitioner company. The schedule of the aforesaid policy, to the extent it pertained to the beneficiaries/respondents, reads as under: SECTION-II FOR

Depositors/Investors, Advance Booking Holders For Housing And Various Services Of Sahara India

G.P.A.S.I. Rs.

No. of Persons

25000

4176000

50000

288000

75000

46000

100000

46000

150000

46000

200000

46000

250000

46000

300000

46000

400000

45000

500000

15000

The deceased having died in an accident four years after deposit of Rs.7,000/- with respondent no. 2 & 3, a claim for payment of Rs.2,00,000/- as compensation in terms of the scheme was lodged by the complainant, she being his mother. The claim was lodged by the complainant with respondent no.2 & 3 who, in turn, raised the same upon the petitioner. The petitioner company made a payment of Rs.25,000/- to respondent no.2 & 3 who retained that amount instead of passing it on to the complainant. Being aggrieved from the non-payment of compensation in terms of the scheme, the complainant approached the concerned District Forum by way of a consumer complaint impleading the petitioner company as well as respondent no.2 & 3 as parties to the complaint though initially, the complaint was filed only against respondent no.2 & 3.

The petitioner company resisted the complaint on the ground that their liability fixed under the insurance policy was only Rs.25,000/- and the said amount had already been made by respondent no.2 & 3. The stand taken by respondent no.2 & 3 was that the petitioner company was liable to pay Rs.2,00,000/- to the complainant.

The District Forum vide its order dated 13.05.2015, restricted the liability of the petitioner company to Rs.25,000/- and directed payment of the balance amount by respondent no.2 & 3. Being aggrieved from the order passed by the District Forum, respondent no.2 Sahara India Commercial Corporation, preferred an appeal before the concerned State Commission which held that the balance amount of Rs.1,75,000/- was also required to be paid by the petitioner company. Being aggrieved from the order passed by the State Commission, the petitioner company is before this Commission by way of this revision petition.

It is not in dispute that as per the scheme in which deposit was made by the deceased, the complainant was entitled to Rs.2,00,000/- in case of his death in an accident after four years of the deposit. It is also not in dispute that the deceased died in an accident, four years after making deposit with respondent no.2 & 3. The only question which requires consideration in this petition is as to whether the liability of the petitioner company needs to be restricted to Rs.25,000/- as was directed by the District Forum or the entire amount of Rs.2,00,000/- needs to be paid by the petitioner company. As far as the interest and compensation is concerned, that would logically follow the extent of the liability of the concerned opposite party.

The learned counsel for the petitioner company has drawn my attention to the letter dated 08.02.2005 written by respondent no.2& 3 to the petitioner and the reply dated 07.03.2005 sent by the petitioner company to the aforesaid letter. A perusal of the letter of respondent no.2 & 3 dated 08.02.2005 shows that they were seeking insurance cover of Rs.2,00,000/- in case the investor in the Silver Year Labh Yojna in the event of death in an accident after four years of opening the account with them. The letter dated 07.03.2005 sent by the petitioner company to Sahara India shows that the aforesaid proposal was

not agreed to and the insurer restricted its liability to the amount given in Table 1 of the letter dated 08.02.2005 even if the accidental death was to occur after four years of opening the account. Table 1 of the letter dated 08.02.2005 reads as under: I. If accidental death occurs within one year of opening account:

Deposit Amount (in Rs.) PA cover in the first year per person (in Rs.)

Upto 9999 25,000

10,000 to 19,999 50,000

20,000 to 26,999 75,000

27,000 to 36,999 1,00,000

37,000 to 46,999 1,50,000

47,000 to 56,999 2,00,000

57,000 to 66,999 2,50,000

67,000 & above 3,00,000

Since the deceased admittedly had deposited less than Rs.10,000/- with respondent no.2 &

3, the amount payable by the petitioner company in case of his death in an accident irrespective of when the death was to occur, was restricted to Rs.25,000/-. There is no evidence of the petitioner company having at any point of time, agreed to grant insurance cover of Rs.2,00,000/- to a person depositing less than Rs.10,000/- and dying in an accident after four years of opening the account. Therefore, the State Commission, in my view, was not justified in reversing the order passed by the District Forum and enhancing the liability of the petitioner company beyond Rs.25,000/-. The entire amount of Rs.2,00,000/- alongwith interest and compensation therefore, needs to be paid by respondent no.2 & 3, which has already received the amount of Rs.25,000/- from the petitioner company.

For the reasons stated hereinabove, the revision petition is allowed, the order passed by the State Commission is set aside and the order passed by the District Forum is restored. The revision petition stands disposed of. No order as to costs.