- (1.) THIS appeal has been preferred under Sec.15 of the Consumer Protection Act, 1986 , against the order dated 1.4.2002, passed in Complaint No.367/2001 by the District Consumer Forum, Raipur (hereinafter referred to as the 'district Forum' for short) whereby the complaint was dismissed by the District Forum.
(2.) THE facts not presently in dispute are that the brother of the complainant later Sajan Das Bajaj had obtained a life insurance policy bearing No.381530965 on 28.7.1995 from the respondent/opposite party No.2, covering risk upto 28.7.2005 and the premium was Rs.784/ - payable quarterly. The aforesaid Sajan Das Bajaj had appointed his brother i. e. , the appellant/complainant as his nominee for purposes of the aforesaid policy. It is also not in dispute that the said Sajan Das Bajaj died on 8.10.1999 and further that the claim filed by the nominee of the deceased i. e. , the appellant/complainant was repudiated by the insurer on 23.6.2000 on the ground that the policy was in a lapsed condition on the date of death of the life assured.
(3.) IN consequence of repudiation of claim, the nominee had filed complaint before the District Forum and contended that the deceased Sajan Das had obtained the aforesaid policy for the assured sum of Rs.3,00,000/ -. During his life -time the life assured paid due premiums, though belatedly, and the same were received and acknowledged by the insurer. It was contended that though a few receipts have been lost and are not available, the policy did not lapse. It was also contended that the practice adopted regarding receipt of premium is that in case of delayed premiums, the company first adjust the past due unpaid premiums and then adjusts the amount towards the latest premium and the policy, even if lapsed, stands revived. The last receipt of premium is dated 24.7.1999. It was further contended that the life assured used to pay cash to the agent for the due premiums, who in turn deposited the same with the insurer. The life assured had paid a sum of Rs.6,306.70 to the agent for being paid towards the due premiums under the aforesaid policy but only one instalment was paid out of the said sum. After the death of the life assured on 8.10.1999 the claim was laid before the insurer for payment of the assured sum of Rs.3,00,000/ - but the claim was repudiated by the insurer. It was also averred in the complaint that the complainant had filed a petition before the Ombudsman at Bhopal and the said petition was partly allowed and the Ombudsman had directed the insurer to refund the amount received towards instalments of premium, together with interest due thereon, instead of direction to make payment of the assured sum of Rs.3,00,000/ -. As the complainant was not satisfied with the award of the Ombudsman, he filed complaint before the District Forum seeking direction for payment of the assured sum of Rs.3,00,000/ - together with interest from the date of filing of complaint calculated @ 18% per annum and costs of proceedings. The complainant also filed affidavit in support of complaint. The opposite party Nos.1 and 2 had averred in the affidavit -cum -reply that the deceased Sajan Das used to make late payment of instalments of premium and he had paid only 15 quarterly instalments. Last premium was paid on 24.7.1999 for the instalment due from 28.1.1999. At the time of death of the insured on 8.10.1999 the policy was lying lapsed as the premiums payable on 28.1.1999 and 28.7.1999 were not paid. It was admitted that there had been some mistake due to fault in the accounting machine. It was further contended that as directed by the Ombudsman, the opposite party Nos.1 and 2 were prepared to refund the amount of premium received from Late Sajan Das together with interest @ 12% but the complainant declined to accept the same. It was also averred that the opposite party Nos.1 and 2 neither authorised opposite party No.3 nor opposite party No.4 to receive the amount of premium. As the policy had lapsed prior to death of the life assured the complainant is not entitled to any relief claimed by him.;