1. THIS appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 28.8.2001 in Complaint No.
134/2000 by District Consumer Disputes Redressal Forum, Sarguja (hereinafter called the ''District Forum'' for short) directing the appellant
insurer to pay a sum of Rs. 20,000/- and Rs. 50,000/-, totalling Rs. 70,000/- towards the two policies obtained by the deceased Ram Awtar.
2. UNDISPUTABLY deceased Ram Awtar, husband of complainant/respondent obtained two money back policies from the appellant/insurer for
assured sum of Rs. 20,000/- and Rs. 50,000/- on 28.3.1993 and 28.12.1992 respectively. The amount of premium was deducted from the salary
of deceased Ram Awtar and was remitted to the appellant/insurer. It is also not in dispute that the said policies were with extended double benefit
i.e., in case of death due to accident, additional amount equal to the assured amount was payable under the said policies. Further, it is also not in
dispute that the deceased Ram Awtar died during the subsistence of the policy. The complainant/respondent laid claim under the policies for
payment of the amount with extended double benefit. Though assured amount under the policies were undisputably paid to the
complainant/respondent but the extended double benefit was not allowed by the appellant/insurer on the ground that extended double benefit was
not available to the complainant in view of Clauses 10(b)(i) and 10(b)(iv) which provides that Corporation shall not be liable to pay additional sum
referred to in case of death of the life assured caused by intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is
under the influence of intoxicating liquor, drug or narcotic or resulted from the life assured committing breach of law.
The complainant felt aggrieved by the denial of his claim for extended double benefit. Accordingly, she preferred complaint before the District
Forum.
The complaint was resisted by the appellant/insurer. According to them the death of deceased Ram Awtar was not on account of accident but it
was due to illicit love affair which cannot be treated as an accident. Hence they justified repudiation of the claim for extended double benefit to the
complainant/respondent.
3. THE District Forum allowed the complaint and directed the appellant/insurer to pay a sum of Rs. 70,000/- under the two policies towards
extended double benefit.
Learned Counsel for appellant/insurer assailed the impugned order. He submitted that the complainant/respondent was paid the assured amount
under the policies on 20.3.1997 and the amount was received by the complainant in full and final satisfaction of her claim. Learned Counsel for
appellant/insurer also submitted that copy of statement of accounts has been filed by him showing the payment of the assured amount. How over,
even if it is assumed that assured amount was paid as per the statement of accounts, but it cannot be inferred therefrom that she accepted the
amount in full and final satisfaction of her claim under the said policies. It may be noticed that receipt or acknowledgement of the complainant has
not been filed by the appellant/insurer.
4. LEARNED Counsel for appellant/insurer also submitted that the claim is time-barred inasmuch as the complaint was filed in the year 2000 and
the limitation would start from that time. However, it may be noted that though assured amount under the policies was paid to the complainant, the
complainant was constantly raising the grievance that she has not been given the extended double benefit equivalent to the assured amount. The
grievance of the complainant is not regarding the payment of the assured amount, but it is regarding non-payment of extended double benefit to
her. The limitation would start from the date of repudiation of the claim of extended double benefit, by the appellant/insurer. The date of
repudiation has neither been specifically mentioned in the written version nor any document has been filed to indicate the date of repudiation
thereof. Hence, it cannot be said that the complaint was time-barred. The contention in that regard of the appellant/insurer cannot be accepted.
The claim was repudiated by the appellant mainly on the ground that the deceased died on account of illicit relations. The judgment of the Sessions
Court in Case No. 41/97 is placed on record which indicates that the deceased died due to strangulation or drowning. It is also noticed from the
observations in said judgment that the deceased was intoxicated at the time of his death. However, no material has been placed on the record of
the District Forum to show that death occurred on account of influence of liquor. The observation in the judgment of the Sessions Court may be
based on the evidence placed before it. However, it was obligatory on the part of the appellant to have established the fact by placing adequate
material in the complaint. However, they have failed to do so. In the circumstances, the said observations by the Sessions Court cannot render any
assistance to the appellant/insurer in the present complaint. Moreover, there is nothing on record to show that the insurer considered the claim of
the complainant and repudiated it on the aforesaid ground.
In the circumstances, it is clear that the complainant was entitled to get extended double benefit because appellant/insurer has failed to discharge its
burden of proving that the claim could be justifiably repudiated on any of the clauses as aforesaid. Accordingly, the finding of the learned District
Forum appear to be justified. No interference therein is called for. The impugned order is accordingly affirmed.
5. LEARNED Counsel for appellant/insurer lastly contended that District Forum has awarded excessive interest @ of 12% per month, on the
amount payable by the appellant/insurer to the complainant. The interest as awarded is obviously excessive and deserves to be modified. The
appeal is allowed to the above extent and it is directed that the appellant/insurer shall pay to the complainant/respondent a sum of Rs. 70,000/-
(Rupees seventy thousand) with interest @ 12% p.a. from the date of complaint i.e., from 2.8.2000. Appeal partly allowed.