Life Insurance Corporation of India vs DEVINDER SHARMA

THIS revision petition arises out of the order of the State Consumer Disputes Redressal Commission, Punjab, whereby the State Commission upheld the order of the District Forum.

THE brief facts in this case are that the respondent had a medi-claim policy, Ashadeep from the Life Insurance Corporation of India on 25th November,1993. THE risk was covered w.e.f. July, 29, 1993. On December 4, 1994 he suffered renal disease for which he took treatment from the Post Graduate Institute, Chandigarh. THEreafter, he submitted claim to the LIC who repudiated the claim on September 26, 1996 on the ground that the disease had occurred within one year of the date of the policy. This led the complainant to approach the District Forum with a complaint. THE District Forum after going into the facts and evidence allowed the complaint and awarded a sum of Rs. 25,000/-. A further sum of Rs. 10,000/- p.a. exceeding 10% of the award. Notice was issued on this revision confined only to this amount. THE facts and law has been examined at two stages. We cannot find any fault with those. However, what has escaped the attention of the Appellate Court is that the sum of Rs. 10,000/- p.a. could not have been awarded in terms of the policy under Benefit-B, Clause (iii) which provided that the payment of amount equal to 10% of the sum assured every year commencing from the policy anniversary falling on or immediately after the date of eligibility for benefit and ending with the policy anniversary preceding the stipulated date of maturity or the date of death of the life assured, whichever is earlier. THE policy is for Rs. 50,000/- and 10% of it would come to Rs. 5,000/- and not Rs. 10,000/- as awarded by the District Forum erroneously. Accordingly, we are of the opinion that the amount Rs. 10,000/- should be reduced to Rs. 5,000/- p.a. THE orders of the State Commission and the District Forum shall stand modified to that extent. No other point arises as notice was issued only limited to the point discussed above. THE revision petition is disposed of in the manner stated hereinabove. In the facts and circumstances of the case, there is no order as to costs. Revision Petition disposed of.