BHANUBEN VALJIBHAI, AMBALIYA MOTHER & LEGAL HEIR OF DECEASED DAXAY VALJIBHAI AMBALIYA Vs. LIC OF INDIA

JUDGEMENT

(1.) The present revision petition has been filed against the judgment dated 16.12.2011 of the Gujarat State Consumer Disputes Redressal Commission, Ahmedabad ('the State Commission') in Appeal no. 1245 of 2011.

(2.) The facts of the case as per the original complainant/ petitioner are that the deceased Dakshay Valjibhai Ambliya had taken 'Bima Gold Policy with double accident benefits', from the respondent/ LIC with sum insured at Rs.5.00 lakh and the policy number was 813075506. The said policy was valid from 28.03.2006 to 27.03.2021. The deceased policy holder expired on 30.09.2006 due to injuries caused in a vehicular accident on 12.09.2006 and as the petitioner was the legal heir of the deceased policy holder, she filed a claim before the respondent seeking payment of benefits available under the aforesaid policy. The respondent had made the payment for single benefit under the said policy. However, the double benefit (i.e., accidental death benefit) was rejected vide letter dated 26.06.2007 on the ground that the policy holder had committed breach of law. The petitioner called upon the respondent/ LIC vide notice dated 23.07.2007 to pay the benefits under the said policy. However, since the respondent had shown deficiency in service by not paying the amount, accordingly, a complaint was filed before the Consumer Disputes Redressal Forum, Rajkot District with the following prayer: The respondent be directed to pay Rs.5,00,000/- with interest at the rate of 18% per annum towards double benefit amount of insurance policy from the date of accident till date of payment; The respondent be directed to pay Rs.50,000/- towards pain, shock and suffering suffered by the petitioner on account of not paying the genuine claim within time; The respondent be directed to pay Rs.10,000/- towards the cost of the legal proceedings and advocate fees; and Any other relief which District Forum may deem fit to grant.

(3.) The respondent/ LIC in their written statement had stated that the deceased policy holder was holding a learning licence. At the time of the accident, the deceased was driving the vehicle in breach of the provisions of the Motor Vehicle Rules 1989. As per their defence, in terms of Rule 3 of Central Motor Vehicle Rules 1989, any person holding the learning licence was prohibited or restricted from driving vehicle except in the event when alongside any person holding a legal licence and ''L' plate is affixed on the front portion and on the rear side of the vehicle. The claim of the petitioner was rejected since the deceased policy holder was driving the vehicle without a pillion rider holding a valid legal licence and thereby committed breach of clause 10 (b) (4) of the terms and conditions of the policy. If the claim is rejected under the terms and conditions of the policy, it cannot be said to be deficiency in service and therefore, the complaint is liable to be dismissed.