(PER: HON'BLE MR. JUSTICE M.I.ARUN)
2. Grant such other order or orders as this Hon'ble
Court may deem fit in the circumstances of the
case."
NC: 2025:KHC:10400-DB
2. The appellant is Life Insurance Corporation of India and the
respondent is a policy holder called 'Jeevan Saral'. He had availed
of the policy and paid a premium of Rs.48,040/- per annum for a
period of ten years. After maturity, the respondent was informed
that he is entitled for a maturity benefit of Rs.1,74,362/- by the
appellant. Aggrieved by the same and on the ground that the
respondent is actually entitled to a maturity benefit of
Rs.10,00,000/-, the respondent approached the office of Insurance
Ombudsman (Karnataka), which accepted the contention of the
respondent and passed the following award:
"AWARD
Taking into account, the facts & circumstances of the case,
and the submissions made by both the parties during the
course of Personal hearing the RI is directed to settle the
maturity claim under the said policy for maturity sum assured
of `.10,00,000/- together with loyalty additions if any as per
policy terms and conditions without penal interest.
The Complaint is 'Allowed'."
Aggrieved by the same, the appellant herein preferred Writ Petition
No.3257/2021 and prayed for setting aside the award. The learned
Single Judge did not find any error in the same and has dismissed
the writ petition, against which this writ appeal is filed.
NC: 2025:KHC:10400-DB
3. The contention of the appellant is that as per the terms of the
contract, the respondent is entitled to a benefit of Rs.1,74,362/-
only and not Rs.10,00,000/- as held by the Insurance Ombudsman
and the learned Single Judge.
4. Per contra, the respondent justifies the orders passed by the
Insurance Ombudsman and the learned Single Judge and prays for
dismissal of the writ appeal.
5. The maturity amount to be paid to the respondent depends
upon the terms and conditions of the insurance contract entered
into between the appellant and the respondent. As per the
insurance policy issued by the appellant in favour of the
respondent, the column mentioning the sum assured reads as
under:
"DIVISIONAL OFFICE: BANGALORE DIVISION I Branch Office:
YESHWANTHPUR BRANCH 61D
1 Policy No Maturity Sum Assured (Rs.) Installment Premium for main Plan (Rs.)
2 Date of Commencement Death benefit Sum Assured under main plan (Rs.) Installment Accident Benefit Premium (Rs.)
3 Date of Commencement Risk Accident Benefit Sum Assured (Rs.) Installment Term Rider Premium (Rs.)
4 Table & Term Term Rider Sum Assured (Rs.) Total Installment Premium (Rs.)
616218516 1000000 47040.00
28/05/2010 1000.00
29/05/2010 1000000 .00
165 10 48040.00
NC: 2025:KHC:10400-DB
6. The contention of the appellant is that the sum assured of
Rs.10,00,000/- mentioned twice in the aforementioned column
pertains to death benefit and accident benefit and does not pertain
to sum assured on maturity of the policy, if the insured does not die
or suffer any accident. According to the appellant, the respondent
is entitled to the sum assured upon completion of ten years i.e., on
maturity of the policy would be Rs.1,74,362/-.
7. The Insurance Ombudsman, upon verification of the policy,
has concluded that a sum of Rs.10,00,000/- mentioned in the
aforementioned column should be considered as a sum payable to
the insured upon maturity of the policy and the other
Rs.10,00,000/- towards death or an accident claim. It has further
come to the conclusion that nowhere the terms and conditions of
the policy mentions that the respondent is entitled to only a sum of
Rs.1,74,362/- as contended by the appellant herein and based on
the terms and conditions of the contract has entertained the petition
of the respondent herein and has passed the award. The decision
of the Insurance Ombudsman has been found to be correct by the
learned Single Judge and accepting the reasoning given by the
Ombudsman, the writ petition has been dismissed.
NC: 2025:KHC:10400-DB
8. The appellant in the course of the proceedings has failed to
show from the insurance contract or the policy issued in favour of
the respondent, how the respondent would be entitled to a sum of
Rs.1,74,362/- only as contended by the appellant. There is no
mention of the said amount any where in the contract. The policy
issued mentions a sum of Rs.10,00,000/- in the column referred to
above and under the given facts and circumstances of the case, in
our opinion, Rs.10,00,000/- has to be considered as the sum
assured upon the maturity of the policy. We do not find any error
either in the order of the Insurance Ombudsman or in the order of
the learned Single Judge passed in Writ Petition No.3257/2021.
For the aforementioned reasons, the writ appeal is hereby
dismissed. Pending interlocutory applications, if any, stand
disposed of.
SD/-
(N. V. ANJARIA)
CHIEF JUSTICE
SD/-
(M.I.ARUN)
JUDGE
hkh.
