Date of filing:- 24/09/2016.
Date of Order:-12/03/2018.
DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (COURT)
B A R G A R H.
Consumer Complaint No. 38 of 2016.
Prativa Panda, aged about 43(forty three) years,W/o-Late Chandra Kumar Panda, Occupation- House Wife, Resident of Ranibandh Para,Ward No-10(ten), Po/Ps/Dist-Bargarh. ..... ..... ..... Complainant.
-:V e r s u s:-
(1) Life Insurance Corporation of India represented through.
(i) The Branch Manager, Life Insurance Corporation of India, Bargarh Branch Office, At/P.o:- Bargarh, Ps. Bargarh (Town), Dist-Bargarh.
(ii) The Divisional Manager, Life Insurance Corporation of India, Sambalpur Division,At/P.o./Dist-Sambalpur.
(2) Medical Officer, C.H.C.Sohela, Po/Ps. Sohela, Dist-Bargarh.
..... ..... ..... Opposite Parties.
Counsel for the Parties:-
For the Complainant :- Sri T.C. Tripathy, Advocate with others Advocates.
For the Opposite Party No.1(one)
(i) and (ii):- Sri S.K. Dash, Advocate.
For the Opposite Party No.2(two):- Himself.
-: P R E S E N T :-
Sri Krishna Prasad Mishra ..... ..... ..... ..... ..... P r e s i d e n t.
Ajanta Subhadarsinee ..... ..... ..... ..... ..... M e m b e r (W).
Dt.12/03/2018. -: J U D G E M E N T:-
Presented by Sri Krishna Prasad Mishra, President:-
Brief Case of the Complainant ;-
The gist of the complaint is that the Complainant is the wife of one late Chandra Kumar Panda who was working as Statistical Assistant being posted at C.H.C. Sohela by the time of his death and the Opposite Party No.2(two) was his Drawing and Disbursing Officer, has assured his life with the Opposite Party Corporation under the Bima Kiran Scheme Policy under Salary Saving Scheme of Opposite Party No.1(one) vide Life Insurance Policy No.570306081 on Dt.15/11/1995.
The further case of the Complainant is that under the said salary saving scheme the Opposite Party No.2(two), who was the Drawing and Disbursing Officer, has to remit the premium amount to the Opposite Party No.1(one) after deducting the same from the salary of the insured person and in that case the insured person has got no role to play so far as the payment of premium is concerned and the Drawing and Disbursing Authority is solely responsible for the payment of the premium to the Opposite Party No.1(one), And in the said policy of the deceased insured person, his wife i.e. the Complainant was the Nominee.
In furtherance to his case the said insured husband of the Complainant fell ill seriously from cerebral Malaria followed by brain hemorrhage, paralysis and got complete bed ridden and remained under the treatment at different places in different hospital from Dt. 25.01.2013 till his death on Dt.24.06.2013 during that period he was in complete leave from his office.
Subsequently after the death of the late deceased husband of the Complainant, she lodged due insurance claim before the Opposite Party No.1(one) for the sum assured amount of her husband along with the required documents, but the Opposite Party No.1(one), instead of settling her claim repudiated the same on the ground that the policy was not in force for non payments of the premium amount, and transferred an amount of Rs. 23,256/-(Rupees twenty three thousand two hundred fifty six)only as a notional paid up amount as the same was in force for five years on Dt.14.01.2015 through NEFT to the account of the Complainant, even if clarification and protest was made before the Opposite Party No.1(one), and he conveyed through a letter vide letter Dt.23.01.2015 which was received by the Complainant on Dt.29.01.2015 reiterating the same observation that the premium for the period of the illness has not been paid as such the repudiation.
The further case of the Complainant is that since under the salary saving scheme the Opposite Party No.2(two) was entrusted with the duty to remit the premium amount time to time, in case of any deviation on that he is responsible for such of his negligence and for that the deceased or his nominee should not suffer, since being entrusted with such duty, he acts as an agent of the Opposite Party No.1(one) and for the deficiencies of his agent it is his responsibility as the master to co-ordinate the scheme for which act of them both the Opposite Parties are equally responsible and hence jointly and severally liable to make good of the sum assured amount of the Complainant. And by repudiating the genuine claim of the Complainant in false and factitious ground are nothing but commission of unfair trade practice and deficiencies in rendering due service to it’s Consumer, in such circumstances the Complainant has to face a lot of mental, physical and financial harassment, as such claim cause of action for filing of the case before the Forum arose on Dt.14.01.2015 when the Opposite Party No.1(one) deposited the paid up value in the account of the Complainant and on subsequent dates while sent letters of repudiation. And Complainant has filed the case claiming Rs.50,000/-(Rupees fifty thousand)only for her sufferings beside the sum assured amount of Rs.1,00,000/-(Rupees one lakh)only and an amount Rs. 20,000/-(Rupees twenty thousand)only towards litigation expenses, and in substantiating her case has relied on some following documents:-
Xerox copy of Life Insurance Policy No. 570306081 Dt.15/11/1995 (two sheets).
Xerox copy of Death Certificate of insured Chandra Kumar Panda Dt.01/07/2013 (one sheet).
Xerox copies of medical Discharge ppers of insured Chandra Kumar Panda issued on different dated by different hospitals (seven sheets).
Xerox copy of legal Hair Certificate (one sheet).
Xerox copy of certificate by employer Dt.12/09/2014 (one sheet).
Xerox copy of letter of Complainant to C.D.M.O., Bargarh Dt.21/06/2013 (one sheet)
Xerox copy of letter of Complainant to M.O., CHC, Sohela Dt.12/07/2013 (one sheet).
Xerox copy of letter of Complainant to B.M., L.I.C., Bargarh Dt.24/04/2014 (one sheet).
Xerox copy of letter of Complainant to B.M., L.I.C., Bargarh Dt.15/01/2015 (one sheet).
Xerox copy of letter of Complainant to B.M. L.I.C., Bargarh by regd. Post with postal receipt Dt.17/01/2015 (two sheets).
Xerox copy of letter of B.M., L.I.C., Bargarh to Complainant Dt.23/01/2015 (one sheets).
Having gone through the Complaint, the documents and on hearing the counsel of the Complainant the case was admitted and notice was served on the Opposite Parties, and in response, they appeared before the Forum and filed their respective version separately, the Opposite Party No.2(two) has filed his independent paragraph wise reply to the allegation of the Complainant and also filed a statement of the same in a separate sheet of papers stating to have remitted the due of the premium amount in due time to the Opposite Party No.1(one) hence has not committed any deficiencies in giving him service and as such is not liable to any action for the same.
And the Opposite Party No.1(one) has also filed his version and the same is all an evasive one to the case of the Complainant, as has been contended therein that the Drawing and Disbursing Authority of an insured person is not his agent rather it is the responsibility of the insured person to make payments of the premium in case the authority fails to remit the same and has claimed the insured to have entered upon an agreement with the corporation while entering in to the policy and also has claimed to have given the best possible service to the Complainant by remitting the amount under the purview of the policy terms and condition embodied in the policy bond and that the case has been filed with an ulterior motive to extract money and has claimed to dismiss the case U/s 26 of the Act. And to substantiate their case has relied on some following documents.
Copy of Authorization singed by policy holder.
Terms and conditions of policy.
Statements from CHC, Sohela-6(six) pages.
Copy of policy bond- 570306081.
Copy of policy status.
Having gone through the Complaint, the documents filed in her favor, and the version of both the Opposite Parties and on hearing the respective counsels and the citations filed by the Complainant, some points have cropped before us to adjudicate the case for the just decision of the case as follows.
Whether any unfair trade practice and deficiencies in rendering service has been committed by the Opposite Parties ?
Whether the Complainant is entitled to the claim as has sought for ?
Firstly while dealing with the points as to whether there has been commission of unfair trade practice and deficiencies in rendering service on the part of the Opposite Parties, while delving deeply in to the materials available in the record it came to our notice that the statements submitted by the Opposite Party No.2(two) with regard to the period of the leave undertaken by the deceased due to his illness has not been complied with though it has been submitted by his paragraph wise comments that the period of leave of the deceased has been sanctioned later on after the death of the deceased husband of the Complainant, so it was the primary duty of the said authorization to draw the amount from the salary and remit the same to the Opposite Party No.1(one) but in his reply to the averments made by the Complainant it was beyond his knowledge and since the salary for those period of his leave was not drawn, it was not possible on his part to deduct the premium amount and to remit the same, and also he has got the information about the same from the Complainant later on after the death of the deceased neither he was informed by the Opposite Party No.1(one) about the non payment of the same.
On the contrary the Advocate for the Opposite Party No.2(two) submitted that they have got no liability in entertaining the claim amount for the sum assured amount as it is clear that the premium for the period of leave of the deceased husband of the Complainant has not been paid as such by the time of his death the policy was not in operation but in spite of that the Opposite Party has paid a considerable amount through the account of the Complainant as per the terms and condition of the policy bond hence are not liable for further claim of the Complainant hence have rightly repudiated the same.
In reply to the submission of the Advocate for the Opposite Parties the Advocate for the Complainant vehemently argued with the case and contended that it is the primary duty of the insurer to remind the insured about the present status of the payment position and also to remind the officer in charge to remit the premium in case of salary saving scheme to remit the same in time, but in this case it has not been complied with and also claimed that in such case it is mandatory on his part to make payments of the entire amount of sum assured amount, in support of his such claim has cited a decision of the Honorable National Commission reported in CPJ.(2007)1 page 205 wherein it has been made clear of the duty of the insurer in case where premium under salary saving scheme is not remitted and have held the insurer to be responsible and is bound to pay the sum assured amount to the claimant and also clarified the duty of the Authorized officer in clear dictum embodied by the references of the Honorable Supreme Court also, furthermore the learned advocate for the Complainant has cited another befitting decision of our own Honorable High court where his Highness has supported the case of the Complainant and have made it clear that in such case, as the case in hand it is the duty of the Authorized officer to remit the premium amount in time and also the duty of the insurer in such case and if it is not remitted then it is the duty of the insurer to inform about the same to the insured and the Drawing officer, it is also contended by the learned counsel for the Complainant that these references of the Honorable Higher Forum are very similar to the case of the Complainant, to which we very vividly gone through and found that both the decision are very much similar to the present case and hence we are of the opinion that the Opposite Party No.1(one)(i) and (ii) are very much deficient in discharging it's duty towards the claim of the Complainant and as such are liable there under with an exceptional view as the insurer has also not intimated the facts of discontinuation of the remittance of the premium amount to the Authorized officer too it becomes the sole responsibility on his part to make good of the compensation amount, as such our views is expressed in assertive to the case of the Complainant.
Secondly while dealing with the entitlement of the claim of the Complainant, as we have already discussed in details of the case with reference to the decision of the Honorable Higher Forums and have expressed our view in affirmative to the case of the Complainant, it is now obvious to hold that the Opposite Party No.1(one)(i) and (ii) are liable to pay the claim of the Complainant, hence order follows.
-: O R D E R :-
Hence the Opposite Party No.1(one) (i) and (ii) are directed to pay the sum assured amount of Rs.1,00,000/-(Rupees one lakh) only after deduction of an amount of Rs.23,256/-(Rupees twenty three thousand two hundred fifty six) only the payment already received by the Complainant i.e Rs.76,744/-(Rupees seventy six thousand seven hundred forty four)only on the deducted amount with an interest @ 9% (nine percent) per annum from the date of filing of the case till the date of Order, within thirty days of receipt of the order and also directed to pay an amount of Rs. 10,000/-(Rupees ten thousand)only as compensation towards the mental, physical and financial harassment undergone by the Complainant and Rs.5,000/-(Rupees five thousand)only as litigation expenses, in default of which the entire amount would carry an interest @ 12%(twelve percent) per annum till actual realization of the total amount. And the Opposite Party No.2(two) is hereby exonerated from any liability.
Accordingly the case of the complainant is allowed against the Opposite Party No.1(one) and the same is pronounced in the open Forum to-day i.e. on Dt. 12/03/2018, and the case is disposed off.
Typed to my dictation
and corrected by me.
(Sri Krishna Prasad Mishra)
P r e s i d e n t I agree
(Ajanta Subhadarsinee)
M e m b e r (w)
