Complaint filed on: 19-01-2023

                                                      Disposed on: 13-09-2023

BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION, TUMAKURU

DATED THIS THE 13^th DAY OF SEPTEMBER 2023

PRESENT

SMT.G.T.VIJAYALAKSHMI, B.Com., LLM., PRESIDENT

SRI.KUMARA.N, B.Sc. (Agri), LL.B., MBA., MEMBER

SMT.NIVEDITA RAVISH, B.A., LL.B.(Spl)., LADY MEMBER

Consumer Complaint No. 08/2023 

Smt. Pushpa, A/a 44 years,

W/o Late T.B.Babu,

Pound Road, Near Yellamma

Temple Kote, Tiptur.

(GPA Holder – Sri.Rangaswamy H.N.)

V/s

1.       The Branch Manager,

          Karnataka Bank Ltd.,

          Allammajji Complex,

          B.H.Road, Tiptur Taluk,

          Tumkur District.

2.       Life Insurance Corporation of India,

          P & GS Unit, Mangalore Popular Building,

          2^nd Floor, KS RAO Road, Mangalore. 

(OP No.1 – By Sri. M.C.Prabhu, Advocate)

(OP No.2 – By Sri. A.C.Mamatha, Advocate)

:O R D E R:

BY SMT.NIVEDITA RAVISH –  LADY MEMBER

            This complaint is filed by the complainant Under Section 35 of Consumer Protection Act, 2019 against the Opposite Parties to direct them to pay a sum of Rs.2,00,000-00 (two lakhs only) as per Pradhan Mantri Jeevan Joti Bima Yojana (PMJJB) Scheme along with damages of Rs.10,00,000-00 and cots.

2.        The Opposite party No.1 is the Branch Manager Karnataka Bank Limited, Tiptur, Tumkur District (hereafter called as OP No.1). Life Insurance Corporation of India, P & G.S. Unit, Mangaluru, is the opposite party No.2 (hereinafter called as OP No.2).

3.        The case of the complainant is that, late Shri T.B. Babu husband of the complainant has taken insurance policy i.e. Pradhan Mantri Jeevan Jyothi Bima Yojana (hereinafter called as PMJJBY) on 09.06.2015 through OP No.1 and Rs.330-00 was transferred every year to OP No.2 from bank account No.7542500100900301 of complainant’s husband towards premium to PMJJBY and last premium amount transferred to OP No.2 on 31-5-2021.   The husband of the complainant died on 23-02-2021 and the complainant, who is the nominee of late shri T.B. Babu, submitted the claim form for claiming death benefit of Rs.2,00,000-00 under PMJJBY to OP No.1. The complainant was surprised to receive letter from OP No.1 stating that, premium amount for the year 2019-2020 was recovered on 19-07-2019 i.e., after renewal date i.e, 01-06-2019 and it is treated as new date of joining i.e., 19-07-2019 and further age of late Shri T.B.Babu was 52 years 9 months and 5 days as on 19.07.2019, hence deceased was not eligible to join under the said scheme. Though the complainant has wrote a request letter on 27.09.2021 to OP No.1 and on 03.01.2022 to OP No.2 as stating that, the OP No.1 has deducted the premium amount premium for every year from 09-06-2015 towards PMJJBY, the OP No.1 or OP No.2 has not settled the claim. Hence, this complaint.

 4.       After receipt of notice from this commission OP Nos. 1 & 2 were appeared before this Commission with their respective counsels and filed their respective versions.

5.        OP No.1 has admitted that,  Rs.330-00 was deducted every year from 25.05.2016 from the complainant husband’s account and further submitted that, OP No.1 has sent the premium of amount of Rs.330-00 for PMJJBY to OP No.2 and role of OP No.1 is only intermediately.   When the husband of complainant was aged as 52 years as on 19-7-2019, the OP No.2 should repay the premium amount to the account of the husband of the complainant. The OP No.2 did not do the same and kept the premium amount with themselves.  Hence, OP No.1 has submitted that there is no any deficiency of service on the part of OP No.1 and prayed for dismissal of the complaint against the OP No.1.

6.        OP No.2 has also admitted about premium paid amount every year from 25-5-2016 from the account of husband of the complainant and denied all other allegations made by the complainant as false. Further OP No.2 has submitted that, as per eligibility criteria maximum age for new enrollment is 50 years nearer birthday and premium for the year 2019-2020 (Annual Renewal year 1-06-2019 to 31-05-2020) was not auto debited by the OP No.1 in time i.e., before 31-05-2019 and also not within the grace period (i.e., from 01-06-2019 to 30-06-2019). The premium was deducted later on 19-7-2019. i.e.,  after the annual renewal date of 01-06-2019 and it considered as new entry for the scheme.  Further OP No.2 has submitted that, on new date of joining i.e., 19-07-2019 the person was 52 years 9 months and 5 days as per the age proof submitted by the OP No.1, hence complainant’s husband was not eligible to enter in to the scheme as per the conditions of the scheme.  Further OP No.2 has submitted that they were acted as per the rule and regulations framed as per the Memorandum of understanding. Hence, OP No.2 has prayed for dismissal of the complaint against OP No.2.

7.        One Sri. Rangaswamy H.N. S/o Narayanappa, GPA holder of Complainant, filed his affidavit evidence and marked the document as Ex.C1 to Ex.C6.   One Mr.Vignesh G.R., Branch Manager of OP No.1 has filed his affidavit evidence on behalf of OP No.1 and produced 01 document with memo on 16.05.2023 and marked as Ex.R1.  Smt. M.N.Meenakshi, Administrative Officer, has filed her evidence by way of affidavit on behalf of OP No.2.  The OP No.2 marked one document as Ex.R1.

8.        We have heard the arguments of complainant counsel and respective counsels of OP No.1 and 2. Peruse the written arguments filed by OP No.1 and 2.   The OP No.1 filed intimation copy issued by Ministry of Finance, Department of Financial Service (Insurance Division) Government of India along with memo at the time of arguments.

9.        The points that would arise for determination are as hereunder:-

1. Whether complainant proves the deficiency of service on the part of OPs?

2. Is complainant entitled to the relief sought for?

10.       Our findings on the aforesaid points are as under:

Point No.1:  Partly Affirmative

Point No.2: Partly Affirmative, as per the final order

                        for the following;

:REASONS:

Point Nos.(1) & (2):-

11.      GPA holder of complainant has argued that, deceased Sri. T.B.Babu husband of the complainant has taken /purchased the Policy No.900100036 from OP Nos.2 through OP No.1 by paying premium amount Rs.330-00 on 09-06-2015. The same was admitted by OPs and Ex.C1/copy of the PMJJBY - claim form, Ex.C5/copy of the bank account statement reveals the same.  Further the GPA holder of the complainant has argued that, the husband of the complainant has died on 23-2-2021, which was admitted by the OPs.,  Further, the GPA holder of the complainant has argued that the OP No.1 has deducted Rs.330-00 from the account husband of  the complainant every year from 09-06-2015 to 31-05-2021.   OPs are admitted this arguments of the complainant and Ex.C5/bank account statement of the complainant’s husband reveals that Rs.330-00 was deducted towards PMJJBY insurance premium every year from 09-06-2015 to 31-05-2021.  Further GPA holder of complainant has argued that, the complainant’s husband T.B. Babu died on 23-02-2021. Further GPA holder of complainant has argued that, the complainant who is the nominee of his husband for PMJJBY insurance policy, was submitted the claim form for death benefit of his husband under PMJJBY.  The OPs admitted that the complainant is the nominee of deceased T.B.Babu for PMJJBY insurance policy.  Further, the GPA holder of the complainant has argued that, the OP No.2 has repudiated the claim of the complainant and wrote letter on 29-4-2021 by stating that, the premium amount for the year 2019-2020 was recovered on 19-7-2019 was treated as new date of joining and as on new date of joining i.e., 19-7-2019, the age of complainant’s husband was 52 years 9 months 5 days, hence deceased was not eligible to join under the said scheme. Ex.C2/ copy of the letter Ref:P&GS/PMJJBY/POL NO.900100036, Rej5/2021-2022 establishes the same. Further GPA holder of complainant has argued that, it is the duty of the OP No.1 to send premium every year promptly to OP No.2 and it is the duty of the OP No.2 to provide benefit of the insurance policy when premium of was deducted every year regularly.  

12.      Counsel for OP No.1 has admitted about insurance policy under PMJJBY taken/purchased by complainant’s husband late Shri. T.B. Babu and also admitted that, the premium of Rs.330-00 was debited automatically every year from 09-06-2015 to 31-05-2021 and sent to OP No.2, Ex.R1 produced by OP No.1 on 16.05.2023 proves the same. Further counsel for the OP No.1 has submitted that, every premium amount was being transferred to the OP No.2 by OP No.1. Ex.C5/copy of amount transaction details of OP No.1 bank, produced by the complainant which established that the OP No.1 has sent the premium amount of Rs.330-00 towards PMJJBY to OP No.2.  Further counsel for OP No.1 has admitted that, the complainant, who is the nominee for insurance policy of PMJJBY of his deceased husband, submitted claim form during the month of March 2021 claiming death benefit of Rs.2,00,000-00. Further counsel for the OP No.1 has submitted that, OP No.2 has sent claim form along with relevant documents to OP No.2.  Ex.C1/ copy of the claim form, Ex.C2/ copy of letter from P and GS unit Mangalore of OP No.2, produced by the complainant proves the same. Further counsel for the OP No.1 has argued that, OP No.1 has played intermidiatory role in this transaction and OP No.1 has acted properly by sending all premium amount, hence OP No.1 has not done any deficiency in service and further counsel for OP No.1 has argued that, though collecting premium amount from complainant through account maintained in OP No.1 bank. OP No.2 was not settled the claim of the complainant. Further counsel for OP No.1 has argued that, it is the duty of OP No.2 to settle the insurance claim and not the duty of the OP No.1.

13.      In contrary counsel for the OP No.2 has argued that, PMJJBY scheme covers eligible individual lives having bank account and as per eligibility criteria maximum age for new enrollment is 50 years nearer birthday. Point No.A(a) of Ex.R1/copy of the Memorandum of understanding produced by OP No.2 establishes same by explaining as “NOW THIS MEMORANDUM OF UNDERSTANDING WITNESS AS UNDER: (A) LIC will provide following under the scheme:- A life cover of Rs.2,00,000/- only on death to the Saving Bank Account holder of the bank, subject to the following conditions:- (a) Saving bank account holders should be aged between 18 years (completed) and 50 years (age nearer birthday) on the date of enrollment”.  Further, counsel for the OP No.2 has argued that, premium for the year 2019-20 (Annual Renewal year 1-06-2019 to 31-05-2020) was not auto debited by the OP No.1 in time i.e., before 31-05-2019 and also not within the grace period (i.e., from 01-06-2019 to 30-06-2019) and the premium was deducted later on 19-07-2019 i.e., after the annual renewal date (ARD) of 01-06-2019.  Ex.C5/ copy of bank account statement of complainant’s husband established that, the premium for Rs.330-00 for year 2019-20, has deducted by the OP No.1 from the account of complainant’s husband on 19-7-2019 and transferred to OP No.2 on the same day.   As per point No.A(f) in page No.2 and details of “Renewals” under point No.B in page No.3 of Ex.R1/ copy of the Memorandum of understanding, produced by the OP No.2 revealing that, date of renewal for premium is 1^st June of every year. Further counsel for the OP No.2 argued that, on new date of joining i.e., 19-7-2019, the complainant’s husband late Shri. M.N. Narashimahamurthy was 52 years, 9 months, 5 days as per the age proof submitted by OP No.1. Hence the husband of the complainant was not eligible to enter in to the scheme as per the condition of the scheme.   Neither OP No.1 nor the complainant has not pleaded and  not argued that deceased husband of the complainant not crossed the age of 50 as on 19.07.2019.  Hence, it is considered that complainant and OP No.1 admitted that the deceased husband of the complainant crossed the age of 50 as on 19.07.2019.

14.      On perusing the Ex.R1/ copy of Memorandum of Understanding produced by the OP No.2,  it reveals that, these conditions of the MOU are agreed between Life Insurance Corporation (OP No.2) and OP No.1. The policy holders of the PMJJBY were not aware about conditions which are agreed between OP No.1 & 2. point No.A(f) in page NO.2 of Ex.R1 produced by OP No.2 reads as “The Annual Premium of Rs.330-00 or any amount as decided from time to time (plus service tax, if applicable) per member per annum, is to be deducted and remitted by the Bank to LIC on annual renewal date, i.e. June 1^st every year. Change in Premium, if any, will be intimated to the Bank by LIC before Annual Renewal date.  Hence, as per above condition the OP No.1 should deduct and remit the premium amount of Rs.330-00 to OP No.2 before or on 1^st June every year. But in this case the OP No.1 has debited and remitted the premium amount on 19-7-2019 for year 2019-20.   Ex.C5/ copy of Bank account statement showing there is sufficient balance is in the account of complainant’s husband. Though there is sufficient balance in the account of the policy holder, the OP No.1 has deducted and remitted the premium amount to OP No.2 after 49 days from last day of renewal of insurance for the year 2019-20.   Further point No.D(2) of Ex.R1 produced by OP No.2 reads as: “Termination of assurance: The assurance on the life of the member shall terminate on any of the following events and no benefit will become payable there under:

(2) Closure of account with the Bank or insufficiency of balance to keep the insurance in force.

Bank shall remit the premium on or before 30^th of June every year, failing which the insurance will cease”.   Hence, as per above condition the OP No.1 has remit the premium amount before 30^th of June every year, which was not done by OP No.1 for the year of 2019-20 in the complaint’s husband case. Further point No.E in page No.4 of Ex.R1 produced by OP No.2 is reads as  “If the Insurance cover is ceased due to any technical reasons such as insufficient balance to keep the insurance in force on due date or due to any administrative issues, the same can be reinstated on receipt of premium during the grace period and a satisfactory statement of good health”.  As per above condition OP No.2 was given assurance about reinstated on receipt of premium during the grace period and a satisfactory statement of good health.  Counsel for the OP No.1 has submitted that the premium of complainant’s husband for year 2019-2020 was deducted and remitted on 19-7-2019 after grace period by technical problems in auto debit system. But OP No.1 has failed to produce any document to show that, OP No.1 has informed about technical problems which occurs during renewal period for 2019-2020 to the OP No.2. The OP No.1 has produced the copy of the circular/intimation by the Ministry of Finance, Department of Financial Service (Insurance Division). Government of India dated:23.06.2015 and submitted that it is related to grace period for auto debit of premium by the Bank.  But the said circular was only for the year 2015, not for the year 2019-2020.  Hence, it is not considered.  It is the duty of the OP No.1 to correct the technical problem in time.  Hence, we do not found any deficiency in service on the part of OP No.2.  Hence, complaint is liable to be dismissed against OP No.2.

15.      The memorandum of understanding of PMJJBY (Ex.R1) produced by the OP No.2 was agreed and executed in between OP No.1 and OP No.2.  The policy holders of PMJJBY have not been aware about the terms and conditions of the said MOU.  The complainant’s deceased husband who was the policy holder of PMJJBY has taken the policy on believing OP No.1.  The OP No.1 should follow the terms and conditions of the MOU.  The OP No.1 has violates the conditions by sending the premium of husband of the complainant after grace period for the renewal of the policy of the complainant’s husband for the year 2019-20.   If OP No.1 would have sent the premium amount to the OP No.2 in time i.e. before 01.06.2019 or in between grace period i.e. 30.06.2019, then husband of the complainant had been remained eligible person for the said policy. The husband of the complainant was become not eligible person for negligent act of the OP No.1. Hence, OP No.1 is liable for the loss occurred to the complainant as nominee of his deceased husband’s PMJJBY policy benefit. Hence OP No.1 shall liable to pay Rs.2,00,000/- which is the benefit under the PMJJBY insurance policy with interest @ 8% p.a from the date of repudiation of the claim of the complainant i.e., 29-4-2021 till the payment to the complainant.  The complainant has prayed damages of Rs.10,00,000-00.  But complainant has not produced any document to show that she has entitled for damages of Rs.10,00,000-00.  But considering the mental agony caused to the complainant by the deficiency of service of OP No.1,  the OP No.1 is liable to pay the compensation of Rs.5,000-00 to the complainant.  Further OP No.1 has compelled the complainant to approach this commission, hence, OP No.1 shall liable to pay Rs.10,000-00 as litigation cost to the complainant.  Accordingly, we pass the following:-

:ORDER:

The complaint filed by the complainant is allowed in part with costs against OP No.1.

The complaint against OP No.2 is dismissed.

It is directed that OP No.1 shall pay Rs.2,00,000-00 (Rs.Two Lakhs only) to the complainant with interest @ 8% P.A. from 29.04.2021 till the payment.

It is further directed that OP No.1 shall pay compensation of Rs.5,000-00 and litigation cost of Rs.10,000-00 to the complainant.

The OP No.1 is further directed to comply the above order within 45 days from the date of receipt/knowledge of this order.

Furnish copy of this order to both parties at free of cost.