Order No.  13  dt.  26/07/2018

       The case of the complainant in brief is that the complainant opened two LIC policies bearing nos. 495079254 and 495079475 of sum assured Rs.6 Lakhs each on 28.05.2012. The first premium of Rs.6,915/- was paid through a cheque on 13.03.2012, monthly premium was Rs.3,483/- of each policy that has been deducted from the savings account of the complainant on 28^th of every month through ECS system, but the premium of policy no. 495079475 was not deducted from the account of the complainant from the month of Sept. 2013. On enquiry the complainant was informed that the policy has been stopped by LICI Branch and the complainant sent a letter and received a reply whereby it was informed that the policy has been proved to be a fraudulent activity at City Branch Office 19, the policy cannot be operated by the competent authority. So the question of restart of the policy is not at all possible and the complainant was informed to contact Manager (CRM) at 10^th floor of Jeevan Prakash Building. The complainant went to the office and came to learn that one Debabrata Roy, Assistant Branch Manager who made fraud activity at the branch due to these many policies had been affected and under investigation of CBI. The complainant thereafter, requested the o.p. to refund the money, but o.p. did not pay any heed for which the complainant filed this case praying for direction upon the o.p. to refund the amount paid by the complainant as well as compensation and litigation cost.

            The o.p.  contested the case by filing w/v and denied all the material allegations of the complaint. It was stated that out of two policies taken by the complainant dispute arose in respect of the policy no. 495079475 regarding the payment of first premium and the said policy was suspected as originated from the fraudulent misappropriation of the money of the o.p. Therefore, o.p. apprised the said fact to the complainant and requested him to submit certain documents. During the investigation and/or verification process the premium was not accepted in order to facilitate the investigation of the case, since the said policy was under internal as well as CBI investigation ambit. During the process of the said investigation it took some time for which the premium could not be accepted. After the investigation it was found that the said policy was not involved in the said fraudulent transaction as suspected by o.p. and tried to regularize the same by asking the complainant to pay the balance premium, but the complainant failed to pay the amount for which the policy has lapsed and there is no deficiency in service on the part of o.p. and as such, o.p. prayed for dismissal of the case. 

            On the basis of the pleadings of the respective parties following points are to be decided :-

1. Whether the complainant had the policy with o.p.?
2. Whether the complainant paid the premium as per the terms of the said policy?
3. Whether the o.p. suddenly stopped receiving the premium from the complainant?
4. Whether there was any deficiency in service on the part of the o.ps.?
5. Whether the complainant will be entitled to get the relief as prayed for?

Decision with reasons :-

            All the points are taken up together for the sake of brevity and avoidance of repetition of facts.

            Ld. Lawyer for the complainant argued that the complainant opened two LIC policies bearing nos. 495079254 and 495079475 of sum assured Rs.6 Lakhs each on 28.05.2012. The first premium of Rs.6,915/- was paid through a cheque on 13.03.2012, monthly premium was Rs.3,483/- of each policy that has been deducted from the savings account of the complainant on 28^th of every month through ECS system, but the premium of policy no. 495079475 was not deducted from the account of the complainant from the month of Sept. 2013. On enquiry the complainant was informed that the policy has been stopped by LICI Branch and the complainant sent a letter and received a reply whereby it was informed that the policy has been proved to be a fraudulent activity at City Branch Office 19, the policy cannot be opened by the competent authority. So the question of restart of the policy is not at all possible and the complainant was informed to contact Manager (CRM) at 10^th floor of Jeevan Prakash Building. The complainant went to the office and came to learn that one Debabrata Roy, Assistant Branch Manager who made fraud activity at the branch due to these many policies had been affected and under investigation of CBI. The complainant thereafter, requested the o.p. to refund the money, but o.p. did not pay any heed for which the complainant filed this case praying for direction upon the o.p. to refund the amount paid by the complainant as well as compensation and litigation cost.

            Ld. Lawyer for the o.p. argued that out of two policies taken by the complainant dispute arose in respect of the policy no. 495079475 regarding the payment of first premium and the said policy was suspected as originated from the fraudulent misappropriation of the money of the o.p. Therefore, o.p. apprised the said fact to the complainant and requested him to submit certain documents. During the investigation and/or verification process the premium was not accepted in order to facilitate the investigation of the case, since the said policy was under internal as well as CBI investigation ambit. During the process of the said investigation it took some time for which the premium could not be accepted. After the investigation it was found that the said policy was not involved in the said fraudulent transaction as suspected by o.p. and tried to regularize the same by asking the complainant to pay the balance premium, but the complainant failed to pay the amount for which the policy has lapsed and there is no deficiency in service on the part of o.p. and as such, o.p. prayed for dismissal of the case. 

            Considering the submissions of the respective parties it is an admitted fact that the complainant obtained two policies and out of these one policy being no. 495079475 involved in the dispute as raised by the complainant which has also been admitted by o.p. The o.p. in their w/v as well as evidence stated that during the period of receiving the policy premium it was detected that there was fraudulent transactions in respect of some policies and o.p. suspected this policy was involved in the said fraudulent transaction. The CBI started investigation in respect of the misappropriation of the fund of o.p. and this policy was also referred to CBI. After investigation it was found that this policy was not involved in any fraudulent transaction. It is an admitted fact that the complainant advised the o.p. for obtaining the premium from the bank through ECS system. The complainant after opening the policy paid the premium through ECS system and the complainant paid the amount of Rs. 60,000/- which has not been disputed by o.p. It appears from the materials on record that o.p. all on a sudden stopped to receive the premium for which the dispute arose. The complainant thereafter, visited the office of o.p. but no fruitful result was achieved after getting clearance from CBI that the said policy was not involved in any fraudulent transaction, the complainant was given opportunity to pay the arrear premium, but the complainant due to his financial hardship could not pay the amount and for which complainant demanded the refund of the amount paid by complainant. It is found from the materials on record that the complainant is attached to CRPF and he has to attend his duty at remote places and he keeps his family in Kolkata. The complainant after taking leave from his employer visited at the office of o.p. on numerous occasions, but he was not entertained properly for which he faced harassment and subsequently with the clearance of the allegation against the complainant regarding involvement of the said fraudulent transaction itself is a ground for harassment on the part of o.p. for which the complainant will be entitled to get refund of the money paid by him as well as compensation and litigation cost. Thus all the points are disposed of accordingly.

            Hence, ordered,

            That the case no.217/2017 is allowed on contest with cost against the o.p. The o.p. is directed to refund the amount of Rs.60,000/- (Rupees Sixty Thousand) only to the complainant along with compensation of Rs.5,000/- (Rupees Five Thousand) only for harassment and mental agony and litigation cost of Rs.2,000/- (Rupees Two Thousand) only within 30 days from the date of communication of this order, i.d. an interest @ 8% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.