-::BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT BIDAR::
C.C. No.72/2017.
Date of filing: 16.10.2017.
Date of disposal: 13.06.2019.
P R E S E N T:-
(1) Shri. Jagannath Prasad Udgata, B.A., LL.B.,
President
(2) Shri. Shankrappa (Halipurgi),
B.A.LL.B.,
Member.
COMPLAINANT/S: Jagdevi, W/o Late Jaganath Tugaon,
Age: Major, Occ: House Hold,
R/o Halhalli (K), Tq.Bhalki, Dist.Bidar
Karnataka State Pin-585415.
( By Sri. Narayan Ganesh, Adv.)
VERSUS
OPPONENT/S: 1. The Branch Manager,
Life Insurance Corporation, Branch,
Bidar, Near Railway Station, Bidar
Karnataka-585401.
2. The Divisional Manager (L & HPF)
Divisional Office, Jeevan Prakash
Near Mahathma Gandhi Stadium,
Raichur-584101.
3. Director /Superintendent of Department of
Animal Husbandry and Veterinary Services,
At Nandi Nagar Kamthana Road Tq & Dist.Bidar.
4. Veterinary Dispensary Officer,
At Mandaknalli, at post Mandaknalli,
Tq. Bidar Karnataka State-585401
( O.P. No.1 and 2 By Sri. Sanjay Kumar.S.Patil., Adv.)
( O.P.No.3- Exparte )
( O.P.No.4- Inperson)
:: J UD G M E N T ::
By Shri. Jagannath Prasad Udgata, President.
The instant complaint U/s.12 of C.P.Act, 1986 is by the mother and nominee of L.I.C. policy no. 661754328 purchased by a deceased Govt. employee ( Veterinary Assistant) of Govt. of Karnataka under salary saving scheme on 28.03.201. Consequent upon the refusal of the L.I.C. to settle the claim after the death of the policy holder. The pleadings of the complainant are as underneath:
2. The complainant states that, her son Nagesh was working as Veterinary Assitant in the over all establishment of the Directorate of Veterinary and Animal Husbandry, Govt. of Karnataka. Though in initio, the complainant unsure about the particulars of the Drawing and disbursing office had not arrayed that entity as a party to the proceedings, at a later stage moving an application, the relevant official was impleaded as O.P.no.4. Said late Nagesh had purchased LIC policy bearing no. 661754328,dt.28.03.2015 for a sum assured of Rs.10,00,000/- under salary saving scheme and had authorised his employer to deduct the monthly premium from his salary and remit to the L.I.C. regularly and the same was being practised. Later Nagesh, died due to Road Traffic accident on 08.09.2016 caused to him at about 11.30 hrs. by the negligent driving of the driver Bolero Jeep bearing No. K.A.-38/8375, consequent upon which, the jurisdictional Bidar Traffic police had registered a case in Cr.no.127/2016 alleging offences U/sec. 279 and 304 (A) of the I.P.C.
3. It is then avered by the complainant, bearing the nominee of the policy she lodged claim with L.I.C. to disburse the sum assured and also accidental death coverage with all relevant documents but, her claim is not settled yet and she is before us claiming the relief of Rs.10,00,000/- the sum assured.
4. The opponent Nos.1 and 2 upon notice have entered into the defence through counsel and have filed written versions disputing the entitlements of the complainant. The said O.Ps in the versions have admitted the facts of obtainment of the policy by the deceased policy holder Nagesh under salary saving scheme but, have raised dispute about the death of the policy holder. They further claim that, the due premiums for the months of May and June of 2015 had remained unpaid by the employer of the late policy holder, whereby the policy was in lapsed condition as on the date of death of the policy holder and therefore, they are not bound to defray the sum assured to the nominee. They vouch about their diligence and fair play and canvass that, the repudiation was justified by all means. The defence of other opponents are perfunctory in nature not worth to be discussed.
5. Considering the prons and cons of the case, the following points arise for our consideration.
- Does the complainant prove deficiency of service in the part of the L.I.C. and other opponents?
- Does the LIC prove that, it was justified in repudiating the claim ?
- What orders?
6. Our answers to the points raised are as follows:-
- In the positive.
- In the negative.
- As per the final orders owing to the following:-
:: REASONS ::
7. Points at (a) and (b) are to be dealt together being intricately webbed together. The complainant has submitted ample documents regarding the obtainment of the policy by her late son as detailed at the end of the order. Even if neigher of the parties have opted to submit the original or copy of the policy documents before us, the admissions of O.P.no.1 and 2 clinches the issues regarding the issuance of the policy under reference. Further the status report of L.I.C. proves existence of policy Howerver, nothing is demonstrated before us regarding the double assurance cover in case of accidental death of the holder as claimed by the complainant That claim falls in a grey area. We leave it open to be dealt by the Insurance company in right perspective. However, by producing the documents from police authorities and the post-mortem report, the complainant has amply proved the death of her son due to Road Traffic Accident on 08.09.2016, which have gone undisputed. Next putting our anxious consideration about the defence of L.I.C. regarding lapsations in payment of premiums of earlier months, we have gone through the judgments of Punjab State Commission reported in III (2009) CPJ 140 (Punjab) L.I.C. V/s Mamchand and another and also that of 2015 NCJ 466 ( NC) L.I.C. V/s Ramsakshi. The two Judgment clinch the whole issue.
8. In the former Judgment, the Hon’ble Punjab State Commission has been pleased to analyse the queer responsibility of the insurer in the case of a policy under salary saving scheme. It has been held by the Punjab State Commission as follows:-
“Since Insurer assumed responsibility of writing to the employer of life assured to deduct premium amount from assured salary-Insurer liable to pursue the matter with employer. If not paid by employer insurer liable to infom assured-Deficiency of service in the part of the insurer proved”.
The Honb’le National Commission in the case L.I.C./ V/s Ramsakhi has been pleased to hold as hereunder interalia.
In analysing the matter in para-13 of the Judgment the Hon’ble National Commission has further inferred that,
Para 13.4 and 16 of manual for policy servicing department (no.14) of the L.I.C. is as described hereunder.
“Para 13.4 –Default in premium should be informed to the party. If unpaid lapse can happen”.
“ In para 16 of the manual it is mandated that, notice to employer has to be sent in form no.5227 and notice of lapse in form no. 5228.
9. In the instant case it is nowhere pleaded or demonstrated that, the L.I.C. has acted according to the in house instructions of the corporation. Rather the corporation has cooly accepted premiums for months together without any intimation. The subsequent premiums could have been first adjusted towards the unpaid dues under intimation to the employer and life assured, which is not forthcoming from the pleadings and evidences. After the non payment of two consecutive monthly premiums, at no point of time either the employer or employee were notified by the same.
10. As far as the case against O.Ps no.3 and 4 both officials while deducting the monthly premiums for subsequent remittance to the L.I.C. a free service was being rendered by them to the life assured as well as the corporation. Hence teh case against O.P.no.3 and 4 is liable to be dismissed.
11. Now, coming to consider the quantum of award for the complainant, we are in a hobson’s choice. While the complainant in the prayer has claimed recovery a sum of Rs.10,00,000/- plus accidental benefits, neither of the parties have bothered to submit the copy of the policy concerned. We are in dark as to what were the benefits promised under the policy conditions and it would be unreasonably fatal to believe in one sided clamours of the complainant.
12. However, since it is in the admissionof the L.I.C. that the deceased son of the complainant had purchased the policy captioned as “Jeevan Anand “ under salary saving scheme, bearing no.661754328 and the benefits of the same has remained unpaid on flimsy grounds, we proceed to pass the following:
::ORDERS::
The complaint is allowed.
- Both the O.P.no.1 and 2 are hereby jointly and severally directed to pay the complainant a sum of Rs.10,00,000/- or whatever was the assured sum in policy no. 661754328 purchased by late Nagesh (complainant’s Son) together with all benefits appurtenant thereto ( consequent upon death of life assured) to the complainant;
- In the peculiar situation of the case, we don’t propose to saddle the L.I.C. with any interest or compensation payment, however, a sum of Rs.10,000/- be paid towards litigation expenses both by O.P.no.1 and 2
- Case against O.Ps no.3 and 4 stands dismissed.
- Four weeks time granted to comply this order.
(Typed to our dictation then corrected, signed by us and then pronounced in the open Forum on this 13th day of June 2019).
Sri. Shankrappa H. Sri. Jagannath Prasad
Member. President.
Documents produced by the complainant
- Annexure.A- Acknowledged copy of claim application
- Annexure.B– Attested copy of letter from L.I.C. to Veterinary officer Dt.16.04.2015
- Annexure.C- Letter of authorisation (copy)
- Annexure.D–F.I.R. in Cr.No.127/2016 of Bidar Traffic. P.S.(copy)
- Annexure.E- Statement of the complainant before Police (copy)
- Annexure.F- P.M. report (copy)
- Annexure.G- Chargesheet (copy)
- Annexure H- Status report of policy no.661754328 (computer print)
- Annexure J - ( Í’excluded) Communication of L.I.C. regarding death claim (computer print)
- Annexure K- 11 (Eleven) calculation sheets indicating premium payments
- Annexure L- Intimation of L.I.C. to complainant.
Document produced by the Opponent.
- Annexure.R.1- Letter of Veterinary officer to the Forum.
- Annexure R2- Pay slip by Veterinary Officer
- Annexure R3- Communication of Veterinary officer Mandaknalli to Forum.
- Annexure R4- Communicaiton of Dy.Director Veterinary to the Forum.
Witness examined.
Complainant.
- P.W.1- Smt.Jagdevi, W/o Late Jagannath Tugaon (Complainant).
Opponent.
- R.W.1- G.Venkat Sai (Opponent)
Sri. Shankrappa H. Sri. Jagannath Prasad
Member. President.
