Karnataka

Gadag

CC/35/2019

Santosh S/o Nelappagouda Dyavangoudar - Complainant(s)

Versus

The Manager, State Bank of India Mundargi Branch Mundargi and another - Opp.Party(s)

D.R.Kulkarni

10 Aug 2020

ORDER

-::O R D E R::-

 

BY: SMT.C.H.SAMIUNNISA ABRAR, PRESIDENT.

 

The complainant has filed this complaint claiming direction to the OPs to close the loan amount related to the house property of deceased Neelappagouda Dyavanagoudar by his Master Policy No.70000000810 and loan Account No.64098732310, special compensation of Rs.5,00,000/-, refund of Rs.10,66,000/- and such other relief.

-::Brief facts of the case are as under::-

2.       The case of the complainant is that, father of complainant by name Neelappagouda S/o Fakirgouda entered with the contract with OP No.1 for his life assurance under the RINN Raksha Group Insurance Scheme Master Policy in respect of loan A/c No.64098732310 for home loan amount of Rs.24,75,000/- and the said Neelappagouda died on 02.06.2016 due to brain related issue.  The policy bearing No.70000000810was commenced on 29.12.2012.  After his death, the LR’s have approached OP No.1 several times to close the entire housing loan amount, but OP No.1 and 2 have not  closed the said loan amount and instead of it, OP No.2 has paid the death claim amount of Rs.4,35,144/- stating that the policy lapsed due to non-payment of premium.  OP No.1 has to deduct the amount from the Bank Account bearing No.64098732310 belongs to father of complainant, for which the undertaking has been given by deceased Fakirgouda Dyavanagoudar.  It is further submitted that, on the date of lapse of the premium of policy complainant was having sufficient balance to deduct the premium in the said account, but the OP No.1 intentionally not deducted the premium amount from the deceased Neelappagouda Dyavanagoudar.  In terms of insurance scheme and contract of insurance, it is the duty of the insurance company when the premium was due, the same has to be intimated to the deceased Neelappagouda, but the OP failed to do so.  It is further submitted that, as on the date of death of said Neelappagouda i.e., on 02.06.2016, his account extract shows the balance amount of Rs.9,86,164/-.  It is further submitted that, on 02.02.2016 OP No.1 has deducted Rs.10,000/- from the complainant’s father account and they also recovered Rs.66,000/- from the complainant.  Complainant approached OPs several times to settle the loan amount and to follow the RINN Raksha Group Insurance Scheme conditions, but they have denied to settle the same.  Therefore, complainant got issued legal notice through his Advocate on 19.01.2018, but the OPs failed to settle the matter, which is a deficiency of service.  The cause of action arose to file this complaint on the date when the reply notice issued by the OP.  Hence, prayed to close the loan amount related to the house property of deceased Neelappagouda Dyavanagoudar by his Master Policy No.70000000810 and loan Account No.64098732310, special compensation of Rs.5,00,000/-, refund of Rs.10,66,000/- the OPs are liable to pay an amount of Rs.4,80,000/- with interest at the rate of 18% p.a and such other relief.

3.       Registered the complaint and notice was ordered, as such OPs present before the Forum and filed written version, the contents are as follows.

Written Version of the OP No.1

4.       The OP No.1 contended that, the deceased Neelappagouda Fakkiragouda Dyavanagoudar should have taken care for activation/regularization of the Policy bearing No.70000000810 as it is his responsibility inspite of reminder of lapse notice issued by OP No.2 and also auto debit mandate received by the deceased Neelappagouda Fakkiragouda Dyavanagoudar, did not pay the insurance premium for the second year onwards till his death.  It is further submitted that, on 29.09.2014, Neelappagouda Fakkiragouda Dyavanagoudar voluntarily requested the OP No.1 Bank to close the RINN Suraksha A/c bearing No.64132929026 by transferring an amount of Rs.51,111/- and also intended to transfer an amount of Rs.10,00,000/- to his housing loan account bearing No.64098732130.  It clearly shows that, the deceased was well aware of the fact that, the said policy bearing No.70000000810 was in lapsed condition, the same could have been activated/regularized since 29.12.2013 as it was his responsibility being an insured and complainant himself has to explain that his father’s account is having Rs.9,86,164/- on 02.06.2016, the complainant is put to strict proof of the same.  It is further submitted that, OP No.1 did not deduct an amount of Rs.10,00,000/- from the complainant’s father account without his intimation and the OP No.1 did not recovered Rs.66,000/- from the complainant and this OP processed the insurance claim of the complainant and same was promptly forwarded to the OP No.2.  It is loan account 64098732310 cannot be debited since there was no sufficient balance in it to pay the insurance premium and complainant’s father did not submitted any undertaking to debit the said account to OP No.1 with regard to insurance premium of his policy bearing No.70000000810.  OP No.2 informed several times with regard to lapse of policy and OP No.1 also informed many times to deceased Neelappagouda Fakkiragouda Dyavanagoudar.  The deceased was followed the instructions of OP No.2 with regard to medical test as per the requirement raised by OP No.2 and also paid the extra premium as per the intimation by OP No.2 except after receiving the lapse notice of his policy by the OP No.2 and the deceased Neelappagouda Fakkiragouda Dyavanagoudar did not approached the OP No.1 for the renewal of his policy, as it was his obligation for responsibility on his part.  It is further submitted that, the father of complainant including his LR’s are well aware of the facts and unnecessarily blaming the OP No.1 is baseless and trying to get wrongful gain from OP No.1 by filing this false complaint and hence, prayed for dismissal of the complaint.

Written Version of the OP No.2

5.       The OP No.2 emphatically denies all the averments made in the complaint.  The contents of para 1 and 2 are accepted to the extent that, the deceased Neelappagouda Fakkiragouda Dyavanagoudar had applied for insurance cover under RINN Raksha Group Insurance Scheme bearing Master Policy No.70000000810 vide Membership Form No.700847760 on 29.11.2012. and accordingly the insurance cover was issued to the DLA with date of commencement 29.12.2012 for initial sum assured of Rs.27,04,015/- with yearly paying term of 5 years with premium of Rs.66,820/-.  This OP has received only the initial premium under the policy and the due date for renewal was 29.12.2013, but the same was not received by this OP and hence, the insurance cover was lapsed due to non-payment of renewal premium for the due date 29.12.2013 and onwards.  As the insurance cover was lapsed since 29.12.2013 and death happened on 012.06.2016, the claim was repudiated as the insurance cover was in lapsed status as on the date of death deceased and paid up value under the policy amounting to Rs.4,35,144/- was paid to the Master Policy holder vide Cheque No.366065 dated 22.09.2016 and the said amount has been admitted to have been received by the complainant and an amount of Rs.5231/- has been paid vide cheque No.366066 dated 22.09.2016 drawn in favour of nominee Poornima as per the terms and conditions of the Master Policy and COI which is just and legal.   It is further submitted that, SBI and SBI Life are two different legal entities and it is denied that the premium was supposed to be deducted directly from the Bank account bearing No.64098732310.  As per the proposal form, the account bearing No.64098741405 was given for debiting the renewal premium itself and it was closed on 29.09.2014 and hence, the debit of payment of renewal premium itself was not possible.  OP No.2 tried to debit the renewal premium on 15.11.2014, but failed due to closure of loan plus account bearing No.64098741405 and the statement of account clearly states that account was closed on 29.09.2014 and it is clear that, there is no sufficient balance in December 2013 to debit the renewal premium also.  The Branch Manager of SBM also confirmed vide mail dated 04.08.2016 that Suraksha loan account bearing No.64098741405 was closed on 29.09.2014. This OP is not aware about the said premium payment arrangement between the Bank and the insured if any and there is no deficiency in service on the part of this OP.  The payment of the premium is the responsibility of the insured member.  It is beyond the prudence of any person as to how an insurance company cannot be blamed for non-payment of premium by the insured and there is no contractual obligation on the part of this OP to send the renewal premium intimations/lapse notices as the schedule of payment of renewal premium is clearly mentioned in the certificate of insurance, which is a contract between life assured and the insurer for which both parties are bounded for the insurance agreement.  The loan Plus/Suraksha account bearing No.64098741405 which was opened for the debit of payment of renewal premium itself was closed on 29.09.2014, hence the debit of payment of renewal premium itself was not possible.  Therefore, it is clear from the statement that, there was no sufficient balance in December 2013 to debit the renewal premium also.  The Branch Manager of State Bank of Mysore also confirmed vide mail dated 04.08.2016 that Suraksha loan account bearing No.64098741405 was closed on 29.09.2014.  As a gesture, this OP sent lapse notice intimating that policy lapsed with effect from 29.12.2013 and advised to comply with the revival formalities to restore the invaluable insurance cover.  It is further submitted that, Mr. Neelappagouda Fakiragouda Dyavanagoudar should check the deduction of premium from his account and should arrange for payment of renewal premium.  Instead of that, insurer is blaming for non-payment of renewal premium which is not tenable and hence, prayed for dismissal of the complaint.    

6.       The complainant has filed his affidavit evidence and filed 06 documents.  The Manager of OP No.1 and authorized representative of OP No.2 filed their affidavit evidence and 14 documents have been produced.

COMPLAINANT FILED DOCUMENTS AS follows

	Particulars of Documents	Date of Document
C-1	Legal Notice
C-2	Reply to Legal Notice
C-3	Postal acknowledgement
C-4 to 6	Postal receipts

OPs FILED DOCUMENTS AS follows

OP-1	Super suraksha loan account sanction copy bearing No.64098741405
OP-2	Letter by OP No.2
OP-3	Mandate Form for payment of SBI RiNn Raksha premiums
OP-4	Statement of Account	01.07.2012 to 16.07.2019
OP-5	Statement of Account	01.01.2012 to 04.05.2019
OP-6	Statement of Account	21.06.2012 to 30.04.2019
OP-7	Statement of Account	01.01.2016 to 31.03.2016
OP-8	Statement of Account	27.02.2019 to 27.02.2019
OP-9	Statement of Account	21.12.2013 to 31.01.2016
OP-10	Statement of Account	01.02.2016 to 02.02.2016
OP-11	Letter by OP No.1
OP-12	Statement of Account
OP-13 & 14	Transfer debit forms

 

7.     On the basis of above said pleading, oral and documentary evidence, the following points arises for adjudication which are as follows:

1.  Whether the complainant proves that, this complaint is falls under the pecuniary jurisdiction of this Forum?

2.  Whether the OP proves that, complaint is barred by limitation?

3. Whether the complainant proves that, OPs made deficiency in service and entitled for the relief?

4.  What order?

8.       Our Answer to the above points are:-

1.  

                     

2.  

 

3. As per the final order.

REASONS

9.       Point No-1 & 2:- Since both the points are identical and interlinked with each other and hence, we proceed both together.   

10.     The complainant filed this complaint against the OPs stating that, his father by name Neelappagouda died on 02.06.2016 due to some brain related issues.  Deceased Neelappagouda assured his life under the RINN Raksha Group Insurance Scheme, it is a master policy in respect of the loan account with OP No.1.  After the death of Neelappagouda, the legal heirs have approached the OP No.1 to close the housing loan but, the OP No.1 has not closed the said loan account,.  Instead of that, OP No.2 has paid the death claim amount of Rs.4,35,144/- stating that, policy has lapsed due to non-payment of premium.  Further complainant submits that, on the date of lapse of premium of the policy, the complainant was having sufficient balance to deduct the premium in the said account.  But OP No.1 had not done so.  Further complainant submits that, it is the duty of OP No.1 and 2 to inform the same, the premium is due but, they have not informed nor deducted the amount from his account.   On the other hand, OP No.1 submits that, complainant[‘s father availed a home loan of Rs.24,75,000/- and another loan Super Suraksha loan of Rs.2,40,415/- as per the terms and conditions specified in the housing loan agreement Super Suraksha agreement and further submits that, the complaint does not falls on pecuniary jurisdiction. 

11.     Further OP No.1 alleged that, it is barred by limitation and denied all the allegation made by the complainant.    Further OP No.1 submits that, the Bank has paid the first year premium to OP No.2 at the request of complainant and the complainant father did not intending to regularize the insurance policy after lapse of policy due to non-payment in spite of several reminder by OP No.1.  OP No.2 sent a lapse notice to the father of complainant in the year 2013 itself and sent auto-debit mandate for renewal of his policy but, the deceased was requested to close the Super Suraksha account on 29.09.2014.  Bank has closed the said loan account as per the request of deceased, hence, OP no.1 has no obligation to pay further premium.  Further submits that, the other allegation made by the complainant is not acceptable.  OP No.2 filed an objection the SBI Life Insurance Company has a group insurance scheme for the borrowers of loan from SBM issued the master policy to the deceased Dyavanagoudar (father of the complainant).  The terms and condition of the master policy are binding on all the members in a group insurance, the privity of contract between the master policy holder and the insurer and the terms and conditions of master policy are binding on all insured member and OP No.2 also raise that the complaint does not falls under this Forum due to lack of pecuniary jurisdiction and also submits that, it is barred by limitation and denied all the allegations made by the complainant. 

12.     On going through the records on file, both the OPs alleged that, the complaint does not falls under the pecuniary jurisdiction since, the sum assured is Rs.21,75,722/-.  But as per the complainant’s prayer, the complainant claimed Rs.15,66,000/-.  Such being the fact, there is no need to explain elaborately on this point and another thing that is on the limitation, it is clear that, the OP answered the legal notice in the year 2018 issued by the complainant, it is clear that, there is a continue correspondence made between complainant and the OPs.  The limitation starts from the last communication made between the parties i.e., in the year 2018. Then then there is no issue and OPs have failed to prove the same on limitation point.

13.     Point No.3:- As per the document produced by the OP No.2, the document and the objection itself speaks that, the policy was a SBI life RINN Raksha Group Credit Life insurance plan and the master policy holder is OP No.1.  Of course, both the parties agreed on some point that complainant availed a housing loan and also complainant agreed to the RINN Suraksha Policy for his housing loan.  Here, the main point we had to discuss is that the OPs have recovered all loan amount from the complainant and the deceased Dyavanaagoudar and OP No.1 not paid the premium to OP No.2.  The legal heir of deceased Dyavanagoudar i.e., complainant submits that, his father was under the shelter of RINN Raksha Policy but, OPs have not closed the loan account. 

14.     On going through the records filed by the OP No.2 and OP No.1, it is clear that, as per the ANNEXURE-A of OP No.2 i.e., policy document the name of master policy holder is stated in the policy is the State Bank of Mysore i.e., OP No.1 and premium and service e Tax amount is payable by both Bank and the party who availed a loan.  Such being the fact, it is clear that, both complainant and OP No.1 are liable to pay the premium amount to OP No.2.  They have submitted that, the OP No.2 issued lapse notice to the complainant’s father which has been produced before the Commission i.e., Annexure-F but, in that letter there is no date or else, no acknowledgement has been found to say that, it has been received by the deceased or his family members.  Annexure-E i.e., mail of OP No.2 to OP No.1, in this mail, there was a correspondence between OP No.1 and 2 and OP No.1 clearly said as follows:

“With reference to the SBM Suraksha Loan account No.64098741405 of Shri. Mr. Neelappagouda Fakiragouda Dyavanagoudar, we state that the account was fully repaid and subsequently closed on 29/09/2014.  We hereby note that the customer has always been prompt to pay his loan dues and kept minimum overdue amount in the loan had been closed”.  

 

15.     With reference to the above mail, it is clear that, the deceased Neelappagouda is prompt in payment of his loan dues.  Moreover, when OP No.1 opened the another account for paying the premium of the policy.  In the year 2013, it is clear that, there is a sufficient balance in the Bank to pay the premium amount to OP No.2.  such being the fact, why OP No.1 had not come forward to pay the premium amount to OP No.2 and OP No.1 is the master policy holder and in the policy condition, it is clear that, the policy premium has to be paid by both party and the Bank.  It is best known to OP No.1 itself that, why they have not done this and another doubt arises here is that, in 2014, why they accepted that, the account No. 64098732310 is closed when they are not dedcting the amount of policy premium in the year 2013.  IT IS THE bounded duty of OP No.1 to deduct the premium amount and it is also the responsibility of deceased Fakirppa (father of complainant) to look-after that whether the policy is in force or not.  Hence, we come to the conclusion that, the said complaint is allowed in the non-standard basis.  Hence, we answer Point 3 in partly affirmative.

16.     Point No.4:- For the reasons and discussion made above, we proceed to pass the following:-

6698606.  

 

1. The complaint filed by the complainant is partly allowed.

 

2.  OP No.1is directed to refund the amount of Rs.5,00,000/- to the complainant and the nomineies of deceased Neelappagouda F Dyvannagoudar after receiving the LR’s Certificate and further OP No. 1 is directed to pay a compensation of Rs.10,000/- towards litigation charges and Rs.2,000/- towards mental harassment to the complainant.

 

 

3. Further OP No.1 is directed to pay the above amount within one month, failing which the OP No.1 is directed to pay interest @ 12% on Rs.5,00,000/- from the date of filing the complaint till realization.

 

4. Complaint against OP No.2 is dismissed.

 

5. Send a copy of this order to both parties free of cost.  

(Dictated to the Stenographer, transcribed by him, corrected and then pronounced by me in the Open Court 10^th day of August-2020)

 

 

 (Shri B.S.Keri)                                        (Smt.C.H.Samiunnisa Abrar)

       MEMBER                                                      PRESIDENT