Date of Filling:      15.02.2017

                                                                                                                       Date of Disposal:  10.08.2018

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

THIRUVALLUR-1

PRESENT:   THIRU.S.PANDIAN, B.Sc., L.L.M.                                 ….PRESIDENT

THIRU:R.BASKARKUMARAVEL, B.Sc.L.L.M., BPT., PGDCLP.,      …MEMBER

CC No.16/2017

FRIDAY, THE 10 DAY OF AUGUST 2018

V.Ramu,

S/o.Vadivelu,

Perumal Koil Street,

No.43, Panapakkam Village and Post,

 Uthokootai Taluk,

Thiruvallur District -602 028.                                        ……Complainant.

                                                 //Vs//

1.The Branch Manager,

    LIC of India,

    Thiruvallur Branch,

    Thiruvallur.

2.The Manager,

    State Bank of India,

    Uthukottai Branch,

    Old Ni513/2A, New No.513/6 &541/4,

    Uthukottai, Thiruvallur District.                             …..Opposite parties.

The complaint is coming upon before us finally on 31.07.2018 in the presence of Thiru.A.R.Poovannan, counsel for the complainant and M/s.K.V. Srinivasan, counsel for the 1^st opposite party and 2^nd opposite party was reminded Exc-parte for non appearance and upon hearing arguments, having perused the documents and evidences on the side of the complainant and 1^st opposite party, that Forum delivered the following.

ORDER

PRONOUNCED BY THE S.PANDIAN, PRESIDENT.

This complaint is filed by the complainant U/S 12 of the Consumer Protection Act-1986 against the opposite party for seeking direction to pay a sum of Rs.1,00,000/-  for the complainant’s claim amount and a sum of Rs 1,00,000/-towards compensation for the mental agony, hardship, strain inconvenience due to the opposite parties and with cost Rs.5,000/-

2.The brief averments of the complaint are as follows:-

That on 15.03.2014 the complainant entered a policy with the 1^st opposite party under ENDOWMENT PLAN No.814-16-16 in policy Number 708340830 in the name of his minor son Rahul for a sum of Rs.1,00,000/-.  That the monthly premium amount is Rs.550/- per month and it was decided to pay such premium through ECS directly from the account of the complainant from the state Bank of India, Uthukottai Branch, the second opposite herein.

3. From the date of inception of the policy the premium was regularly deducted from complainant’s account from his account in State Bank of India Uthukottai Branch.  The complainant submits that complainant’s son namely minor R.Rahul the insured met with an accident and died on 29.06.2016.

4. That the complainant then made an application claiming the insurance amount and was shocked to receive reply from 1^st opposite party, that the policy was lapsed as the premium for the above policy was not at all paid from the month of February 2016.

5. That it is not the policy for which the premium is paid directly by the insurer and it was transferred under the ECS scheme from the complainant’s account to LIC of India.  Further on verification of the account the complainant doesn’t understand as to why the monthly premium was not deducted from his account.

6. That, under the impression that the premium is regularly detected he is maintaining sufficient balance in his account to enable the LIC of India/the 1^st opposite party to detect the monthly premium.  When complainant enquired with his banker as to why the premium was not detected from his account it was informed by the banker that the amount will be debited only upon the request from the LIC.

7. The repudiation by the first opposite party without any notice of termination stating that the policy was terminated for non- payment of premium is highly illegal.  Further the complainant doesn’t able to understand as to why the premium was not detected and how the policy was terminated without any notice of termination.  The complainant was put to great hardship and strain.

8. The reason for the reputation of complainant’s claim that too only after the claim made by complainant is not right and it amounts to gross deficiency in service.  The complainant submits that the act of the opposite party is high handed.  The complainant is maintaining sufficient balance in his account to enable LIC of India to detect the monthly premium and it is for the opposite parties to recover the same from the complainant’s account.  The complainant is no way responsible for the fault and it is purely negligence on the part of the opposite parties.

9. Therefore on 02.08.2016 issued a legal notice to the 1^st opposite party to accord sanction to the claim of the complainant.  The opposite party in spite of the receipt of the legal notice on 02.08.2016 had not chosen to sanction to the claim of complainant or not given any reply.  Hence this complaint.

 10. The contention of written version of the 1^st opposite party is briefly as follows:-

 The complaint is not maintainable in law and on facts. It is malicious, frivolous and vexatious.  The allegations mentioned in the complaint are denied except which are expressly admitted herein. It is true that the complainant entered into a endowment plan vide policy number 708340830 in his minor son name which commenced on 15.03.2014 for Rs.1,00,000/-.  The complainant is liable to pay Rs.550/- per month.  The mode of payment chosen by the complainant was ECS monthly trough 2^nd opposite bank A/c.32568536673.

11. At the outset, this opposite party brings out the terms and conditions of ECS, which the complainant is very much aware of under which it is clearly spelt that “LIC will not be responsible for any dishonor raided by the Bank for whatsoever reason.  Any dispute regarding dishonor should be taken up with the Bank only.  This opposite party submit the averments on para 5,6and 7 that the premium was not regularly paid.  Even in the month of july and August 2014 the ECS got dishonoured and the complainant had approached the LIC office and paid the premium directly in the branch.   ECS deduction was restarted thereafter from September 2014.  Every month LIC raided the ECS demand with the RBI SEQ No for the period 15.04.2014 to 15.02.2016.  All the demand for the above period was honoured except july 2014 and February 2016.  1^st opposite party also informed the complainant about the dishonor of premium deduction through ECS on 15.02.2016 for the reason as “Miscellaneous”.  It was further informed to the complainant to pay the premium due with dishonor charges at the cash counter of any LIC branch and ECS will continue only thereafter.  It was informed to the complainant to pay the premium due for the month of February 2016 on 26.02.2016 through post.  If the ECS demand for a particular month is dishonoured no further demand by ECS will be raised with the bank till the premium are paid upto date.

12. As the policy was taken by the complainant on the life of minor son R.Rahul, the policy document itself reveals, there is no premium charged for accident coverage for minor life.  More over material aspects were suppressed by the complainant.  The details of the death of minor in road accident was not furnished.  As per the terms and condition of the document it is specified that the death benefit is payable, provided the policy is in full force by paying up to date premium on the death of life assured.  It is also the bounden duty to the complainant to ensure that he had paid the premium regularly either from his bank account or paid directly in LIC.  This opposite party has no role to operate complainant’s bank account.  The dishonoured ECS for reason miscellaneous can be briefed only by the 2^nd opposite party and complainant.

13. In spite of the intimation notice sent by LIC he has not approached the 1^st opposite party.  The complainant cannot presume that the premium amount will be debited from his account, it is the duty of the complainant to follow whether the premium amount are paid periodically. Having knowledge of the non debit from his account he has failed to pay the premium towards his policy.

14. The complainant has made all fault and it is negligence of the complainant for non paying the premium towards policy.  Is only after thought happening after the unfortunate death of life assured.  LIC is only within its limits in denying the claim due to non-payment of premium dues and the policy is only terminated on the death of life assured.  The policy is only terminated on the death of life assured.  The policy has not even completed 2 years.  There is a default within 2 years.  This opposite party directly contacted the complainant through their agent and informed about the all the terms and conditions of the policy and payment through ECS made.  After understanding there only, the complainant has subscribed to the policy under ECS made.  There is no high handedness in the denial of claim.  It is done only on the basis of terms and conditions enunciated in the policy document.  The complainant is evasive and is without any locus standi.  No payment can be claimed beyond the terms and condition of the policy contract.

15. There is no cause of action to file this petition.  The opposite party is not liable to pay compensation or the cost claimed by the complainant. The relief sought for by the complainant shall not be granted.  The complainant is a defaulter and there is no deficiency of service on the part of this 1^st opposite party. Hence complaint is liable to be dismissed.

16. In order to prove the case, on the side of the complainant, the proof affidavit submitted for his evidence and Ex.A1 to Ex.A6 were marked.  While so, on the side of the 1^st opposite party, the proof affidavit is filed and Ex.B1 to Ex.B5 are marked on their side.  The 2^nd opposite party is remained ex-parte.

17. At this juncture, the point for consideration before this Forum is:-

Whether there is any deficiency of service on the part of the opposite party as alleged in the complaint?

To what other reliefs, the complainant is entitled to?

18. Written arguments filed and oral arguments also adduced by both sides.

 Point no:1:-

19.  It is learnt from the complaint that the 1^st opposite party wrongly repudiate the insurance claim against the policy No.708340830 which was taken for the minor son namely R.Rahul for a sum of Rs.1,00,000/- who is subsequently died in the accident though the premium of Rs.550/- for the said policy per month was paid through ECS directly from the account of the 2^nd opposite party SBI, Uthukottai Branch.

20. On the other hand, it is contented by the 1^st opposite party that in fact there is no deficiency of service on the part of the 1^st opposite party and at any cost LIC will not be responsible for any dishonor raised by the Bank for whatsoever reason and the 1^st opposite party has rightly reputed the claim as per the terms and condition of the said policy which was already furnished to the complainant.  Further, it is the duty of the complainant to verify whether the premium has been debited in his account in spite of the intimation notice sent by LIC he has not approached the 1^st opposite party and having knowledge of the non-debit from his account, he has failed to pay the premium towards his policy therefore there is no cause of action to file this complaint.  In such circumstances the 2^nd opposite party is remained ex-parte in spite of receipt of notice from this Forum. 

21. At this juncture, on careful perusal of the rival submissions put forth on either side, it is crystal clear that there is no dispute in respect of taking the ENDOWMENT PLAN No.814-16-16 in the name of minor son R.Rahul of the complainant for a sum of Rs.1,00,000/- and the monthly payment of the LIC premium has been paid through ECS from the account of the complainant maintained in State Bank of India, Uthokottai Branch and the same has been regularly deducted and is brought into account of the LIC till 15.01.2016.  It is further seen from the evidence of the Ex.A1 is the first page of the State Bank of India of SBI account pass book and Ex.A2 is copy of the policy issued by the 1^st opposite party without the terms and conditions and Ex.A4 statement of account for deducting the premium from the account of the complainant by the State Bank of India, Uthokottai Branch.

22.  At the outset, it is further learnt from the evidence of the complainant though the complainant’s minor son R.Rahul died on 29.06.2016 for which Ex.A3 death certificate is marked.  After the death of the minor son, when the complainant made an application for claiming the insurance amount and was shocked to receive reply from 1^st opposite party, that the policy was lapsed as the premium for the above policy was not at all paid from the month of February 2016.  It is further stated by the complainant in his evidence that the impression of premium is regularly deducted by maintaining sufficient balance in his account to enable the LIC of India 1^st opposite party to deduct the monthly premium.   For non-deduct of premium, the complainant enquired with the 2^nd opposite party, it is informed by the banker that the amount will be debited only upon the request from the LIC and therefore the repudiation  by the 1^st opposite party is highly illegal which amounts to gross deficiency of service and therefore the complainant has sent legal notice  Ex.A5 to the 1^st opposite party and was received through acknowledgement card which is marked as Ex.A6.

23. While being so, on careful seeing the evidence of the 1^st opposite party it is stated that the premium was not regularly paid by the complainant even in the month of July and August 2014 through ECS and thereafter on approach of the complainant, the premium was paid directly in the Branch and therefore the deduction was restarted from September2014.  In this connection, even month LIC raised the ECS demand with the RBI SEQ for the period of 15.04.2014 to 15.02.2016 and the demand for the above period was honoured except July 2014and February 2016.  It is further adduced that the opposite party informed to the complainant about the dishonor of cheque due on 15.02.2016 for the reason as “miscellaneous” and directed to pay the premium due with dishonor charges at any Branch and it was informed to the complainant to pay the premium due for the month of February on26.02.2016 through post Ex.B1. But the complainant has not come forward to pay the premium due and therefore the LIC has no role to operate complainant’s account.  So, it is bounden duty of the complainant to ensure that he had paid the premium regularly either from his bank account or paid directly in LIC.

24.  Furthermore, it is stated by 1^st opposite party that Ex.B2and Ex.B3 are premium history for ECS.  Ex.B4 is the copy of the terms and conditions for ECS facility and Ex.B5 is the copy of the LIC s NEW ENDOWMENT PLAN along with Annexure having terms and conditions of the policy.  Though the premium for said policy has been paid through ECS and there is some default in the month of July 2014 and therefore it is stated by the 1^st opposite party that there is no deficiency of service as alleged by the complainant and in fact the 1^st opposite party has acted upon as per the terms and condition of the policy.

25. At this juncture, on careful perusal of the rival submissions put forth on either side, it is crystal clear that there is no dispute about the alleged policy No. 708340830 was taken by the complainant in the name of his minor son R.Rahul who was subsequently died in the accident.  Similarly, it is an admitted fact that the premium of the said policy has been deducted through ECS from the State Bank of India Account of the complainant that is 2^nd opposite party.  At the outset, the allegations made by the complainant that it was informed by the 2^nd opposite Bank that the amount will be deducted only upon the request from the LIC. Regarding this allegation, it is clearly explained by the 1^st opposite party that it is no need to make a request to each and every month for deduction of the premium through ECS from the saving account in SBI, Branch of the complainant.

26.  In fact, as rightly pointed out by the 1^st opposite party that on the non-receipt of the premium amount through ECS on 15.02.2016 for the reason as miscellaneous as per the ECS Seq. No.3108212665 and 3108212666 immediately the 1^st opposite party informed that to pay the premium dues with dishonor charges at the cash counter in any branch and thereby ECS will be continue thereafter.  But there is no evidence to show that the complainant has paid the premium amount due has directed by the 1^st opposite party till the repudiation of the claim of the complainant by the 1^st opposite party.  Further, it is learnt from the evidence of the 1^st opposite party that as per the terms and condition of LIC if the ECS demand for the particular month is dishonoured no further demand by ECS will be raised with the bank till the premium dues are paid.  As per point No.11 in the terms and condition for ECS policy under Ex.B4, it is crystal clear that from the above point, that the LIC will not be responsible for any dishonour raised by the bank for whatsoever reason.  Any dispute regarding dishonour should be taken up with the bank only by the complainant.

27. The next point to be taken into consideration is as to whether the demand letter or any proper notice for repudiation of the claim has to be sent by the 1^st opposite party which leads to gross negligence as raised by the complainant.  In this aspect, on careful perusal of the Ex.B5 the terms and condition of the alleged policy it is clearly stated in point No.3 as follows.

If the policy has lapsed due to non-payment of due premium within the days of grace, it may be revived during the life time of the life assured, but within a period of 2 consecutive years from the date of the first unpaid premium and before the date of maturity on submission of proof of continued insurability to the satisfaction of the corporation and payment of all the arrears of premium together with interest at such rate as fixed by the corporation time to time.  It is the discretionary right of the corporation to accept or deny.

Therefore, it is clearly mentioned in Ex.A5 that there is no need of 1^st opposite party sending demand notice for the payment of premium amount for each and every month or prior notice for the repudiation of the claim to the complainant by the 1^st opposite party.  Therefore the complainant is having knowledge of the non-debit from this account but he failed to pay the presmum due towards his policy directly in any branch of LIC in order to revive the said policy. Further the policy documents itself reveals the fact that there is no premium charged for accidental coverage for the minor life as per Ex.B5 para No.11 has already pointed out.

28. In the light of the above facts and evidence it is crystal clear that the 1^st opposite party has rightly repudiated the claim of the complainant as per the terms and conditions averred in Ex.B4and Ex.B5.  Therefore the objection raised by the complainant that there is no proof of documents neither to show the Ex.B1 nor any acknowledgement for receipt of the Ex.B1 by the complainant produced by the 1^st opposite party has become futile and also there is no gross negligence committed by the 1^st opposite party since they have acted according to the terms and conditions of the LIC policy. 

29. As all discussed in the previous paragraph and the evidence adduced from the both sides, it is not disputed that the alleged premium amount has been deducted through ECS from the SBI account maintaining by the complainant in 2^nd opposite party Branch.  On careful going through the Ex.A4, the statement of account from the 2^nd opposite party it is well known that the Bank statement of account prior to 16.11.2015 has been produced by the complainant.  Whereas on seeing the Ex.B3, the premium dishonour for ECS policy which is pertaining to 15.02.2014 till 15.02.2016 it is brought to the knowledge of this forum that as rightly pointed out by 1^st opposite party that on the earlier point of time, that is, in the month of August 2014 also the premium amount has not been deducted through ECS.  So, for the month of August 2014, it is needless to say that the premium amount has been paid directly by the complainant in the LIC branch and to that effect there is no dispute raised by the complainants side.  Further, it is seen that till 15.01.2016 the premium amount paid ECS has been properly accounted in 1^st opposite party branch account.  At the outset it is learnt that the complainant is having such previous experience what will do whenever the charge issued towards premium due to be deducted through ECS.  Further, it is an admitted fact that the 2^nd opposite party has dishonoured the cheque even paid by the complainant towards the premium due to be deducted from his account through ECS, but the same has been dishonoured as miscellaneous and therefore the premium amount for the period of 15.02.2016 has not been accounted for in 1^st opposite party branch.  If it is so, it is the bounden duty of the complainant to pay the premium due directly in any of the L.I.C., Branch but he has failed to do it. Then only, he has to approach the 2^nd opposite party about the dishonour of cheque that the complainant is having sufficient amount in his account but 1^st  opposite party has no business to deal with that matter.

30. In such circumstances, the opposite party-2 is the competent authority to say what for reasons the alleged cheque issued by the complainant for the payment of LIC premium through ECS has been dishonoured and though he was having sufficient fund in his Saving Bank Account.  Regarding the averment of the complaint as to whether the demand of request from LIC is just and necessary for each and every month as narrated by the complainant to be explained only by the 2^nd opposite party who has failed to appear before this forum in spite of notice received by the 2^nd opposite party.  Further 2^nd opposite party has not come forward to rebut the evidence of the complainant and 1^st opposite party.  At this juncture, from going through the other facts and circumstances and 2^nd opposite party has remained exparte it is needless to say that because of the negligence of the 2^nd opposite party the premium amount has not been deducted through ECS which clearly leads to deficiency of service of 2^nd opposite party only and thereby caused mental agony and monitary loss to the complainant.  Thus the point no 1 is answered accordingly.

PointNo:2-

31. As per the conclusion arrived the point No.1, because of the deficiency of service on the part of the 2^nd opposite party only the complainant has incurred heavy monitary loss by repudiation of the L.I.C. claim made by the 1^st opposite party on the demand of the complainant.  Hence the same has to be compensated by the 2^nd opposite party with reasonable compensation and cost. In respect of 1^st opposite party the complainant is not entitled for any compensation.  Thus the point no 2 is answered accordingly.

In the result, this complaint is allowed in part.  Accordingly, the 2^nd opposite party only is directed to pay a sum of Rs.25,000/- (Rupees Twenty Five thousand only) towards compensation to the complainant herein for causing mental agony, hardship and monetary loss due to the deficiency of service on the part of the  2^nd opposite party and also to pay a tune of Rs.5,000/- (Rupees Five thousand only) towards cost of litigation expenses.  Regarding 1^st opposite party, this complaint is dismissed without Cost.

 The above amount shall be payable within one month from the date of receipt of the copy of the order, failing which, the said amount shall carry interest at the rate of 9% per annum till the date of payment.

Dictated by the president to the stent-typist, transcribed and computerized by him, corrected by the president and pronounced by us in the open Forum on this 10^th August 2018.

    -Sd-                                                                                         -Sd-

MEMBER                                                                            PRESIDENT

List of document of the complainant.

List of document of the 1^st opposite party.

       -Sd-                                                                                                   -Sd-

   MEMBER                                                                                       PRESIDENT