DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KANDHAMAL, PHULBANI
C.C.NO.06 OF 2019
Date of Filing : 29.04.2019
Date of Order : 25.10.2022
Kabita Manjari Bhoi
W/O: Dillip Kumar Bhoi
AT/PO-Dasapalla
Dist- Nayagarh …………………….. Complainant.
Versus.
1. Branch Manager,
L.I.C of India, Phulbani
At/Po-Phulbani,Dist.- Kandhamal
2. Divisional Manager L.I.C of India
At/Po-Berhampur,Dist-Ganjam
3. Block Education Officer, Harabhanga
AT/PO- Charichhaka, DIST- Boudh
4. D.E.O Boudh
At/Po/Ps- Boudh ……………………….. OPP. Parties.
Present: Sri Purna Chandra Mishra - President.
Sri Sudhakar Senapothi - Member.
For the Complainant: Advocate P.Sahu & associates
For O.P.1& 2 - Adv. Bijaya Mohanty
For O.P.3 & 4 - None
JUDGEMENT
Mr. Purna Chandra Mishra,President
The Complainant has filed this case alleging deficiency of service on the part of the OPs for non-payment of the insured amount of her deceased husband late Dillip Kumar Bhoi amounting to Rs,2,00000/- praying therein for a direction to the OPs to pay a sum of Rs,4,000,00/-,which is inclusive of the insured amount,interest etc.
- Brief fact leading to the case is that the husband of the complainant was having a life insurance policy bearing No.570613636 in LIC of India and it was on Salary Saving Scheme as he was a government teacher. During the force of the policy on 07.04.2007 late Dillip Kumar Bhoi died on a road accident and right from that day she has been running to the insurance company to get the insured amount. As the OP company did not take any steps to release the insured amount, she lodged written complaint through registered post to the company but there was no response from them. Being aggrieved by the lacsidal attitude of the insurance company she made an application to the consumer counseling centre for amicable settlement of the matter and even after notice from the consumer counseling centre, the O.Ps did not appear for which the complainant has been compelled to file this case before this Commission for the reliefs prayed for in the complaint petition.
- After receipt of notice the O.P No.1 & 2 appeared through their Adv. and filed their joint written statement. The O.P No 3 appeared through his authorized representatives. O.P No.4 did not appear.
- The O.P No. 1 & 2 in their written statement admitted the fact that the petitioner was having this policy under Salary Saving Scheme under plan-14, term 16 years for insured value of Rs,1 lakh with monthly premium of Rs,549/-per month. When the claimed was lodged the OP NO.1 & 2 searched the records
and couldn’t trace out the payment of premiums from September 2003 to April 2006. So employer was asked to submit the payment details for this period. The payment authority from 04.08.2017 submitted the format supplied by them in which it was stated that the salary was paid for the month of Marh 2006 in which a sum of Rs.873/- has been deducted towards premium for 3 policies. The claimant couldn’t produce deduction particular for other 14 months. The Branch has received premium for a period of 3 years and 1 month including March 2007 but in the instant case LIC should have received premium for 4 yrs and 3months regularly and continuously prior to his death. The Branch has issued registered letter on 03.02.2021 to the complainant with required claim form for furnishing the particulars after duly filled in along with original policy. As the complainant has paid the premium for 3 yrs and one mo nth instead of 4 yrs and 3 months the policy acquired paid up status for non-payment of premium regularly and it was responsibility on the policy holder to look after regular deduction of premium from the salary. As policy was not in force they have rejected the claim and there is no deficiency on their part and case be dismissed against them.
- The O.P No 3 in his written statement stated that deceased husband of the complainant was working under the control of the Dist Inspector Boudh and at present Block Education office Boudh. Deceased was transferred to Baring Primary School under the control of BDO Harabhjanga and joined on 07.04.2004. The Block Education Office was established with effect from 11.07.2013 and prior to that he had expired on 07.04.2007 while in service. On verification of a acquittance role, it is revealed that from 04./2004 till death he has been paid salary up to 07.04.2007 and sum of Rs.873/- has been deducted against 3 policies premium up to March 2007.
- O.P No.4 did not appear nor filed written statement.
- The Complainant in support of her case has filed the copy of GR case record, Copy of death certificate, Copy of LIC status report, Copy of letter dtd.27.06.2015, 10.09.2015, 16.10.2015, 17.05.2017 of the complainant to LIC, copy of the letter dtd. 06.06.2015, 09.11.2015 to the complainant, copy of the letter 24.06.2017 of Consumer counseling center Kandhamal, copy of the letter dtd. 07.08.2017 BDO Harabhanga, copy of the letter dtd.16.08.2017 to the complainant, copy of the letter dtd.19.08.2017,22.10.2018 and 04.12.2018 to LIC
On the other hand the O.P No.1 & 2 have filed copy of the letter of authorization given by late Dillip Kumar Bhoi, copy of the insurance policy, copy of the statement of accounts submitted by BDO Harabhanga.
- In view of the pleadings and counter pleadings of the parties the following issues are framed.
- Whether the petitioner is a consumer?
- Whether the case is barred by limitation?
- Whether the complainant is entitled to get the insured amount?
- Is there any deficiency on the part of the OPs?
- To what relief complainant is entitled?
- The first issue relating to this case is whether the petitioner is a consumer or not?
The petitioner was the nominee in the policy as well as she is the legal heir of the deceased policy holder. It is settled principle of law that a nominee of an Insurance policy is a consumer and the issue is answered in favour of the complainant.
9. The next issue is whether the case is barred by limitation?
The insured late Dillip Kumar Bhoi died on 07.04.2007. The complainant pleads that she has been running to the office of the O.P No.1 & 2 right from the death of her husband and has been writing to them continuously as they did not listen to her verbal grievance. This aspect of the allegation is not denied by the O.P No.1 & 2 in there written statement. The complainant has filed her evidence in shape of affidavit which remains unchallenged and uncontroverted. From the documents on record it is seen that she has written more than six letters for redressal of her grievance. But the O.P No. 1 & 2 have not taken any steps and kept the lady complainant who is a widow in a hanging stage for years together. It is settled principle of law that where the claim is not repudiated, it gives rise to continued cause of action. In the instance case not a single document has been filed by the O.P No.1 &2 to prove that the claim was repudiated and duly communicated to her. As the O.P No.1 &2 did not repudiate the claim, it gives rise to continued cause of action and as such not barred by limitation as the cause of action is continuous. So Issue no. 2 is answered in favour of the complainant.
- Now the third issue relating to the case is whether the complainant is entitled for the insured amount or not?
It is admitted by the O.P No.1 &2 in their written statement that it was an insurance policy under Salary Saving Scheme. In a Salary Saving Scheme the insured gives the authority to the insurance company to take collect his premium regularly from his salary through the DDO. After giving the authority the DDO of any institution who agrees to deduct the amount from the salary works as the agent of the insurance company. It is for the insurance company to ensure that the premium is regularly collected from the salary till the expiry of the policy. If the DDO fails to deduct the amount and deposit it in the insurance company, the insurance company should verify from the DDO whether such mandate given by the insured has been stopped by any instruction or not ? If the DDO does not deduct and deposit the amount it casts a duty on the insurance company to immediately intimate the policy holder regarding such act of the DDO and instruct him to deposit the premiums directly. In the instant case the insurance company has not whispered a single word that they have intimated the policy holder regarding non deduction and deposit of the premium with them. So there was no scope on the part of the deceased policy holder to know that he has become defaulter in payment of premiums. Raising this point after the death of the insured is unacceptable in the eyes of law and violative of the principles of natural justice. We are fortified by a decision of the Hon’ble Supreme Court of India where in the Hon’ble Apex Scope Court has ruled that the corporation can not be permitted to take advantage of its own wrong and also the wrong of its agent. (2005 - 3 - CLT -203 -SC) . So in view of the decisions of the Hon’ble Supreme Court of India, it is crystal clear that the claim of the complainant should have been paid without any hassle. So in view of the discussion made in the preceding paragraphs we are of the view that the insurance company shouldn’t have harassed the widow and she is entitled to get the benefits of the policy.
- Now comes the question whether there is deficiency in service on the part of the O.Ps. It is clear from the discussion made in the preceding paragraph that the insurance company has illegally withhold the genuine claim of the complainant and the complainant is entitled to get the benefits of the policy
and by devoiding her of the genuine claim the O.P No.1 & 2 have caused deficiency in service and the liable to compensate the petitioner.
- Now comes the question to what relief the complainant is entitled?
It is crystal clear from the discussion made in the preceding paragraphs that the petitioner is entitled to the benefits in the insurance policy and the O.P No 1 & 2 have caused deficiency in service and harassment to the petitioner and are liable to compensate the petitioner for the harassment caused to her and hence the order.
ORDER
The complaint petitioner is allowed on contest against O.P No 1 &2 and dismissed against other O.Ps. The O.P No 1 & 2 are directed to pay the insured valued of Rs.2,00000/-(Two Lakhs)only to the complainant with interest at the rate of 9% per annum from the date of claim till it is paid to the complainant. The O.P No 1 &2 are further directed to pay sum of Rs.50, 000/-(Fifty thousands) only as compensation for deficiency in service and harassment and a sum of Rs.15,000/- towards cost of litigation. The order is to be complied with in a period of 30days from the date of communication of the order.
I Agree
MEMBER PRESIDENT
Pronounced in the open Commissioner today on this 25th day of October 2022 in the presence of the parties.
MEMBER PRESIDENT
