Order No.  11  dt.  10/08/2018

          The case of the complainant in brief is that the complainant being the nominee of the deceased policy holder Mathura Das who used to work as shoe cobbler. The complainant’s father Mathura Das had purchased LIC Jeevan Rakshak (with profit) policy no. 458796425 of the repeated requests of the policy agent. After purchase of the said policy the policy holder submitted mandate form to pay premium through ECS mode  on 18/12/2014. The sum assured of the said policy was Rs.75,000/- and the installment of the premium was Rs.270/- per month. After commencing of the policy the policy holder Mathura Das continued to pay premium of the policy till death. Since five months prior to the death of deceased policy holder was continuously sick under effect of fever and died on 05/10/2016. The monthly premium of Rs.270/- was deducted by o.ps. through ECS mode from the account of the policy holder which will be transpired from the pass book of the policy holder issued by Dena Bank wherefrom it can be found that on 7^th or 8^th day of each and every month the premium was deducted by o.ps. through ECS mode. The deceased policy holder’s policy premium was deducted through ECS mode on 08/08/2016 after which next due date was on 08/09/2016, but on that day the amount of Rs.500/- was lying in the credit of the account of deceased policy holder. In spite of having such amount in the account of the deceased policy holder the LIC neither deducted the premium on due date nor deducted within the grace period of 15 days arising from due date due to negligence on the part of LIC authorities. Subsequently Mathura Das died on 05/10/2016 and his nominee, the complainant claimed the assured sum, but o.ps. refused to pay the same, for which the complainant filed this case praying for direction upon the o.ps. to pay the assured sum of Rs.75,000/- as well as compensation and litigation cost.

                The o.ps. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that Mathura Das took a policy from o.ps. for sum assured of Rs.75,000/- and mode of payment of the premium was ECS (monthly from the account of the Dena Bank of the policy holder). The monthly installment premium was Rs.270/-. Since the policy holder opted option for payment of premium through his bank i.e. Dena Bank, Dharmatala Branch, as per ECS mandate dt, 18/12/2014, the service branch office of o.ps. issued to send the demand notice for the purpose of insurance premium to Dena Bank, Dharmatala Branch on 7^th of every month except it is Sunday, holiday or there is any internet/machine problem as is apparent from the bank statement annexed by the complainant. The o.ps. sent the demand notice for the premium payable for the month of September,2016 to Dena Bank, Dharmatala Branch on 07/09/2016, but the said transaction was dishonroured by the serving bank of the policy holder since the account holder had no sufficient fund. The statement has been annexed with the w/v. Since the policy holder even after expiry of the said period within 15 days he failed to pay the amount by cash in the counter of the serving branch of o.ps., therefore, the policy became lapsed and after the demise of the policy holder the claim made by the complainant was not entertained. There was no deficiency in service on the part of o.ps. and as such, o.ps. prayed for dismissal of the case.

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

1. Whether the complainant’s father had the policy with o.ps?
2. Whether the policy holder failed to pay the premium within the stipulated period through ECS mode?
3. Whether there was any deficiency in service on the part of o.ps.?
4. 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 being the nominee of the deceased policy holder Mathura Das who used to work as shoe cobbler. The complainant’s father Mathura Das had purchased LIC Jeevan Rakshak (with profit) policy no. 458796425 of the repeated requests of the policy agent. After purchase of the said policy the policy holder submitted mandate form to pay premium through ECS mode on 18/12/2014. The sum assured of the said policy was Rs.75,000/- and the installment of the premium was Rs.270/- per month. After commencing of the policy the policy holder Mathura Das continued to pay premium of the policy till death. Since five months prior to the death of deceased policy holder was continuously sick under effect of fever and died on 05/10/2016. The monthly premium of Rs.270/- was deducted by o.ps. through ECS mode from the account of the policy holder which will be transpired from the pass book of the policy holder issued by Dena Bank wherefrom it can be found that on 7^th or 8^th day of each and every month the premium was deducted by o.ps. through ECS mode. The deceased policy holder’s policy premium was deducted through ECS mode on 08/08/2016 after which next due date was on 08/09/2016, but on that day the amount of Rs.500/- was lying in the credit of the account of deceased policy holder. In spite of having such amount in the account of the deceased policy holder the LIC neither deducted the premium on due date nor deducted within the grace period of 15 days arising from due date due to negligence on the part of LIC authorities. Subsequently Mathura Das died on 05/10/2016 and his nominee, the complainant claimed the assured sum, but o.ps. refused to pay the same, for which the complainant filed this case praying for direction upon the o.ps. to pay the assured sum of Rs.75,000/- as well as compensation and litigation cost.

                Ld. lawyer for the o.ps. argued that Mathura Das took a policy from o.ps. for sum assured of Rs.75,000/- and mode of payment of the premium was ECS (monthly from the account of the Dena Bank of the policy holder). The monthly installment premium was Rs.270/-. Since the policy holder opted option for payment of premium through his bank i.e. Dena Bank, Dharmatala Branch, as per ECS mandate dt, 18/12/2014, the service branch office of o.ps. issued to send the demand notice for the purpose of insurance premium to Dena Bank, Dharmatala Branch on 7^th of every month except it is Sunday, holiday or there is any internet/machine problem as is apparent from the bank statement annexed by the complainant. The o.ps. sent the demand notice for the premium payable for the month of September,2016 to Dena Bank, Dharmatala Branch on 07/09/2016, but the said transaction was dishonroured by the serving bank of the policy holder since the account holder had no sufficient fund. The statement has been annexed with the w/v. Since the policy holder even after expiry of the said period within 15 days he failed to pay the amount by cash in the counter of the serving branch of o.ps., therefore, the policy became lapsed and after the demise of the policy holder the claim made by the complainant was not entertained. There was no deficiency in service on the part of o.ps. and as such, o.ps. prayed for dismissal of the case.

                Considering the submissions of the respective parties it is an admitted fact that the complainant’s father was the policy holder and during the enjoyment of the said policy it was the direction of the policy holder to deduct the monthly premium from his account of Dena Bank, Dharmatala Branch through ECS mode. The Ld. lawyer for the complainant has stated that on 7^th and 8^th of every month o.ps. used to collect the amount, but o.ps. in their w/v stated that actual date of realization of the policy premium was 7^th of each month, in case of any holiday or any internet/machine problem the date could have been shifted on the next date. The o.ps. as per direction of the policy holder intimated the bank for collection of the premium, but the bank informed the o.ps. that there was insufficient fund in the account of the policy holder and therefore, the amount could not be transferred to o.ps. It is an admitted fact that in case of non-payment of the policy premium within the stipulated period the policy holder could have availed the time of 15 days grace period for depositing the premium amount in the concerned branch of o.ps. But the policy holder failed to deposit the said amount. It appears from the materials on record that the policy holder died on 05/10/2016. After the demise of the said policy holder the complainant being a nominee of the said policy holder claimed the amount which was repudiated by the o.ps. since the policy had already lapsed. The complainant in order to claim that the policy holder had the amount of Rs.500/- on that date i.e. on 07/09/2016 but o.ps. claimed that the amount was not credited in the account of o.ps. If that be the so, there must be some fault on the part of the bank. On perusal of the statement of accounts of deceased policy holder it appears that o.ps. had realized the amount towards premium on 8^th day of various months prior to the disputed month of transferring the amount in the account of o.ps. On perusal of the pass book it appears that the amount of Rs.500/- was deposited on 07/09/2016 i.e. on that date the amount was lying in the credit of the account holder i.e. the policy holder. Due to some wrong communication between the bank and insurance company the amount was not credit towards the premium of the policy holder of o.ps. Since the policy holder was a cobbler and his son is a daily labourer and rickshaw puller and it is crystal clear that they are quite illiterate and they were not aware regarding the pros and cons of the procedure in case of non-payment of the premium within the stipulated date by tendering the sum within 15 days in the office or concerned branch o.ps. Be that as it may since the complainant was suffering from fever for prolonged period which ultimately caused death to the policy holder. therefore, we hold that the denying of the claim of the complainant for the sum assured is a gross deficiency in service on the part of o.ps. and the complainant will be entitled to get the amount. Thus all the points are disposed of accordingly.

                Hence, ordered,

                That the CC No. 308/2017 is allowed on contest with cost against the o.ps. The o.ps. are jointly and/or severally directed to pay the amount of Rs.75,000/- (Rupees Seventy Five 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.