D.O.F:06/03/2019
D.O.O:31/08/2021
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.No.46/2019
Dated this, the 31th day of August 2021
PRESENT:
SRI.KRISHNAN.K :PRESIDENT
SRI.RADHAKRISHNAN NAIR.M : MEMBER
SMT.BEENA.K.G : MEMBER
Kunhambu Nair.C
S/o Kunhambu, Malamkundu,
Bandadukka Village, P.O. Bandadukka : Complainant
Kasaragod Taluk.
(Adv: M. Narayanan)
And
1. The Branch Manager,
Reliance Life Insurance Company
Land Mark Centre, Kasaragod,
Commercial Complex, Near New Bus Stand : Opposite Parties
Kasaragod – 671121
2. Reliance Life Insurance Company,
H. Block, 1st Floor, Dada Bhai Ambani
Knowledge City, Navi Mumbai,
Maharashtra – 400710
(Adv: Mohan Prakash.K OP 1 and 2)
ORDER
SRI.RADHAKRISHNAN NAIR.M : MEMBER
The complaint is filed under section 12 of the Consumer Protection Act, 1986 ( as amended). The facts of the case in brief is that the complainant is an insurance policy holder of the Opposite Party having policy ID No.85167091. The policy was started on 25-01-2013 for a period of 5 years .He took Policy from the agent, namely, Ganapathi Bhat who collected premium regularly. The complainant paid to Ganapathi Bhat Rs.6,516. 31 on 25 03.2013, Rs.6,420 /- on 24-03-2014, Rs 6,420 /- on 04-08-2014 and thereafter Rs.6420 /- each in two occasions, for which Sri. Ganapathi Bhat issued receipts, except for the Iast two remittances. There after Sri.Ganapathi Bhat Ieft the place and the complainant could not pay the remaining premiums, as the Opposite Party didn't make necessary arrangements to collect the sum from him. Thereafter, when the complainant approached the office of the Opposite Party, it was told that Ganapathi Bhat had not remitted the above mentioned Iast 2 premiums and aIso the above policy itself was lapsed due to non remittance of subsequent premiums. The Complainant states that there was no any intimation or demand from the Opposite Party company to remit the premium amount after the disappearance of the agent Ganapathi Bhat. No notice was issued to the complainant before putting his policy in lapsed status.
The complainant states that it was due to the service deficiency of the Opposite Party, the Policy got lapsed. The Opposite Party didn't make necessary arrangement to issue timely intimation to the complainant to remit premium .The Opposite Party 's agent Ganapathi Bhat failed to give proper service to him . The complainant remitted a total amount of Rs.38,600/- towards the premiums and the Opposite Party is Iiable to refund the same .The complainant approached the Opposite Party several times but the Opposite Party didn't refund the amount. Hence this complaint is filed seeking the direction to refund of the above said Rs. 38,600/- together with Rs.10,000/- towards compensation for mental agony and costs.
The opposite party entered appearance through their counsel who filed detailed written Version.
As per the version of the Opposite Party, the complaint is liable to be dismissed as all averments are inconsistent and are denied in totality. The Opposite Party admitted the issuance of the policy. The above said Policy was issued through the agent namely Vijayakumar HS .The person named Ganapathi Bhat against whom all the allegations are levelled in the complaint, has no connection to Opposite Party. The case is bad for non –joinder as both Vijayakumar HS and Ganapathi Bhat are not made parties. The Opposite Party had provided insurance cover on the life of the complainant and acted strictly as per the terms and conditions of the Policy. The complainant was required to pay Half yearly premiums of Rs.6630/- for a period of 5 years whereas the Opposite Party was in receipt of only 4 premiums for 2 years , a total amount of Rs.25,873/- and the policy had acquired a lapsed status, due to the failure of the complainant to remit the renewal premiums thereafter. As per the policy terms and conditions, if the premiums for the first 3 year are not paid, the policy Iapses at the end of the grace period and insurance cover will cease immediately. No benefits will be paid when the policy is in lapsed status .The complainant had 2 years time to revive the policy by paying the premiums and fulfilling the procedures, but the complainant failed to revive the policy and aIIowed the policy to for close . No claim can be made out of a policy either been in a lapsed status or in for closed status.
There is no service deficiency on the part of the opposite party and Opposite Party is not Iiable to make any payment to the complainant. The complainant is not entitled for any relief and the complaint is liable to be dismissed.
The Complainant filed proof affidavit in lieu of chief examination and documents
Ext. A 1, A2 and Ext. A3 are marked .The Ext - A1 is the Insurance Policy. Ext - A 2 series are the insurance Premium Receipts (3in number) and Ext A3 is the lawyer notice. The Opposite party adduced no oral evidence but produced 2 documents which are marked as Ext .B 1 and B2.Ext. B1 is the Proposal Form of complain ant's policy. Ext B2 is the policy conditions. Based on the pleadings and evidence of the rival parties in this case the following issues are framed for consideration.
1. Whether there is any service deficiency on the part of any of the opposite party?
2. If so, what is the relief?
For convenience, both these issues are considered together.
Here the specific case of the complainant is that he is an insurance policy holder of the opposite party having policy ID No.85167091. The policy was started on 25-01-2013 for a period of 5 years .He took Policy from the agent , namely ,Ganapathi Bhat who collected premium regularly. The complainant paid to Ganapathi Bhat Rs.6516. 31 on 25 03.2013, Rs.6420 /- on 24-03-2014, Rs 6420 /- on 04-08-2014 and thereafter Rs.6420 /- each in two occasions, for which Sri. Ganapathi Bhat issued receipts, except for the Iast two remittances. There after Sri.Ganapathi Bhat Ieft the place and the complain ant could not pay the remaining premiums, as the opposite party didn't make necessary arrangements to collect the sum from him. Thereafter, when the complainant approached the office of the opposite party it was told that Ganapathi Bhat had not remitted the above mentioned Iast 2 premiums and aIso the above policy itself was lapsed due to non remittance of subsequent premiums. The complainant states that it was due to the service deficiency of the opposite party, the Policy got lapsed . The OP didn't make necessary arrangement to issue timely intimation to the complainant to remit premium . opposite party 's agent Ganapathi Bhat failed to give proper service to him . The complainant remitted a total amount of Rs.38,600/- towards the premiums and the opposite party is Iiable to refund the same .The complainant approached the opposite party several times but the opposite party didn't refund the amount. Hence this complaint is filed seeking the direction to refund of the above said Rs. 38 ,600/- together with Rs.10,000/- towards compensation for mental agony and costs.
As per the version of the Opposite Party, the complaint is liable to be dismissed as all averments are inconsistent and are denied in totality. The opposite party admitted the issuance of the policy. The above said Policy was issued through the agent namely. Vijayakumar HS .The person named Ganapathi Bhat against whom all the allegations are levelled in the complaint, has no connection to opposite party. The case is bad for non - joinder as both Vijayakumar HS and Ganapathi Bhat are not made parties. The opposite party had provided insurance cover on the life of the complainant and acted strictly as per the terms and conditions of the Policy. The complainant was required to pay Half yearly premiums of Rs.6630/- for a period of 5 years whereas the opposite party was in receipt of only 4 premiums for 2 years , a total amount of Rs.25,873/- and the policy had acquired a lapsed status, due to the failure of the complainant to remit the renewal premiums thereafter. As per the policy terms and conditions, if the premiums for the first 3 year are not paid, the policy Iapses at the end of the grace period and insurance cover will cease immediately. No benefits will be paid when the policy is in lapsed status .The complainant had 2 years time to revive the policy by paying the premiums and following the procedures, but the complainant failed revive the policy and aIIowed the policy to for close .No claim can be made out of a policy either been in a lapsed status or in for closed status.
There is no service deficiency on the part of the opposite party and opposite party is not Iiable to make any payment to the complainant. The complainant is not entitled for any relief and the complaint is liable to be dismissed.
From the above discussion it can be seen that the main dispute raised by the opposite party is that as per the policy terms and conditions, if the premiums for the first 3 year are not paid, the policy Iapses at the end of the grace period and insurance cover will cease immediately. No benefits will be paid when the policy is in lapsed status .The complainant had 2 years time to revive the policy by paying the premiums and following the procedures, but the complainant failed revive the policy and aIIowed the policy to for close . No claim can be made out of a policy either been in a lapsed status or in for closed status.
Here the complainant's argument is that since the opposite party had not made any arrangement to give timely intimation he could not remit the premiums. The Complainant states that there was no any intimation or demand from the opposite party company to remit the premium amount after the disappearance of the agent Ganapathi Bhat. There was no notice was issued to the complainant before putting his policy in lapsed status.
Here there is no case for the opposite party that they have given any notice or intimation to the complainant before or after the lapsation of the insurance policy. Complainant’s definite case is that he was regularly remitting the premiums according to the demand of the agent Ganapathi Bhat, for which receipts were also issued by the opposite party for that for 2 years. He also paid 2 more premiums. The opposite party argue that they received only premiums for 2 years and there after no remittance in that policy account. Ultimately the policy is kept as lapsed for not remitting premiums for 3 years. The opposite party has no case that they have issued any notice or intimation either in writing or orally through their agents. No pleading. No document for that . So it is clear that the complainant's insurance policy has been put as lapsed without any notice in violation of principle of natural justice. There is no justification for that. If there was such an intimation, before lapsation the complainant could have remit the premiums to avoid Iapsation of his policy. If there was notice after lapsation the complainant could have get a chance to revive the policy following necessary procedures and remittance. That chance was denied to the complain ant by the opposite party in this case.
Therefore considering circumstances and available evidence in this case, this commission is of the view that there is service deficiency on the part of the Opposite Party due to which the complainant suffered mental agony and suffering apart from monetary loss. Here the complainant states that it was only when he approached the opposite party’s office, he was told that his policy had been lapsed due to non remittance of premiums.
Here the complainants prayer is for the amount remitted along with compensation for mental agony and sufferings. He is not seeking any other benefits and he is not entitled for that. Here complainant’s case is that he had given a total of Rs.38,600/- to Ganapathi Bhat. But the opposite party states that only a total amount of Rs.25,873/- is received by them, for which proper receipts are issued. So it is clear that the amount for 2 premiums, claimed to be paid by the complainant might have been swallowed by Ganapathi Bhat. The above mentioned Ganapathi Bhat is not made party in this case. The OP denies any relation with Ganapathi Bhat to them. They had no agent with such a name. The complainant 's policy was proposed by one agent namely Shiva Prasad SH. Also the complainant could not establish any connection with the Ganapathi Bhat to the opposite party. Therefore this commission is of the view that the complainant is entitled for the refund of Rs.25,803/-only. The Opposite Party is liable to compensate for the mental agony and sufferings. The commission is of the view that Rs. 5,000/- will be a reasonable amount of compensation in this case.
ln the result , the complaint is allowed in part and the Opposite Party directed to pay Rs.25,803 /- to the Complainant with 8% interest per annum from 06.03.2019,the date of complaint till payment. The opposite parties are also directed to pay Rs. 5,000/- (Rupees Five thousand only) towards compensation and Rs.5,000/- (Rupees Five thousand only), towards the costs.
Time for compliance is 30 days from receipt of the copy of the Judgement.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exhibits
A1- Insurance Policy
A2- Insurance premium receipts
A3- Lawyer Notice.
B1- Proposal form
B2 – Policy Conditions.
Witness Examined
Pw1- Kunhambu.c
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
Senior Superintendent
Ps/
