Complaint Case No-15/2013, Consumer Complaint Date of Pronouncement: 15.09.2022
IN THE COURT OF DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION WEST SINGHBHUM AT CHAIBASA
Date of institution: 02.05.2013
Date of Final hearing: 24.08.2022
Date of Pronouncement: 15.09.2022
C. C. Case No. 15/2013
IN THE MATTER OF
Ram Bilash Pandit resident of Bank More, Kiriburu, P.O. & P.S. Kiriburu, District West Singhbhum, Jharkhand………………………..….................Complainant
Advocate for Complainant………........Sri D. L. Vishwakarma, Advocate.
Vs.
Life Insurance Corporation of India Chaibasa Branch………………..Opposite Party
Advocate for Opposite Party…….....…Sri Amresh Kumar Sao, Advocate.
CORAM
1. Sri Vijai Kumar Sharma, President,
2. Sri Rajiv Kumar, Member,
3. Smt. Deoshree Choudhary, Member.
Present: -
1. Sri Vijai Kumar Sharma, President,
2. Sri Rajiv Kumar, Member,
3. Smt. Deoshree Choudhary, Member.
PER: Sri Vijai Kumar Sharma, President.
JUDGMENT
The present case has been filed by the complainant Ram Bilash Pandit, resident of Bank More, Kiriburu, P.O. & P.S. Kiriburu, District West Singhbhum, Jharkhand before this Commission against O.P. Life Insurance Corporation of India Chaibasa Branch for an award of Rs.1,20,000.00/-(Rupees One Lakh Twenty Thousand) only including compensation towards physical and mental harassment along with interest, cost of the litigation showing deficiency of service.
Briefly stated case of the, above named, complainant, is that his son Sanjay Kumar Pandit had taken policy of O.P. Life Insurance Corporation of India Chaibasa Branch bearing Policy No.551589309 showing nominee complainant of this case. Further that regular premium was being paid by the son of the complainant and maturity amount was assured as Rs.100000.00 and premium amount was Rs.501.00 only quarterly against the some assured for Rs.100000.00. Further that Policy bond was also issued in favour of the complainant. Further case of the complainant is that Sanjay Kumar Pandit died on 20.07.2011 and as per the Nomination Paper and Policy Bond complainant became entitled to receive the sum assured amount as premium amount is paid by his son regularly 9 years continuously but claim of the complainant as per the terms and conditions of the Policy was reluctantly refused on the vague ground while as a matter of fact complainant was entitled to received the claim amount and due to refusal by the O.P. complainant has suffered mental physical and monetary loss and accordingly complainant has filed instant case for an award of Rs.1,20,000/- /-(Rupees One Lakh Twenty Thousand) against the O.P.
After admission notice was issued to the O.P. who has appeared in this case and show-cause has been filed on behalf of the Branch Manager Life Insurance Corporation of India Chaibasa Branch. Show-cause filed on behalf of the O.P. reveals that ground of maintainability degree of relationship of deceased Sanjay Kumar Pandit with complainant and further ground has been taken that under the law of insurance nomination is not succession so unless complainant brings succession certificate, his claim cannot be decided by the O.P. Further that Policy in question is not a paid up one rather Policy in question is ULIP Policy. Further ground has been taken that deceased Sanjay Kumar Pandit died on 20.07.2011 and the last premium was deposited on his behalf on 24.07.2011 without any information of death on that date. Further that since the last premium was not deposited during the lifetime of Sanjay Kumar Pandit so fraud has been played on behalf of the complainant and as a matter of fact Policy in question will be deemed to have lapsed, and as per the rule of insurance a person may be given such sum equal to the premium paid minus first year, premium without any bonus or interest as per the permissible limit under the terms of Policy and finally prayer has been made to dismissed the case of the complainant.
In support of the case complainant has filed his affidavited evidence, genealogical table duly signed by him, Death Certificate of Sanjay Kumar Pandit issued by the Registrar Birth and Death MGM Medical College Jamshedpur, Photocopy of the Premium Receipt, Photocopy of Certificate regarding Cremation of the Death Body of Sanjay Kumar Pandit issued by the care taker of Parvati Ghat Jamshedpur. On the other hand in support of the show-cause no any affidavited evidence has been filed on behalf of the O.P.
We have perused the material available on record and heard the learned counsel in support of their case and during argument following issues are determined:-
Issues
Issue No -1. Whether complainant’s case is maintainable in its present form ?
Issue No -II Whether policy no 551589309 issued in favour of deceased Sanjay kumar Pandit has lapsed on the date of death of Sanjay Kumar Pandit i.e. 20.07.2011?
Issue No III Whether complainant or claimainant Ram Bilas Pandit is required to produce succession certificate to get the required claim from OP?
Issue No - IV Whether complainant / Claimanant is entitled to get any relief in this case?
FINDING
Issue No –(II)
It has been stated by the complainant in his complaint petition that life insurance policy number 551589309 was issued by the OP in favour of Sanjay Kumar Pandit and he has been made nominee in this policy. Further that in the policy bond, sum assured was mentioned as Rs 1, 00,000/- towards life insurance mode. Further that complainant’s son Sanjay Kumar Pandit has died on 20.07.2011. Further that complainant’s deceased son had regularly been paid premium quarterly as fixed by the insurance company amounting Rs 501/- regularly and accordingly OP_ has issued certificate in this regard. Further that regulary premium was paid by Sanjay Kumar Pandit upto 9 (Nine) years continuously and acceptance of first premium was acknowledged through letter and premium receipt on 15.11.2001. But after death of complainant son, complainant claimed the sum assured from the OP due to being nominee but the same was refused by OP by raising vague objection. Although complainant has raised claim bonafidely and only company has sent an account payee cheque of Rs 12,730/- in place of Rs 1,00,000/ (One Lakh) which has not been accepted by the claimant as the same has been insufficient and against the terms and conditions of policy bond. On the other hand showcause filed by the OP goes to shows that in Para 5, averment has been made on behalf of OP that assured Sanjay Kumar Pandit died on 20.07.2011 and last premium was deposited on his behalf on 24.07.2011 without any intimation of death of insured person and as per the rule of the policy and Government circular. Since the last premium was not deposited in time (before the death of insured person) and it was deposited only on 24.07.2011 after death of the person assured by playing fraud on LIC, so, the policy in question will be deemed and to has lapsed and policy became non paid up policy . Further Complainant has supported his complaint petition by filing affidavited evidence but O.P has not filed any evidence rather during hearing Learned Counsel has relied documents of complainant as admitted fact.
Learned counsel appearing on behalf of the complainant has argued that last premium in this case was filed on behalf of assured person on 24.07.2011 and the same has been accepted by the OP so, policy can’t be deemed as lapsed and complainant is entitled to get sum assured in the policy bond instead of amount which has been calculated by the OP and for which A/c payee cheque was issued by the OP in favour of complainant and the same has been not accepted due to being insufficient amount. In support of the contention, learned counsel for complainant has relied upon the decision reported in 2000 (Vol 3) CPR page no 155.
On the other hand learned counsel for OP has argued that in view of the Rule of LIC as well as Government Circular, nominee is entitled to get sum assured when policy is not lapsed on the date of death of the assured person and he has further argued that decision relied upon by the counsel for complainant is not applicable in this case as fact in hand is different from the fact decided by the Hon’ble Court.
After hearing argument of both parties and perusal of the evidence and pleading of the parties, we find that death of the assured Sanjay Kumar Pandit is admitted fact. Only issue is involved that whether policy in question was lapsed on the date of death of deceased Sanjay Kumar Pandit .It is also admitted fact that last premium was paid on behalf of the assured on 24.07.2011 and death of the assured took place on 20.07.2011 . The premium receipt submitted on behalf of the complainant also goes to show that in the month of May 2011, premium for the period 2- 2011 was deposited with fine i.e. Rs 511/- including Rs 10/ as fine and premium receipt on 23.05.2011 further shows that next premium due has been shown as till May 2011. Another premium receipt which was deposited on 28.04.2011 also shows that premium was deposited with late fine of Rs 16/- So far as reported case is concerned , on perusal of the above judgement , we find that assured has deposited last premium on 14.02.1994 and his death took place on 15.06.1994 , it means when death of the assured takes place, policy was in running condition and not lapsed actually assured had not deposited annual premium of two years i.e. of 1992 & 1993 rather he deposited annual premium for 1994 and before checking the arrear , the concerned person has accepted the annual premium on 14.02.1994 and for such mistake L.I.C was held responsible and not assured person and policy was not deemed lapshed. So it is clear that the case of the reported judgement is different from the case in hand before the commission because last premium on behalf of the deceased Sanjay Kumar Pandit has been deposited after his death and keeping in view the above situation, it can’t be held that policy of the insured Sanjay Kumar Pandit has not lapsed rather it can safely be held that policy of the assured Sanjay Kumar Pandit has lapsed and his death took place during the lapsed period of the policy. Accordingly this issue is decided against the complainant.
Issue No (III)
It has been stated on behalf of OP that complainant has not disclosed his degree of relationship with the assured deceased or the existence of other relatives if any. Further that under the law of insurance, nomination is not succession so as per the rule claimant has to produce Succession Certificate issued from the competent court of law. On the other hand learned counsel for complainant has argued that OP is taking such grounds only to languish the matter as a matter of fact without demanding succession certificate an account payee cheque was issued in favour of claimant but the same was not accepted because the cheque amount was insufficient. Further that OP should be stopped from taking such ground subsequently.
After hearing both parties and perusal of the case record as well as evidence available on record, we find that a photocopy of cheque dated 30.09.2011 for Rs 12,730/- was issued by the OP in favour of claimant Ram Bilash Pandit mentioning claimant’s account number and detail letter about calculation of amount i.e Rs/- 12730.00 has also been issued by the OP in same date in favour of Ram Bilash Pandit without demanding the succession certificate. So we agree with the submission of learned counsel for Complainant that OP can’t be permitted to raise such condition of Succession certificate and accordingly this issue is decided in favour of complainant in view of Principle of Estoppel.
Issue No (I) & (IV)
On perusal of para 7 of the show cause by OP , we find that OP has clearly and fairly admitted that as per the rule of LIC, a person may be given such sum equal to the premium paid minus first year premium without bonus or interest and as per permissibility of the policy of the bond. Since as per finding of issue no (I) , policy of the assured Sanjay Kumar Pandit has lapsed on the date of his death so sum assured mentioned in the policy document can’t be given to the complainant rather we are of the view that complainant should get equal to the premium paid minus first year premium along with interest thereon along with compensation towards mental, physical and economic loss and he is entitled for above mentioned relief in this case . So we are of the view that the case of the complainant is maintainable in the present form and complainant is entitled for following relief:-
ORDER
A) For an award of Rs 17,030/- (Rs Seventeen Thousand Thirty) only @ 9% Per Anum from the date of filing till final realization
B) Rs 10,000/- (Rupees Ten Thousand) compensation towards litigation cost as well as compensation towards mental and physical harassment
Above amount will be paid by the O.P to complainant within 30 (Thirty) days from the judgment communicated to him, as case is decreed on contest.
Application pending if any, stands disposed of in terms of aforesaid judgment.
A copy of this judgment be provided to all the partied free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
File be consigned to record room along with a copy of this Judgment.
(Vijai Kumar Sharma)
President
(Rajiv Kumar)
Member
Pronounced on 15.09.2022
(Deoshree Choudhary)
Member
