IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Friday the 30th day of October, 2009
Present
- Sri. Jimmy Korah (President)
- Sri. K. Anirudhan (Member)
- Smt. Shajitha Beevi (Member)
in
C.C.No.252/2008
between
Complainant:- Opposite Party:-
Sri. G.Shyamaprakash The Chief Manager
Peedika Parambil LIC of India
Umbernadu, Kallumala P.O. Mavelikara Branch
Mavelikara, Alappuzha Dt. (By Adv. S.Devalal)
(By Adv. N. Rubyraj)
O R D E R
SRI. K. ANIRUDHAN (MEMBER)
Filed on 28/10/2008
Sri. Shyamaprakash has filed this complaint against the opposite party. The Chief Manager, LIC., Mavelikara – alleging deficiency in service on the side of the opposite party. The allegations are as follows:- He was working as a conductor in the Kerala Road Transport Corporation, Mavelikara, Sub Depot. On 27.4.2001 a proposal was made to take Life Insurance policy and an agreement was arrived at with the opposite party. Accordingly 2 policies are issued to him; as per the agreement, the premium was paid through salary deduction. Deduction of salary was effected up to October, 2002. Due to disease he could not attend the office and so he could not pay the premium in time. On 30.4.2003, he took VRS from the department. Based on the condition of the policy, he contacted the opposite party for revival of the policy on 29.5.2003. Since there was no positive attitude of the opposite party, he contacted higher authorities including Ombudsman. On 14.6.2006, the opposite party had intimated him that the policy can be revived subject to certain conditions. By that time, only 8 months were left over for the maturity of policy No.591879812 dt. 28.4.2001and only 32 months left over for the maturity of the policy No.3918779861 dt. 27.7.2001. If the opposite party allowed him to revive policies on 29.5.2003, he could have got the said policies revived. By this act the opposite party committed deficiency in service. He has not obtained any communication as per the letter sent by the Insurance Ombudsman to the Divisional Manager, Kottayam for favourable consideration. Hence this complaint seeking relief.
2. Notice was sent to the opposite party. They entered appearance and filed detailed version.
3. In the version, opposite party has admitted the details of the policy subject to the connection of Table No.122-6 and stated that if 3 full years premium have not been paid before discontinuation of the payment, the policy will lapse and no benefits are payable and further stated that the policy can be revived within 5 years from the date of joint unpaid premium on submission of roof of continued insurability to the satisfaction and on payment of all areas with premium with interest. It is further stated that the complainant had paid the premium of two policies from 28.04.2001 to 28.10.2002 and 27.1.2001 to 27.10.2002 respectively ie. for 1 year 7 months and 1 year 4 months only for both policies and these by policies became lapsed and denied the approach of the complainant with them on 29.5.2003. They have fully explained the details of the said policies to the wife of the complainant when she contacted them. It is further stated that another policy was also pending along with above 2 policies in the name of the complainant – 780808253 – which commenced in May, 1997 and that needed no medical examination for revival. They have not taken any lame excuses to revive the said 2 policies. It is stated that the Insurance Ombudsman have fully examined the request of the complainant and forwarded the matter for consideration and as such, the opposite party has issued a revival quotation to the complainant on 4.6.2006 but the complainant could not responded the same.
4. Considering the contentions of the parties, this Forum has raised the following issues:-
1) Whether there is deficiency in service on the side of the opposite party?
2) Compensation and costs.
5. Issues 1 and 2:- Complainant filed proof affidavit in support his case and produced documents in evidence and he has been examined as PW1 and cross examined. The documents – Exts.A1 to A6 marked. Ext.A1 is the copy of the original policy No.391879812 dt. 28.4.2001 showing the details of the amount of remittance and policy conditions. Ext.A2 is the copy of the original policy No.391879861 dt. 27.7.2001. Ext. A3 is the letter of Ombudsman dt. 31.5.2007 addressed to the opposite party to take the matter in a sympathetic way. Ext.A4 is the discharge summary dt. 17.3.2003 of PVS Memorial Hospital, Cochin. Ext.A5 is the letter dt. 21.5.2007 of the complainant addressed to the Insurance Ombudsman showing the details of his remittance and reasons to remit the premium in time. Ext.A6 is the order dt. 22.2.2003 of the KSRTC showing the voluntary retirement of the complainant from the office with effect from 30.4.2003.
6. Opposite party has filed proof affidavit in support of their case and produced document in evidence and he has been examined as RW1 and cross examined. Ext.B1 document produced and marked. It is the copy of the Delegation of Powers showing that the Zonal Manager has the Power to represent the opposite party.
7. We have perused the entire matter of this case and verified the documents produced by both parties in evidence and examined the depositions of complainant and opposite party in detail and heard the case. It is undisputed that the complainant had taken 2 policies from the opposite party and premium was remitted through the deduction from the salary off the complainant; up to October, 2002 onwards and he had undergone an operation. He had taken VRS from the department on 30.4.2003. But the remittance of premium amount was defaulted due to his disease and operation. Later, when he contacted the opposite party for remittance of the premium amount and its dues, the opposite party had not allowed him to remit the same. At that time, the complainant had filed a petition before the Insurance Ombudsman showing the details off the matter and requested to allow him to remit the arrear premium amount for revival. The Insurance Ombudsman had directed the opposite party to consider the case of the complainant in a sympathetic way Ext.A3). The opposite party had intimated the complainant that the policy can be revived with certain conditions. But the opposite party had not shows the details of their conditions. Complainant alleged that he had contacted the opposite party to revive the policy. But the opposite party had not allowed him to renew the policy. Considering the entire matter of this case, we are of the view that the opposite party ought to have taken steps to renew the policy in time after taking the reasonable cause of the complainant to consider the matter in a sympathetic way. But the opposite party had taken a negligence view in this case. The entire action taken by the opposite party shows that they have not shows any earnest effort to renew the policy. It is highly illegal, arbitrary and it is against the principle of natural justice. The opposite party is bound to take the reasonable ground in a positive way. But ion this case, the opposite party had taken flimsy ground for the rejection of the claim of the complainant. It is highly irregular and all the contentions raised by the opposite party for the cause of the rejection of claim have no bona fides and it cannot be taken into account. The whole actions of the opposite party shows the deficiency of service and negligence and for this, opposite party is answerable to the complainant. After considering the whole matter of this case, we are of the strong view that the allegations raised by the complainant against the opposite party are to be treated as genuine. Since there is deficiency in service and negligence on the part of the opposite party by way of refusal to renew the policy in time after taking the reasons of the complainant, the complainant is fully entitled to get compensation and costs. All the issues are found in favour of the complainant.
In the result, we hereby directing the opposite party to take revival procedure of the said policies and pay the monthly annuity and other benefits fully to the complainant as agreed in the policy certificate No.391879812 dt. 28.4.2001 and policy certificate No.391879861 dt. 27.7.2001 and further directing the opposite party to pay a sum of Rs.10,000/- (Rupees ten thousand only) to the complainant for his mental agony, sufferings, physical strain, loss and inconvenience due to the deficiency in service, negligence by way of willful refusal to renew the policies and causing delay to release the benefits to the complainant in time, and further pay a sum of Rs.1000/- (Rupees one thousand only) to the complainant as costs of this proceedings. We direct the opposite party to comply the order within 30 days from the date of receipt of this order.
Pronounced in open Forum on this the 30th day of October, 2009.
Sd/- Sri.K.Anirudhan
Sd/- Sri. Jimmy Korah
Sd/- Smt.N.Shajitha Beevi
Appendix:-
Evidence of the complainant:-
PW1 - G.Shyamaprakash (Witness)
Ext.A1 - Copy of the original policy No.391879812 dt. 28.4.01
Ext.A2 - Copy of the original policy No.391879861 dt. 27.7.01
Ext.A3 - Letter of Ombudsman dt. 31.5.2007
Ext.A4 - Discharge Summary dt. 17.3.03
Ext.A5 - Letter dt. 21.5.2007 of the complainant to the insurance
Ombudsman
Ext.A6 - Order dt. 22.2.03 of KSRTC
Evidence of the opposite party:-
RW1 - Kanakaraj (Witnesss)
Ext.B1 - Copy of the delegation of powers showing that the Zonal
Manager has the Power to represent the opposite party
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite party/S.F.
Typed by:-pr/-
Compared by:-
