C.F. CASE No. : CC/2013/08
COMPLAINANT : Jagattara Bibi,
W/o Lt. Sirafot Sk.
Vill. Palashipara (Kalapara)
P.O. Palashipara,
P.S. Tehatta, Dist. Nadia,
PIN- 741155
OPPOSITE PARTIES/OPs : 1) Divisional Manager,
LIC of India
Kolkata Suburban Divisional Office,
Jeevan Prabha, DD-5, Sector – 1,
Salt Lake City, Kolkata – 700064
2) Branch Manager,
LIC of India,
Krishnagar Branch – I,
5/1-A, D.L. Roy Road,
P.O. Krishnagar, P.S. Kotwali,
Dist. Nadia, Pin – 741101
PRESENT : SHRI PRADIP KUMAR BANDYOPADHYAY, PRESIDENT
: SHRI SHYAMLAL SUKUL, MEMBER
: SMT REETA ROYCHAUDHURY MALAKAR, MEMBER
DATE OF DELIVERY
OF JUDGMENT : 30th September, 2013
: J U D G M E N T :
The instant case was filed by one Jagattara Bibi, W/o Lt. Sirafat SK, a resident of Palashipara (Kalapara), P.O. Palashipara, P.S. Tehatta, Dist. Nadia against the Life Insurance Corporation of India ( in short LICI) with an allegation of deficiency in service.
Shorn off the unnecessary details, the material facts of the present case are that the husband of the petitioner / complainant Sirafat Sk (now deceased) obtained an insurance policy (LICI’s New Bima Gold T-179) with ‘accidental benefit’ and ‘Extended cover’ benefit for the sum assured Rs.1,00,000/- of LICI bearing No. 426712606 on 05.11.2007. The husband of the petitioner / complainant i.e., insured expired on 08.03.2011 in an accident and thereafter, the petitioner / complainant being wife as well as nominee of the deceased lodged a claim in the opposite parties. Complaining with all formalities of the OP No. 2 i.e., LICI, Krishnagar Branch I, settled the claim by sending a cheque for Rs.1,00,000/-. The petitioner/ complainant received the said cheque but she was not satisfied with the said amount and the corollary of that she made several representations to the OP No. 2 claiming “Double Accident Benefit” plus bonus. The OP No. 2 resisted the claim and contended that “Double Accident Benefit” is payable only if the policy is in force condition as on the date of death of the insured. When the grievance of the petitioner / complainant was not redressed, left no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986, was filed with this Ld. Forum by the petitioner / complainant praying “Double Accident Benefit” with bonus and other reliefs as well.
On notice the opposite parties entered appearance and contested the case by filing written version, challenging, inter alia, the very maintainability of the case. The opposite parties have got to say that the proceeding is misconceived, malafide, groundless and also bad for want of cause of action. On such grounds, the Opposite parties pray straightway dismissal of the case.
The core points for consideration before us are:
- Whether there was any deficiency in service from the side of the opposite parties?
- Whether the petitioner /complainant is entitled to get relief, if so, to what extent?
DECISIONS WITH REASONS
At the very outset, let us note that in order to substantiate their respective cases the parties did not prefer adducing any verbal evidence despite opportunity given to them. They relied upon documentary evidence only. Status of the petitioner / complainant as “consumer” is nowhere challenged by the opposite parties. Documents on record indicate beyond doubt that she happens to be a ‘consumer’ as per meaning of the term laid down under Section 2(d) of the Consumer Protection Act, 1986.
Other question relates to the points of limitations. To get relief under Consumer Protection Act, one is to bring one’s petition of complaint within a period of 2 years from the date of cause of action has arisen. On this point too the present petitioner is in the right side of the matter.
Now, let us have a look to the admitted points in the case. Death of the policy-holder was not disputed. Secondly, the existence of the New Bima Gold policy (T 179) too was not questioned; thirdly the way of the policy-holder died too was not challenged; fourthly, it is admitted that at the time of death of the policy holder the policy was not ‘auto cover period’; and fifthly it is also not denied that the claim-forms were submitted by the petitioner. These are all factual aspects of the petitioner’s case and it is well-settled that the admitted facts need not to be established and proved. Pivotal question centres round the obligation and liability of the opposite parties in facts and circumstances of the present case.
Now, we switch over to the pivotal question involved in the case. The whole disputes between the parties, as it appears, rests on the facility of “Double Accident Benefit” plus bonus.
Ld. Advocate appearing for the petitioner / complainant contends that the petitioner is entitled to get “Double Accident Benefit” plus bonus. In order to substantiate his submissions, Ld. Advocate appearing for the complainant has referred to Section 4 of the “Conditions and Privileges’ of the said Bima Gold Policy (T 179). Para 1 of Section 4 reads as follows:
“If after at least two full years’ premiums have been paid, and any subsequent be not duly paid, full death cover shall continue for a period of two years from the due date of the ‘First Unpaid Premium” (FUP). In the present case the insured obtained Bima Gold Policy (T-179) on 05.11.2007. The premium was paid up to 05.11.2010 i.e., more than two years since the purchase of the policy. Therefore, the said policy of the insured was in force condition on the date of death of the insured and the corollary of that the petitioner / complainant is entitled to get “Double Accident Benefit” plus bonus, which was whimsically repudiated by the opposite parties. Thus, the opposite parties fall squarely within the mischief of unfair trade practice as well as deficiency in service. Under the circumstances, petitioner / complainant is entitled to get compensation for mental harassment and costs of the proceeding in addition to the loss suffered by the petitioner.
On the other hand, ld. Advocate appearing for the opposite parties contradicts and pleads that the opposite parties are not liable to pay, “Double Accident Benefit” because the policy was in lapsed condition as well as in “Auto Cover Period” at the time of the death of the insured. Ld. Advocate appearing for the petitioner has failed to notice the later part of the said Clause i.e., Clause 4 of ‘conditions of privileges’ of New Bima gold Policy (T 179) in which it is categorically mentioned, “The Accident Benefit Rider will cease to apply. If the policy is in lapsed condition, during Auto Cover Period, the Accident Benefit Rider shall not be available.
As regards the bonus amount ld. Advocate appearing for the opposite parties contends that New Bima Gold Policy (T 179) does not cover any bonus amount which is quite fictitious not supported by ‘Conditions and privileges’ of the New Bima Gold Policy (T179). A simple reading the said Clauses of the ‘conditions and privileges’ of the New Bima Gold Policy (T179) will make it clear that there was no negligence / deficiency in service on the part of the opposite parties. The opposite parties sincerely settled the claim of the petitioner as per terms and conditions of the said New Bima Gold Policy (T179) as soon as they received the claims.
We have given our anxious thoughts to the arguments advanced by the ld. Advocate of the parties and pursued the materials available in record.
It has been long recognized rule, “Caveat emptor qui ignorare non debuit quod jns alienum” let a purchaser who ought not to be ignorant of the amount and nature of the interest which he is about to buy, exercise proper caution. It is important to mention here that the conspectus of the aforesaid facts shows that the entire problem arose due to the wilful ignorance and carelessness of the complainant. Before purchasing the aforesaid policy the complainant ought to be well-aware of the ‘conditions and privileges’ of the Bima Gold Policy. Thus, we impose punitive costs upon the complainant for wanting the precarious time of the Forum.
Having considered the matter from all possible angles we are of the considered opinion that the petitioner / complainant has miserably failed to establish her case by adducing cogent and reliable evidence. The complaint of the complainant / petitioner bears no merit at all for which the petitioner is not entitled to get any relief and the case is liable to be dismissed. Accordingly it is ….
Ordered,
that, the case is dismissed on contest with punitive costs of Rs. 5,000/-.
The complainant is directed to deposit the costs of Rs. 5,000/- with “Consumer Welfare Fund” within a period of 2/two weeks from today. In case the complainant fails to deposit the aforesaid costs within the prescribed period, then it shall be liable to pay interest @ 9% per annum till realization.
Let a copy of this judgment be delivered to the parties free of cost.
