Karnataka

Chitradurga

CC/38/2018

B.K. Shashikala - Complainant(s)

Versus

Divisional Manager,LIC Of India - Opp.Party(s)

H. Sreenivasa

15 Nov 2018

ORDER

COMPLAINT FILED ON:19.04.2018

DISPOSED  ON:15.11.2018

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.

 

 

CC.NO:38/2018

 

DATED:  15^th NOVEMBER 2018

PRESENT :-     SRI.T.N.SREENIVASAIAH :   PRESIDENT                             B.A., LL.B.,

                        SMT. JYOTHI RADHESH JEMBAGI

BSc.,MBA., DHA.,                LADY MEMBER

 

……COMPLAINANT	B.K. Shashikala, W/o Late Raghavendra, V.K. Aged about 28 years, Nittuvalli Village, Davanagere District.   (Rep by Sri.H. Srinivasa, Advocate)
V/S
…..OPPOSITE PARTIES	1. Divisional Manager, LIC of India, Divisional Office, Jeevan Prakash, 100 feet road, Gopala Gowda Extension, Shivamogga.   2. Branch Manager, LIC of India, Bracnh Office, P.B. Road, Chitradurga.   3. The Manager,Vedhantha Village, Megalalli village, Hireguntanuru Hobli, Chitradurga tq.    (Rep by Sri. HS.Sathyanarayana Shetty, Advocate for OP No.1 and 2 and Sri.K.E. Mallikarjuna, Advocate for OP No.3)

ORDER

SRI. T.N. SREENIVASAIAH:   PRESIDENT

The above complaint has been filed by the complainant u/Sec.12 of the C.P Act, 1986 for the relief to direct the OPs to pay Rs.10,00,000/- towards policy amount, Rs.67,060/- towards premium amount and Rs.50,000/- towards mental agony and such other reliefs.

2.     The brief facts of the case of the above complainant is that, the husband of the complainant by name Sri. V.K. Raghavendra was working as a Driver/Technician with the OP No.3.  On 20.08.2014, he obtained LIC New Money Back Plan Policy bearing No.629963040 for the period from 20.08.2014 to 20.08.2034 for a period of 20 years from OP No.1 and 2 for Rs.5,00,000/- along with death benefit of Rs.5,00,000/-.  The premium amount is of Rs.3,353/-.  The husband of the complainant has agreed to pay the premium amount through his salary drawn from OP No.3.  Accordingly, OP No.3 has deducted the same from his salary and send the same to OP No.1 and 2, but the OP No.3 has not deducted the premium amount for the month of October 2014.  After October 2014, the OP No.3 has deducted the premium amount from the salary of the husband of the complainant and send the same to OP No.3 till the death of husband of the complainant.  The husband of the complainant was died on 10.05.2016 due to the accident occurred before the premises of OP No.3.  After the death of her husband, the complainant has filed necessary documents before the OP No.1 and 2 claiming insurance amount, but the OP No.1 and 2 have send a letter the complainant on 17.05.2017 and 17.03.2017 stating that, the OP No.3 has not deducted the premium amount for the month of October 2014, therefore for nonpayment of the premium for the month of October 2014, the policy was lapsed.  But the OP No.1 and 2 have received the premium amount up to April  2016 from the salary of the husband of the complainant.  The cause of auction for this complaint arose on 10.05.2017 when the death of the husband of the complainant and from 17.03.2017 and 17.05.2017 when the OPs have repudiated the claim of the complainant, which is within the jurisdiction of this Forum and hence, prayed for allow the complaint.

  3.   After service of notice to the OPs, one Sri.H.S. Sathyanarayana Shetty, Advocate appeared on behalf of OP No.1 and 2 and Sri.K.E. Mallikarjuna, Advocate appeared on behalf of OP No.3 and filed their version. 

According to the OP No.1 and 2, the complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine. Further, the allegations made in para 2 to 7 of the complaint is denied as false and the complainant is put to strict proof of the same.  It is true that, the deceased V.K. Raghavendra had taken insurance policy bearing No.629963040 called LIC’s New Money Back Plan which is serviced by Chitradurga Branch by submitting proposal dated 20.08.2014 for a basic sum assured of Rs.5,00,000/- with accident benefit of Rs.5,00,000/- under table 820 with term of 20 years with salary savings mode of payment with monthly premium of Rs.3,252/-, the date of commencement was on 20.08.2014.  Further the initial premiums of August and September 2014 are paid by the Life Assured V.K. Raghavendra along with proposal and the same is adjusted.  But the husband of the complainant has not paid the premium amount of Rs.3,252/- for the month of October 2014 and further admitted that, the OP No.1 and 2 have received the premium amount from 11/2014.  There is a gap of premium amount for the month of 10/2014.  Further it is stated that, the DLA has given an undertaken that he shall be entirely responsible for any consequences on account of nonpayment of premium of his policy for the reasons behind the control of his employer and it will be his responsibility to make arrangements for remittance of premium direct to the corporation at the increased rate specified in the policy to prevent his policy from going into lapsed condition.  Accordingly, the OP No.1 and 2 have send the letters dated 17.01.2015 and 07.02.2015.  As per the policy condition No.2 printed on the policy bond that, “if the premium is not paid before the expiry of days of grace, policy lapses”.  Because of nonpayment gap premium amount and the death is occurred within 3 years from the date of commencement of policy – the policy has not acquired any paid up value and claim concession is also not applicable.  The remaining contents as stated in para 7 and 8 are known by this OPs.  The Nationalized Insurance Companies in India are holding public money, what they have to deal with is public fund, they are accountable to public for every Pie of it” as per the decision reported in AIR 2002 SC 662 and prays for dismissal of the complaint.

According to the version filed by OP No.3, the complaint filed by the complainant is not maintainable either in law or on facts and the same is liable to be dismissed in limine.  The complainant has filed this false case against the OP No.3.  Further it is true that, the complainant is the wife of V.K. Raghavendra and it is true that the OP No.3 is a mining company and doing mining business and further true that the husband of the complainant was working as a Driver with OP No.3.  It is submitted that, the husband of the complainant was working under the OP No.3 as a Driver and he died due to accident.  After his death, the OP No.3 has completely settled the legal dues of the husband of the complainant and the entire dues has been paid to the complainant as per the directions of the Hon’ble Senior Civil Judge, Chitradurga.  Further it was non within the knowledge of this OP No.3 that, the husband of the complainant had taken any LIC policies or any other type of policies from any other service providers and further the OP No.3 is under no obligation to enquire with its employees about their personal facts.  However only in the month of October 2014, OP No.3 received belated intimation from OP No.1 and 2 dated 10.10.2014 stating that, the deceased husband of the complainant has taken policy from OP No.2 and requested for deduction of premium from the salary.  Since the said intimation was totally belated and the OP received such belated intimation only in the third week of October 2014.  By that time, the OP No.3 has disbursed the salary for the month of October 2014.  Hence, the OP No.3 could not able to recover the premium from the salary of deceased husband of the complainant.  It is further submitted that, the OP No.1 and 2 have received the premium amount of Rs.3,252/- regularly from OP No.3 from November 2014 till April 2016.  Now the repudiation of the claim of the complainant is oppose to law and facts.  Hence, the OP No.1 and 2 are jointly and severally liable to pay the insurance amount to the complainant and this OP No.3 has not committed any deficiency of service.  Further it is stated that, the OP No.1 and 2 have stated in their version and taken a contention that, OP No.3 has not deducted the premium amount of the deceased husband of the complainant for the month of October 2014 and further the OP No.1 and 2 have accepted the premium of the deceased complainant up to April 2016.  If the policy is in lapsed condition under what capacity they have received the premium amount from OP No.3, which was deducted from the salary of the deceased husband of the complainant and hence, prayed for dismissal of the complaint and fix the liability against OP No.1 and 2 only. 

4.     Complainant herself examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-18 got marked and closer her side.  On behalf of OP No.1 and 2, one Sri. B. Shamanna, the Administrative Officer has examined as DW-1 and Ec.B-1 to B-5 documents marked and on behalf of OP No.3 one Sri. Chandrakanth. S. Patil, AGM – Logistics and CSR has examined as DW-2 and Ex.B-6 and B-7 got marked and closed their side.

 

5.     Arguments heard.

6.     Now the points that arise for our consideration for decision of above complaint are that;

(1)  Whether the complainant proves that the OP No.1 and 2 have failed to pay the policy amount along with accident benefit and entitled for the reliefs as prayed for in the above complaint?

              (2) What order?

        7.     Our findings on the above points are as follows:-

                Point No.1:- Partly in Affirmative.

                Point No.2:- As per final order.

 

REASONS

8.     It is not in dispute between both the parties that, the deceased V.K. Raghavendra was an employee under OP No.3 and further there is no dispute with regard to obtaining of accident death benefit policy from the OP No.1 and 2 and further there is no dispute that, the OP No.3 has deducted the premium amount from the salary of said Raghavendra and send the same to OP No.1 and 2.  After the death of said Raghavendra, her husband i.e., the complainant has approached the OP No.1 and 2 and claimed the death benefit of her husband.  By that time, the OP No.1 and 2 have stated that, the policy of her husband is in lapsed condition because of nonpayment of the premium amount in the month of October 2014 as the same was not deducted from the salary of deceased Raghavendra.  After October 2014, the OP No.3 has deducted the premium amount from the salary of the deceased Raghavendra, the same has been send to the OP No.1 and 2 and the same has been accepted by the OP No.1 and 2 up to April 2016.  The husband of the complainant was died in the month of May 2016.  The version and the arguments addressed by the OP No.1 and 2 that, the OP No.3 has not deducted the premium amount for the month of October 2014 and they have not send the same to them that’s why the policy was under lapsed condition.  The arguments advanced by the OP No.3 and complainant that, when the policy was in lapsed condition, why the OP No.1 and 2 have accepted the premium amount for the month of 11/2014 onwards till April 2016.  On that day itself, the OP No.1 and 2 have to send the letter to the employer of the deceased Raghavendra and to the policy holder stating that, the policy is under lapsed condition and therefore, the premium amount is not acceptable.  The OP No.1 and 2 have received the premium amount of the deceased Raghavendra up to April 2016.  As per the documents, version filed by both the sides, it clearly shows that, the OP No.1 and 2 have received the premium amount up to April 2016. 

    9.                 We have gone through the entire documents filed by both the parties, which clearly shows that, the husband of the complainant Raghavendra has obtained LIC’s New Money Back Plan Policy from OP No.1 and in the month of August 2014 and accordingly, the said Raghavendra was having accident benefit policy from OP No.1 and 2. The Ex.A-1 to A-18 produced by the complainant clearly shows that, the husband of the complainant has obtained the policy from the OP No.1 and 2 and as per the documents produced by the OP No.1 and 2 clearly shows that, they have accepted the premium amount of Raghavendra from OP No.3 till April 2016.  If really, the policy is in a lapsed condition, how can this OP No.1 and 2 have received the subsequent premium amount from the OP No.3, it is purely a bonafide mistake and deficiency of service committed by the OP No.1 and 2 for settling the death benefit claim of the deceased V.K. Raghavendra.  No doubt the deceased V.K. Raghavendra was not paid the premium amount in the month of October 2014.  If the policy is under lapsed condition, whether it is possible to receive the remaining premium amount under the said policy and the same is under lapsed condition, the same is to be informed to the employer or to the policy holder.  But, the OP No.1 and 2 have failed to do the same, it is a deficiency of service and negligence on the part of OP No.1 and 2.      Hence, the complainant is entitled for compensation from OP No.1 and 2.    Accordingly, this Point No.1 is held as partly affirmative to the complainant.

          10. Point No.2:- As discussed on the above point and for the reasons stated therein we pass the following:-

ORDER

The complaint filed by the complainant U/s 12 of CP Act 1986 is partly allowed.

It is further ordered that the OP No.1 and 2 are hereby directed to pay a sum of Rs.5,00,000/- towards the policy amount and Rs.5,00,000- towards accidental benefit, in all a sum of Rs.10,00,000/- to the complainant along with interest at the rate of 9% p.a from the date of complaint till realization.

It is further ordered that, the OP No.1 and 2 are hereby directed to pay Rs.10,000/- towards mental agony and Rs.5,000/- towards costs of this proceedings to the complainant. 

The complaint as against OP No.3 is hereby dismissed.

It is further ordered that, the OP No1 and 2 are hereby directed to comply the above order within 30 days from the date of this order.

            (This order is made with the consent of Member after the correction of the draft on 15/11/2018 and it is pronounced in the open Court after our signatures)         

 

           

MEMBER                                                   PRESIDENT

-:ANNEXURES:-

Witnesses examined on behalf of Complainant:

PW-1:-  Complainant by way of affidavit evidence.

Witnesses examined on behalf of OPs:

DW-1:-  Sri. B. Shamanna, the Administrative Officer by way of affidavit evidence.

DW-2:- Sri. Chandrakanth. S. Patil, AGM – Logistics and CSR by way of affidavit evidence.

Documents marked on behalf of Complainant:

01	Ex-A-1:-	FIR
02	Wx.A-2:-	Complaint given by one complainant
02	Ex-A-3:-	Spot panchanama
03	Ex-A-4:-	Inquest Mahazar
04	Ex.A-5:-	PM report
05	Ex.A-6:-	Death Certificate
06	Ex-A-7:-	Voter ID
07	Ex.A-8:-	Appointment letter
08	Ex-A-9 to 15:-	Salary Certificates for the month of Dec-2014 to, April-2015, October 2015, November 2015, January 2016, March 2016 and April 2016
09	Ex-A-16:-	Policy Bond
10	Ex-A-17:-	Letter dated 17.03.2017
11	Ex-A-18:-	Letter dated 17.05.2017

Documents marked on behalf of OPs:

01	Ex-B-1:-	Copy of LIC Policy
02	Ex-B-2:-	Letter of authorization executed by Raghavendra V.K
03	Ex-B-3:-	Copy of addendum to the application for insurance under SSS
04	Ex.B-4:-	Letter of gap intimation dated 07.01.2015
05	Ex.B-5:-	Letter of gap intimation dated 07.02.2015
06	Ex-B-6:-	Letter of intimation dated 10.10.2014 by LIC
07	Ex.B-7:-	Intimation issued by LIC to OP No.3
08	Ex.A-8:-	Letter dated 30.04.2018 by OP No.3

 

 

MEMBER                                                   PRESIDENT

Rhr**