Orissa

Cuttak

CC/177/2022

Smt Sipra Dhal - Complainant(s)

Versus

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

B R Dalai & associates

28 Sep 2023

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C. No.177/2022

 

Smt. Sipra Dhal,

W/o: Subash Chandra Jena,

Plot No.D/1029,Sector-6,

P.O:Markatnagar,Dist:Cuttack,

Pin-753014.                                                                     ... Complainant.

 

                                                                Vrs.

1.     Divisional Manager,LIC of India,

           Nuapatna,Mangalabag,

           Dist:Cuttack.

 

2.       The Branch Manager,

           L.I.C of India,Cuttack Branch-1,

           C.D.A,P.O:Markatnagar,

           Dist:Cuttack,Pin-753014.                                             ... Opp. Parties.

 

 

Present:               Sri Debasish Nayak,President.

                                                Sri Sibananda Mohanty,Member.

 

               Date of filing:     06.09.2022

Date of Order:    28.09.2023

 

For the complainant:          Mr. B.R.Dalai,Adv. & Associates.

For the O.Ps.                 :      Mr. S.K.Mohanty,Adv. & Associates.

    

Sri Sibananda Mohanty,Member.                                          

          Case of the complainant in short is that she had obtained three nos. of policies bearing policy no.597845126,595520317 & 599298517 from the O.Ps.  It is stated by the complainant that she was paying her premium amount regularly by way of cheque to the O.Ps.  But suddenly she received default notice from the O.Ps and on enquiry she found that there were some default on payment of her premium amount for which  on 18.2.2022, she gave an objection to the O.P no.2 as she had not defaulted in payment of any premium dues.  It is further stated by the complainant that she had paid her premiums by way of cheques and the said cheque amounts had already debited from her bank account but the said amount was not credited/paid against the premium of her policies.  It is learnt by the complainant that her premium amount has been credited against other third party’s policies.   It is also stated by her that the O.P no.2 after receiving objection from the complainant, vide his letter dtd.1.2.22 demanded the deposit receipts from the complainant.  While the matter stood thus, the complainant on further enquiry, came to know that all her cheques were tampered and credited towards the premium of other third-party policies, which is illegal.  As the O.Ps did not redress her grievance, she sent a legal notice on 22.3.22 to enquire into the irregularity committed at their end and to regularise all the policies of her but the O.Ps did not take any steps in that regard.    It is stated by the complainant that earlier she had filed C.C. no.92 of 22.   The said case was disposed of with the observation that without the bank statement the case cannot be adjudicated and the complainant after receipt of the bank statement, has filed the present case.  It is alleged by the complainant that as the O.Ps did not take any effective steps, she has filed the present case with a prayer for a direction to the O.Ps to regularise all her policies and to pay compensation amount of Rs.5,00,000/- to her.

          The complainant has filed copies of some documents in order to prove her case.

2.       The O.Ps have filed their written version, wherein they have admitted about the three policies of the complainant, which were issued by them to the complainant.  It is stated by the O.Ps that all the policies of the complainant were lapsed due to non-payment of the premium.  It is further stated by them that the O.Ps after receiving the complaints from the complainant as well as other persons made an investigation through their internal vigilance department.  The preliminary enquiry of the Vigilance Department reveals that the cheques issued by the complainant towards the premium bore numbers of other policy holders in the backside of the cheques, for which amounts of the cheques were debited from the S.B. Account of the complainant and the said amount was paid towards the premium of third parties.  It further reveals from the said investigation that one LICI agent namely, Late Sangram Keshari Swain, who died on 29.6.21 had deposited the cheques issued by the complainant to the LICI towards payment of the premiums due under LICI policy nos. of different policy holders including of his own LICI policy but not in favour of the complainant’s policy premium resulting in mis-appropriation of the said amounts including premium amount of other policy holders.  It is further stated that the complainant has not produced the premium payment receipts, which reveals that the said agent had misused the cheques of the complainant thereby defrauded the complainant alongwith other policy holders.  It is stated by the O.Ps that the LICI Agents Regulation forbids the agent from collecting premium from the policy holders.  Hence, it is stated by the O.Ps that it is the dispute between the agent and policy holder and they are no way responsible in the matter.  The O.Ps have disputed about the tampering of the complainant’s cheques.  It is stated by them that the complainant has not mentioned her LICI policies at the backside of the cheque and had not deposited the same in the Collection Counter herself rather had handed over her cheque to the agent.  Hence, it is stated by the O.Ps that they have not committed any deficiency of service and as such stated that the complaint case is not maintainable.

          The O.Ps have also filed copies of some documents in order to support their stand.

3.       Keeping in mind the averments as made in the complaint petition and the contents of the written versions of the O.Ps no.1 & 2, this Commission thinks it proper to settle the following issues in order to arrive at a definite conclusion here in this case.

i.          Whether the case of the complainant is maintainable?

ii.         Whether there was any deficiency in service on the part of the O.Ps  ?

iii.        Whether the complainant is entitled to the reliefs as claimed by her?

Issue no.II.

Out of the three issues, issue no.ii  being the pertinent issue is taken up  first for consideration here in this case.

          After perusing the documents available in the case record, it is noticed that the complainant had obtained three numbers of policies bearing no597845126,595520317 & 599298517.   It is alleged by the complainant that she had paid the premium amount to the O.Ps but the said amount has been adjusted by the O.Ps towards the premium of third parties and thereby her policies had lapsed.  The O.Ps found from their Internal Investigation that one agent namely, Sangram Keshari Swain had misappropriated the premium amounts of some of the policy holders including of the present complainant.  The case of the O.Ps is that the agent is only authorised to receive the first premium as due from the new policy holder and he is not authorised to receive subsequent premiums.  It is admitted fact that the amount paid by the complainant through cheques to the O.Ps has been adjusted by the O.Ps towards the premium of third party policies.  The complainant is unable to produce the premium payment receipts to prove her case of payment of her premiums through cheques.  The stand of O.Ps to the effect that the complainant had paid premium through cheques to the agent, namely Sangram Keshari Swain, who had mis-utilised the cheques of the complainant cannot be disbelieved and held to be true.   The O.Ps in their version have alleged that the complainant has not mentioned her policy number in the backside of the cheque for which the cheque amount was misappropriated by the agent.  On verification of xerox copies of some of the cheques issued by the complainant as filed by the O.Ps, it reveals from the reverse of the said cheques, that the policy nos. of third parties has been mentioned and in some cases by scoring the policy no. of the complainant, third party’s policy no. has been inserted.  Be that as it may, the complainant has failed to prove the fact that she had paid premium to the O.Ps through cheques as she could not produce premium payment receipt.  As such, there is no latches on the part of O.Ps for lapse of the policies of the complainant.

 Both the parties have relied upon a decision of the Hon’ble Apex Court in the case of Harshad J Saha and another Vrs. L.I.C of India and others wherein their lordships had held that the payment of premium made to the agent is not construed to the payment of premium to LICI.  In that decision the Hon’ble Supreme Court had observed that even if the policy had lapsed considering the facts and circumstances of the case, they had directed the L.I.C of India to refund the entire premium amounts paid alongwith interest @ 15% per annum. 

In the present case in hand, the complainant is unable to prove the fact that she had paid all the premiums of her three policies in due time.  The O.Ps have filed documents stating therein that all the three policies have lapsed due to non-payment of premium.

Out of the three policies, when one of the policy had lapsed which was matured, it was the duty of the O.Ps to pay the paid-up value of the policy but the O.Ps have not done so.  In the present peculiar case, where the agent appointed by the O.Ps had misappropriated the premium amount of the complainant, the O.Ps should have taken prompt steps for payment of paid-up value of that policy.  Thus, by not doing so, the O.Ps have committed deficiency of service. 

In view of the decision of the Hon’ble Apex Court of India as stated above and by applying the principles decided therein, it can safely be said here that the O.Ps were required to pay the complainant the paid up value of the policy which was matured promptly, so also they were required to return the premium amount promptly to the complainant towards the policy, which cannot be revived, when the complainant had made complaint about lapse of her policies and by not doing so the O.Ps are undoubtedly found to be deficient in their service.  Accordingly, this issue goes in favour of the complainant partly.

 

Issues No.i & iii.

          From the discussions as made above, the case of the complainant is maintainable partly. She is entitled to a reasonable amount of reliefs.  All the policies are in lapsed conditions.  In the meantime, one policy bearing No.597845126 has been matured and the complainant is entitled only to her entire premium amount which she had paid to the O.Ps alongwith interest in respect of that policy.  Both the parties have not filed policy conditions.  As such it is not clear whether rest of two nos. of policies of the complainant can be revived as per the policy conditions or not.  If the said two policies cannot be revived as stated above, in that case, the O.Ps are required to refund the premium amount as they had received alongwith interest component.  Hence, it is so ordered;

                                                          ORDER

Case is decreed partly on contest against the O.Ps who are found to be jointly and severally liable here in this case.  Thus, the O.Ps are directed to return the LICI premium amount as they have received in respect of Policy No.597845126 to the complainant alongwith interest thereon @ 12% per annum from the respective date of deposits of premium till the amount is quantified.  The O.Ps are also directed to revive the policy No.595520317 and 599298517 on receipt of unpaid premiums of the said policies alongwith interest/other charges, if any, as per the policy conditions, and observing other formalities as per the policy conditions,  if the said policies can be revived as per the policy conditions.  If the policies cannot be revived as per the policy conditions, in that case the O.Ps are directed to return the LICI premium as they have received in respect of said two policies to the complainant alongwith interest thereon @ 12% per annum from the respective date of deposits till the amount is quantified.  The O.Ps are further directed to pay a sum of Rs.20,000/- to the complainant towards her litigation expenses.  This order is to be carried out within a period of 30 days from the date of receipt of copy of this order.

Order pronounced in the open court on the 28^th day of September,2023 under the seal and signature of this Commission.      

                                                                                     

                                                                               Sri Sibananda Mohanty                                                                                                                                                                                  Member.

 

 

                                                                               Sri Debasish Nayak

                                                                                    President.