Date of Filing : 04.07.2012
Date of Order : 03.11.2012
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KOLAR
Dated 3rd NOVEMBER 2012
PRESENT
Sri. J.N. HAVANUR, B.Sc., LLB (SPL) ……. PRESIDENT
Sri. T.NAGARAJA, B.Sc., LLB. …….. MEMBER
Smt. K.G.SHANTALA, B.A., LLB …….. MEMBER
CC No. 82 / 2012
Sri. M.S. Uday,
Lecturer,
Government Polytechnic College,
KGF. ……. Complainant
V/s.
District Insurance Officer,
The Karnataka Government Insurance Department,
(K.G.I.D.),
Kolar. …… Opposite Party
ORDER
By Sri. J.N. HAVANUR, PRESIDENT
This Complaint is filed by the Complainant against the OP praying to pass an order directing the OP to issue new KGID Policy in his name for Rs.11,07,000/- from 13.07.2011 in place of Policy having a sum of Rs.10,50,000/-, to pay damages and costs of Rs.5,000/- and other reliefs. The brief facts of the Complaint can be state as under:
Complainant is working as a Lecturer in Government Polytechnic College, KGF, Kolar. Since taking of KGID Policy was compulsory, so the Complainant who being recently appointed as a Lecturer, and other Lecturers have agreed to take Policy on monthly premium of Rs.3,000/- and accordingly Complainant got KGID Policy on monthly premium for more than the amount fixed by the KGID. After verification of KGID Policy issued to other Lecturers of same age of the Complainant, there is a difference in total insured amount. The Complainant is getting Rs.90,000/- less as compared to insured amount of other Lecturers. In this regard, Complainant has made correspondence with the higher-ups of his Department and come to know that difference of total insured amount depends on the age, height & weight of the insured and KGID is following the Rules & Regulations of LIC. So, Complainant is constrained to approach this Forum. Complainant has got policy No. 2327640 from the OP for a sum of Rs.10,50,000/-. If the said Policy of the Complainant is compared with other Lecturer’s Policy, total of Rs.90,000/- is less than the Policy amount of the colleagues. The total amount of the premium to be paid by the Complainant would be Rs.11,04,000/- and adding insured initial deposit of Rs.3,000/-, it will be Rs.11,07,000/- i.e., Rs.57,000/- will be paid excess by the Complainant to KGID. When the Complainant enquired with the OP, he was informed that whatever the policy issued to his colleagues is correct as it is depending on the age, height & weight of the Policy holder. So, present Complaint is filed praying to issue direction to the OP to issue fresh policy for Rs.11,07,000/- from 13.07.2011 in place of Policy issued for Rs.10,50,000/-, to pay Rs.5,000/- towards conveyance and costs and other reliefs.
2. After service of notice, OP has appeared through Dist. Government Pleader and filed objection contending inter alia as under:
Complaint of the Complainant is not maintainable either in law or on facts. The Complainant is not sure as to the relief claimed. There are as many as 12 reliefs claimed in the Complaint and jurisdiction of the Forum is very limited. A bare perusal of the Complaint discloses that the Complainant will not come under the definition of the consumer. As per the requisition of the Complainant praying for issue of KGID Policy, he has submitted requisition Form to the Opponent along with report of the District Surgeon, General Hospital, KGF. In the said report, his height is mentioned as 180 cms. and his weight is mentioned as 80 Kgs. After receipt of the requisition, this opponent has forwarded the same to the Director of Health & Family Welfare, Bangalore, for opinion & permission. In view of the abnormal weight, it is considered that the Complainant has extra life risk, accordingly as per the Rules of the Department L2 Policy was accorded. As on the date of the medical check-up as submitted by the Complainant, he is placed in L2 for extra life risk as per the Karnataka Government Employees Compulsory Life Insurance Rules 1958 i.e., Rule 32 & 36 and this Complaint is not maintainable. Hence, it is prayed to reject the Complaint in the interest of justice & equity.
3. So, from the averments of the Complaint of the Complainant and objection of the OP, following points arise for our consideration:
(1) Whether the Complainant proves that there is deficiency in service of Opponent?
(2) What Order
4. Our findings to the above points are:
(A) Negative
(B) As per final order
REASONS
5. Point No. 1 - So as to prove the case, Complainant has filed his affidavit by way of evidence and produced copy of the KGID Policy and also produced one Medical Certificate issued by the District Surgeon, Bangalore. On the other hand, no affidavit is filed by the OP, but produced 4 documents along with Memo dtd. 06.10.2012 and two more documents were produced along with Memo dtd. 20.10.2012. Mr. M.S. Uday who being a Complainant has stated in his affidavit filed by way of evidence that he joined Government service on 01.04.2011. Taking a KGID Policy was compulsory, so when he joined service as a Lecturer in Government Polytechnic College, KGF, he and other Lecturers together agreed to take Policy on a monthly premium of Rs.3,000/- and took KGID policy. The sum of the Policy taken was more than the amount fixed by the Government. After verification of the Policies of his colleagues, he found difference in the total insurance amount. An amount of Rs.90,000/- has been shown as less to his total amount of the policy as compared to the Policies of other colleagues. When he made correspondence with his Department, he came to know that there is difference in the total amount of the Policy since the Policy will be issued on the basis of the age, height & weight of the person insured and he came to know that KGID Authorities are following the Rules & Regulations of the LIC. There is difference between the Medical Certificate issued by the District Surgeon and the Medical Certificate of the OP who issued Certificate in the name of the Complainant. OP has not supplied any documentary evidence to him with regard to L2 policy. He being a government servant, he is totally unaware of these facts. If he was informed about this fact earlier, he would have taken policy having appropriate monthly subscription instead of Rs.3,000/- per month. So, present Complaint is filed. So, order be passed as prayed in the Complaint.
6. By making careful scrutiny of the averments of the Complaint and evidence of the Complainant as mentioned supra, it is made manifest that the Complainant has tendered evidence in conformity with the averments of the Complaint. Let us have cursory glance at the documentary evidence of the Complainant so as to know whether oral evidence of the Complainant is fortified by the documentary evidence or not. Complainant has produced copy of the KGID policy issued by the OP in the name of the Complainant bearing Policy No. 2327640 wherein the total amount of insurance was Rs.10,50,000/- and it is signed by the OP and in the Policy in special Annexure column it is written as RSAL2 and date of declaration of the policy was 28.04.2011 and the said policy is covered under Rules & Regulations of the Karnataka Insurance Act and Circular of the Government. Complainant has produced copy of the Medical Certificate issued by the District Surgeon, Bangalore dtd. 28.05.2011 in the name of the Complainant as per his requisition and in the Certificate on the top of the right side portion, the height of the Complainant is mentioned as 175 cms. and weight is mentioned as 72 Kgs. We do not know why the Complainant got examined himself on 28.05.2011 by the District Surgeon, Bangalore and produced the Certificate in the present case on hand. It is an admitted fact between the parties that complainant was subjected to medical examination by the District Surgeon on 28.05.2011, one month after issuance of the KGID Policy in the name of the Complainant. As can be seen from the Complaint and evidence of the Complainant that both in the Complaint and evidence, Complainant has reiterated that after verification of the policies issued in the names of his colleagues, it came to the complainant’s notice that total sum mentioned in the policy of the Complainant and total sum assured in the policies of the colleagues of the Complainant are varying and an amount of Rs.90,000/- has been shown less in the Policy of the Complainant and KGID Authorities are following the Rules & Regulations of the LIC. But, unfortunately, Complainant has neither produced the copies of the Policies of his colleagues nor any documentary evidence to show that KGID Authorities are following the Rules & Regulations of LIC. Except producing copies of KGID Policy and medical certificate issued by the District Surgeon, Bangalore, no believable documentary evidence is produced for the reasons best known to the Complainant. In the absence of vouchsafing any convincing documentary evidence, it is unsafe & hazardous to rely on the solitary testimony of the Complainant that there is a difference between KGID Policies of the Complainant and Policy of the colleagues of the Complainant with regard to total sum assured and KGID Authorities are following the Rules & Regulations of LIC etc. The material evidence in this regard is lacking in its credibility. That apart, in the Complaint it is not stated on which date cause of action to file the present Complaint arose. The whole Complaint is ominous silent on this vital aspect. Besides, Complainant did not send either an e-mail or a notice or any letter to the OP before filing the present Complaint. In fact, the claim of the Complainant has not been repudiated by the OP before filing the Complaint. So, Complaint of the Complainant is not maintainable on account of non repudiation of the claim of the Complainant by the OP.
7. At this stage, it is relevant to have a look at the documents of OP. Document No. 1 of OP produced along with Memo dtd. 06.10.2012 is copy of the facing sheet dtd. 03.06.2011 wherein OP has endorsed over weight by 13 kgs., so policy is accepted as L2 for a total sum of Rs.10,50,000/-. 2nd document of OP is proposal form of the Complainant dtd. 28.04.2011 having signature of the Complainant and in that proposal form the weight of the Complainant is mentioned as 80 kgs. and not 72 kgs. as mentioned in the Medical Certificate produced by the Complainant. 3rd document is copy of the Challan for having credited Rs.3,000/- as initial premium and the said Challan bears the signature of the Complainant. 4th document of OP is the copy of the report dtd. 28.04.2011 issued by the Medical Officer of KGID in respect of the Complainant and in the report the weight of the Complainant is mentioned as 80 kgs. and on the third page of the report, signature of the Complainant is found. Having put the signature to the report of the Medical Officer by the Complainant dtd. 28.04.2011 admitting the report as true & correct, Complainant is estopped from contending contrary to the report of Medical Officer dtd. 28.04.2011. OP has produced copy of Rules 32 & 36 of the KGID Rules at Document No. 1 of the Memo dtd. 20.10.2012. At this stage, it is relevant to cull out Rule 32 & 36 for the sake of discussion as under:
Rule 32 – In the case of lives exposed to extra risk either on account of employment in hazardous occupation or defects in the personal or family history of the proposer the Director reserves to himself the right to accept the proposal on such special terms and conditions as he considers fit.
Rule 36 – No suit or other legal proceedings shall lie against any officer in respect of anything in good faith done or intended tobe done in pursuance of these rules.
8. The said Rules of the KGID make it abundantly clear that the Director of KGID is having the full discretion to accept the proposal of the proposer on such special terms & conditions and no suit or other legal proceedings shall lie against any Officer of KGID in respect of anything done in good faith or intended tobe done in pursuance of these Rules. So viewing the case of the Complainant on the background of the documentary evidence of the OP, it is vivid and clear that OP has accepted the proposal of the Complainant for KGID Policy after examining the Complainant by Medical Officer and Complainant has signed the report of the Medical Officer after verifying the contents of the report as correct and OP has issued Policy in the name of the Complainant as L2 as Complainant was over weight and whatever Policy issued by the OP is in accordance with the Rules & Regulations of KGID and there is no negligence or deficiency of service, as such, on the part of the OP in issuing the KGID Policy in the name of the Complainant. Having considered the totality of the material evidence of the Complainant and documentary evidence of the OP together with Rules 32 & 36 of the KGID Rules, we are of the considered opinion that the Complainant who knocks the door of the Forum seeking relief has miserably failed to prove this point satisfactorily by placing clear & tangible evidence. Accordingly, we answer this point in the negative.
9. Point No. 2 - In view of the negative finding on Point No. 1, we proceed to pass the following order:
ORDER
Complaint is hereby dismissed. So, under the circumstances, parties to bear their own costs.
Supply free copy of the Order to both the parties.
(Dictated to the Stenographer, got it transcribed and corrected and pronounced in the open Forum on this the 3rd day of November 2012)
T. NAGARAJA K.G.SHANTALA J.N. HAVANUR
Member Member President
SSS
