Final Order / Judgement

(Dated : 18 Apr 2023)

PER MR. A. Z. KHWAJA HON'BLE PRESIDING MEMBER

     Complainant Smt.Bhavana Kombe has preferred the present complaint under the provisions of Consumer Protection Act,1986.

2.         Short facts leading to the filing of the complaint may be narrated as under..

          Complainant Smt.Bhavana Kombe is the wife of deceased Prashant Kombe and a resident of Bhadravati, Distt.Chandrapur. Complainant has contended that her deceased husband had taken a Life Insurance Policy on 17/2/2012 bearing policy No.578040142 and as per policy, the sum assured in case of death was Rs.12,50,000/-. Complainant has contended that after taking the policy, on 30/1/2013, at about 2.00 p.m. the policy holder went to the premium collection centre of LIC run by Mr.Nazir Hussain. However, there was sudden failure of internet connectivity and so the owner of the collection centre, told the deceased policy holder to wait for some time till restoration of internet connection.  After some time the deceased policy holder paid the premium and was returning back. When he reached to the Railway gate on Chandrapur Bhadravati Road, an accident took place resulting in death of husband of the complainant. Complainant contended that though her husband had died on 30/1/2013, her husband had paid necessary premium of LIC policy, however, he could not obtain the print out due to internet failure and the print out was generated at about 6.15 p.m. only.

3.           Complainant contended that thereafter, the complainant submitted claim claiming sum assured but the LIC did not respond nor the claim was settled. Complainant submitted that her husband had paid the premium prior to his death and therefore, the Opponent LIC had committed deficiency in service as well as Unfair Trade Practice, and so the complaint.

4.            After filing of the complaint, due notice was issued to the Opponent . Opponent appeared before the Forum and filed its written version. Opponent LIC admitted that husband of complainant had taken the policy and that he had died on 30/1/2013 in a road accident. However, the Opponent categorically denied that prior to his death, the deceased policy holder had paid the premium of Rs.31,285/- at the LIC premium centre run by Nazir Hussain.  Opponent has contended that as per the FIR lodged with police station, the death of life assured Mr.Prashant had taken place at about 3.30 p.m. whereas the premium of his policy came to be paid at 6.15 p.m. after his death. Opponent contended that there was no question of honouring claim as the insurance policy had already lapsed on 30/1/2013. Hence there is no deficiency in service nor Unfair Trade Practice on the part of Opponent and the complaint is not tenable in law and deserves to be dismissed with cost.

5.           Complainant thereafter led evidence by filing affidavit on record. He also placed on record several documents namely copy of insurance policy, FIR, Spot panchnama, policy premium renewal receipt and repudiation letter. Further the complainant has also relied upon one affidavit of one Nazir Hussain. Opponent has also adduced evidence by way of affidavit. Both the parties have filed Written notes of arguments. We have carefully gone through the contents of the complaint, documents as well as written notes of arguments filed by both the parties. On the basis of the facts stated above, following points arises for our determination , and our findings thereon are noted as against them for the reasons herein below:

REASONS:

6.             It is undisputed that husband of complainant had taken the policy and that he died on 30/1/2013 in a road accident occurred near the Railway gate on Chandrapur Bhadravati Road as he was hit by a Tipper. It is also not in dispute that on the same day report regarding accident was also lodged at Bhadravati Police Station and accordingly crime No.24/13 came to be registered.

7.           It is the specific case of the complainant that her husband died on 30/1/2013, but prior to the accident her husband had paid the premium at the Premium Centre run by one Mr.Nazir Hussain. It is also the specific case of the complainant that her deceased husband had paid the premium of the LIC policy at the centre at about 2 p.m. but as there was failure of internet connectivity the receipt could not be generated, and the same was generated at 6.15 p.m. But though the deceased husband had paid the premium for renewal of policy prior to his death, the LIC rejected the claim of the complainant on the ground that the policy was in a lapsed condition.

8.                The Opponent LIC has resisted the complaint stating that the insurance policy had already elapsed on 30/1/2013 and secondly the payment of premium was made after the death of policy insured.  In order to support his contentions the complainant has placed reliance upon several documents including FIR as well as copy of receipt regarding payment of premium and the same is on record as document No.A-6 in appeal compilation. It is argued by Mr.Kullarwar, learned advocate for the Complainant that though the deceased policy holder had made payment of policy renewal premium at 2 p.m. at the Collection Centre run by Mr.Nazir Hussain, the printed receipt could not be generated due to failure of internet connectivity. On this aspect he has relied upon copy of receipt which clearly shows the time as 6/51 p.m. Shri.Gedam, learned advocate for the Opponent  has controverted this contention and has submitted that in fact the insurance policy was already in lapsed condition and so there was no question of payment of premium on 30/1/2013 by the husband of the complainant. Further he has drawn our attention to the copy of FIR which shows that death of husband of the complainant occurred at 3.30 p.m. whereas payment was made by the husband of the complainant at about 2 p.m. On this aspect Shri.Kullarwar, learned advocate for the Complainant has heavily relied upon one affidavit of Mr.Nazir Hussain who is the owner of Premium collection Centre which was allotted to him by the LIC. If we turn to his affidavit, he has clearly stated on affidavit that on 30/1/2013 Mr.Prakash Kombe visited his collection centre and deposited the premium of Rs.31,285/- at about 2.15 p.m. He has further stated that he tried to generate the receipt but the same could not be generated due to technical problem and the same was generated at 6.54 p.m. On the basis of this affidavit of Mr.Nazir Hussain as well as the copy of receipt and copy of FIR it is submitted by Shri.Kullarwar, learned advocate for the Complainant/complainant that the husband of the complainant had paid premium of the policy prior to his death on the same day. On this point, Adv.Gawande appearing for the  Opponent contended that the insured had already died in the road accident and the premium of his policy was paid subsequently so as to claim sum assured under the policy.  It is argued by learned advocate for the Opponent that there was no failure of internet connection and complainant had paid the premium fraudulently at 6.54 on 30/1/2013 after the death of the life assured. Opponent has categorically denied  the story of internet failure, but the complainant has filed affidavit of Mr.Nazir Hussain, the owner of premium collection centre to support his contention. If there was no internet failure, it was open to the Opponent to place on record material as well as affidavit in rebuttal to establish the same. So the statement of Mr.Nazir Hussain on affidavit that the receipt could not be generated at 2.15 p.m. due to internet failure cannot be brushed aside lightly. Further it is pertinent to note that the premium was also paid on 30/1/2013.

9.                  It is also submitted by the learned advocate appearing for the LIC that the premium was due on 30/1/2012 and was to be paid within a grace period of 30 days and, therefore, also was in a lapsed condition. We are unable to accept this contention in view of the fact that the receipt generated on 30/1/2013 itself shows that the same was renewal premium receipt and therefore it cannot be said that the insurance policy was already lapsed. If really the insurance policy had lapsed as claimed by the Opponent there was no question of the premium collection centre accepting the amount of renewal and there is no explanation forthcoming on this aspect from the LIC.  We find that the LIC has heavily relied upon one statement of amount collected on 30/1/2013 by the LIC. No doubt, it gives the details about amounts received by the LIC, but it is surprising to note that this list does not contain entries of all the transactions and receipts during entire day. As such, not much weight can be attached to this copy of statement filed by the LIC.

10.                   During the course of arguments, the learned advocate for the Opponent /LIC has also placed reliance upon a list of authorities as under..

1. National Insurance Co.Ltd. Vs. Sobina Laki & Ors. Reported in (2007) 7 SCC 786
2. LIC of India V. Venu Yelne ( Case No.440 of 2009 (NC)
3. Ashwini Kumar Vs. BaldevSingh Rohal & LIC with LIC of India Vs. Baldeosingh Rohal & Asgwubujynar (Revision Petition No.3767/2008 & 55/2009( NC)
4. Sheela Devi Vs. LIC of India & Others (II (2014) CPJ 284 (NC)
5. LIC Vs. Consumer Education & Research Society & Anr. (Rev.Petition No.1406.2006)
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6698606.  

1. Complaint is hereby allowed.
2. It is hereby declared that the Opponent LIC has committed deficiency in service as well as Unfair Trade Practce as defined under Consumer Protection Act,1986.
3. Opponent LIC is hereby directed to pay the sum assured under the death benefit of Rs.12,50,000/- as well as double accident benefit Rs.12,50,000/- to the Complainant alongwith interest @9% p.a. from 30/1/2013 till realization.
4. The Opponent LIC is further directed to pay compensation of Rs.25,000/- towards mental and physical harassment with cost of litigation of Rs.10,000/- to the Complainant.