Date of Filing : 24.10.2011
Date of Order : 27.03.2012
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KOLAR
Dated 27th MARCH 2012
PRESENT
Sri. H.V. RAMACHANDRA RAO, B.Sc., BL, ……. PRESIDENT
Sri. T.NAGARAJA, B.Sc., LLB. …….. MEMBER
Smt. K.G.SHANTALA …….. MEMBER
CC No. 209 / 2011
Sri. V.K. Prasanna Kumar,
S/o. (L) Krishnaiah Setty,
#326, Gowripet, 4th Cross,
Kolar – 563 101.
(By Sri. K.V. Manjunatha Gowda, Adv.) ……. Complainant
V/s.
1. Life Insurance Corporation of India,
KGF Branch,
Dr. Ambedkar Road, Robertsonpet,
KGF – 563 117.
2. Life Insurance Corporation of India,
Bangalore Division-I,
Jeevan Prakash, P.B. 6694, J.C. Road,
Bangalore – 560 002.
(By Sri. N. Sreenath, Adv.) …… Opposite Parties
ORDER
By Sri. H.V. RAMACHANDRA RAO, PRESIDENT
The brief antecedents that lead to the filing of the Complainant made u/s. 12 of the C.P. Act, 1986 seeking direction to the OPs to issue Health Plus Policy in his favour and to pay Rs.10,000/- are necessary:
Being attracted with advertisement of the Ops, Complainant on 07.07.2010 gone to LIC and as per their directions undergone the Blood Test at Aditya Laboratory by Dr. M. Udaya Kumar and on 10.07.2010 had undergone medical check-up from Dr. V. Lakshmaiah. He was forced to open S.B. Account in the Syndicate Bank and duly filling ECS form and duly signed by the Manager along with cancelled Cheque leaves handed over to LIC. LIC has instructed the Complainant to deposit half yearly premium of Rs.3,110/- on 15.12.2010, Rs.750/- on 31.08.2010 & Rs.1,500/- on 15.09.2010 as proposal deposit and OPs have issued proposal No. 4373. Complainant has spent Rs.780/- towards medical examination. Complainant has opened S.B. Account by depositing Rs.1,000/- and spent other expenses of Rs.150/-. But, till today OPs have not issued the Policy.
2. In brief version of OPs are:-
OP2 has nothing to do with this case. Under the jurisdiction of LIC, Division II OP1 works and not OP2. Complainant has submitted proposal dtd. 10.07.2010 on 20.09.2010 under Plan No. 902 for Health Protection Plus Plan. OPs have not directed the Complainant to undergo any medical test either on 07.07.2010 or on 10.07.2010. Earlier to the submission of the proposal, Complainant himself had gone to Doctors and in the format of the OP had obtained the signature which is impermissible. Complainant has not completed the declaration in Page-3 of the proposal form. Complainant had undergone the test for HBA1C on 13.08.2010 at Adithya Laboratory and ECG on 10.07.2010 at Akshaya Nursing Home before submitting the proposal form. This itself proves there was no direction given by the OP in this regard. The proposal under question was submitted “half yearly mode” and not under “ECS mode”. Complainant had deposited Rs.3,110/- on 15.12.2010, Rs.1,500/- on 15.09.2010. OPs have not issued proposal No. 4373, but has registered the Complainant’s proposal under Proposal No. 4373 on 20.09.2010. Complainant was duly informed on 03.10.2010 that the Plan 902 is regretted with suggestion to go in for an alternative Plan and his wife principal insured-2 (P2) can propose her life under Plan 902. Complainant has submitted proposal of his wife under Plan 902 on 09.12.2010 and the Policy No. 364848615 is issued and adjusted the deposit amount of Rs.1,500/- and Rs.750/- towards his wife on 09.12.2010. The Complainant submitted fresh proposal with the date mentioned as 10.07.2010, for Plan 14-15 (Endowment) on 15.12.2010 along with remittance of the deposit of Rs.3,110/- on 15.12.2010. It was registered and the sum assured is Rs.75,000/-. It is clear from the proposal and medical report that the Complainant had undergone an operation for Excision of Lipoma during 2008 and this has been declared so in the proposal. As per the Discharge Summary issued by Mallya Hospital, Bangalore, the Complainant has been hospitalized between 16.10.2005 to 18.10.2005, the final diagnosis being Large Lipoma ® Arm. The history is patient c/o a large swelling over the right arm which has been slowly growing to attain present size which was 5x6x8”. The Complainant had undergone Excision of Lipoma under the general anesthesia on 17.10.2005 and not in 2008 as declared by him. Fresh proposal form received on 16.12.2010 and physician report, histopathology report and treatment details were called. The Complainant submitted the physician report on 05.02.2011 and not submitted the histopathology report. The Complainant was directed to undergo for review with histopathology examination report. Complainant did not furnish required documents. The validity of the proposal was only for 6 months and as the documents were not produced it was lapsed and the OP refunded Rs.3,000/- by Cheque and the Complainant encashed it on 16.11.2011. Hence, the Complainant cannot seek direction to the OP to issue Policy. This is the Law settled in AIR 1984 (SC) 1014 and case between Smt. Sheela v/s. LIC of India in NC-RP 1257/2011 dtd. 03.08.2011 and (2009) 8 SCC 316. All the allegations to contrary are denied.
3. To substantiate their respective cases, parties have filed respective affidavit. Complainant was absent at the time of hearing the arguments of the Ops.
4. Point that arise for our consideration are as under:
POINTS
(A) Whether there is deficiency in service?
(B) What Order
5. Our answers for the above points are as under:
(A) Negative
(B) As per detailed order for the following reasons
REASONS
6. Reading the pleadings in conjunction with the affidavits and documents on record, it is an admitted fact that the Complainant had made application for issue of Health Policy with the OP. For the reasons stated in the version and documents, Ops declined to issue Policy and returned the money and that cannot be questioned by the Complainant before this Forum. It is the discretion of the OP to issue Policy under the particular circumstances to a particular person or not. This Forum is not Policy issuing Authority. It is just like parties seeking loan from the Bank and the Bank rejecting the lone. Under their policy, loan can be granted or cannot be granted, that cannot be questioned as deficiency in service. Similarly, when Complainant has not come within the norms of the Policy in question and within the period in question, OP had treated the policy as lapsed. Hence, Complainant cannot seek direction to the OP to issue Policy. If at all the Complainant wants particular policy, again he may submit all the documents with the OP and seek policy. But, without submitting the records as claimed by the OP seeking direction to issue policy, it means there is no deficiency in service. Here the amount received by the OP towards Policy has been returned to the Complainant and he has encashed it. Hence, the Complainant cannot be a consumer and the OP is not a trader.
7. Here there is no concluded contract between the Complainant on one side and OP on other side. When there is no concluded contract, the question of deficiency in service does not arise. If at all OP has issued the Policy and declined granting the relief then there might have been deficiency in service. OP is governed by certain statutes and it cannot act indiscriminately. The Forum also cannot compel the OP to either enter into contract with the proposal as the offer does not come under the statute. This is Law laid down in AIR 1984 (SC) 1014 and our Hon’ble State Commission in Appeal No. 140/2002 dtd. 06.11.2003. Hence, we hold points accordingly and we pass the following order:
ORDER
1. Complaint is dismissed. No costs.
2. Send copy of this Order to the parties free of costs.
3. Return extra sets to the parties concerned under the Regulation 20(3) of the Consumer Protection Regulations 2005.
4. Dictated to the Stenographer, got it transcribed and corrected and pronounced in the open Forum on this the 27th day of March 2012.
T. NAGARAJA K.G.SHANTALA H.V.RAMACHANDRA RAO
Member Member President
SSS
