The complainant filed this case U/s 12 of the Consumer Protection Act, 1986 with the prayer for an order directing the O.Ps. to pay principal maturity amount of Rs.25,390/- for Jeevan Madhur Plan of LICI, compensation of Rs.50,000/- for harassment and mental pain and agony and Rs.10,000/- as litigation cost.
In short the case of the complainant is that the complainant is a resident of Kushmandi, Dakshin Dinajpur opened a policy of Jeevan Madhur Plan, vide No.455571605, under LICI commencing from 15.07.2008 of Rs.25,390/- and at Rs.3,000/- monthly premium. O.P. No.1 properly issued policy deed. Petitioner regularly paid premium to O.P. No.4, Branch Manager of Jeevan Madhur Plan Office of Uttar Dinajpur Group for Human Resource Development at Raiganj (UDGHRD). The date of maturity of the policy was on 15.07.2013 and last premium was duly paid on 15.01.2013. When petitioner thereafter claimed for maturity amount to O.P. No.4 (UDGHRD), but he was denied any payment then the complainant made his claim before O.P. Nos. 1, 2 & 3 (LICI Authority), then it was told that O.P./ LICI never received any payment from the petitioner and are not bound to pay maturity amount. Petitioner therefore finding no other alternative filed his complaint before this Forum for deficiency of service against the O.Ps. with the above mentioned prayer.
O.P./ LICI appeared and filed written version to contest this case. Be it mentioned that initially notice upon O.P. No.4 returned with remark without service because the O.P. No.4 left the office keeping under lock and key and fled away for good and the petitioner was directed to take fresh steps but no steps was taken on consecutive dates and subsequently the name of O.P. No.4 was expunged vide order No.4, dated 21.11.2014 without any objection from either side.
In the written version, O.P./ LICI stated that the Registered NGO, UDGHRD was given distributorship for selling Micro Insurance Policy such as Jeevan Madhur Plan as per guideline of IRDA Regulation and O.P. No.4/ UDGHRD operated the service from the address at Raiganj mentioned in the plaint. O.P. admitted the petitioner opened the policy mentioned above and was eligible to surrender the same at least paying premium of two full years to receive 30% of the premiums. That the complainant deposited Hly. premiums up to Jan’09. The LICI issued First Premium Receipt at the time of taking policy and Renewal Receipt would be issued after adjustment of Renual Premium from O.P./ LICI’s end as mandatory. O.P./ LICI specifically stated complainant had not deposited full term of the policy, nor surrendered the policy and therefore is not entitled to receive maturity amount as prayed for. Again O.P./ LICI admitted that the distributor NGO, UDGHRD never deposited the premium in LICI, Micro Department hence as per deposited premium LICI adjusted the same to LIC Books of A/c. Since the receipts of deposits shown/ submitted by the policy holder to concerned NGO are not issued by LICI. So, PAB (Premium Acknowledgement Book) supplied by the LICI for maintaining premium records, in the instant case it is not maintained by UDGHRD. Receipts issued to policy holders by the NGO may be with ulterior motives. That Micro Insurance Policies are quite different from LICI’s mainstream policies and LICI had to depend on the activity and trust of the concerned NGO, here Micro Agent, O.P. No.4 (UDGHRD). LICI as per Central Government’s direction working through MI Unit through various NGOs to rural areas and till date no complaint or dispute arise from MI Unit, barring UDGHRD, Raiganj. Following such complaints LICI taking all procedural measures, finally terminated the agency of NGO, UDGHRD w.e.f. 19.02.2014. It was displayed on the notice board of Divisional Offices and also published in the leading daily newspapers on 21.04.2014. Legal proceedings are going to be taken against UDGHRD. That LICI has no lapses or deficiency in service and is not liable for the unfair practices of UDGHRD, if proved true are wholly made by the distributor of the scheme UDGHRD. Since Micro Policies Holders are no way connected directly with the LIC of India as per design of the scheme of Central Government. LICI therefore prays for dismissal of this case.
To prove his case the complainant has filed examination-in-chief, oral evidence and some photocopies of documents, LIC deed, Receipt showing payment of premiums of Jeevan Madhur Plan including First Premium Receipt, etc.
On the other hand the O.Ps. filed documents like status report of policy No.455571605, photocopy of notice dt.19.02.2014, Jeevan Madhur Policy Deed, Newspaper showing publication of notice dt. 19.02.2014, copy of FIR, P.S. Case No. 83/14 dt. 27.01.2014 against O.P. No.04 and Acknowledgement receipt of money suit against the O.P. No.4.did not adduce any evidence except filing W.V. only.
DECISIONS WITH REASONS
On careful perusal of complaint, documents and evidence that the complainant as P.W.1 deposed as per version of complainant petition by submitting the above mentioned documents. He was cross-examined by O.P. and deposed that he verbally contacted with the O.Ps. 1, 2 & 3 for receiving maturity payment. That he paid premium regularly to one Manirul Islam against receipt etc.
From the documents filed by the parties, admittedly, LICI issued First Premium Receipt to the complainant on 15.07.2008 for the Jeevan Madhur Policy. Thereafter, O.P. No.4 issued receipt regularly in favour of the complainant till 15.01.2013 as per the policy agreement. Therefore, complainant has no knowledge about any unfair trade practices by O.P. No.4 as agent of MI Unit of LICI. It is only after payment of the last premium, when he went to collect the maturity amount and he was denied by the LICI. In the written version O.P./ LICI specifically stated and submitted copies of notice, news paper publication that the agency of NGO, UDGHRD bearing MI Code No.83020R045 was finally terminated on 19.02.2014. So, it is clear that complainant paid the entire premiums of the policy up to Jan’13 long before publication of this notice regarding termination of agency of UDGHRD. In such circumstances LICI cannot avoid its liability of any payment made by any policy holder to the MI Unit, UDGHRD before 19.02.2014. Therefore the complainant has been able to prove his case that he as a policy holder made full payment of all premiums of the policy and he is entitled to receive the principal maturity amount as per the policy terms and condition. Unfortunately, O.P./ LICI deny the maturity amount to the complainant for no fault of the complainant. Complainant was harassed for such deficiency of service of the O.P./ LICI and as a genuine policy holder after full payment of all the premiums he is entitled to get the reliefs. To our considered view the complainant has been able to prove his case successfully.
Fees paid is correct.
Hence, it is
ORDERED,
That the complaint case being No.79/2014 is allowed in part and the O.Ps./ LICI are directed to pay principal maturity amount of Rs.25,390/- to the complainant with interest @8% from the date of maturity of the policy i.e. 15.07.2013 till realization. O.Ps. are also directed to pay a compensation of Rs.3,000/- for his harassment, mental pain and agony and also Rs.2,000/- as litigation cost within one month from the date of passing of this Final Order, in default complainant is at liberty to put his claim in accordance with law.
Copy of this order be supplied to each parties free of cost.
