Before  the District Consumer Dispute Redressal Commission [Central], 5th Floor                                         ISBT Building, Kashmere Gate, Delhi

                               Complaint Case No. 220/2019

Veena Gupta

ND-21, Vishakha Enclave

Pitampur, Delhi-110088                                                          ...Complainant

                                      Versus

OP1-Managing Director

Life Insurance Corporation of India

Plot No.630, Jeevan Bharti Building

Connaught Place, Delhi-110001

OP2-Sh. R.N. Goel-Sr. Business Associates

Life Insurance Corporation of India

Branch No.11-K, 12/56

Desh Bandu Gupta Road, Karol Bagh,

New Delhi-110005

OP3-Sh. Mahender Pal-Agent

Life Insurance Corporation of India

Branch No.11-K, 12/56

Desh Bandu Gupta Road, Karol Bagh,

New Delhi-110005                                                                  ...Opposite Parties

                                                                                                                Senior Citizen Case

                                                                   Date of filing:             06.08.2019

                                                                   Date of Order:            03.10.2023

Coram: Shri Inder Jeet Singh, President

             Ms. Shahina, Member -Female

   Shri Vyas Muni Rai,    Member

Vyas Muni Rai

                                             ORDER

1.1  The present complaint has been filed by Ms. Veena Gupta ( in short ‘the complainant’) u/s 12 of the Consumer Protection Act 1986 against (1) Managing Director; Life Insurance Corporation of India, Jeewan Tara Building, Connaught Place, Delhi (in short OP No.1); (2) Sh. R.N. Goel, Sr. Business Associates, LIC of India, Branch Office, Karol Bagh, Delhi (in short OP No.2) and (3) Sh. Mahendra Pal, Agent, LIC of India, Branch Office, Karol Bagh, Delhi (in short OP No.3)

1.2. The complainant took Jeevan Anand Policy of LIC and paid the premium of Rs. 80,347/- vide cheque no. 180226 dated 21.01.2009 (dated 21.02.2009 seems to has been mentioned by error in complaint) to the OP No.2 through OP No.3 (Agent), who introduced with OP No.2 to the complainant but the cheque was returned due to some mis-management of the fund.

1.3. The complainant again paid amount by fresh cheque No. 180629 dated 29.01.2019 (dated 21.02.2009 is mentioned by error) Rs. 80,347/-  drawn on Bank of Baroda, Delhi to the OP No.3, who handed over the cheque to OP No.2 and this cheque was duly cleared on 02.02.2009.

1.4. The cheque mentioned in para 1.3 was cleared from the bank and receipt No. 1034715 dated 04.02.2009 was issued by OP No.3 after obtaining the same from OP No.2 in which policy No. 124375362 with premium of Rs. 80,347/- and maturity date 21.01.2019 were mentioned; sum insured was mentioned as Rs. 4,50,000/- and OPs were required to make payment of insured amount afer expiry of the maturity period.

1.5. The complainant, immediately after the expiry of maturity period approached OP No. 2 and submitted all the relevant documents along with the bond on 05.03.2019 by speed post No. RD 79283338IN  IVR 8268792833381 through Ashok Vihar, Post Office (but speed post receipt was not  filed, as observed from record).

1.6. The complainant also visited Branch Office of OP on 19.03.2019 for the payment of maturity amount but it was told to the complainant that policy has already cancelled due to return of the cheque and for this reason payment cannot be made. It was clarified to the OP that after the cheque was returned as unpaid, a fresh cheque was issued and after clearance of the cheque receipt was issued on 04.02.2019 but despite receiving the payment and issue of the receipt there was no communication from the OP for cancellation of the policy.

1.7. The premium paid by the complainant was used by the OP without information to the complainant by OP that policy was cancelled. Once OP has accepted the payment and issued premium receipt against the policy and money was retained for the entire period for which policy was obtained then the OP is liable to pay the sum insured. The OP has never cancelled the policy as alleged and now under the garb of earlier cheque dishonor it wants to grab the sum assured (Rs. 4,50,000/-).

1.8 The complainant visited the office of OP on 19.03.2019, also submitted representation on 20.03.2019 and on 04.04.2019, but no action was taken by the OP to make the payment of assured amount. If the policy was cancelled, OP was required to refund the premium amount paid by the complainant immediately after the cancellation but money was not refunded which amounts to deficiency of the services.

1.9. The complainant prays for direction to OP to pay maturity amount of Rs. 4,50,000/- as mentioned in the policy No. 124375362 and refund the payment along with interest; to pay the compensation  of Rs. 1,00,000/- to the complainant on account of mental pain and agony; apart from Rs. 25,000/- as litigation charges.

1.10. Complaint is accompanied with policy receipt No. 124375362; letter dated 04.04.2019 to Branch Manager, LIC, letter dated 20.03.2019 to Branch Manager, LIC and copy of passbook of Bank of Baroda.

2.1. OP files reply under the signature of Sh. Ajay Tyagi, Manager (Legal-HPF), Delhi Division at office-I, Jeevan Prakash, 25 K.G. Marg, New Delhi-110001 and complaint is opposed.

2.2. The complaint is not maintainable ; it is without any cause of action; the complainant has approached the Commission without clean hands; it has suppressed the material facts; hence  is liable to be dismissed.  

2.3. The present complaint is liable to be dismissed as the first premium deposited  vide cheque No. 180626 dated 21.01.2009 for Rs. 80,347/- was dishonoured due to reasons of insufficient fund and as such the policy was cancelled. Therefore, the claimant without getting the policy revived, deposited the premium through another cheque dated 29.01.2009. The said amount was lying deposited in sundry account of the OP and since the complainant had not taken any steps either to revive the policy or refund of the said amount despite reminders; hence the amount lying in the sundry account was written off on 12.04.2010. The OP shall refund the said amount after completing all the formalities to be completed by the claimant. The amount of Rs. 80,347/- deposited on 29.01.2009 vide cheque No. 180629 was written off due to non-submission of fresh proposal. The deposit of premium amount didn’t construe to automatic restoration of policy.

2.4. OP in its reply further pleads that complainant was informed about the status of the policy and was asked to complete the formalities, which she failed to do so. The complainant cannot be awarded for her own fault.

The complainant has filed rejoinder to the reply of OP and has denied the allegations of OP. If the policy was cancelled by the OP, it was the duty of the OP to inform the complainant regarding cancellation but OP never informed the complainant, even deposit of the amount on 29.01.2009 was encashed by the OP. Once the OP2 has accepted the payment without any protest or intimation regarding alleged cancellation of the policy, then at this stage OP cannot say that policy cancelled but the policy was continued. If the policy was cancelled immediately after dishonour of the cheque, then OP has no authority to keep the money of the complainant.

4.1. OP No.3 (Agent of LIC of India) was served the notice of complaint but did not put appearance nor filed reply.

4.2. The complainant filed her affidavit of evidence, while fortifying support from the documents filed with the complaint. The documents proved are copy of the bank statement, copy of premium receipt dated 04.02.2009, representation dated 20.03.2019 and 04.04.2019.

4.3. OP’s Sh. Biju George, Manager, L & HPF, posted at Divisional Office-1, K.G. Marg, New Delhi has led evidence with support of voucher, of payment/details of Rs. 80,387/- on 12.03.2020 (which is disputed by complainant). Affidavit is replica of the reply filed by it. No policy was issued. OP had also offered to pay interest @6.32% on Rs. 80,347/- as per rules when case was heard in Lok Adalat on 21.08.2023.

5. Both the sides have filed their written arguments, which are reiteration of pleadings and evidence. As per proceedings Mr. B.P. Aggarwal, Advocate on behalf of the complainant and Mr. Lalit Kumar, Advocate for Sh. Sanjiv Kumar Gupta, Advocate for OP dated 24.08.2023 and dated 12.03.2020 that the amount of premium was transacted in the credit of complainant. Oral submissions were completed by the counsels of both the parties.

5.1. The contentions of both the sides are considered keeping in view the material on record and the same will be discussed accordingly.

5.2. The complainant’s case is that initially she paid the premium amount Rs. 80,347/- vide cheque dated 21.012009 to OP No. 2 through OP No.3 (Agent) and when the cheque was dishonoured due to insufficient fund in her account, another fresh cheque for the said premium was deposited with OP2 on 29.01.2009 which was encashed by OP-2 and premium receipt bearing policy No. 124375362 dated 04.02.2009 was issued to her by OP No. 2 having sum assured Rs. 4,50,000/-

5.3. The premium receipt issued to the complainant by OP contains the date of maturity 21.01.2009. On expiry of the maturity period, the complainant contacted Branch Office of OP2 and submitted all relevant documents on 05.03.2019 by speed post for getting the assured amount but in vain. Thereafter, complainant visited OP2’s office on 19.03.2019 for payment of maturity amount when she was told by OP2 that policy is already cancelled.

5.4.  It is matter of general prudence that when the policy was to be cancelled by the OP2, in all fairness as an insurance professional, it should have refunded the premium amount to the complainant immediately instead of keeping the premium amount in sundry account to be written off on 12.04.2010. No communication for cancellation of policy was sent to the complainant nor sending of any such communication has been proved by the OP2. Specific date of cancellation of policy has also not disclosed & proved by the OP2 nor in what manner policy was cancelled.

5.5. OP2 in its reply states that complainant was informed about the status of the policy and was asked to complete the formalities which she failed to do so, but OP2 failed to prove the mode and manner of the information given to the complainant for the purpose.

5.6. The complainant’s plea to the effect that once the OP has accepted the payment without any protest or intimation regarding alleged cancellation of the policy, then at this stage OP cannot say that policy was cancelled but policy continued has substance and carries weight. OP2 and OP1 had no authority to keep the premium money of the complainant for years together and to say only during the pendency of the present complaint and at the time when policy attained maturity that the same is cancelled. This stand of OP2 is highly unprofessional and. It is unfair trade practices.

5.7.  OP2’s defence in its reply that it shall refund the amount after completion of all the formalities to be completed by the complainant without disclosing and communicating the complainant of the formalities to be completed. OPs have also not disclosed nor proved as to what were those formalities, to be completed by the complainant when it brought and submitted the transaction slip/voucher dated 12.03.2020 for payment of Rs. 80,347/- in favour of the complainant during the proceedings dated 24.08.2023. OP2 has also not disclosed this fact.

5.8. The complainant has successfully proved policy receipt No. 124375362 dated 04.02.2009 for premium of Rs. 83,347/- for assured amount of Rs. 4,50,000/-, letters dated 04.04.2019 and dated 20.03.2019 sent to Branch Manager of OP2, Bank of Baroda’s passbook statement of her account, while no document has been proved by OP2 except voucher of payment dated 12.03.2020 for payment of Rs. 80,347/- in favour of the complainant. OP2’s defence are based only on the conjectures and surmises & to shield its own internal lapses.  

5.9.  By taking into account the stock of the circumstances and material on record, it is held that complainant has succeeded in establishing deficiency of services against OP1 and OP2, apart from unfair trade practices.

5.10. The complainant has her valid claim of maturity amount of policy Rs. 4,50,000/- which was declined by OP1 and OP2, it amounts to deficiency of services.

5.11. The facts and circumstances proves case of complainant that she lodged valid claim for maturity amount of Rs. 4,50,000/-, however, she was paid premium amount  of Rs. 83,347/- on 12.03.2020 vide transaction slip dated 12.03.2020. Thus, complainant is held entitled claim of maturity amount of policy i.e. Rs. 4,50,000/- after adjusting the already paid amount of Rs. 83,347/-, which comes to Rs. 3,56,653/-.

5.12. The complainant also sought damages/compensation Rs. 1,00,000/- towards harassment, mental tension and agony; apart from cost of Rs. 25,000/-. By considering totality of circumstances of case of both sides damages are quantified as Rs. 20,000/- apart from cost of litigation of Rs. 10,000/- in favour of complainant and against OP1 & OP2.

5.13. The complainant has also sought other relief and interest on the maturity amount of the policy without mentioning the rate of interest on account of non-payment of her valid claim. Therefore, interest @ 6% pa is allowed in her favour and against OP1 and OP2, it would justify for both ends, interest will be computed from the date of complaint till realisation of amount against OP1  & OP2.

5.14. Accordingly, the complaint is allowed in favour of complainant and against OP1 & OP2 to pay jointly and/or severally (balance amount of maturity) Rs. 3,56,653/- along with simple interest @ 6% pa from the date of complaint till realisation of amount; besides damages of Rs. 20,000/- and costs of Rs. 10,000/-.         OP1 & OP2 are also directed to pay the amount within 30 days from the date of receipt of this order. In case amount is not paid within 30 days from the date of receipt of order, the interest will be 7% pa  (instead of 6% pa) on amount of Rs. 3,56,653/-.

6. The complaint against OP3 (being agent OP1) is dismissed.

7:  Announced on this 03.10.2023.

8. Copy of this Order be sent/provided forthwith to the parties free of cost as per rules for necessary compliance.

[Vyas Muni Rai]                        [ Shahina]                            [Inder Jeet Singh]

         Member                       Member (Female)                               President