The instant case was instituted on the basis of a petition under Section 12 of Consumer Protection Act, 1986 filed by one Smt. Bina Saha, Wife of Late Pranab Kumar Saha, resident of Kshudiram Pally, P.O & P.S- Islampur Dist.-Uttar Dinajpur which was registered as Consumer Case No. 53/18 in this Forum.
The fact of the case as revealed from the petition of complaint as well as from the evidence is that the husband of the complaint (Sri. Pranab Kumar Saha) since deceased was a holder of Jeevan Anand policy under L.I.C of India through Islampur Branch bearing policy No-455104690 and the sum assured under the said policy was Rs.1,00,000/-(One lack) with effect from 15-03-2008 to 15-03-2019 and the complainant Smt. Bina Saha was the nominee of the said policy.
The deceased policy holder used to pay monthly premium at the rate of Rs.1150/- from 15/03/2008 and paid an amount of Rs.1,22,259.32/- up to 23/08/2016.
But unfortunately in the month of February, 2013 the said policy holder (Pranab kumar Saha) became ill and firstly he was treated under Dr. Sekhar Chakraborty at Siliguri, who after fully check up and referred him to Tata Memorial Hospital at Mumbai.
After receiving advice of the said doctor the policy holder (Pranab Kumar Saha) was immediately taken to the Tata Memorial Hospital at Mumbai and he was first seen in the hospital on 06/03/2013. Since then the treatment was started. After prolonged treatment the policy holder (Pranab kumar Saha) left the world on 28/08/2016 at his own residence.
It has been further stated that after the demise of the policy holder the death intimation was given to the O.P/L.I.C and as per their advice the complainant filled up the required documents along with the claim statements.
On 13/03/2017 the amount of Rs.88,790/- (including bonus Rs.31,500/-) was credited to the saving bank account of the complainant.
After receiving the said amount the complainant several times attended the office of the O.P/L.I.C for making payment of rest deposited amount and the O.P.No-1 assured her that the matter will be solved as early as per decision of O.P.No-2. After the lapse of long time no response was received from the side of the O.P. Thereafter, the complainant was compelled to file an application to the office of O.P.No-2 under RTI Act, 2005 on 26/02/2018.
Thereafter, in reply to the RTI the O.P.No-2 informed the complainant that the O.P/L.I.C has repudiated the claim of the complainant.
The further case of the complainant is that due to the negligence on the part of the O.P, the complainant has been deprived of her claim for which the complainant is suffering from mental pain and agony. As such the complainant come to the Forum for her relief as prayed for.
The petition has been contested by the L.I.C that is O.P.No-1&2 by filing the W.V denying all the material allegations as labeled against the L.I.C contending inter alia that the instant case is not maintainable either in facts or in law and the case is also barred by law of limitation and there is no cause of action to file the case against the L.I.C.
The definite defence case is that the revival made on 13/09/2014 and 15/07/2015 on the basis of false statement and such giving false statement has nullified the whole contract under the policy in question.
The further defence case is that the policy was revived on 13/09/2014 and again on 15/07/2015 with a personal statement of good health but the fact is that the complainant was suffering from cancer since February 2013. So the real fact was suppressed by the deceased policy holder, as such the case was repudiated.
The further case of the L.I.C is that the total premium was paid Rs.66700/- and paid Rs.23000/- on 13/09/2014 as revival premium (20th installments) and Rs.12650/- as revival premium (11th installments) paid on 15/07/2015 and thereafter premium was paid up to 08/2016.
The further defence case is that in form No-680 dated 1st August 2014 and 2nd July 2015 are the proof of the mis statement. For giving such false statement entire contract of the Insurance may be treated as null and void and entire money paid may be forfeited by the Corporation.
So, considering such facts and circumstances the instant case is liable to be dismissed.
In order to prove the case the complainant (Bina Saha) was herself examined as PW1 and she was cross examined. No other witness was examined on behalf of the complainant. On the other hand the L.I.C has examined one Sudeb Mohanta as OPW 1 and he was also cross examined and documents was exhibited on behalf of L.I.C as exhibits A and A1.
Now, the point for determination as to whether the complainant is entitled to get any relief from this forum or not?
D E C I S I O N W I T H R E A S O N S:
At the time of argument the Ld. Lawyer of the O.P /L.I.C argued that the claim was repudiated on the ground that the revival of the policy was made by suppressing the real fact. According, to the argument as advanced by the Ld. Lawyer of the O.P is that in the claim petition it has been clearly stated that the husband of the complainant was suffering from cancer and he was admitted for treatment at Tata Memorial hospital in Mumbai on 06/03/2013. But the revival was made in the year 2015, so definitely it was a suppression of fact that the husband of the complainant was suffering from cancer. In the revival petition the complainant (Bina Saha) has stated that her husband was in good health, as and when a person suffering from cancer cannot be said that he is in good health.
On the other hand the Ld. Lawyer of the complainant argued that there is no record to show that the revival letter has been accepted and there is no endorsement on the part of the L.I.C Authority. But such argument as advanced by the Ld. Lawyer of the complainant is not acceptable as because the revival letter is submitted by the complainant herself and in the revival letter there is no prescribed provision that the L.I.C Authority will accept the same. The revival letter is a mere declaration. As the revival letter has been accepted this is why the complainant (Bina Saha) paid the revival premium. So, the argument as advanced by the Ld. Lawyer of the complainant is that the revival letter was not accepted by the L.I.C authority is not tenable. As the revival letter was submitted by the complainant herself for giving false statement as such the L.I.C Authority rightly repudiated the claim. On perusal of the evidence it is found that the L.I.C has paid Rs.88,790/-(Eighty eight thousand seven hundred and ninety) including bonus of Rs.31,500/-(Thirty one thousand and five hundred). But main dispute arises whether the complainant is entitled to get the amount which was paid for the revival of the policy amounting to Rs.1150 X 24= 27,600/-(Twenty seven thousand and six hundred). But the Ld. Lawyer of the O.P/L.I.C submitted that the competent authority (DODRC dated 31.01.2017) repudiated the claim and the premium paid by way of revival on 15/07/2015 become null & void. So, the claimant is not entitled to get the amount which was paid by the complainant. As and when it is found that the husband of the complainant died due to cancer and actually the amount was paid by the deceased for revival of the policy, though the rule does not permitted to refund the premium paid by way of revival but for the humanitarian ground as and when the husband of the complainant died due to cancer and he has paid the amount. So it will be just and proper to pass an order to refund the amount without any interest. What is the necessity of keeping any amount from a person who is no more in the world? So, considering such facts and circumstances the instant case is liable to be dismissed on the ground that the revival was made by giving false statement.
C.F. paid is correct,
Hence, it is,
O R D E R E D:
That the complainant case being No. CC-53/18 be and the same is dismissed on contest but without any cost.
However, for the humanitarian ground the L.I.C is requested to refund the amount of Rs.27,600/-(Twenty seven thousand and six hundred only) to the complainant but without any interest within 3 months from the date of order.
Let a copy of this order be given to the parties free of cost on proper application.
