West Bengal

Paschim Midnapore

CC/48/2016

Chandan Patra - Complainant(s)

Versus

Life Insurance Corporation of India - Opp.Party(s)

Asim Kumar Dutta

29 Aug 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                                                                                                               

Bibekananda Pramanik, President,

Mrs. Debi Sengupta, Member

and

 Kapot Chattopadhyay, Member.

   

Complaint Case No. 48/2016

                                                        

             Sri Chandan Patra, S/o Late Kalipada Patra of Vill. Dharmapur, P.O. –Jagul, P.S. Kotwali,

             Dist. Paschim Medinipur…………..….……Complainant.

                                                                              Vs.

1. Life Insurance Corporation of India, notice to be served Kharagpur Divisional Office, Life Insurance Corporation of India, at Malancha Road, P.O. Nimpura, P.S. Kharagpur (L), Dist. Paschim Medinipur, PIN-721304,
2. Life Insurance Corporation of India, notice to be served Branch Manager, C.A.B. Kharagpur, Malancha Road, P.O. Nimpura, P.S. Kharagpur , Dist. Paschim Medinipur, PIN-721304..………...........…..Opp. Parties.

 

                For the Complainant: Mr.  Asim Kumar Dutta, Advocate.

                For the O.P.               : Mr. Diptendu Ghosh, Advocate.

 

Decided on: -29/08/2016

                               

ORDER

                          Bibekananda Pramanik, President – Facts of the case, in brief, is that Ruma Chakraborty, since deceased, the wife of the complainant was an agent of the O.P.-L.I.C.I. from 15/07/1992 and her agent code  no. was 52/431 and agent licence  no.117159346.   As an agent of L.I.C.I., Ruma Chakraborty sold many policies of L.I.C.I and collected premium of such policies and deposited the premium in the office of the

Contd………………..P/2

 

 

( 2 )

 opposite party regularly and the opposite party also paid her commission in her account no.31505 of Axis Bank.  She also purchased three policies of L.I.C.I in her name being policy nos.432965985, 432965876 and 432965675 in the year 1999 and other two policies  in the year 2001 and last deduction date was 11/2030, 2/2025 and 2/2029 and in her life time, opposite party deducted the premium from her commissions regularly.  As per policy, opposite party opened Group Insurance Scheme for confirmed tied agents and category of the Group Insurance in the year basis of agency and in the life time of the wife of the complainant, renewal premium was deducted from her commission as per scheme.  The complainant being the husband of Ruma Chakraborty is the nominee of those four policies alongwith Group Insurance Policy.  Unfortunately, Ruma Chakraborty was attacked with kidney disease and she was admitted in Appollo Hospital in Chennai on 04/10/2013.  She was thereafter admitted in S.S.K.M. Hospital, Kolkata and Maroari Relief Society in Kolkata but unfortunately she died on 18/10/2015.  After demise of Ruma Chakraborty, the complainant being the nominee deposited all relevant papers alongwith policies in the office of the opposite party.  Opposite party received the same and deducted the premium of three policies up to 10/2015 but the opposite party settled the claim of three policies at Rs.9427/-, Rs.8736/- and Rs.8109/- although the maturity value of those policies were Rs.50,000/- each which the complainant is entitled to get.  The opposite party increased the Group Insurance Scheme at Rs.10,00,000/- w.e.f. 01/09/2015.  Agency of the wife of the complainant was more than 10 years and she is entitled said coverage.  Opposite party received the premium of Ruma Chakraborty in respect of such Group Insurance Policy from her commission but the opposite party did not deduct the said premium  although the opposite party deducted the money from other Group Insurance holders from their commission on 11/2015. It is stated that the opposite party intentionally did not deduct the renewal premium of Ruma Chakraborty within time.  Aforesaid three policies in the name of the wife of the complainant were continuing. After the death of his wife, the complainant filed  several representations before the office of the opposite party but the opposite party forwarded the said letter to the higher authority for decision but higher authority did not pay any heed to the request of the complainant.  It is alleged that such act of the opposite party is deficiency in service on their part.  Hence the complaint, praying for directing the opposite parties to pay balance amount of Rs.1,23,668/- of those three policies and for a direction to pay of Rs.10,00,000/- alongwith interest in respect of Group Insurance Scheme and for other reliefs.

                  Both the opposite parties have contested this case by filling a joint written objection.

Contd………………..P/3

 

 

( 3 )

                 Denying and disputing the case of the complainant, it is the specific case of the opposite parties that all the aforesaid three policies of Ruma Chakraborty were under “Bima Kiran Plan” in which claim concession is not applicable.  Being an agent of L.I.C.I, Ruma Chakrabory was very much aware of the scheme as her agency was more than 10 years and after being understood about the pros and cons, Ruma Chakraborty purchased those three policies.  As per circular no. C.O/MKtg/XD/18/2015 dated 14/09/2015  revised G.I. schedule is effective from 01/09/2015 and as per the basic condition of the schedule rule  vide  circular no.272 dated 16/08/2007, no benefit will become payable there under for  discontinuation of contributions relating to the assurance for any reasons whatsoever.  In case of lapsed policy only return of premium is payable in case of the aforesaid three policies.  It is stated that at the time of death of said Ruma Chakraborty all the said three policies  were in lapsed condition and as the said policies were not in force  so only National paid up value i.e. premium paid minus extra premium  has been paid.  All the said three policies are eligible for death claim cover and the claim is thus admitted for National paid up value and no benefit will become payable under discontinuation of contributions relating to the assurance for any reason whatsoever.    On annual renewal date, said Ruma Chakraborty had no sufficient commission to get the premium recovered.    As no deduction was made in respect of G.I. premium in the year 2015 due to insufficient commission and non-availability of consent letter so no question of Group Insurance  coverage of said agent Ruma Chakraborty has arisen.  It is further stated that till now L.I.C.I. has not repudiated the claim of the complainant and as such no cause of action of the instant case has arisen at all.  Opposite party has also denied that there is any deficiency in service on their part and therefore they claim dismissal of the complaint with cost.

                                                                 Point for decision

1. Is the case maintainable in it,s present form and prayer ?
2. Has the complainant cause of action to file this case ?
3. Is there any deficiency in service on the part of the opposite parties ?
4.  Is the complainant is entitled to get the reliefs, as prayed for ? 

                    

Decision with reasons

For the sake of convenience and brevity, all the above points are taken up together for consideration.

At the very outset, it is to be stated here that in this case neither the complainant nor

Contd………………..P/3

 

 

( 4 )

the opposite parties has adduced any sort of evidence, either oral or documentary but they have relied upon some documents so filed by them.  Admittedly, Ruma Chakraborty, since deceased, the wife of the complainant was an agent for the opposite party-Insurance Company and she during her life time obtained three policies being nos. 432965985, 432965876 and 432965675 in the year 1999.  It is also admitted that Ruma Chakraborty being an agent was under the scheme of Group Insurance of the O.P.-L.I.C.I.  It is not denied and disputed that the complainant is the nominee of those policies and after the death of Ruma Chakraborty, the complainant being the husband-name of those policies submitted claim before the O.P.-Insurance Company in respect of those policies.  It is also undisputed that the opposite parties settled the claim of three policies at Rs.9,427/-, Rs.8,736/- and Rs.8,109/-.  According to the complainant, the value of those three policies is Rs.50,000/- each and the complainant is entitled to the full value of those policies.  As against this, it is the case of the opposite parties that at the time of death of Ruma Chakraborty said three policies were in lapsed condition and as the said three policies were not in force, so only “National Paid Up Value” has been paid.  Complainant filed no document to show that those three policies were in force and those were not in lapsed condition.  In view of that, O.P.-Insurance Company did no illegality in paying National paid up value of those policies instead of full coverage of policies.

   Regarding Group Insurance Policy, it is the case of the opposite party that on the annual renewal dates of said Group Insurance Policy, Ruma Chakraborty had no sufficient commission to get the premium recovered and as such no deduction has been made in respect of G.I. premium in the year 2015 due to insufficient commission and non availability of consent letter. Complainant filed no documents to show that Ruma Chakraborty had sufficient amount of commission to get the premium of Group Insurance policy recovered from her account.  However, the O.P.-Insurance Company has admittedly did not repudiate the said claim of the complainant but they have forwarded the claim papers regarding such claim of Group Insurance Policy to their Divisional Authority for their necessary consideration and that would also be evident from the letter dated 26/06/2016 addressed to the Ld. Advocate Mr. Ashanul Alam of the complainant.  Said letter has been filed by the opposite parties in this case and from that letter we find that regarding claim of  Group Insurance Policy the same has been  forwarded by the Ops. to their Divisional Authority on 29/12/2015 and 21/03/2016 for their necessary consideration and till date they have not yet heard from them and they requested the complainant to bear with them.  In view of that the opposite party have stated the since L.I.C.I has not yet repudiated the claim of Group

Contd………………..P/4

 

 

( 5 )

Insurance as yet, so no cause of action has arisen for filing this instant case.  Since admittedly the claim of Group Insurance Policy has not yet been repudiated by the opposite parties, so we are of the view that the claim of benefit of Group Insurance Policy is pre-matured and the complainant has no cause of action to file this case regarding such claim of Group Insurance.

In the above circumstances and in view of our above discussions, it is held that the petition of complaint is liable to be dismissed.

All the points are accordingly disposed off against the complainant.

                                                         Hence, it is,

                                                                              Ordered,

                                        that the complaint case no.48/2016  is hereby dismissed on contest but in the circumstances without cost.

                               Let plain copy of this order be given to the parties free of cost.

            Dictated and Corrected by me

                      Sd/-B. Pramanik.       Sd/- D. Sengupta.    Sd/- K.K.Chattopadhyay.   Sd/-B. Pramanik. 

                          President                       Member                        Member                       President

                                                                                                                                    District Forum

                                                                                                                                 Paschim Medinipur