Orissa

Cuttak

CC/68/2022

Sasmita Swain - Complainant(s)

Versus

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

S Mishra & associates

08 May 2023

ORDER

            IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.68/2022

          Sasmita Swain,

           W/O: Late KanneyanPragyaban Jena

          At:Plot No.129/1234,Lane 13(D),Sivasakti Nagar,

          Andilo,Balianta,Bhubaneswar,

           Khurdha-752101.                  ... Complainant.

          Vrs.

 

1.       Life Insurance Corporation of India,

District Branch Office,Jeevan Jyoti Complex,

Link Road,Cuttack-753012.

 

2.       The Senior Branch Manager, Bharat Machine,

Life Insurance Corporation of India,

District Branch Office,Jeevan Jyoti Complex,

Link Road,Cuttack-753012.

 

 

3.       Bhagyaranjan Mohapatra,

Authorised Agent of Life Insurance Corporation of India

  At-Kandal,PO-Uttaran,PS-Govindapur

Dist:-Cuttack-754105.                                                                             ...Opp. Parties.

 

 

Present:            Sri Debasish Nayak,President.

                             Sri SibanandaMohanty,Member.

 

Date of filing:   18.04.2022

Date of Order:  08.05.2023

 

For the complainant:                   Mr. Sohan Mishra,Adv.& Associates.

For the O.Ps.1 & 2  :                  Mr. A.K.Nath,Adv. & Associates.

For the O.P no.3:                          Mr. A.K.Samal,Advocate.

 

 

Sri Debasish Nayak,President

          Case of the complainant as made out from the complaint petition in short is that her late husband had entered into a policy proposal with the O.Ps on 28.11.2019 under the scheme “Jeevan Umang” bearing policy no.848518562.  The O.P No.3 who is authorised agent of the O.Ps had executed the said policy proposal.  The late husband of the complainant had paid the first premium instalment of Rs.20,913/- and in the said policy she was the nominee.  The subsequent monthly premiums were paid to the O.Ps by her late husband through the authorised agent who is O.P no.3 in this case.  O.P no.3 was provided the premium receipts till the month of October,2020.  The late husband of the complainant had paid all the premiums through O.P no.3 till the month of February,2021.  When the money receipts were being claimed from O.P no.3 he had assured that those premiums were deposited in time and shortly the premium receipts will be made available from the month of November,2020 till February,2021.  On 15.3.2021 due to cardiac arrest, the husband of the complainant had died.  It is for this, the complainant being the nominee of the “Jeevan Umang” policy of her deceased husband had claimed the sum assured of Rs.15,00,000/- from the O.Ps and had provided all the necessary documents as available with her to them.  But on 22.3.22 the complainant was informed by O.P no.2 that the policy as availed by her late husband has lapsed.  The O.P no.3 had not deposited the monthly premiums with effect from December,2020 to February,2021. Thus, it is alleged by the complainant through her complaint petition that due to the non-deposit of the premium amounts by O.P no.3 who is the authorised agent of the O.Ps, her death claim could not be settled for which she has come up with this case demanding from the O.Ps the sum assured amount of Rs.15,00,000/- alongwith interest thereon @ 12% per annum from the date of filing of the claim i.e., from 6.10.2021 till the total amount is quantified.  She has also prayed for a sum of Rs.3,50,000/- from the O.Ps towards her mental agony and harassment and further a sum of Rs.50,000/- towards her litigation expenses.  She has made prayer for any other reliefs as deemed fit and proper.

          In order to prove her case, the complainant alongwith here complaint petition has filed copies of several documents also.

2.       On the other hand, out of the three O.Ps as arrayed in this case, O.Ps no.1 & 2 have jointly contested this case and have filed their written version whereas O.P no.3 has filed his separate written version.  According to the written version of O.Ps no.1 & 2 the case of the complainant is not maintainable which is liable to be dismissed.  They have also questioned the jurisdiction of this Commission in their written version.  Ofcourse they admit about the policy obtained by late Kanneyan PragyabanJena on 18.11.19 vide policy no.848518562 and about the payment of the first premium instalment to the tune of Rs.20,193/-.  In the said policy of Late Kanneyan Pragyaban Jena the complainant was the nominee being the wife.  They also admit about the death of the said policy holder Kanneyan Pragyaban Jena on 15.3.21.  But they have urged that due to non-payment of the premiums the policy had lapsed for which according to them, the death benefit as claimed by the nominee/complainant is not payable. O.Ps no.1 & 2 also admit about the policy being procured by O.P no.3 vide Agent Code no.296460.  The O.Ps no.1 & 2 through their written version have urged that the authorised agents are not authorised to collect the renewal premiums from the policy holder.  Thus, it is the contention of the O.Ps no.1 & 2 that the complaint as filed is liable to be dismissed with heavy cost.

          On the other hand, O.P no.3 through his written version has stated that the complaint case as filed is not maintainable which is liable to be dismissed.  O.P no.3 has mentioned in his written version that he has no role to play in the claim of the complainant and  only O.Ps no.1 & 2 are answerable towards her claim.  He admits that he is an authorized agent of LIC of India who is O.P no.1 in this case and had provided the proposal form to the late husband of the complainant who had agreed for obtaining the “Jeevan Umang” policy where the nominee was the complainant.  He has further mentioned that the O.P no.1 had authorised him to open the Premium Collection Centre at Adashpur,Cuttack in the month of February,2020 in order to give facility to the policy holders for depositing premiumsnear their residence.  The premium amounts of the policy of the late husband of the complainant were being paid either by the complainant or her sister, O.P no.3 was always delivering them the money receipts to that effect.  O.P no.3 admits in his written version that the policy holder who was the husband of the complainant, had died on 15.3.21 and the first unpaid premium was to be on 28.1.21.  O.P no.3 through his written version has vehemently denied about the late husband of the complainant or the complainant herself to have given the subsequent premiums of the policyto him for depositing the same.  Thus, according to him, he is in no way liable here in this case for which he has prayed for dismissal of the complaint petition as filed.

3.       Keeping in mind the averments as made in the complaint petition and the contents of the written versions of the O.Ps, this Commission thinks it proper to settle the following issues in order to arrive at a proper conclusion here in this case.

i.          Whether the case of the complainant is maintainable?

ii.         Whether there was any deficiency in service on the part of the O.Ps ?

iii.        Whether the complainant is entitled to the reliefs as claimed by him?

O.P no.3 has filed his evidence affidavit which when perused, it is noticed that the same is only the reiteration of the written version as filed by him.

Issue no.ii.

Out of the three issues, issue no.ii  being the pertinent issue in this case, is taken up  first for consideration here.

After perusal of the complaint petition, the contents of both the written versions and also the copies of documents as available in this case record, it is noticed that Late Kanneyan Pragyaban Jena, husband of the complainant Sasmita Swain had obtained Jeevan Umang Policy bearing Policy no.848518562 and had paid through O.P no.3 the first premium instalment of Rs.20,913/- which is not disputed.  The said policy holder died on 15.3.21 which is also not in dispute.  The crux of the matter is that the O.Ps have not received the monthly premiums towards the said policy of the deceased policy holder Kanneyan Pragyaban Jena from December,2020 till February,2021 but the premium commencing from 28.12.2020 was deposited on 24.2.21 and the policy was in force upto 28.1.21.  Thus, by the time the policy holder died i.e. on 15.3.21, the policy had lapsed.  In this context, it is the contention of the complainant that the premiums were being paid by her Late husband through O.P no.3 who was the agent of the LIC of India (O.P no.1).  Be that as it may, as a matter of fact, O.P no.1 hasnot received the premiums as regards to the Jeevan Umang policy of the policy holder Late Kanneyan Pragyaban Jena for the months of December,2020, January,2021 & February,2021.  The complainant has urged that the premiums were paid to the O.P no.3 who is the agent of O.P No.1.  O.Ps no.1 & 2 have stated that as per their regulation, the agent of the LIC of India is  only authorised to receive the first premium as due from the new policy holder and not the subsequent premiums.   The premiums which were being paid by the policy holder Late Kanneyan Pragyaban Jena through O.P no.3 subsequent to the first premium if were being paid through him, in that case, O.P no.3 would have acted as the agent of the said policy holder and not as the agent of the LIC of India.  Moreso, it is the duty of the complainant to ensure that he obtains all the money receipts from the agent, whenever he had paid any money towards the premiums of his policy which was intended to be paid promptly by the agent to the LIC of India.  The O.Ps 1 & 2 have also relied upon a catena of decisions which favours the present case in hand. (i) 2011(2) SCC – Rubi Chandra Datta Vrs. United India Insurance Company Ltd., (ii) 1994 CPJ,95 NC-Life Insurance Corporation of India Vrs. Consumer Education & Research Society, (iii) Life Insurance Corporation Vrs. Hemalata Gour, (iv) JT,2008 (SC) 250 Life Insurance Corporation of India Vrs. Jaya Chandel.  But, it would also be pertinent to quote the decision of the Hon’ble Apex Court in the case of Harshad J Saha and another Vrs. L.I.C of India and others wherein their lordships had observed that even if the policy had lapsed considering the facts and circumstances of the case, they had directed the L.I.C of India to refund the entire premium amounts paid alongwith interest @ 15% per annum.

In the present case in hand, the complainant is unable to prove that if infact her late husband had paid all the monthly premiums uptoFebruary,2021 towards his Jeevan Umang policy through O.P no.3.  The O.Ps have stated that the policy had lapsed due to non-payment of the premiums as due for the months of December,2020, January,2021 & February,2021.   This shows that right from the inception of the “Jeevan Umang” policy the O.P/L.I.C of India  was receiving the monthly premiums from the policy holder Kanneyan Pragyaban Jena  upto the month of November,2020,  Thus, when the policy has lapsed, it is the obligatory duty of the O.P./L.I.C of India in order to return the premium amounts at least as received from and on behalf of the policy holder Late Kanneyan Pragyaban Jena  but the O.Ps have not done so.  Thus, it can be concluded here keeping in mind the quoted pertinent decision of Hon’ble Apex Court that by not returning the premium, amounts as received from and on behalf of the policy holder when the complainant had made a claim after the death of her husband which was the policy holder, the O.Ps are undoubtedly found to be deficient in their service.  Accordingly, this issue is answered.

Issues no.i& iii.

From the above discussions and from the facts and circumstances of the case, it is noticed that the case of the complainant is partly maintainable and she is entitled to a reasonable amount of relief even though the policy of her late husband had lapsed.  Hence it is so ordered;

 

                                              ORDER

Case is decreed partly on contest against the O.Ps who are found to be jointly and severally liable here in this case.  The O.Ps are directed to return the monthly premium amounts as received by them towards the policy of Late Kanneyan Pragyaban Jena   vide policy no.848518562 from 28.11.2019 onwards alongwith interest thereon @ 12% per annum till the total amount is quantified and also to bear her litigation expenses to the tune of Rs.50,000/-.  This order is to be carried out within a period of 30 days from the date of receipt of copy of this order.

Order pronounced in the open court on the 8^th day of May,2023 under the seal and signature of this Commission.          

                                                                                                                        Sri Debasish Nayak

                                                                                                                                  President

 

 

                                                                                                       Sri Sibananda Mohanty

                                                                                                                         Member