Assam

Dibrugarh

CC/19/2014

SMTI PRANATI BARUAH - Complainant(s)

Versus

LIFE INSURANCE CORPORATION OF INDIA - Opp.Party(s)

SRI RABIRAJ BORBARA

06 May 2022

ORDER

IN THE COURT OF THE PRESIDENT , DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION AT DIBRUGARH

 

C.C. Case No.19/2014.

                                                Present -

                                                            1. Shri P.R. Kotoky, President,

                                                            2. Shri Jadav Gogoi, Member,

                                                            3. Smti. Nibedita Bose, Member,

    District Consumer Dispute Redressal  

    Commission, Dibrugarh.

 

 

Smti. Pranati Baruah,

D/o Shri Haren Baruah,

Resident of Sanipatia Gaon,

P.O. & P.S. Lahowal, District Dibrugarh, Assam.

 

                                                            -Vs-

 

                                    1.         Life Insurance Corporation of India,

                                                Central Office, Yoga  Khersha Jivan Bima Marg,

                                                Mumbai.

                                    2.         Divisional Manager, Life Insurance Corporation of

                                                India, Jorhat Divisional Office, P.O & P.S. Jorhat,

                                                Assam.

                                    3.         Branch Manager, Life Insurance Corporation of India,

                                                Dibrugarh Branch, Dibrugarh, Assam.

 

                                                                        Date of Argument – 04-09-2021.

 

                                                                        Date of Judgment – 17-02-2022.

 

                        The C.C. case has been filed u/s 12 of the Consumer Protection Act, 1986 by the complainant praying for directing the opposite parties to pay the amount of sum assured with all the benefits accrued thereon upon the Insurance policies of her brother and to pay a compensation of Rs.50,000/- (Rupees fifty thousand)only for mental agony, pain and unnecessary harassment and a sum of Rs.50,000/- (Rupees fifty thousand)only being the cost spent by the complainant for meeting the requirements of the opposite parties.

 

Judgment

 

                        The case of the complainant in brief is that the complainant is the elder sister of Dipen Baruah, (since deceased) who died on 08.10.2014 by drowning in River Brahmaputra by falling from a boat. During his lifetime, Dipen Baruah was holding two life insurance policies, namely  (1) New Janaraksha Plan with Profits (with accidental benefit) being the policy No.443635930, dtd. 28.08.2009 for a period of 15 years and the sum assured was  Rs.30,000/- (Rupees thirty thousand)only, (2) Money Back policy being the policy No.442122818, dtd. 22.11.2003 for a period of 20 years and the sum assured was Rs.1,01,000/-(Rupees one lakh one thousand)only. The complainant was made the nominee in both the policies by the policy holder Dipen Baruah and the said policies were in continuation from the date of commencement till accidental death of the policy holder in 2004. At the time of death, the insured policy holder Shri Dipen Baruah was an employee in the GREP company at Silapathar, Dhemaji, Assam and use to work in a boat owned by the company which sails in the River Brahmaputra. On 08.10.2010, Dipen Baruah was drown in River Brahmaputra at about 12:30 noon and he could not be rescued and his body could not be traced out. An FIR was lodged at Silapathar Police Station about the incident by the G.D. entry No.251, dtd. 09.10.2004 (Silapathar P.S. Case No.180/2004). The police could not trace out any clue of the incident and they filed a final report closing the investigation.

 

                        That, after the death of Dipen Baruah, his nominee Smti. Pranati Baruah requested through a letter for payment of the sum assured with benefits from the Life Insurance Corporation of India, Jorhat for settlement of both the claims. The Manager, Life Insurance Corporation of India, Jorhat Branch vide letter No.JDO/DCL/REQ, dtd. 28.03.2007 asked for certain  requirements to settle the claims of the complainant. The requirements were -

1. Final Police Report on GDE. No.251, dtd.09.10.2004.
2. Post Mortem report, if done.
3. Eye witness of the incident
4. Report from employer on settlement of terminal benefit of late Dipen Baruah, if paid.

 

                        The complainant, as per requirement of the LICI furnished all the documents to LICI Divisional Branch of Jorhat. But, inspite of receipt of the said documents, the claims of the complainant has not been settled by the opposite party, rather the opposite party vide letter No.JDO/Claims/REQ-10-11, dtd. 05.03.2012 again asked for a court's order for presumption of death and the opposite party assured the complainant that on receipt of the court's order, final decision will be taken for settlement of her claim.

 

                        Accordingly, the complainant furnished the order and the judgment, dtd. 13.05.2013 of the Court of the Munshif No.1, Dibrugarh passed in Title Suit No.5/2013 to the opposite party. However, inspite of furnishing the required documents, the opposite party has refused to settle the claim of the complainant vide letter No.JDO/Claims/AKM, dtd. 13.07.2013 without assigning any reason thereof. The complainant had to run from pillar to post and spent much time, energy and money has been spent  to meet the requirement of the opposite party for settlement of her claim and in due course she had to spent more than Rs.50,000/- (Rupees fifty thousand)only for arranging the required documents and her visit to different places thereafter.

 

                        That, being the lawful nominee of the said two ploicies of Life Insurance Corporation of India, the complainant is entitled to get both the claimed amounts in respect of both the policies with all benefits and interests. The claimant regards the acts of the opposite party as an act of deficiency on the part of the opposite party to settle the pending claim even after compliance with all the requirements as asked for by the opposite party and claims that the O.P. be directed to pay the sum assured in both the policies concerned with all the benefits accrued thereon and to direct the O.Ps. to pay a sum of Rs.50,000/- (Rupees fifty thousand)only as compensation for mental agony, pain, suffering and unnecessary harassment and also to pay a sum of Rs.50,000/- (Rupees fifty thousand)only being the cost spent by the complainant for meeting the requirements of the O.P.

 

                        After registering the case, notices were issued to all the opposite parties who contested the case and submitted their written statement stating that the case is not maintainable under law as well as on facts and no cause of action arise for the case. The O.P. submitted that the policy No.443635930 is on the life of Smtil Pranati Baruah, i.e. the complainant herself and the policy No.442122818 is only on the life of late Dipen Baruah. It is also submitted that the Policy No.442122818 is a lapsed policy. The O.P. has enclosed a copy of the said policy bearing No. 442122818 –Exhibit-A. The O.P. submits that they, vide their letter No.DBO/Claim/MNR/ dtd. 09.11.2004 informed the complainant that the claim would be settled only on production either proof of death or a decree of the court that the life assured is presumed to be dead under the provision of Indian Evidence Act. It was also categorically informed to the complainant that it was absolutely necessary to keep the policies in force by regular payment of premium till any application is filed in court for a decree/declaration of presumed death. But the policies were not continued by the complainant as informed. Annexure-B is that letter. On submission of the decree/order of the Learned Court of Munshif No.1 at Dibrugarh by the complainant on 16.01.2014 in the office of the O.Ps. at Dibrugarh, the claim was immediately processed and the competent authority decided as -Nothing Payable for the cause - the policy was in lapsed condition as per standing rules and law of the Life Insurance Corporation of India. The opposite parties claim that the claim of the complainant be dismissed as the complainant has not approached the Forum with clean hands in lemine with a cost of Rs.10,000/- (Rupees ten thousand)only to the opposite party u/s 26 of the C.P. Act, 1986.

 

                        In this case, the complainant gave his evidence by swearing affidavit and exhibited as many as 10(ten) documents. On the other hand the O.P. gave his/their evidence by swearing affidavit and exhibited as many as 5(five) documents.

 

DECISION AND REASON THEREOF :

 

                        Upon going through the evidence of complainant, it is found that complainant is the elder sister of Dipen Baruah (since deceased) who died on 8-10-2014 by drowning in Brahmaputra river. The brother of the complainant was holding 2(two) Life Insurance Policies Nos. viz (1) under the scheme "New Janaraksha Plan with Profits (with accidental benefits)" Policy No.443635930 dtd. 28-8-2009 for a period of 15 years and the sum assured was Rs. 30,000/- (Rupees thirty thousand)only and (ii) One Money Back Policy being Policy No.442122818, dtd. 22-11-2003 for a period of 20 years and sum assured is  Rs. 1,01,000/- (Rupees one lakh one thousand)only.

 

                        The yearly premium was fixed at Rs. 547/-(Rupees five hundred forty seven)only for the policy No.443635930 and date of maturity was 28-8-2024. The said policy was in continuation from the date of commencement till the accidental death of the policy holder in 2004.

 

Exhibit -1 is the death certificate, issued by the Registrar of Birth and Death, Dibrugarh.

 

              The complainant being the nominee requested through letter for payment of sum assured with benefits from the Life Insurance Corporation of India, Jorhat Division for settlement of both the claims.

 

Exhibit -2 is the LIC Policy being Policy No.443635930, dtd. 28-8-2009

 

Exhibit -3 is the LIC Policy being Policy No.442122818 dtd. 22-11-2003.

 

Exhibit -4 is the claimant's statement for payment of sum assured with benefits from the Life Insurance Corporation of India. The Manager of LICI, Jorhat Division Branch vide letter No.JDO/DCL/REQ, dtd. 28-3-2007 and also vide letter dated 28-07-2007 asked for certain requirements to settle the claim.

 

Exhibit -5 and Exhibit -6 are the letters issued by the Life Insurance Corporation of India and asked for certain requirements to settle the claim.

 

                        The complainant also stated in her evidence that as per the requirements of the aforesaid letters, she has furnished all the documents to LICI, Divisional Branch, Jorhat but inspite of receipts of the said documents, her claim has not been settled by the Opposite Party, rather the Opposite Party vide letter No.JDO/Claims/REQ-10/11 dtd. 5-3-2012 again asked for documents, i.e. Court Order for Presumption of Death and the Opposite Party assured the complainant that on receipt of Court Order regarding death, the final decision will be taken for settlement of claim.

 

Exhibit -7 is the final reminder issued by the LICI.

 

Accordingly, the complainant furnished the order and judgment dt 13-5-2013 of the court of the Learned Munsiff No.1, Dibrugarh passed in Title Suit No.5/2013 to the Opposite Party.

 

Exhibit -9 is the Police Report issued by the Officer-in-Charge, Silapather Police Station.

 

Exhibit -10 is the copy of the order passed by the Learned Court of Munsiff No.1, Dibrugarh. Inspite of furnishing the court order and other required documents by the complainant, the LICI, Jorhat Divisional Branch has denied the claim vide letter No.JDO/Claims/akm, dtd. 13-07-2013. Exhibit-8 is the letter issued by Life Insurance Corporation of India on 13-07-2013 stating that policy got lapse immediately after missing of the person namely Dipen Baruah.

 

                        The Opposite Parties in their evidence submitted that the policy No.443635930 is on the life of Miss Pranati Baruah, i.e. the complainant herself and the policy No.442122818 is only on the life of Lt. Dipen Baruah. The premium for the policy No.442122818 is 1637/- (one thousand six hundred thirty seven)only as mode of payment quarterly with date of maturity as on 22-08-2023 and the complainant of the instant case was made nominee. The opposite party submitted that the policy No.442122818 is a lapse policy. In all policies the terms and conditions are clearly embedded in the policy itself and in page No.2 of the said policy in the head 'Conditions and privileges within referred to' and the clause No.5 forfeiture in certain events read as follows :

 

                        “In case the premium shall not be duly paid or in case any condition herein contained or endorsed hereon shall be contravened or in case it is found that any untrue or incorrect statement is contained in the proposal, personal statement, declaration and connected documents or any material information is withheld. Then and in every such case but subject to the provisions of section 45 of the insurance Act, 1938, wherever applicable, this policy shall be void and all claims to any benefit in virtue hereof shall cease and determine and all moneys that have been paid in consequence hereof shall belong the Corporation, excepting always in so far as relief is provided in terms of the privileges herein contained or may be lawfully granted by the Corporation.

 

                        The clause No.2 of the said Policy grace period under the head 'Conditions and privileges within referred to' read as follows :

 

                        A grace period of one month but not less than 30 days, will be allowed for payment of yearly, half yearly or quarterly premiums. If a premium, that has become due is not paid before the expiry of date of grace, the policy lapses. If death occurs in first policy year any premium that has fallen due but not paid and premiums, if any, falling due before the next policy anniversary shall be deducted from the claim amount.”

 

Exhibit - 'A' is copy of the said policy. In his evidence the Opposite Party submitted that vide letter No.DBO/Claims/MNR, dtd. 09-11-2004, the O.P. informed the complainant that the claim  would be settled only on production either a proof of death or a decree of the court that the life assured is presumed to be dead under the Provision of Indian Evidence Act. Besides that it was also categorically informed to the complainant that it was absolutely necessary to keep the policies in force by regular payment of premium till any application is filed in court for a decree of presumed death. The Policies were not continued by payment of premium regularly and became lapse under the rules and terms and conditions of the policies.

 

Exhibit -'B' is the copy of the said letter No.DBO/Claim,s/MNR, dt. 09-11-2004. The complainant  was informed as final reminder vide No.JDO/Claims/RFEQ-10/11, dt. 05-03-2012 to keep the policy in force once again prior to submit court order for presumption of death. But the complainant did not pay any heed to the suggestion of our corporation.

 

Exhibit –‘C’  is the copy of the said letter No.JDO/Claims/REQ-10-11, dtd. 05-03-2012.

 

Exhibit - ‘D’ is the statement of payment of premium duly certified.

 

            The Opposite Party submitted that the policy No.443635930 is of the complainant’s own life which has no any relevance with the case.

 

            The complainant submitted one death certificate of Dipen Baruah vide Ref. No. Sl. No.0198368, Registration No.619 dtd. 26-05-2006 issued by the Registrar of Birth and Death, Dibrugarh Municipality on 29-05-2006 wherein it shows date of death as on 08-10-2004.

 

Exhibit –‘E’ is the death certificate of Dipen Baruah.

 

 

Points for Decision

 

1. Whether the Policy No.443635930 is of the complainant’s own life.

 

2. Whether the Policy being Policy No.442122818 is a lapsed policy due to non-payment of premium.

 

3. Whether the complainant is legally entitled to get both the claim amount in respect of policy No.443635930 and policy No.442122818.

 

 

Points Decided

 

1. From above discussion and verifying the exhibits put before the Commission, it is seen that policy No.443635930 stands in the name of the complainant herself and not in the name of Dipen Baruah as it is evident from Exhibit No.2, i.e. the original LIC Policy.

 

2. Perusing all the documents filed before the Commission as Annexures/Exhibits it is crystal clear that LIC Policy No.442122818 is in the name of Dipen Baruah, the brother of the complainant. Though the O.P. in their evidence tried to show that policy as a lapsed policy claiming that the policy premium after the death of the policy holder were not paid by the complainant inspite of repeated request of O.P.

 

3. From perusal of Exhibit –‘D’, the statements of payment of premium filed by the O.P. it is seen that the last premium against policy No.442122818 was paid on 25-04-2005 and the amount shown was 3360/- and from this statements it is evident that the policy premium was paid after the death of Dipen Baruah, brother of the complainant and policy holder of the aforesaid policy on 08-10-2004. So the plea of the opposite party of denial of policy amount on the ground of lapsed policy is not believable. Clause 5 of the terms and conditions embedded in the policy as narrated by the O.P. in their evidence clearly states “if death occurs in first policy year any premium that has fallen due but not paid and premiums, if any,  falling due before the next policy anniversary shall be deducted from the claim amount” (section 45 of the Insurance Act).

 

                        Moreover, the O.P. had informed the complainant, a lady of about 30 years, at the initial stage of the claim that the policy was a lapsed one, the complainant would not definitely had to run from pillar to post to meet all the required documents sought for by the O.P. by expending money, time and energy. We have observed that if such practices on the part of the O.P. like LICI, the most trustworthy corporation in the minds of the common people, are allowed to be continued, common people will loss faith on such organization. At the same time if the Consumer Commission fails to give proper justice to the consumers, the Commission will be of no use in the eye of public.

 

 

                        From all above discussion this Commission comes to a conclusion that the complainant is not entitled to get the sum assured or any compensation with regard to policy No.443635930 as the policy holder is the complainant herself. The complainant as the nominee of the deceased policy holder- Dipen Baruah is entitled to receive the sum assured of policy No.442122818.

 

1. The O.P., Life Insurance Corporation of India, Dibrugarh Branch is directed to pay the complainant –Smti. Pranati Baruah the sum assured Rs.1,01,000/- (Rupees one lac, one thousand)only in Policy No.442122818 along with the vested Bonus and other benefits thereof with 9% interest per annum from the date of filing the case till 20-12-2016.

 

2. This Commission is pleased to direct the O.P.- Life Insurance Corporation of India, Dibrugarh Branch to pay to the complainant a sum of Rs.30,000/-(Rupees thirty thousand)only as compensation for mental agony, pain, suffering and unnecessary harassment.

 

3. Further, O.P., LICI, Dibrugarh Branch is directed to pay Rs.10,000/- (Rupees ten thousand)only as cost of litigation.

 

       All the above amount be deposited in credit of this Commission by the O.P. within 30 days from the receipt of this order and judgment, failing which the O.P. will be liable to pay an extra interest @ 10% per annum.

 

            Send copy of this judgment to the O.P. for compliance.

 

            The instant C.C. No.19/2014 is disposed of on contest.

 

            Given under the hand and seal of this Commission this the 17^th Day of February, 2022 in presence of the Learned Members of the Commission and Learned Counsel of the Complainant.

 

 

 

 

Nibedita Bose                         Jadav Gogoi                            P.R. Kotoky,

Member                                   Member                                   President,

District Consumer Dispute     District Consumer Dispute     District Consumer Dispute

Redressal Commission,           Redressal Commission,           Redressal Commission,

Dibrugarh                                Dibrugarh                                Dibrugarh