Date of filing : 28-09-2011
Date of order : 23 -07 -2012
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC. 243/2011
Dated this, the 23rd day of July 2011
PRESENT
SRI.K.T.SIDHIQ : PRESIDENT
SMT.P.RAMADEVI : MEMBER
SMT.K.G.BEENA : MEMBER
Sharada.M, } Complainant
W/o. Late. Narayana Naik.S. Sale House,
Adkasthala-Panaie Road, Perlathadka,
Katukukke, Kasaragod.Dt. 671552
(Adv.K.Shrikantha Shetty, Kasaragod)
1. National Insurance Co.Ltd, } Opposite parties
TVM Divisional office, P.B.No.434,
St.Joseph’s Press Building, Vazhuthacad,
Thiruvananthapuram. 695 014.
(Adv.M.Balagopalan, Kasaragod)
2. Director of Insurance,
Kerala State Insurance Department,
Housing Board Building, Housing Board Junction,
Thiruvananthapuram.
3. Principal Secretary, Finance Department,
Govt of Kerala, Thiruvananthapuram.
4. Sub-Treasury officer, Kasaragod.
5. Director of Treasuries (Govt of Kerala),
Directorate of Treasuries, Power House road,
Chalai, Thiruvananthapuram.
(Ops 2 to 5 Addl.Govt. Pleader,)
O R D E R
SMT.K.G.BEENA, MEMBER
The issue raised in this complaint is whether the complainant is entitled for benefits under group personal accident insurance policy issued to her husband due to his accidental death? Opposite parties rejected the claim on the ground that premium was not remitted to opposite party in time. Husband of the complainant late Sri. Narayana Naik died by drowning on 30-03-2008. The premium payable to the said policy is deducted by the Headmaster from the salary of the individual employees and remitted to Sub Treasury office, Kasaragod as per challan No.249 dt.2-2-2008. As per policy the complainant was entitled to get `3,50,000/-. But the claim was repudiated by opposite parties. Hence the complaint for necessary redressal.
2. According to opposite party No.1, the Government of Kerala entered into a Mou in respect of giving coverage to all accidental and permanent total disablement of government employees and teachers including part time contingent employees under Group Personal Accident Policy and the policy was issued for a period of 1-1-2008 to 31-12-2008. A request for inclusion of teaching and non-teaching staff of Sri. Subrhmaneshwara Higher Secondary School, Katukukke also was given. Though Late Narayanan Naik paid `50/- as premium to the Head Master of the said school it is received by the company from the Director of Treasuries only on 31-03-2008, which is one day after the death of Sri. Naryana Naik. Since the company has not received the premium prior to the death of Sri. Narayana Naik, the company had repudiated the claim and their contention was that the complaint is bad for non-joinder of necessary parties, i.e. Director of Treasuries who is the designated controlling officer of the “88-Group Personal Accident Insurance Fund”.
3. According to opposite party No.2, as per clause 12 of the Government Order, if the dependents are of the opinion that compensation claim rejected by the company is not in accordance with terms and conditions for issuing policy they may make complaint to Principal Secretary within 60 days of the rejection of the claim by NIC. As soon as the complaint is received the Principal Secretary shall forward a copy of the claim to the company with a request to authorize a representative to appear before government to have discussion to settle the matter. But the legal heirs of late Narayana Naik have not filed appeal petition to Principal Secretary within the time limit. The 3rd respondent is not at all liable to pay any compensation in this case.
4. According to opposite party No.5 premium amount of `250/- has been recovered from the salary of Sri. Narayana Naik on 2-2-2008. The opposite party collected the details of amount collected towards the GPAI scheme premium from all treasury officers through the District Treasury Officers concerned and the consolidated amount is remitted by DD in the name of Senior Divisional Manager, NIC collecting the details from the entire 204 treasuries through 23 District Treasury Officers is a time consuming process. However the amount recovered towards the scheme is remitted to NIC. The date of remittance of the recovered amount has not been informed by the government. Hence opposite parties given direction to all the District Treasury Officers vide letter dated 19-03-2008 to report the entire amount recovered. The entire amount was remitted to NIC on 31-03-2008. Eventhough the government has issued a letter dated 19-03-2008 directing to remit the amount on 24-03-2008 the same is received in the office of opposite parties only on 22-03-2008. But only one day is remaining in between it could not be done on 24-03-2008. Since it was humanly impossible to do it in one day. The scheme being a group insurance scheme it is not practical to remit the amount recovered towards premium from each and every employee on the date of recovery itself. Since the remittance is made in various treasuries it can be remitted to the insurance company by collecting and consolidating the same in a phased manner. It is not practical from more than 4 lakh employees, teachers aided institutions and Universities etc to the company before the unfortunate accidents, which could not be predicted. The Insurance company is expected take the date of recovery of premium from insured as the date of effect to coverage. The Insurance company rejected the claim on flimsy and hyper technical reason which is against the true spirit of Mou and scheme. There is no deficiency of service on the part of opposite party No.5.
5. The facts of the case is that the complainant’s husband was working as FT Menial at Sri.Subhramaneshwara Higher Secondary School, Kattukukke. The said school had coverage of Group Personal Accident Insurance of employees and teachers. Complainant’s husband was also insured under the policy of opposite party No.1. The premium payable to the said policy is deducted by the Head Master from the salary of the individual employees and remitted to Sub-Treasury Office, Kasaragod as per chalan No.249 dt. 2-2-2008 and the policy Ext.B9 was issued from 1-4-2008 to 31-03-2009. The premium of late Narayana Naik was remitted by the Director of Treasuries, Trivandrum on 31-03-2008 which is as the complainant had no oral evidence Ext.A1 marked. Opposite party No.1 also has no oral evidence taken. Exts B1 to B9 marked on the side of opposite party No.1. Opposite party No.5 filed affidavit eventhough he had no oral evidence all sides heard and documents scrutinized. One day after the death of Late. Narayana Naik since the company has not received the premium prior to the death of Narayana Naik the company has rightly repudiated the claim. Eventhough government has issued a letter to opposite party No.5 on 19-03-2008 directing to remit the amount on 24-03-2008, the same is received the premium prior to the death of Narayana Naik the company has rightly repudiated the claim. Eventhough government has issued a letter to opposite party No.5 on 19-03-2008 directing to remit the amount on 24-03-2008, the same is received in the office of opposite party No.5 on 22-03-2008, only one day is remaining in between it could not be done on 24-03-2008 and remitted the amount only on 31-03-2008. If opposite party No.5 complied the letter dated 19-03-2008 complainant would have eligible for the policy amount.
6. We agree that incase of Group Insurance Scheme it is not practical to remit the amount recovered towards premium from each and every employee on the date of recovery itself. But it could have been remitted at least in Week ends. Here the government requested through Ext.B11 letter to remit the amount with details on “24-03-2008 itself”. Opposite party No.5 received Ext.B11 on 22-03-2008. As an ordinary prudent officer opposite party No.5 could have shown more vigilance as it is a case of “Assuring Life Insurance” each and every seconds delay is material concerning complainant since accident would not be predicted. Here the premium amounts were deducted from the salary of Late Sri.Narayana Naik from February 2nd onwards. But opposite party No.5 failed to remit the same to insurance company in time and thereby caused monetary loss and mental agony to the complainant. Relying upon the decision in LIC of India & Another V. Smt. Laxmi Patnaik and another (2002) II CPJ 63 (NC) there is deficiency in service on the part of opposite party No.5. Considering the order in Delhi Electronic Supply undertaking V. Basanthi Devi, AIR 2000 SC 43 confirm the finding.
7. As per Ext.B10 letter from Director of Treasuries dt. 19-03-2008 only from the date of remitting the premium amount to the insurance company by knowing this opposite party No.5 would have shown reasonable care and caution in remitting the amount with details either as per Ext.B11 letter or at least within 5 days from 24-03-2008. In a policy assuring life, every seconds service of opposite party is vital as far as the life of insured is concerned. We are relying upon the time allowed by the government for remittance of the amount with details i.e. 24-03-2008. From the version and affidavit filed by opposite party No.5, it is clear that opposite party No.5 did not made an earnest effort to remit the amount with details within 2-3 days from 24-03-2008. As a responsible officer, he took one week further time to remit the amount with details. This shows the lethargic attitude of opposite party No.5. Hence we are of the opinion that the loss suffered by the legal heirs of Late. Sri.Narayana Naik has to be compensated by opposite party No.5 only.
In the result, complaint is allowed and opposite party No.5 is directed to pay `3,50,000/- with a cost of `5000/- to the complainant within 30 days from the date of receipt of this order. Failing which 9% interest shall be charged on `3,50,000/- from 30-06-2008 till payment.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exts.
A1.05-05-2010. Copy of claim rejection by OP No.1.
B1. Photocopy of Memorandum of Understanding.
B2. 29-02-2008 copy of letter issued by Secretary(Finance Expenditure) to Senior
Divisional Manager, NIC Ltd, Trivandrum.
B3. 10-03-2008 copy of letter issued by NIC Ltd to Secretary (Finance Expenditure)
Govt. of Kerala, Trivandrum.
B4. 19-03-2008 copy of letter issued by Secretary Finance Expenditure to Director of
Treasuries, Trivandrum.
B5. 18-2-09 copy of letter issued by National Insurance Co.Ltd to Dist. Educational Officer,
D.E. Office, Kasaragod.
B6. 22-12-09 copy of letter issued by National Insurance Co.Ltd to Director of Treasuries,
Trivandrum.
B7.26-04-10 letter issued by Director of Treasuries to Senior Divisional Manager, NIC
Trivandrum.
B8.05-05-2010 Letter sent by National Insurance Co.Ltd to Dist. Educational officer,
Kasaragod.
B9. Letter issued by National Insurance Company Ltd.
B10.19-03-2008 letter issued by Director of Treasuries to All Dist.Treasury officers.
B11. 19-03-2008 Letter sent by Secretary (Finance Expenditure) to Director of Treasuries,
Trivandrum.
B12. Copy of GO.(P) No.57/2008/Fin. Dt.Trivandrum. 25-01-2008.
B13. Copy of GO.(P) No. 64/2008/Fin. Dt.Trivandrum. 25-01-2008
DW1. K.Ratnakumar.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Pj/ Forwarded by Order
SENIOR SUPERINTENDENT
