Heard learned counsel for both sides.
2. Here is an appeal filed u/s 15 of the erstwhile Consumer Protection Act, 1986 (hereinafter called the ‘Act’). Parties to this appeal shall be referred to with reference to their respective status before the learned District Forum.
3. The case of the complainant in nutshell is that the complainant being nominee of the deceased policy holder Rashmi Mishra who had purchased life insurance policy from OP No.1 bearing Policy No. 582747492 on 28.10.1997 for assured sum of Rs.60,000/- under Salary Savings Scheme. Under the Scheme the premium is deducted by OP No.1. While the policy was in force, it is alleged inter alia that the insured died on22.10.2001. The complainant allegedly submitted all the documents with death claim but the OP No.1 repudiated the claim on the ground that the policy was in lapsed condition. Being such harassment, the complaint was filed.
3. OP No. 2 was set ex pare. OP No. 1 filed written version stating that the monthly premium having not regularly paid it was in lapsed condition from January, 2000. The policy holder remained careless and silent and no correspondence was made with OP No.1 about the place of working and deduction of premiums. However, after receipt of application form the claim was processed and on 29.4.2002 OP No.2 was being requested to furnish the details of deduction and despatch of premiums and the reasons for non-deduction of premiums to which OP No.2 confirmed that there was no deduction of premium made from January, 2000 to December, 2000 and did not furnish any reason for the same. As the policy was in lapsed condition from the date of death of the deceased policy holder and the premiums from January, 2001 to October, 2001 were received after death, they have decided to refund the premiums. Therefore, they submitted that there is no any negligence on their part.
5. Learned District Forum after hearing both parties has passed the following order. The relevant portion is as follows:-
“ xxx xxx xxx
The complaint is allowed on contest against the OP No. 1 an exparte against the OP No. 2 with cost. The OPs are hereby directed jointly & severally to pay a sum of Rs.60,000/- (Rupees sixty thousand) only to the complainant along with a sum of Rs.10,000/- towards compensation for mental agony and harassment and of Rs.5,000/- towards cost of litigation. The above order is to be complied with by the OPs jointly & severally within a period of one month from the ate of communication, failing which the complainant shall be at liberty to execute the order against the OPs in accordance with law.”
6. Learned counsel for the appellant submitted that the learned District Forum committed error in law by not considering the written version with proper perspectives. He further submitted that the premium amount received after death of the policy holder has been already returned. Moreover, OP No.2 was negligent in making payment of regular premium to OP No.1. Not only he was negligent but also the policy holder was negligent to send the premium regularly. Therefore, he submitted to allow the appeal by setting aside the impugned order.
7. Learned counsel for respondent No. 1 submitted by filing letter dated 31.10.2019 issued by the employer - OP No.2 that all the premiums were remitted to the appellant but premium for the month of October, 2001 was deducted from the salary of deceased and remitted through treasury on 29.10.2001 after the death of the policy holder. However, he submitted that there is no fault with the complainant but fault lies on the appellant. Therefore, he supports the impugned order.
8. Considered the submissions of learned counsel for respective parties and perused the DFR including the impugned order.
9. It is admitted fact that the insured purchased the Policy under salary savings scheme from OP No. 1 on 28.10.1997. It is not in dispute that the insured expired on 22.10.2001. In Delhi Electric Supply Undertaking vrs. Basanti Devi and others reported in AIR 200 SC 43 and Chairman Life Insurance Corporation vrs. Rajiv Kumar Bhaskar reported in AIR 2005 SC 34087, the Hon’ble Supreme Court have held that the principal had to take responsibility. Since LIC is the principal is liable to pay the assured amount.
10. It is admitted fact that the policy holder while working has purchased policy from OP No.1. It is also admitted fact that the premium has been also deducted from the salary by OP No.2 and remitted to OP No.1. The fact remains that whether the premiums from January, 2001 to October, 2001 remitted to OP No.1 by OP No.2. Letter dated 31.10.2019 shows that OP No.2 has deducted the premium of Rs. 520/- and remitted same to OP No.1 on 29.10.2001. Fact remains that she died on 22.10.2001. It is clear from the letter that during the life time the premium has been deducted from her salary. When premium has been deducted from her salary but it was sent little later by the time the insured has expired, there is no fault lies with the employer. It is immaterial, it was received by LIC but fact remains that payment was not received during life time of the insured. Therefore, the responsible lies on the insurer for non-payment of the claim and deficiency in service have been well proved by the complainant. We, therefore concur the finding of the learned District Forum in this regard. Not only this but also we are of the view that the impugned order is reasoned one and there is nothing to interfere with it. So far operative portion of the impugned order is concerned, when burden on both the parties and in view of the letter produced before us, we are of the view that OP No.1/appellant is totally responsible to pay the amount. Therefore, modifying the impugned order, we hereby direct OP No.1 to pay the sum assured of Rs.60,000/- along with sum of Rs.10,000/- towards compensation for mental agony besides Rs.5,000/- towards litigation cost to the complainant within 45 days from today failing which it would carry interest at the rate of 12 per cent per annum from the date of impugned order till the date of payment is made.
DFR be sent back forthwith.
Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.
