The Judgment and order dated 10^th June 1998 passed by the District Forum, East Khasi Hills, District: Shillong in C.P. Case No. 5(S) of 1997 is the subject matter under challenge in this appeal under Section 15 of the Consumer Protection Act, 1986, for short, Act of 1986.

 

2. The facts of the case, in a short compass, are as follows:-

 

The Complainant, namely, Shri Radhey Shyam Bajoria, respondent herein, filed a complaint against the present appellant and its authorities concerned before the Learned District Forum, East Khasi Hills, District: Shillong, for a direction to the present appellant/Life Insurance Corporation of India, for short, Insurance-Corporation to issue policy documents to the complainant/respondent in respect of 3(three) nos. of insurance policies upon payment of up-to-date premium with effect from 31^st October 1993, thus validating the policies on completion of all the formalities pertaining to the policies and also to make payment of Rs.10,000/- (rupees ten thousand) only as cost, compensation and lawyer,s fee by contending, inter alia, that the complainant submitted 3(three) proposal forms of Life Insurance policy on 30^th October 1993 and deposited a sum of Rs.22,355/- (Rs.8,942/-, Rs.8,942/- and Rs.4,471 respectively) for the three proposals on the same day after complying with the personal statement, medical report and agents report etc. and the said premium was duly paid to the office of the Insurance Corporation which also acknowledged the receipt of the same. However, the Insurance Corporation did not issue acceptance letter as well as policy bond in-spite of repeated approaches and correspondences from the complainant, respondent herein. The complainant highlighted detailed facts of the case in the complaint petition, which is supported by the related documents appended to the complaint petition. The case of the complainant is resisted by the respondent, Insurance Corporation and its authority by filing joint show cause statement before the learned District Forum. According to the appellant/Insurance Corporation, the complainant did not comply with essential requirements of Special Medical Analysis-12 (SMA-12), namely: a) Fasting Blood Sugar; b) Serum Creatinine; c) Serum Cholesterol; d) Serum Triglycerides; e) Serum Uric Acid; f) Serum protein Albunine and Globulin; g) Serum Bilirubin – direct and indirect; h) S.G.O.T.; i) S.G.P.T.; j) Serum Calcium; k) Serum Potassium; l) Serum Alkaline Phosphatese. It is also in the case of the Insurance Corporation that the SMA-12 is an essential requirement of the policies taken under Ashadeep Policy Scheme which the proponent himself chose to take but did not submit the SMA-12 even after requests for submission of the report. The Insurance-Corporation also raised certain facts and pleas in the show-cause statement and the grounds column of it and further sought for dismissal of the complaint petition with cost. However, in the result, the complaint petition was disposed of by the learned District Forum on 10^th June 1998 with the direction to the appellant and its authority to issue the acceptance letter against the 3 (three) premium and also the Life Insurance certificate(s) to the Complainant to be effective from 1993 and subject to the clearance of all the pending premium which the complainant is to pay to make the policy current and this should be completed within a period of two months from the date of the order. The learned District Forum also observed that if the appellant/opposite party in the complaint faled to comply the order as directed, they shall have to pay cost at Rs.5,000/- together with interest @ 15% till compliance of the order. Being aggrieved by the impugned Judgment and Order dated 10^th June 1998, the appellant/Insurance Corporation filed this appeal.

 

3. At the very outset, Mr.B.P.Dutta, learned counsel, supporting the case of the appellant, contended that the learned District Forum had failed to appreciate the requirement of submission of SMA-12 as provided in the manual for an Ashadeep Policy by the Complainant while passing the impugned Judgment and Order and apart from that the Forum below also failed to consider the fact that the Life insurance Corporation Policy can be issued only on satisfaction of the health condition, that is on a medical report of the proposer. It is also contended by Mr.Dutta, learned counsel that the learned District Forum erred in law in passing the impugned judgment and Order. Supporting his contention, Mr.Dutta has drawn our attention to the grounds column appearing at paragraph 8 of the Memo of Appeal and supported those grounds while arguing the case for and on behalf of the appellant/Insurance Corporation. Those grounds are reproduced as hereunder:-

 

                                                            “GROUNDS”

 

a)      For that the District Forum below failed to appreciate the facts of the case, and the principles of law involved therein.

 

b)      For that the Forum below failed to appreciate the fact that the policies were just in the proposal stage, and are awaiting fulfillment of the terms and conditions.

 

c)      For that the proposal with the deposit of proposal deposit cannot give rise to a contract for issue of policies without fulfillment of the conditions of taking such policies.

 

d)      For that the Forum below failed to appreciate the fact that the submission of proposal paper and proposal deposit by itself cannot give rise to a contract for issue of a policy.

 

e)      For that the Forum below miserably failed to appreciate that the Respondent failed to comply with the requirement of submission of SMA-12 as provided in the manual for an ‘Ashadeep’ Policy

 

f)        For that the Forum below failed to consider the fact that the Life Insurance Corporation Policy can be issued only on satisfaction of the health conditions, that is on a medical report of the proposer, and in the instant case the proposer failed to furnish the report in spite of his information for such requirement as he himself chose to take the ‘Ashadeep’ Policy.

 

g)      For that the Forum below failed to consider that the letter dated 11/11/93 was posted at his address as given in the proposal paper in spite of showing the evidence of posting from the dispatch register, whereas all other letters sent to the same address were received by the respondent.

 

h)      For that the Forum below failed to appreciate that the contract is a bilateral matter and without fulfillment of the conditions by the proponent, the other cannot act.

 

i)        For that the Forum below failed to appreciate the fact that no contract of insurance was entered into by the Corporation with the Respondent, and which could not be done without fulfillment of the health conditions by furnishing SMA-12 as provided in case of ‘Ashadeep’ policies.

 

j)        For that the Forum below failed to appreciate the fact that in the absence of a contract for life insurance with the Corporation, the Respondent/ Complainant could not be a consumer of the Corporation, and that the Forum has no jurisdiction to entertain the Complaint petition.

 

k)      For that the Forum below failed to appreciate the fact that the proposal form cannot provide for the requirement of different types of policies and this could be known only after the proposal is received specifying the type of policy the Proponent intends to take.

 

l)        For that the Forum below erred in observing that the Respondent Complied with the furnishing of Medical report and paid the premiums duly as no premium, in fact, was paid, as the amount paid was only the ‘Proposal deposit and the premium cannot be paid till the proposal is accepted to issue a policy.

 

m)    For that the Forum below failed to appreciate that the contract of insurance was not included and could not be completed without fulfilling the condition of submitting the SMA-12; and hence the Complainant/Respondent could not claim himself to be a consumer.

 

n)      For that the Forum below while accepting the evidence of dispatch of the letter dated 11/11/93 and also accepting the fact that the Complainant/respondent was frequently visiting the Office of the Appellant did not accept the fact of issue of and receipt of the letter sent to the correct address of the Complainant/respondent and his knowledge of submission of the special medical Analysis-12.

 

o)      For that the Forum below failed to appreciate the submission of the fact that on submission of a proposal form and after the scrutiny of age, family history, personal history and others, it is to be decided what reports are required for completion of the proposal and erroneously decided that the Policy be issued on the basis of the proposal form without submission of the Special Medical Analysis-12.

 

p)      For that the Forum below failed to appreciate that the proposal form with ‘proposal deposit’ was submitted only 30/10/93 and the requirements were called on for on 11/11/93 without causing any delay and the letter was posted to the address given in the proposal form, and the question of negligence of laches had not, in any way, arisen.

 

q)      For that the Forum below failed to appreciate the age of the Complainant/Respondent reflecting in the proposal form and in the advanced age routine medical examination is not sufficient to issue a Life Insurance Policy covering the risk of the life of a person in that advanced age.

 

r)       For that the Forum below also failed to appreciate that the ‘Ashadeep’ policy as asked for by the Complainant/respondent essentially requires the submission of SMA-12 as per the provision of the manual.

 

s)       For that the Forum below passed an order in the cases of utmost good faith covering the risk of the life of a person who is advanced in age without any direction of submission of SMA-12 to cover the risk of life of the proposer which threatens to cause loss to the Public Exchequer.

 

t)        For that the impugned judgment and order of the Forum below is bad both in law and facts and is liable to be set aside and quashed.”

 

4. At the hearing, Mrs. Tshering Yangi, learned counsel submitted that there is no infirmity or illegality in the impugned judgment and Order as the learned District Forum had rightly appreciated all the facts and circumstances of the case after perusal of the available materials on record and as such, no interference is called for from the end of this State Commission. Now, this Commission is to see and examine as to whether the appellant could make out a case to justify interference with the impugned Judgment and Order or not?

 

5. We have perused the available materials on record. It is not disputed that the three proposals of Insurance policies were taken by the complainant on payment of Rs.22,355/- after complying with the personal statement, medical report and agent’s report and that the said premium was duly paid in the office of the Insurance company but the appellant did not issue the acceptance letter as well as the policy bond in spite of repeated personal approaches and correspondences made by the complainant. A bare perusal of the copies of the proposal acknowledgement as well as documents as well as documents for proposal for insurance on own life show that there is no whisper on it about the essential requirement and submission of SMA-12. In this regard, it may be mentioned that the learned District Forum had examined the matter pros and cons and was of the view that there is no iota of any indication that the complainant is required to comply with the requirements of the said SMA-12 as alleged to have been informed to the complainant vide, letter dated 11^th November 1993. The relevant observation of the learned District Forum regarding the deficiency of services caused by the appellant/Insurance Corporation to the complainant finds its place at paragraph 8 of the impugned Judgment and Order which is relevant in the instant case and accordingly, it is quoted below:-

 

“8. It is also surprising to note that the Opposite parties have not file the copy of the form of the complainant and it was only in the course of argument at our insistence that a photo copy of one of the proposal form which is dated 29^th October ’93, the complainant was medically examined by a qualified doctor D.J. Goswami and all the particulars pertaining to the health conditions of the complainant have been answered and filled in and there is no iota of any indication that the complainant is required to comply with the requirements of the said SMA-12 as alleged to have been informed to the complainant vide letter dated 11.11.93. If such requirement, which according to the Opposite parties are very vital which complainant has to comply, we failed to understand as to why the same should not have been informed to the complainant on the date the proposal was made and when he was medically examined by the qualified doctor and why should it be sent only on 11.11.93 as alleged by the Opposite parties but denied by the complainant. That apart, the Opposite parties have also failed to prove that he alleged letter dated 11.11.93 was at all received by the complainant. The complainant is not expected to be kept in the dark and that the Opposite parties will play a hide and seek game in the matter of insuring of the life of a person and it is the paramount duties of the Opposite parties to see that all necessary compliance are to be properly informed and failing to comply with the requirement, then only the Opposite parties hands would be vindicated but not in the manner as it was done in this case.”

 

6. According to us, the above finding of the learned District Forum is a reasoned finding and as such, no interference of it is called for. It is also noteworthy to highlight the fact that the appellant/Insurance Corporation had appended the copies of the guidelines for Underwriting of the Life Insurance Corporation of India and Rules for Special medical Reports as in Annexure IX to the Memo of Appeal and the said rules for Special Medical Reports is relevant for just determination of the real points in controversy between the parties.

 

7. In the instant case, the said proposals for insurance on own life of the complainant related to sum proposed of Rs.1,00,000/- (Rupees one lack) each only. A bare perusal of the said rules for Special Medical Reports shows that for the sum under consideration for Rs.1,00,000/- (Rupees one lack) or Rs.2,00,000/- (Rupees two lack), no SMA-12 is required. This can be seen from the above mentioned chart. Therefore, we are of the view that the appellant/Insurance Corporation had put the complainant under hardship and distress by not issuing life Insurance Policy documents/certificates, which is sheer negligence of the appellant and its authority, resulting into deficiency of services to the complainant. This commission is not required to go into depth as suffice is made with the above observations to dismiss the present appeal. Last but not the least, we kept on record the statement of the learned counsel appearing for the complainant that the complainant is still in good health. It is sad to know that for the last about 10 years after the payment of first installment of respective premiums of the said policies, the appellant/Insurance Corporation is not issuing policy documents/certificates in respect of the said three policies without any justification. In the result, the  present appeal is dismissed, thus affirming the impugned Judgment and Order dated 10^th June 1998 passed by the learned District Forum, East Khasi Hills, District: Shillong in C.P. case No.5(S) of 1997 with cost of Rs.10,000/- (Rupees ten thousand) only. It is made clear that the judgment and order of the learned District Forum is to be complied with by the appellant/Insurance Corporation within a week from today and, payment of such cost of Rs.10,000/- is also to be made to the complainant within a period of one week from today by depositing the same with the Registry/Office of this State Commission. The Registry of this Commission is directed to supply a copy of the judgment and order to the learned counsel appearing for the parties during the course of the day.