Per Shri Narendra Kawde, Hon’ble Member This appeal is directed against the order dated 09/08/2002 passed in consumer complaint No.187/2000, Smt.Jayawanti Damodar Joshi V/s. The Sr. Divisional Manager, LIC of India & Anr, by District Consumer Forum, Mumbai Suburban. 2. District Consumer Forum has passed the order directing opponent No.1/LIC of India (hereinafter referred to as ‘the Corporation’) to pay to the complainant the claims/sums assured or death benefits with bonus and additional benefits, if any, in respect of policies bearing Nos.881890261, 882011029 and 892869158 on the life of late Shri Naresh Damodar Joshi, deceased son of original complainant/respondent No.1 together with compensation of `5,000/- for each policy for the inconvenience, hardship and mental agony and `1,000/- for each policy towards expenses/cost of complaint. 3. Aggrieved with the impugned order, present appellant/org. opponent No.1/Corporation preferred this appeal stating that policy Nos. 881890261, 882011029 and 892869158 were issued in favour of deceased life assured Shri Naresh Damodar Joshi under Salary Saving Scheme with arrangement to pay premiums through his employer/respondent No.2. District Consumer Forum did not take into account the responsibility of the deceased employee as per the policy terms and the undertaking executed by him to make payment of premiums through his Employer. Impugned order is outside the purview of policy terms as the policies were lapsed and did not accrue any benefits thereunder payable to the complainant. 4. Admittedly, appellant-Corporation issued subject life policies in favour of Shri Naresh Damodar Joshi, employee of respondent No.2 under the Salary Saving Scheme (SSS). Premiums were to be deducted and paid to appellant-Corporation through employer/respondent No.2. Life assured Shri Naresh Damodar Joshi expired on 02/06/1996. Claims under subject policies were preferred by complainant/respondent No.1, who is mother of deceased life assured Shri Naresh Damodar Joshi. Appellant-Corporation did not honour the claims and refused to pay benefits under these policies on the ground that polices were in lapsed condition at the time of death of life assured and accordingly informed the complainant by way of letter dated 24/04/1999. Thereafter, complainant filed consumer complaint before District Consumer Disputes Redressal Forum. District Consumer Disputes Redressal Forum allowed the complaint and directed to pay to complainant all the benefits under these policies as summarised in para 2, supra. 5. We heard Mr.Rajeev Chavan, Learned Advocate for the appellant/Corporation and Mr.J.B. Gai, Authorised Representative for the respondent No.1. We have perused the evidence/documents led by the parties and the pleadings. 6. Learned Advocate of the appellant-Corporation pleaded that as per the policy terms and conditions, appellant/Corporation is not under obligation to inform about non-payment or non-receipt of premium under the Salary Saving Scheme. In the instant case, all the policies were lapsed for non-payment of premiums. 7. Authorised Representative of the complainant/respondent No.1 relied on the judgement of the Hon’ble Supreme Court in Appeal No.6028/2002, Chairman, Life Insurance Corporation & Ors. V/s. Rajiv Kumar Bhasker, dealing with responsibility of the Employer and the Corporation while deciding the contractual obligations in remitting the payments of premium in respect of insurance policies served under the Salary Saving Scheme of the Corporation. The observations of the Hon’ble Supreme Court are reproduced below :- “…….Even at that stage, the Corporation would have a duty to inform the employee concerned towards his right. Even in case of non-payment of premium for any reason whatsoever, in view of the object the Scheme seeks to achieve, it was the duty of the insurer to inform the employee about the consequences of non-receipt of such premium from the employer. The Corporation has failed or neglected to do so. In that view of the matter, we do not find any reason to take a different view. [Emphasis Supplied] …….Such obligations having been undertaken to be performed by the employer at the behest of the Corporation as its agent having the implied authority therefore, the Corporation cannot be permitted to take advantage of its own wrong as also the wrong of its agent. In any event, the employer was obligated to inform the employee that for some reason, he is not in a position to perform his obligation whereupon the latter could have paid the premium directly to the Appellant herein.” 8. Further, the Authorised Representative of the respondent No.1/complainant pointed out the provisions of the Policy Servicing Manual Clause No.14 (Salary Saving Scheme) which reads as below :- “14. DEFAULT INTIMATION When the premium is not recovered consecutively for 3 or 4 months, the default intimation should be issued before the 5th default in any case.” 9. We observe that appellant-Corporation did not discharge its obligation in this case as held by the Hon’ble Supreme Court in the case referred to the above and instructions laid down in the Policy Servicing Manual, thus, leading to deficiency of service under Section 2(1)(g) of Consumer Protection Act, 1986. 10. In view of the above, we hold that the appeal is devoid of merit. Order passed by the District Consumer Forum in complaint No.187/2000 cannot be faulted with. We hold accordingly and pass the following order:- -: ORDER :- 1. Appeal stands dismissed. 2. Order of the District Consumer Forum is hereby confirmed. 3. No order as to costs. 4. Copies of the order be furnished to the parties. Pronounced Dated 26th August 2011. |