F.A. 897/2009  against C.C. 8 /2009,  Dist. Forum, Adilabad   

Between:

1)  L. I. C. of India

Rep. by its Branch Manager

Branch Adilabad

Opp.   A.R. Head Quarters

Adilabad.

2)  L. I. C. of India

Rep. by its Divisional  Manager

Divisional Office, Karimnagar                     ***                           Appellants/

            Opposite Parties     

                                                                   And

Smt. Kodapa  Roopa Bai

W/o. Kodapa  Ganesh

Age: 42 years, Coolie

R/o. Pattelguda

H/o. Mahagaon Village

Sirpur-U Mandal

Adilabad Dist.                                             ***                         Respondent/

                                                                                                Complainant.  

Counsel for the  Appellant:                         M/s.  N. Mohana Krishna

Counsel for the  Respondent:                     Served.

CORAM:

HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT.

                                             SMT. M. SHREESHA, MEMBER

                                                                   &

                                            SRI  R. L. NARASIMHA RAO, MEMBER
                                                         

MONDAY, THIS THE EIGHTEENTH DAY OF  JULY TWO THOUSAND ELEVEN

ORAL ORDER:  (Per Hon’ble Sri Justice D.Appa Rao, President)

***

1)                This is an appeal preferred by the insurance company against the order of the Dist. Forum directing it to pay  the amounts covered under  four policies  after deducting  premia  due  till 30.6.1996.

2)                The case of the complainant in brief is that  her husband  late  Kodapa Ganesh  while working as constable took four policies  with the appellant insurance company  under salary savings scheme.    The particulars of the policies are as follows:

She was nominee under the above policies.   While he was working at  P.S. Lingapur of Adilabad district  he was visiting  police station from his village  Paattelguda  of  Sirupur mandal.    However, in June, 1996  he did not return.  On the next day  she went to  Lingapur and enquired about her husband where  they informed that  he was not attending  to duty for two days.   They searched for  more than three years but they could not know his whereabouts.    Since he was not heard for about 7 years  it could be presumed that he was dead.   The agent of the insurance company   K. Muralidhar  came to their village and informed about the policies on which  she could  know  the existence  of the policies, and therefore she prayed that the amount covered under the policies be paid. 

3)                The insurance company resisted the case.   While admitting issuance of policies  and that the complainant is  the nominee, however  alleged that  they were in a lapsed condition,  without even acquiring any paid up value.  The premia that was unpaid were as under: 

There is no intimation  from the complainant that her husband was missing and  not to be seen or heard for about 7 years.    No decree from a court of law was obtained.  When there is no proof whatsoever she was not entitled to any amount.    In fact they have addressed a letter to the Superintendent of Police to inform whether  any terminal  benefits  were  paid to  her  for  which  no  reply  was   received.  The complainant was not entitled to any amount, and therefore prayed for dismissal of the complaint with costs. 

4)                 The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A7 marked while the insurance company filed the affidavit evidence of its Administrative Officer  and got Exs. B1 to  B6  marked. 

5)                 The Dist. Forum after considering the evidence placed on record opined that  the assured was not heard or seen  from June, 1996.  He must have been shot dead by naxalites.  Since under these policies  the Superintendent of Police  had to deduct the  premia,  which he did not deduct, and that  the complainant should  not be put to loss for the deficiency of service attributable  to some other official.   She being a Gond  and an illiterate woman and when during 1996 he was last seen,   and the policies were in force  by then she was entitled to the amount after deducting the premia  to be paid   up till 30.6.1996.

6)                 Aggrieved by the said order the insurance company  preferred the appeal contending that the Dist. Forum did not appreciate either facts or law in correct perspective.   It ought to have seen that the policies were lapsed as he did not pay the premia and that the deceased  was dismissed from  service under Article  311(2)(b) of Constitution of India with effect from  30.6.1996. Neither the employer could deduct premia from  out of his salary nor any terminal benefits were paid.    All the four policies were in a lapsed condition The question of presumption  by virtue of Section 107 & 108  of  the Evidence  Act  that he was dead would  not arise.    No amount could be paid  as no paid up value  was accrued, and therefore  it prayed that the complaint be dismissed. 

7)                 The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?  

8)                It is an undisputed fact that the assured late  Kodapa Ganesh  husband of the complainant  had taken four polices  on  28.12.1991, 28.10.1994,  28.10.1994, and 28.6.1995 for assured sum of Rs. 50,000/-, Rs. 1 lakh, Rs. 50,000/- and Rs. 50,000/- respectively.    However, he did not pay   the premia from 10/1992, 12/1994, 12/1994 and 7/1996 respectively.   The premia were to be paid from out of his salary to be deducted by the Superintendent of Police.  The fact remains that he was dismissed from service w.e.f.  30.6.1996 obviously  having joined in naxalities, though the complainant alleges that she was shot dead by the naxalities, there was no evidence to show that  he was shot dead.   There  is no police complaint nor  any evidence to substantiate  the said fact.  The complainant alleges that since her husband was not seen for the last 13 years  she sought a presumption that

he was dead and  obtained a certificate from the  Sarpanch, Grama Panchayat, Mahagaon dt. 5.11.2008.  Basing on the said letter Ex. A5 she wants the amounts covered under the policies to be paid.  The fact remains that complainant’s husband did not attend to the office and was dismissed from service as we have pointed out earlier on 30.6.1996.   When he himself did not earn any salary  in view of his absence  the question of Superintendent of Police  deducting  the premia will not arise.   The policies found lapsed in the months of 10/1992, 12/1994, 12/1994 and 7/1996 respectively.  He did not even pay the minimum amount in order to have paid up value. 

9)                 In LIC  of India Vs. Anuradha reported in 2004- CLR 1-527  the Hon’ble Supreme Court opined  in cases where  the assured had disappeared  and never traced out for a period of   seven years  there is no doubt that the provisions of Section 107 & 108 of the Indian Evidence Act  could be invoked.

Their Lordships’  after considering the import of above said provisions finally opined that  “In order to successfully maintain  the claim for benefit under the insurance policies it is necessary for the  policy to have been kept alive by punctual payment of premiums until the claim was made.  The appellant LIC was justified in turning down  the claims by pleading that the policies had lapsed, and  all that could be paid to the claimants was  the paid up value of the policies. “   Finally considering the plight of widows observed  “ When the assured suddenly disappears or ceased to be traceable may be the beneficiaries or  nominees  do not even know that the deceased had an insurance policy.  They may not be aware  of the insurance premiums  have been paid or  have remained not paid and what were the due dates  and other obligations to be performed by  the assured to keep the policy alive.   Insurance policies with terms and conditions suited to the requirements of  people inhabiting  insurgency or militancy  affected  areas  need to be devised  and  propagated.”

10)               Though the Hon’ble Supreme Court way back in 2004  implored the insurance companies  to extend these  benefits to the under-privileged persons  we do not think that the insurance company would ever extend such benefits.   These objections even from a  Highest  Court of  land have no effect on the insurance companies. 

11)               To sum up,  Ex. B1 letter issued by the Superintendent of Police  shows  that he left  the services, and was dismissed from service on 30.6.1996.   The assured never tried to pay the premia or direct the  Superintendent of Police to deduct  the said amounts from out of his salary.  Obviously he could not have any salary from which the Superintendent of Police  could have deducted  the premia.   When the policies have been lapsed,   and   no paid  up value  was accrued, the question of granting amounts covered under the policies will not arise.   The order of the Dist. Forum is not sustainable under law. 

12)               In the result the appeal is allowed setting aside the order of the Dist. Forum.  Consequently the complaint is dismissed.  However, in the circumstances of case no costs. 

1)       _______________________________

PRESIDENT                 

2)      ________________________________

 MEMBER          

3)      ________________________________

 MEMBER          

       18/07/2011

*pnr

“UP LOAD – O.K.”