BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, VELLORE DISTRICT AT VELLORE. PRESENT: THIRU. A. SAMPATH, B.A., B.L., PRESIDENT TMT. G. MALARVIZHI, B.E. MEMBER – I THIRU. K. DHAYALAMURTHI, B.SC. MEMBER – II CC. 25 / 2007 WEDNESDAY THE 7TH DAY OF SEPTEMBER 2011. A. Selvi, W/o. Late Anbalagan, No.189, Kollaimedu, Keel Arasampattu Village and Post, Vellore Taluk and District. … Complainant. - Vs – 1. The Special Officer, The Pondicherry Co-operative Sugar Mills Ltd., P-315 Lingarereddipalayam, Katterikuppam Post Pin 605 502. Pndicherry. 2. The Regional Commissioner, ` Employees State Provident Fund Office, Chennai – 14. 3. The L.I.C. of India, Manager, Zonal Office, City Branch XI, Chennai D.O. II. Madras – 40. 4. The LIC of India, Divisional Office, Divisional Manager, Arcot Road, Vellore. … Opposite parties. . . . . . This petition coming on for final hearing before us on 6.9.2011, in the presence of K. Armstrong, Advocate for the complainant and Thiru. G. Kalaimani Advocate for the opposite party-1, Thiru. K. Umashankar, Advocate for the opposite party-2 and Thiru. L. Pandurangan, Advocate for the opposite parties 3 & 4 and having stood over for consideration till this day, the Forum made the following: O R D E R Pronounced by Thiru. A. Sampath, President of the District Consumer Disputes Redressal Forum, Vellore District. 1. The brief facts of the case of the complainant is as follows: The complainant is the wife of late C.Anbalagan. The said Anbalagan employed as a watchman after military in the 1st opposite party Pondicherry Co-operative Sugar Mills Limited, Lingareddypalayam, Pondicherry. The 1st opposite party has taken welfare scheme for the workers like family Benefit Policy by paying premium collected from the employees during the disbursement of salary under Group Insurance Scheme. Accordingly the said C. Anbalagan paid Insurance Premium from his salary on 28.12.98 to the 3rd opposite party and they issued a policy also in vide policy No.731058842 and in which the complainant has been nominated as his nominee and wife. The sum assured was Rs.50,000/-. The life assured C. Anbalagan died on 18.2.04. Likewise that the 1st wife Santhi also be nominated in another policy No.716309085 and she has been nominated and the 3rd opposite party settled the claim. The mode of Group Insurance Scheme appears to be that the workmen have enter into the scheme was paying premium from the salary every month during the disbursement of salary and premium amount was collected from the workers, the employer is bound to remit the premium amount with the LIC of India. If the worker died within the stipulated period in the policy the management have to inform the LIC to pay the benefits due to the family under the Group Insurance Scheme. After the death of her husband she has approached the 1st opposite party to get the benefit of the scheme. The 1st opposite party has written to the 2nd opposite party and 3rd opposite party for the settlement of the claim due to the complainant. The LIC of India appears to have repudiated the claim that the premium amount was paid by the Life Assured covered under the Policy. Inspite of the claim form submitted by the complainant being the nominee of the Life assured the opposite parties not taken any care and that there is a deficiency in service and with unfair trade practice. 2. The complainant issued a lawyers notice to the opposite parties on 12.1.07 calling upon the benefits in view of the above said policy. The opposite parties acknowledged the said lawyer notice but there was no reply. Therefore the complainant prays this Forum for directing the opposite parties to pay a sum of Rs.50,000/- due under the Group Insurance Scheme and to pay a sum of Rs.25,000/- for the deficiency of service on their part and to pay interest at the rate of 12% p.a. from the date of death of Anbalagan dt.18.2.04 on the amount due and to pay a sum of Rs.5000/- towards the cost of this proceedings. Hence the complaint. 3. The averments in the counter filed by the 1st opposite party is as follows: The 1st opposite party is not maintainable either in law or on facts and liable to be dismissed. It is true that the deceased Anbalagan, the husband of the complainant joined their mills as Watchman on 6.7.94 and he died due to motor accident on 18.2.04. The said deceased is entitled from the mill is (1) Gratuity, (2) Provident Fund, 3) Employees Deposit Linked Insurance 4) Employees Group Insurance alone. Rest of them are not binding this opposite party in any manner. As per the benefits mentioned in para-3 of the counter item No.1 Gratuity amount of the deceased is Rs.88,551.80/- was already settled to his legal heirs on 10.2.05. Item No.2 for Provident fund concern, the company filled up the Form-10 D and Form 20 and sent it to the Provident fund office at Madras. Thereafter it is the duty of the legal heirs of the deceased to follow it and clear it item No.3) Employees Deposit Linked Insurance is concern after the death of the employee, while he was in service, the company get all the necessary documents from the family members of the deceased and fill up the claim form and then forwarded it to the LIC office to clear the said claim. The same will be (Amount ) cleared by the LIC Office to the bank account of the deceased family members. In this connection with the item No.4) Employees Group Insurance concern the LIC office send Rs.63,000/- to our mill to settle the same to the deceased family after deducting any arrears of amount is said to be settled by the deceased. Accordingly the opposite party company settled all the amount to the deceased family. As per the company rules the opposite party is legally bound to clear the amounts mentioned in item Nos. 1 to 4 and the same was already done by the opposite party office. Hence the 1st opposite party is no way responsible for the clearance of the policy No.731058842 i.e. the case mentioned due in any manner. The suit filed by the complainant in concern with policy No.731058842 for a sum of Rs.50,000/- comes within the purview of “Group Insurance Scheme” is not correct and the said policy is an individual policy to be taken by the deceased on 28.12.98. The company is reasonable in this aspect is to deduct the premium amount from the salary of the deceased from his monthly salary and sent it to the LIC of India office only. It is the duty of the complainant to approach the LIC office to get the individual policy amount (Rs.50,000/-) by submitting all the records, required by the LIC. The 1st opposite party already done their job very well and if at all any delay was caused by the LIC, she filed the suitable case before concern legal forum for her remedy. Hence the above case filed as against the 1st opposite party is not correct and highly illegal one and also not maintainable according to law. As per terms and conditions of the Group Insurance Scheme the company will take one policy for their total employee 730 members and the premium amount will be deducted from the employee salary every month and remitted the same to LIC office. In the policy the person who retired from service are not get any benefits and the persons who died, while he is in service time are alone entitled to get it and the said benefit was already settled to the deceased Anbalagan as per the para-3 mentioned items 1 to 4. Hence this complaint is to be dismissed. 4. The averments in the counter filed by the 2nd opposite party is as follows: The complaint filed by the complainant against the 2nd opposite party does not deserve interference by the Forum as the proceeds of the Insurance policy financed by the late member Anbalagan during his life time has been paid to the rightful claimant and the position in this regard has already been clarified to the Advocate of the complainant vide letter No.CHN/SRO/Pondy/CIC/LEGAL/2007 dt. 28.2.07 by the 2nd opposite party. The averments in para-1 are partly admitted to the extent of the factual position in this regard. Shri. Anbalagan prior to his death on 18.2.04 was working in M/s. The Pondicherry Co-operative Sugar Mills Ltd. Pondicherry. During his life time and working in the above mill he was a subscriber to the Provident Fund and he was holding Provident Fund Account No.PC/286/91. The late member was financing two policies bearing No.716309085 and 731058842 from and out of his Provident Fund Account held by the late member. On the death of the member, the above two policies were re-assigned in favour of Smt. A. Santhi, w/o late C. Anbalagan as per the records of the office and as certified by the employer of the above mill. The averments in para-2 are denied. Late C. Anbalagan was financing two insurance policies bearing No.716309085 and 731058842 from and out of his Provident Fund Account and their premium is respect of these two policies were paid out of the Provident Fund amount lying at the credit of the said late member with the office of the 2nd opposite party. The averments made in para-4 are dined. The 2nd opposite party on receipt of the death certificate of the C.Anbalagan and the claim from the widow Smt. A.Santhi after verifying the records available in this regard, reassigned the policies held by her late husband in favour of Smt. A.Santhi and submitted to LIC of India for payment of Smt. A.Santhi, widow of the late member. The averments made in para-4 are dined. The 2nd opposite party has already replied to the advocate of the complainant on the position with regard to the Re-assignment of policies in favour of Smt. A.Santhi, w/o. Late C.Anbalagan vide letter No.CHN/SRO/POndy/CIC/LEGAL/2007 dt. 28..2.07 of the 2nd opposite party. The averments made in para-7 the complainant is not eligible for any claim on the policy financed by late C. Anbalagan, as the policies have been re-assigned in favour of Smt. A. Santhi, w/o. Late C. Anbalagan who is the rightful claimant as certified by the employer of M/s. The Pondicherry Co-operative Sugar Mills Ltd. Hence this complaint may be dismissed with costs. 5. The averments made in the counter filed by the 4th opposite party and adopted by the 3rd opposite party is as follows: The 3rd and 4th opposite parties denies all the averments in the complaint except save those that are specifically admitted herein and puts the complainant to strict proof of the same. C. Anbazhagan had two insurance polices vide No. 716309085 and 731058842 for a sum assured for Rs.22000/- and Rs.50,000/- respectively. These polices were not Group Insurance Policies as alleged by the complainant in para 1 & 2 of the complaint. Those policies were financed from Provident Fund of the employee every year and not from the salary of the employees every month. The deceased Life Assured nominated his wife Smt. A.Santhi under the policy No.716309085 and Smt. A. Selvi as wife under the policy No.731058842. Both the policies were assigned to the Central Board of Trustees, the Employees Provident Fund on 3.11.99. Once the policies are assigned the nomination gets cancelled automatically. The opposite party C.B.C-12 had received the Death intimation of the life assured C. Anbalgan on 28.9.04 from both the wives Smt. A. Santhi and A. Selvi since the original policy was assigned in favour of Central Board of Trustees, Employees Provident Fund, the original nomination made in favour of his wives stands cancelled. Hence the Provident Fund authorities reassigned both the policies infavour of A. Santhi vide their letter dt. 15.6.04. The death claim was not repudiated by 3rd opposite party as alleged in para-3 of the complaint. Under Policy No.716309085 the claim was settled on 17.1.05 in favour of Smt. A.Shanthy since the nominee and the 2nd assignee are same. Under policy No.731058842 the nominee Smt. A.Selvi and the 2nd assignee is Smt. A. Shanthi, Smt. A.Selvi vide her letter dt. 24.11.05. requested the 3rd opposite party to appraise with the RPF authorities to have the policy reassigned in her favour. Hence CBO 12 had written a letter to RPF authorities on 16.12.05 to clarify and advise to whom the policy moneys are payable for which the opposite party is yet to receive a reply. The original policy bond was also sent to the RPF Commissioner’s Royapettah Office on 20.3.06. As the RPF authorities have not clarified to who the death claim is payable under the Policy No.731058842 the opposite party is unable to proceed further. Immediately on receipt of the clarification from the PRF authorities the opposite party shall proceed to settle the claim. As such there is no deficiency in service by the opposite party. The policy amount under the policy No.716309005 already paid infavour of A.Santhi. Hence this complaint is to be dismissed with costs. 6. Now the points for consideration are: (a) Whether there is any deficiency in service, on the part of the opposite parties? (b) Whether the complainant is entitled to the reliefs asked for?. 7. Ex.A1 to Ex.A10 were marked on the side of the complainant and Ex.B1 to Ex.B12 were marked on the side of the opposite parties. Proof affidavit of the complainant and Proof affidavit of the opposite parties have been filed. No oral evidence let in by either side. 8. POINT NO. (a):- It is admitted case of the parties that the deceased Anbalagan, joined the 1st opposite party Co-operative Sugar Mills Limited, as Watchman on 6.7.94 and he died due to motor accident on 18.2.04. While he was in service, he had two insurance polices vide No.716309085 and 731058842 for a sum assured for Rs.22,000/- and Rs.50,000/- respectively. The deceased life assured nominated as his 1st wife Smt. A.Santhi under the policy No.716309085 and Smt. A. Selvi as 2nd wife under the Policy No.731058842. Under the Policy No.716309085 the claim was settled on 17.1.05 in favour of Smt. A.Santhi. Under policy No.7131058842 the claim was not yet settled to Smt. A. Selvi i.e. complainant herein by the 3rd opposite party. 9. The complainant contended that after death of her husband C. Anbalagan, the complainant approached the 1st opposite party to get the benefit of the above said insurance policy No.731058842, the 1st opposite party informed the complainant that to approach the 3rd opposite party to get the individual policy amount (Rs.50,000/-) by submitting all the records required by the LIC. Inspite of claim form submitted by the complainant being the nominee of the life assured, the 3rd and 4th opposite parties not taken any care and settled her claim. Thereby they committed deficiency in service on their part. 10. The 1st opposite party contented that they deduct the premium amount from the monthly salary of the deceased Anbalagan and sent it to the LIC of India office, and now it is the duty of the complainant to approach the LIC office to get the individual policy amount (Rs.50,000/-) by submitting all the records required by the LIC. Hence the 1st opposite party is no way responsible for the clearance of the policy No. 731058842. The 2nd opposite party contented that while Anbalagan was in service, he was subscribed to the Provident Fund and he was holding Provident Fund Account No.PC/286/91 and he was financing two policies bearing No.716309085 and 731058842 from and out of his Provident Fund Account held by the late member. On the death of Anbalagan, the above two policies were re-assigned in favour of Smt. A.Santhi w/o Late C. Anbalagan as per the records of the office and as certified by the employer of the above mill and submitted to LIC of India for settlement to Smt. A.Santhi, widow of the late member. The 3rd and 4th opposite party contented that the deceased life assured nominated his 1st wife Smt. A.Santhi under the policy No.716309085 and Smt. A. Selvi as 2nd wife under the policy No.731058842. Based on the recorded submitted by the 1st opposite party, both the policies were reassigned infavour of A.Santhi by the 2nd opposite party Provident Fund authorities and informed to the 3rd opposite party that the original nomination made in favour of his wives stands cancelled. However, the 3rd opposite party had written a letter to Regional Provident Fund Authorities on 16.12.05 to clarify and advise to whom the policy (No. 731058842) money is payable, for which the 3rd opposite party is yet to receive a reply. As the RPF authorities have not clarified to who the death claim is payable under the policy No.731058842, the 3rd opposite party is unable to proceed further. As such there is no deficiency in service on the part of the 3rd and 4th opposite parties. 11 The contention of the 1st opposite party that while the deceased Anbalagan was in service, the officials of Co-operative Sugar Mills, deduct the premium amount from the monthly salary of the deceased and sent it to LIC of India office. According to the 3rd and 4th opposite parties that the said policies were financed from Provident Fund of the employee every year and not from the salary of the employees every month. But the 1st opposite party denied the above contention and stated that the said two polices were not come with the purview of the Group Insurance Scheme. The said policies are individual policy taken by the deceased on 28.12.99. From the perusal of Ex.A1 policy No.731058842 for a sum assured Rs.50,000/- it is seen that the above said policy is individual money back policy with profit plus accident benefit, the life assured nominated his wife Smt. A.Selvi. Therefore, the contention of the 2nd opposite party that the deceased Anbalagan was financing two policies bearing No.716309085 and 731058842 from and out of his Provident Fund Account held by the late member is not correct. 12. It is admitted fact of the parties that Ex.A1 Policy No.731058842 for a sum assured Rs.50,000/- is money back policy with profit plus accident benefit, the deceased assured nominated his wife Smt. A.Selvi. From the perusal of the copy of legal heir certificate Ex.A3 dt. / 3 /04 issued by the Vellore Thasildar, it is mentioned that Smt. Santhi 1st wife of the deceased Anbalagan, Selvi. Deepa and Selvi. Subhalakhsmi 1st wife daughter. Smt. Selvi, complainant is the second wife of the deceased Anbalagan, Selvi. Ramya, Selvan. Manikandan are the 2nd wife of the daughter and son. Sri. Chinnappa Gounder and Smt. Kasiammal, father and mother of the said deceased. The Tahsildar further mentioned that the said certificate issued for the purpose of Drawal of Bank amount, Balance Amount, P.F., LIC and Gratuity, Name change in Electric current and CSD Canteen card by the heirs. The complainant in her proof affidavit stated that while her husband was alive, he had two insurance policies, the deceased life assured nominated as his 1st wife A.Santhi under the policy No.716309085 and Smt.A.Selvi (Complainant) as 2nd wife under the policy No.731058842. 13. The 1st opposite party had sent a certificate Ex.B7, about the particulars of the family member of late C. Anbalagan to the Assistant Provident Fund Commissioner, Pondicherry stating that in the above certificate A.Santhi mentioned as wife and A.Deepa and A.Subbalakshmi mentioned as daughters to the Late C. Anabalagan. Based on the above said letter the Provident Fund Authority settled the Gratuity, Provident Fund, 3. Employees Deposit Linked Insurance. 4) Employees Group Insurance amount to the alleged 1st wife A.Santhi. The complainant stated in her proof affidavit that while her husband was alive, he took a vide policy No.731058842 in which the complainant, 2nd wife has been nominated as a nominee, likewise her husband nominated 1st wife A.Santhi in another Policy No.716309085 and the said policy amount has been settled to the 1st wife by the 3rd opposite party. It is admitted fact that the alleged 1st wife A.Santhi has submitted her legal heir certificate before the 1st opposite party Pondicherry Co-operative Sugar Mills. But the 1st opposite party without verifying the legal heirs of late Anbalagan, had sent a certificate Ex.B7 to the 2nd opposite party which they mentioned A.Santhi and her two daughters are only legal heirs of late Anbalagan. Based on the certificate Ex.B7, the said two policies were re-assigned in favour of A.Santhi. However the said policy No.731058842 is individual policy of late Anbalagan, and the life assured nominated the complainant as nominee in the individual policy. During the course of arguments the learned counsel for the 3rd and 4th opposite parties stated that the alleged 1st wife A.Santhi has not made any objection before the 3rd and 4th opposite party to settle the claim under policy No.731058842 in favour of the nominee Smt. A.Selvi. 14. According to the 3rd and 4th opposite parties that The C.B.O. had written a letter to Provident Fund Authorities on 16.12.05 to clarify and advise to whom the policy moneys are payable for which the opposite party is yet to receive a reply. As the Regional Provident Fund authorities have not clarified to who the death claim is payable under the policy No.731058842 the 3rd opposite party is unable to proceed further. Immediately on receipt of the clarification from the Regional Provident Fund Authorities the opposite party shall proceed to settle the claim. There is no reply from the Regional Provident Fund office from 16.12.05. till this date i.e. nearly six years. The learned counsel for the complainant argued that the complainant, 2nd wife A.Selvi is the younger sister of the alleged 1st wife A. Santhi and second wife Selvi has got two children. While her husband was in alive, he nominated the 2nd wife as a nominee under Policy No.731058842 for her family benefits. The 1st opposite party is also directed the complainant to approach the LIC office to get the individual policy amount Rs.50,000/- by submitting all the records, required by the LIC. The alleged 1st wife A.Santhi has also not made any objection to settle the policy amount in favour of A.Selvi, 2nd wife of the life assured. As per the terms and conditions mentioned in Ex.A1 policy, it is the duty of the 3rd opposite party to settle the claim under the above policy in favour of the complainant. Therefore, the contention of the 3rd opposite party that the Regional Provident Fund Authority have not clarified to who the death claim is payable under the Policy No.731058842 the opposite party is unable to settled the amount to the nominee is not acceptable. 15. Hence taking into all the above facts into consideration from the contention of the complaint and the counter, as well as proof affidavit of both the parties and from the documents Ex.A1 to Ex.A10 and Ex.B1 to Ex.B12 we have come to the conclusion that the complainant herein has proved the deficiency in service on the part of the 3rd and 4th opposite parties herein. Hence, we answer this point (a) in favour of the complainant herein. 16. POINT NO. b): In view of our findings on the point No.(b) since, we have come to the conclusion that the complainant has proved the deficiency in service on the part of the 3rd and 4th opposite parties herein. We have also come to the conclusion that the complaint against the opposite parties 1 & 2 are dismissed. The 3rd and 4th opposite parties are jointly and severally directed to pay the Insurance Policy amount of Rs.50,000/- under Ex.A1 along with interest at the rate of 8% p.a. from the date of complaint on 3.5.07 till the actual payment to the complainant. Hence this point (b) also accordingly. 17. In the result, this complaint is partly allowed. The complaint against the opposite parties 1 & 2 are dismissed. The 3rd and 4th opposite parties are jointly and severally directed to pay the Insurance Policy amount of Rs.50,000/- under Ex.A1 along with interest at the rate of 8% p.a. from the date of complaint on 3.5.07 till the actual payment to the complainant. They are also directed to pay a sum of Rs.1,000/- (Rupees One thousand only) towards the cost of this complaint. The 3rd and 4th opposite parties are hereby directed to pay the above said amount within one month from the date of receipt of copy of this order, failing which, the complainant is also entitled to interest on the above said sum @ 9% p.a from the date of default till the date of payment. Dictated to the Steno-typist and transcribed by her, corrected and pronounced by the President, in Open Forum, this the 7th day of September 2011. MEMBER-I MEMBER-II PRESIDENT. List of Documents: Complainant’s Exhibits: Ex.A1- -- - X-copy of Policy. Ex.A2- -- - X-copy of Death Certificate. Ex.A3- .03.2004 - X-copy of Legal Heir ship Certificate. Ex.A4- -- - x-copy of family Ration Card 1st page. Ex.A5- -- - X-copy of Status report of Policy No.731058842. Ex.A6- 12.1.07 - X-copy of lawyer notice. Ex.A7- -- - Postal Ack. Card. Ex.A8- -- - Postal Ack. Card. Ex.A9- -- - Ack. of 3rd opposite party. Ex.A10- -- - X-copy of Visitors Pass by Employees Provident Fund, Chennai. Opposite parties’ Exhibits: Ex.B1- 8.11.10 - X-copy of Gratuity amount details by opposite party-1 Ex.B2- 8.11.10 - X-copy of Provident fund claim details by opposite party-1. Ex.B3- 8.11.10 - X-copy of EDLI claim details by opposite party-1. Ex.B4- 8.11.10 - X-copy of EGI amount details by opposite party-1. Ex.B5- 8.11.10 - X-copy of LIC premium details by opposite party-1. Ex.B6- 28.2.07 - X-copy of reply letter by 2nd opposite party. Ex.B7- -- - X-copy of certificate for family members. Ex.B8- -- - X-copy of final payment intimation to C.I.C. Ex.B9- -- - X-copy of Statement. Ex.B10- -- - X-copy of letter by the complainant to the opposite party-3 Ex.B11- 16.12.05 - X-copy of letter by the 3rd opposite party. Ex.B12- -- - X-copy of Policy. MEMBER-I MEMBER-II PRESIDENT.
| | [ Hon'ble Tmt G.Malarvizhi, B.E] MEMBER[ Hon'ble Thiru A.Sampath, B.A., B.L] PRESIDENT[ Hon'ble Tr K.Dhayalamurthy, Bsc] MEMBER | | 
