O R D E R

Sri. P. Satheesh Chandran Nair (President):

                The complainant filed this complaint before this Forum u/s.12 of the C.P. Act for getting a relief against the opposite parties.

                2. The case of the complainant is stated as follows:  The 1^st opposite party who is the agent of LIC approached the complainant on 2/2011 in his residence and explain the merit of an insurance scheme.  On the basis of her narration and assurance the complainant took 3 insurance policies on 23.02.2011.  The policy Nos. are (1) 394830662 (2) 394830663 (3) 394830664.  The 1^st opposite party accepted the premium amount from the complainant in all months.  According to the complainant, he paid the premium amount up to 8/2014 with a monthly subscription of Rs.231/-. He remitted Rs.9,933/- to 1^st opposite party for the above said policies.  The complainant felt some doubt regarding 1^st opposite party and on 22.09.2014 he sent a registered notice with A/d card to 2^nd opposite party.  The 2^nd opposite party sent a reply to the complainant stating that only up to 8/2012, the company received the premium amount from the concerned.  The complainant stated that this irresponsibilities and defects of the company (2^nd opposite party) has to be investigated.  The complainant again point out that if anything happened him after 2012, the benefit of the scheme would have been not received to his legal representatives.  Hence he requested a relief of Rs. 2 lakhs from 1^st opposite party and Rs.3 lakhs from 2^nd opposite party or he has to get all the benefit which the company recommended for him on 23.01.2016. The complainant filed this complaint before the Forum along with 5 documents.  After perusing the complaint and records the Forum decided to issue notice to both opposite parties. 

        3. The opposite parties appeared before the Forum and filed separate versions as follows:  The 1^st opposite party’s version is stated as follows:  According to 1^st opposite party, she is not at all an agent of LIC.  Factually she was only a collection agent of M/s. Deepam Charitable Trust, Adoor and the said trust entrusted her with the task of collecting amounts from the persons named by them.  For collecting the amount she used to get commission also.  She contended that she is a specified person of LIC and the amount collected by her was promptly deposited with the said trust in time.  She again ascertain that the premium receipt book held by the complainant and the records kept in the said trust proved that she had been promptly remitted the collected amount.  According to her, the allegation of the complainant is based on his guess and not based on facts and moreover the complainant had been paying the premiums irregularly.  The complainant used to pay the amount after 2 or 3 months which fact can be verified from the pass book of the complainant.  The 1^st opposite party again stated that her vision of one eye is defective and she is comes under BPL category and finds it had to raise money even for buying medicine.  But she never retained anybody’s cash with her.      

                4. The 2^nd opposite party filed a separate version as follows:  Through the version 2^nd opposite party admitted that the complainant is a policy holder of Micro Insurance Scheme of LIC premium amounts to “Agent” but the M.I. agent failed to remit the amounts collected.  The Micro Insurance Policies mentioned in the complaint were indeed by LIC on the life of the said complainant and also admitted the sum assured and the monthly premium. According to 2^nd opposite party, 1^st opposite party is not an agent of LIC.  She is not an agent on the roll of LIC as per IRDA (M.I) Regulations, 2005.  Micro Insurance agency is granted by LIC either to NGOs or SHGs or MFIs.  The 2^nd opposite party admitted that in this case the Micro Insurance Agent is an NGOs named Deepam Charitable Trust, Adoor (Code No.83034R039).  The 2^nd opposite party admitted that they received a letter from the complainant on 23.09.2014 despite payment of premium by him, his policy stand lapsed and also enquiring the status of his policies and details of payment of premium from the company.  2^nd opposite party replied that only till 8/2012 the premiums were received by 2^nd opposite party.  According to the 2^nd opposite party when they received the said letter from the complainant they informed the contents of the letter to the concerned agent and ask them to regularize the policies forthwith, if the allegation is true.  Anyway, the M.I. Agent remitted dues of the complainant’s policies from 09/2012 to 07/2014.  According to 2^nd opposite party, the complainant’s policies were regularized and the premium stands paid till November 2014.  As per Circular dated 22.07.2013 when ever a claim arises where the policy holder has entrusted the premium to the M.I. Agent and the M.I. Agent has failed to remit the same the usual practice is to pay the full sum assured to the claimant and recover the dues from the concerned agent.  In this case, the grievances raised by the complainant are hypothetical, unwarranted and have been fully redressed.  The premium payments of the complainant’s policies have been regularized.  The 2^nd opposite party categorically stated that there is no deficiency in service from the part of LIC and regarding the losses and compensation since the complainant has not suffered any loss, the question of any loss does not arise.  The insurance company redressed the complainants grievances without any delay, hence the question of compensation is also does not arise.  Opposite party prays that considering all these aspects this Forum may find the complaint as merit-less and accordingly it may be dismissed with cost of unwarranted litigation to this opposite party. 

                5. Considering the complaint, version and the records produced from both side, this Forum raised the following issues in this case.

1. Whether the petition is maintainable before the Forum?
2. Whether the complainant succeed to prove the allegation of deficiency in service on the part of the opposite parties?
3. Regarding the reliefs and costs?

        6. On the side of the complainant he examined as PW1 and marked Exts.A1 to A7 and Ext.B1 to B3 documents.  Ext.A1 is the policy certificate No. 394830663 dated 23.02.2011.  Ext.A2 is the policy certificate No. 394830664 dated 23.02.2011.  Ext.A3 is the policy certificate No. 394830662 dated 23.02.2011.  Ext.A4 is the Pass Book of Ext.A1 and Ext.A2.  Ext.A5 is the Pass Book of Ext.A3.  Ext.A6 is the letter dated 23.09.2014 issued from 2^nd opposite party to the complainant.  Ext.A7 series are the postal receipts of the registered notice and A/d cards.  At the time of cross-examination of the complainant through him 2^nd opposite party marked Ext.B1 to B3 documents.  Exts. B1 to B3 are the policy status report dated 05.01.2015 of Ext.A1 to A3 respectively. 

                7. After closing the evidence of both sides, we heard the complainant and the learned counsel appearing for opposite party 1 and 2.  The complainant submitted that due to apprehension and non-remittance of the premium by 1^st opposite party caused much mental agony to him and he has no interest to continue the insurance scheme, i.e. Ext.A1 to A3.  1^st opposite party’s learned counsel submitted that 1^st opposite party is not at all an agent of LIC and she has not defaulted the amount and it can be seen that the policy is in order at this time.  The learned counsel appearing for the 2^nd opposite party vehemently argued that there is no deficiency in service committed on the side of the 2^nd opposite party and no laches happened on the part of 2^nd opposite party for redressing any of the grievances of the complainant.  According to 2^nd opposite party, when 2^nd opposite party received the letter referring Ext.A7, 2^nd opposite party taken immediate steps to redress the grievances of the complainant and gave necessary direction to the concerned NGOs, i.e. Deepam Charitable Trust, Adoor to clear the dues.  It is seen from Ext.B1to B3 that the policy is regularized and there is no room for the apprehension of the policies as lapsed policies.  When the complainant is examined as PW1 in cross, he stated that, “എനിയ്ക്ക് ഏജന്റ് correct സമയത്ത്  2^nd O.P യില് അടച്ചില്ലാ എന്നതൊഴികെയുള്ള മറ്റു financial difficulty ഉണ്ടായിട്ടില്ല” and again he adds “എനിയ്ക്ക്v policy തുടരാന് ആഗ്രഹമില്ല ”.  The counsel asked a suggestive question to PW1, “Ext.A1 to A3 policy-കള് 2^nd opposite party മുമ്പാകെ surrender ചെയ്താല് അടച്ച തുകയും, bonusþഉം കൂടി തരാന്  2^nd opposite party തയ്യാറാണ് എന്നു പറയുന്നു ”? He answered, “Forum എടുക്കുന്ന തീരുമാനം ഞാന് അംഗീകരിക്കും ”.  

         8. Point Nos. 1 to 3:- For the sake of convenience and for arriving a decision we are considering all the above issues together.  In this case, 2^nd opposite party is admitted that the complainant is a policy holder of 2^nd opposite party and through Ext.B1 to B3 2^nd opposite party proved that the policy is active and not lapsed.  It is also clear to see that the 1^st opposite party is an agent under the Deepam Charitable Trust, Adoor and she has usually collecting the premium from the complainant.  It is a cogent and conclusive evidence to see that on 23.09.2014 the premium for 08/2012 was only remitted by 2^nd opposite party and the balance was in arrear.  On the other hand from Ext.B1 to B2 it is also clear that on 05.01.2015 Ext.A1 to A3 policy of the complainant was running currently and no dues for these policies.  Considering the evidence before the Forum we can come to an inference that as an agent of 2^nd opposite party the Deepam Charitable Trust cured the defect occurred to the policy, i.e. Ext.A1 to A3.  It is happened due to the non-payment of the policy premium by 1^st opposite party.  Here 1^st opposite party’s attitude is diligence of his duty and it caused doubt on the part of the complainant.  Anyway, at this time the complainant does not want to continue the policy because of his apprehension and non interest.  We find that on the side of 2^nd opposite party the insurance company committed any deficiency in service or laches on their performances.

        9. As a perusal of evidence it can be seen that 2^nd opposite party the insurance company promptly acted on necessary time and avoided the lapse of policy.  But at the same time it is evident to see that 1^st opposite party the person who works as an agent of Deepam Charitable Trust, Adoor made laches in her duty and 1^st opposite party committed deficiency in service.  The 1^st opposite party’s learned counsel argued that 1^st opposite party is not at all an agent of L.I.C and 2^nd opposite party also took the same stand.  As far as the complainant is concerned it is clear that 1^st opposite party receive premium amount from the complainant and moreover it is an admitted fact that 1^st opposite party is the agent of Deepam Charitable Trust, Adoor.  Apart from this 2^nd opposite party specifically stated that as a Non Governmental Organization (NGO) for the above said policies (i.e. Ext.A1 to Ext.A3).  Deepam Charitable Trust, Adoor is the authorized agent of LIC.  The above facts are clinching evidence to see that 1^st opposite party has a direct involvement in the policies described above and the complainant has to get a reasonable agency service from 1^st opposite party.  As per Ext.A6 the agent, i.e. 1^st opposite party remitted the premium only up to 08/2012.  On the other hand from Ext.B1 to B3 the status of the policy is in force on 05.01.2015.  It is clear that the Deepam Charitable Trust, Adoor or 1^st opposite party remitted the balance amount up to November 2014.  The complainant also admitted this fact at the time of cross-examination, “ഇപ്പോള് എന്നെ കാണിച്ചത് 2014 നവംമ്പര് വരെയുള്ള എല്ലാ ഗഡുവും അടച്ചതായി മനസ്സിലാക്കുന്നു”.  It is marked as Ext.B1.  “Ext.A1 to A3 policy-കള്  പ്രകാരമുള്ള പോളിസികളുടെ കുടിശിക അടച്ചുവെന്ന് കാണാന് കഴിയും”.  It is marked as Ext.B1, B2 and B3.  Again he adds, “ഒന്നാം എതൃകക്ഷി രണ്ടാം എതൃകക്ഷിയുടെ ഏജന്റാണ്. അവരുടെ signature passbook ല് ഉണ്ട്”.  It can be seen from the above narration that the insurance policy is in force and there is no apprehension of its laps.  Apart from that the relation between the complainant and 1^st opposite party with regard to this policy is also proved here.

                10. When we appreciate the pleadings of both side and evidence on document and deposition of PW1 the point of maintainability is found in favour of the complainant.  The second issue whether the complainant succeed to prove the allegation of deficiency in service on the part of the opposite parties we have already discussed this fact above and there is no need for a repetition again.  As far as 1^st opposite party is concerned the complainant succeed to prove deficiency of service on her part.  At the same time, we have discussed earlier the part played by the 2^nd opposite party in this case.  The complainant not succeed to prove any kind of negligence, misrepresentation or even deficiency in service on 2^nd opposite party.  Hence 2^nd opposite party has to be exonerated from all charges alleged in this case.

                11. On the basis of the above finding we pass the following orders:

1. 1^st opposite party is directed to pay a compensation of Rs.5,000/- (Rupees Five Thousand only) to the complainant within one month of the receipt of this order and if 1^st opposite party fails to comply it the complainant is also eligible to realize 10% of interest from the date of order till the realization of the above said amount Rs.5,000/-.

2. The 2^nd opposite party is directed to entertain the complainant as and when he approached for the policy surrender as per the provision of law.

3. Considering the nature and circumstances of this case, no order for cost.

        Declared in the Open Forum on this the 30^th day of June, 2015.

                                                                             (Sd/-)

                                                            P. Satheesh Chandran Nair,            

                                                                          (President)

Smt. K.P. Padmasree (Member – I)      :      (Sd/-)

Smt. Sheela Jacob (Member – II)         :      (Sd/-)

Appendix:

Witness examined on the side of the complainant:

PW1  :  Radhakrishna Pillai

Exhibits marked on the side of the complainant:

A1  :  Policy certificate No. 394830663 dated 23.02.2011. 

A2  :  Policy certificate No. 394830664 dated 23.02.2011. 

A3  :  Policy certificate No. 394830662 dated 23.02.2011. 

A4  :  Pass Book of Ext.A1 and Ext.A2. 

A5  :  Pass Book of Ext.A3. 

A6  :  Letter dated 23.09.2014 issued from 2^nd opposite party  

         to the complainant. 

A7 series :  Postal receipts and A/d cards. 

Witness examined on the side of the opposite parties:  Nil.

Exhibits marked on the side of the opposite parties:

B1 to B3  :  Policy Status Report dated 05.01.2015.

                                                                       (By Order)

                                                                           (Sd/-)                   

                                                              Senior Superintendent.

Copy to:- (1) Radhakrishnapillai. P.K., Puthenveettil,

                    Aruvappulam. P.O., Konni, Pathanamthitta,

                    Pin – 689 691.                                            

(2) Sujatha Krishnankutty, Sreenarayanavilasom,

                    Aruvappulam. P.O., Konni, Pathanamthitta,

            Pin – 689 691.

(3)Micro Insurance Manager, Jeevan Prakash,

            P.B.No.608, Kurian Uthup, Nagampadom,

            Kottayam – 688 001.

       (4) The Stock File.