Complaint filed on: 18.01.2015

                                                                                                                             Complaint Disposed on:17.10.2017

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT CHICKMAGALUR.

COMPLAINT NOS.7/2017 & 8/2017

DATED THIS THE 17^th DAY OF OCTOBER 2017

:PRESENT:

HON’BLE SRI RAVISHANKAR, B.A.L, LL.B., - PRESIDENT

HON’BLE SMT B.U.GEETHA, M. COM., LL.B., -MEMBER

HON’BLE SMT H. MANJULA, B.A.L., LL.B., - MEMBER

COMPLAINANT/S:

Dr.Suma Umesh,

W/o Umesh Rao D.,

Medical Practioner,

R/o Maruti Nilaya,

Dattathri Nagara,

Kadur Town,

Chikmagalur District.

                                                ……C.C.No.7/2017

Dr.Umesha Rao D,

S/o D.Bhaskara Rao,

Aged about 53 years,

Medical practitioner,

R/o Maruti Nilaya,

Dattathri Nagara,

Kadur Town,

Chikmagalur District.

                                                ……C.C.No.8/2017

(By Sri/Smt. K.B.Devaraj, Advocate)

V/s

OPPONENT:

1. The Branch Manager,

    LIC of India, Banni Mantapa,

    Mysore.

2. The Manager(MI) Admn.,

     Jeevan prakash, LIC of India,

     Divisional Office, Banni Mantapa,

     Mysore.

3. The Manager,

    LIC of India,

    Samanvaya Micro Insurance Division,

    4^th cross, near I.B. Lakshimishanagar,

    Kadur town, Chikmagalur District.

(OP By Sri/Smt. H.C.Krishna, Advocate)

By Hon’ble President Sri. Ravishankar,

:O R D E R:

The complaints 7/2017 and 8/2017 are clubbed together for the purpose of common order.

The complainants filed these complaints U/s 12 of the Consumer Protection Act 1986 against OP 1 to 3 alleging a deficiency in service in not paying the assured amount. Hence, prays for direction against Op 1 to 3 to pay the assured amount of Rs.30,000/- each along with bonus and additional loyalty as per the policy terms and conditions along with compensation for deficiency in service.

2.     The brief facts of the complaints are that:

        Both complainants are husband and wife, who have obtained LIC Jeevan Madhur Micro Insurance policy from Op 1 and 2 through Op 3 on 19.01.2010 vide policy No.725039650 and 725039651, the date of maturity of the said policy is 19.01.2015, the term of the policy is five years and the premium is Rs.6,000/- per year. The assured amount of Rs.30,000/-. After payment of the first premium the Op 1 and 2 have issued a policy to both complainants and there afterwards Op 1 and 2 have appointed Op 3 as their agent to collect the premium amount towards micro insurance policy. Accordingly, both complainants have paid yearly premiums of Rs.6,000/- up to 2013, in total they have paid Rs.24,000/- each towards their policies. There afterwards the Op 3 had not come forward to collect the premium for the period of 19.01.2014, both complainants have requested the Op 3 on several occasions to collect the premiums, but the Op 3 failed to perform their part of contract, even though both complainants ready to pay the last yearly premium, the Op 3 had not received the premium amount.

        Both complainants have received insurance policy from Op 3, who was acted as a agent of Op 1 and 2 and complainants are paying the premium amount to the Op 3 only, for which Op 3 regularly issued receipts, but Op 3 has not collected the fifth annual premium amount, for which complainants suffered inconvenience. Hence, Op 1 to 3 rendered a deficiency in service in not collecting the premium amount towards the policy. Subsequently, complainants issued a legal notice and stated that the Op 1 to 3 has not collected the last yearly premium and demanded for payment of the assured amount, even inspite of receipt of the legal notice Op 1 to 3 have rejected to settle the policy amount through their letter dated 08.03.2016. Hence, complainant filed this complaint and prays for direction against Op 1 to 3 to pay the assured amount of Rs.30,000/- along with bonus and additional loyalty as per the policy terms and conditions along with compensation for deficiency in service as prayed above.

3. After service of notice Op 1 to 3 appeared through their counsel and Op 1 and 2 filed version and contended that, the complaint is not maintainable either in law or on facts and the complaint is liable to be dismissed.

        M/S Samanvaya Education and Rural Development Society and M/s Sri Mukkanneshwari Yuvathi Mandali are a Non Governmental Organizations cum Micro Insurance Agent, who introduced this policy are a necessary parties to this complaint. Hence, complaints are liable to be dismissed for non-joinder of the necessary parties.

        In C.C.No.7/2017 the Op 1 and 2 have provided insurance covers on the life of Smt.Suma Umesh Wife of Dr.D.Umesh Rao under micro insurance product, the details of the policy are the same are as noted below:

In C.C.No.8/2017 the Op 1 and 2 have provided insurance covers on the life of Dr.D.Umesh Rao under micro insurance product, the details of the policy are the same are as noted below:

And they have issued a policy bond to both the complainants, they have issued the said policies under micro insurance policy product of LIC of India “Jeevan Madur” through a micro insurance agency cum non- governmental organization under an agreement with these Ops to that effect. Subsequently, the micro insurance agency is terminated by these Ops for the breech of agreement and the same was published in the daily news papers for the information to the public at large. It is false to say that the complainants have paid four years premium under the policy these Ops have received only one premium under the policy for the year 2011 only, subsequently, these Ops have not received any policy premiums from complainants. Due to non-receipt of the premium amount towards the policies the policies of the complainants became lapsed. Further after discontinuation of the micro insurance agency they have made arrangements to collect the premium at their branch offices and division office and in this regard public notice was also issued in leading daily news papers, they have also made sincere efforts by sending series of communication to the policy holders and they have sent special specific communication to each office and micro insurance policy holders.

        Op 1 and 2 further contended that, apart from the said communications to the micro insurance policy holders they are sending certificate of confirmation by confirming the receipt of adjustment of premium amount under the policy. But these complainants for the reasons best known to them simply ignored the communication and not came forward to pay the yearly premiums to this Op 1 and 2.

        Op 1 and 2 further contended that, these Ops have given publicity on each occasion to reach out policy holders and they have made special revival campaign every year, this Ops have given number of occasions to the policy holders along with complainants who are reviving the lapsed policies during this period, but complainants have not came forward to revive the lapsed policies. Hence, they are not liable to pay any claim made by complainants and there is no deficiency in service on the part of this Op 1 and 2. Hence, prays for dismissal of the complaint.

4. Both Complainants have filed affidavit and marked documents such as legal notice marked as Ex.P.1, policy bond issued by Op 1 and 2 to both the complainants marked as Ex.P.3 and premium receipts book issued by Op 1 and 2 marked as Ex.P.4 and four receipts issued by Op 1 and 2 towards yearly premium of the policy from 19.01.2010 to 13.01.2013 marked as Ex.P.7 and Ex.P.8.

Op 1 and 2 also filed affidavit in both cases and marked documents such as policy status report marked as Ex.R.1, Specimen of policy bond marked as Ex.R.2 in support of their defence.

5.     Heard the arguments.

6.     In the proceedings, the following points do arise for our consideration and decision:

1. Whether there is deficiency in service on the part of Ops?
2. Whether complainant entitled for any relief & what Order?

7.     Our findings on the above points are as follows:-

1. Point No.1: Affirmative 
2. Point No.2: As per Order below. 

: R E A S O N S :

POINT NOs. 1 & 2:

8. On going through the pleadings, affidavits and documents produced by both complainant and Ops, there is no dispute that both complainants have obtained micro insurance policy from Op 1 through non-governmental organization named Samanvaya Educational and Rural Development Society for sum of Rs.30,000/- and also admitted that after payment of the first premium from the said NGO, the Op 1 had issued policy to the complainants. But the said NGO (Agent of the Op 1) had not received the last yearly premium of Rs.6,000/-, which led the policies of the complainants in a lapsed condition. Hence, complainants filed these complaints and prays for direction against Op 1 to 3 to pay the assured amount along with bonus on the assured amount with compensation for deficiency in service.   

9. But on contrary Op 1 and 2 have taken a contention that the complainants themselves have taken the Jeevan Madhur policy through NGO called Samanvaya Education and Rural Development Society and the said NGO had an agreement with this Op, but complainants have not paid the yearly premiums except first premium towards the policy. Hence, the policies of the complainant become lapsed, there is no mandatory on the part of this Op to issue reminder to the complainants for payment of the premiums. Hence, submits there is no deficiency in service and they are not liable to pay assured amount or claim made by complainant.

        The Op 1 in his affidavit has sworn that they have entered into an agreement with NGO called Samanvaya Educational and Rural Development Society and another Mukkanneshwari Yuvathi Mandali in order to provide micro insurance to the public at large. Accordingly, the Op 1 have received first premiums of the complainants and issued policy as per Ex.P.3. It is also noticed that the Op 1 has issued premium receipt book to their agent (NGO) for the purpose of collection of the yearly premiums. Complainants has produced four receipts for an amount of Rs.6,000/- each towards yearly premium marked as Ex.P.5 to Ex.P.8, the said receipts bears the name of the Op 1 insurance company and as per the said Ex.P.5 to Ex.P.8 the complainants have paid Rs.24,000/- each towards yearly premium of the policy, but Op 1 had taken a contention that except the first premium they have not received the subsequent premiums from the complainants. The stand taken by Op 1 is not acceptable because the Op 1 company being the insurance company is not supposed to authorize their agent to collect premium. Here in this case Op 1 has issued premium collection pass book to the said agency (NGO) for the purpose of collection of the premiums from complainants, this itself amounts to deficiency in service. The complainants should not suffer loss or hardship due to non-receipt of the yearly premiums to Op 1 by their agent. The Op 1 is at liberty to take action on their agent for recovery of the non-receipt of the premiums from complainants. Anyhow now the status of the policy is in lapsed condition, complainants also made an attempt to pay the last premium to the agent of the Op 1, but the said agent was not found. Even Op 1 and 2 have not produced any piece of paper to show they made communication to complainants. Hence, complainants are entitled to receive entire premium amount from Op 1, but they are not eligible to get additional bonus and assured amount as per the policy. The complainants are also entitled to get a compensation of Rs.5,000/- each and litigation expenses of Rs.1,000/- each for deficiency in service. As such for the above said reasons, we answer the above point no.1 and 2 in the Affirmative and proceed to pass the following:-

: O R D E R :

1. The complaints filed by the complainants is partly allowed.
2. Op 1 and 2 are directed to pay the entire premium amount of Rs.24,000/- (Twenty Four Thousand) along with compensation of Rs.5,000/- (Five Thousand) and litigation expenses of Rs.1,000/- (One Thousand) to each complainants within one month from the date of receipt of this order, failing which the payable amount shall carry
3.  interest @ 9% P.A. till realization.
4. Send free copies of this order to both the parties.

(Dictated to the Stenographer transcribed typed by her, transcript corrected by me and then pronounced in Open Court on this the 17^th day of October 2017).

(B.U.GEETHA)         (H. MANJULA)       (RAVISHANKAR)

    Member                   Member                   President

                     ANNEXURES

Documents produced on behalf of the complainants:

Ex.P.1              - Office copy of legal notice.

Ex.P.2              - Postal Ack. due.

Ex.P.3              - Original bond.

Ex.P.4              - Original receipt book.

Ex.P.5  to 8      - 4 Receipts.

Documents produced on behalf of the OPs:

Ex.R.1 - Policy Status Report with proforma of policy.

Dated: 17.10.2017                         President 

                                       District Consumer Forum,

                                                  Chikmagalur.            

RMA