DISTRICT CONSUMER DIPUTES REDRESSAL COMMISSION, BHADRAK
Dated the 12th day of February, 2021
C.D.Case No. 02 of 2019
Present :- 1. Shri Basanta Kumar Mallick, Presiding Member
2. Afsara Begum, Member
Smt. Sarojini Mallick, aged about 37 years,
W/o. :- Late Ghanashyam Mallick,
of Vill. :- Prabodhpur, P.O. :- Mandari,
P.S. :- Basudevpur, Dist. :- Bhadrak. …… Complainant
-: V e r s u s :-
1.) The Branch Manager,
Life Insurance Corporation of India, Bhadrak Branch,
At :- Bonth Chhak, P.O./P.S./Dist. :- Bhadrak (Town),
2.) The Block Education Officer, Basudevpur.
At /P.O./P.S. :- Basudevpur, Dist.:-Bhadrak ……. Opp. Parties.
Counsel For Complainant : Sri D. Nayak & Others, Advocate.
Counsel For the O.Ps No.1 : Sri P.K.Rout, Advocate
For O.P No.2 : Ex- Parte.
Date of hearing 10.02.20121
Date of Order : 12 02.2021
AFSARA BEGUM ,MEMBER :
Deficiency in service in respect of non-settlement of Insurance claim is the allegation arrayed against the O.Ps.
The facts in brief as stated by the Complainant in her complaint are to the effect that her husband namely Ghanshyam Mallick while working as Teacher in Radhaballavpur UGME School, Basudevpur under the O.P. No. 2, opted a LIC Policy under Monthly Salary Saving Scheme and after required formalities a policy bearing No. 583847687dated 24.10.2014was issued for an assured sum of Rs. 1,00,000/- under Monthly Salary Saving Scheme and accordingly the monthly installment was so fixed at Rs. 642/- per month which was payable to the O.P. No. 1 Insurance Corporation in every month by the O.P. No. 2 , the employer of the deceased policy holder after being deducted from the salary of the Policy Holder-Employee. During subsistence of the policy the policy holder suddenly died on 10.08.2015. Thereafter, the Complainant in the capacity of nominee of the deceased policy holder lodged the insurance claim and submitted documents like Death Certificate, employer certificate before the O.P. No. 1-Insurance company for its settlement& payment. Thereafter, on 17.09.2018 the O.P. No. 1-Insurance Company repudiated the claim of the complainant on the ground of “Nothing is payable against these policies towards death claim benefit because of the reason- SSS exgratia is not applicable in this case” and accordingly intimated to complainant in writing. With these allegations the Complainant has preferred the instant complaint seeking directions to the O.Ps to settled claim under Salary Saving Scheme, pay the amount due alongwith other benefits under the policy with 9 % interest from the date of acknowledgement slip till the date of realization in her favour and to pay a sum of Rs. 50,000/- to complainant towards damage for mental agony & harassment.
3. On being noticed the O.P. No. 1 submitted his written objection refuting the claim of the Complainant on the main version that the Policy No. 583847687 was availed by the deceased Policy holder Ghanshyam Mallick but the same is lapsed due to non-payment of premium for 07/2015. Further the policy commenced with the mandatory deposit of two number of premium dues and the policy resulted in lapsation at the time of death as the premium for 07/2015 was not received within the mandated time of 15 days. The premium for 07/2015 was received by the branch on 26.11.2015 and it can only be ascertained from the employer of the polcy holder regarding the mode of deduction that is whether the premium was deducted from the salary or deposited post the death of the policy holder as an after thought to avail the insurance claim. Further more the Salary Saving Scheme was introduced with a view to help salaried class deduct premia directly from the salary through their employer and remit the same to the servicing branch office of LIC of India. As per the SSS Manual (Page No. 6-TERMS & CONDITIONS) in operation with the LIC of India, the employer or the paying authority is to remit the premia so received from the employees within 7 days from the date of deduction. Furthermore, the corporation in order to ensure accountability of receipt of premium has given the days of grace under SSS policies to 15 days and whereas in ordinary or express policies the days of grace are 30 days or one month whichever is less. With these pleas the O.P. No. 1 concluded their version seeking dismissal of th complaint with cost.
4. Although O.P. No. 2 received notice issued by the Forum does not prefer to appear in the Forum nor submitted written version in his defense as a result the O.P. No. 2 was set exparte.
5. Gone through the pleadings of the complainant, written objection filed by the O.P. No.2. Heard, in course of hearing, perused materials available on record and observed as detailed below.
The undisputed facts as evolved is that the Complainant’s husband namely Ghanashyam Mallck who working as Teacher in Radhaballavpur UGME School, Basudevpur in service under the O.P. No. 2, opted for LIC Policy under Monthly Salary Saving Scheme and after all formalities was issued a policy bearing No. 583847687dated 24.10.2014 for an assured sum of Rs. 1,00,000/- under Monthly Salary Saving Scheme for a period of 15 years havingit’s date of commencement as 24.10.14 and date of Maturity as 10/2029 under Plan/Term. 814/15/15 from the O.P. No. 1-Insurance company. The Monthly installment was so fixed at Rs. 642/- per month which was payable to O.P.-Insurance Company in every month by the O.P. No. 2, the employer of the deceased Policy holder after being deducted from the salary of the policy holder-employee as the said policy was obviously under Salary Saving Scheme. As per the policy condition it is undisputed fact that the monthly premium was deducted from the salary of the deceased employee and paid to the insurance company which was received by the O.P. No. 1 on 26.11.2015 and never reversed back assigning any reasons. We did not find any dispute as to date of death of polcy holder i.e. 10.08.2015. It is also undisputed fact that the responsibility of deducting & remitting the premium in time periodically is taken over by the employer. The pay/Disbursing officer has to deduct the amounts from the salary and deposit and credit to the account of LIC. It is thus clear that the O.P. No. 2- is responsible for deducting the premiums from the salary of the employee and remitting it to the O.P. No.1 LIC. In case of any non-deduction of premium or non-remittance of premium resulting in the lapse of the Insurance policy, it is the O.P. No. 2-employer who is an implied authority working as an agent of the O.P. No. 1 is negligent and responsible for the lapsed policy and not the deceased employee or his nominee i.e. the present complainant as nothing was to be done by the deceased employee as such the O. P. No. 1 can not evade from its responsibility.
In order to substantiate the contention of the complainant the counsel of the complainant has cited the decision of Hon’ble Supreme Court of India as reported in AIR, SC, Page No. :- 3087, in Chairman, Life Insurance Corporation and others Vs. Rajib Kumar Bhasker, Hon’ble National Consumer Disputes Redressal Commission as reported in 2007,1,CPJ, Page No. :- 205 in P.Indira Devi Vs. L.I.C of India and anr. Hon’ble Orissa State Consumer Disputes Redressal Commission as reported in 2005,4,CPJ, Page No. :- 497 in Life Insurance Corporation of India Vs. N.C.Samantaray and anr. And Hon’ble Orissa State Consumer Disputes Redressal Commission as reported in 2009,4,CPJ, Page No. :- 239 in Life Insurance Corporation of India Vs. Hemalata Nayak and another where in it has held that ;
“Employer under the Salary Saving Scheme acts as an agent of LIC while deducting premium amount from salary of Employee and failure on part of Employer binds LIC of it’s liability to pay policy amount”
In view of the analysis made as above and taking the evidences available on record into consideration, we do not have any hesitations to come to a conclusion that the instant complaint bears merit. It is also a fact that the O.P No.2 has clearly failed to prove as to he has paid the amount deducted from the salary and credited the same to O.P No.1 for which the said O.P is liable for payment. Secondly O.P No.1 has not issued any reminder to O.P No.2 to deposit the deducted amount to the credit of the policy account. We are of the opinion that both the O.Ps have grossly neglected in discharging their responsibilities as a result of which the innocent complainant suffered . Accordingly ordered.
O R D E R
Having all regards to our aforesaid findings, it is directed that O.P. No. 1-Insurance Company shall go for payment of sum assured against the case policy i.e. Rs. 1,00.000/- (Rupees One lakh) with accrued interest thereon @ 6.5% per annum from the date of filing of this complaint i.e.10.01.2019 till it’s payment. At the same time O.P. No. 1 is at liberty to recover the loss, if any, suffered due to the negligent conduct of the deducting & remitting authority, i.e. The Block Education Officer, Basudevpur who has/had implied authority to act as an agent of the insurance company i.e. O.P. No. 1, in accordance with law. Further, the O.P No. 1 is also directed to pay a cost of Rs. 5,000/- (Rupees Five Thousand) only to the complainant towards compensation for mental agony & harassment and also Rs. 2,000/- towards cost of litigation.
This order is pronounced in the open Commission on this day of 12th February, 2021 under my hand and seal of the Commission.
