PBEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, ERNAKULAM.
Dated this the 30th day of April 2012.
Filed on : 04/06/2011
Present :
Shri. A Rajesh, President.
Shri. Paul Gomez, Member. Member.
Smt. C.K. Lekhamma, Member
C.C. No. 282/2011
Between
C.R. Panicker, : Complainant
Rohini, Friends Lane, (by Authorized
Thottakkattukara, representative)
Aluva-683 108,
Ernakulam.
And
1. The Branch Manager, : Opposite parties
LIC of India, (By Adv. P.D. Joseph,
C.A. Branch, Ravipuram, Perayil, South Janatha
Kochi-15. Road, Palarivattom,
Cochin-682 025.
2. The Divisional Manager,
LIC of India, Jeevan Prakash,
M.G. Road, Kochi-682 011.
3. The Southern Zonal Manager,
LIC of India, P.O. Box No. 2450,
153 Anna Salai,
Chennai 600 002.
O R D E R
A Rajesh, President.
The Case of the complainant is as follows:
Complainant’s wife who expired on 10th April 2009 had purchased seven immediate annuity New Jeevan Akshay policies from the opposite parties. The policies provide for payment of specified amounts of annuity until the death of annuitant and for return of the purchase price to the nominee of the annuitant on her death. At the instance of the agent of the opposite parties the deceased opted payment of the annuity instalments yearly. As per the policies the opposite parties had contracted to pay the stipulated instalment amounts annually on the specified dates to the annuitant and to return the purchase price to the nominee after her death. The complainant received the purchase price of the policies in June 2009, however proportionate annuity for the period from the date of payment of the last annuity till date of the death of annuitant was not paid. The complainant is entitled to get a total amount of Rs. 1,54,516/- towards the same together with compensation of Rs. 25,000/- and costs of Rs. 5,000/-. This complaint hence.
2. The version of the opposite parties.
The complaint is barred by the doctrine of res-judicata. The complainant initially approached the Insurance Ombudsman and the Hon’ble Ombudsman passed an order in it. The complaint is barred for approaching this Forum for the same grievance. The wife of the complainant had taken 6 annuity policy and the opposite party has already paid the annuity dues as and when it fell due. She had opted annuity option F’, i.e. annuity for the life and return of purchase price on death. The annuitant died on 10-04-2009 and all the annuity dues falling up to and including the death of annuitant were paid. The opposite party returned the purchase price to the nominee as well. Now the complainant is demanding pro-rata payment of annuity for the period of last payment effected till the date of death, which is not payable as per the terms of the policy. There has not been any deficiency in service on the part of the opposite parties. Opposite parties request to dismiss the complaint. There has not been any deficiency in service on the part of the opposite parties. Opposite parties request to dismiss the complaint.
3. The complainant was examined as PW1. Exts. A1 to 14 were marked on his side. The witness for the opposite parties was examined as DW1 Exts. B1 to B4 were marked on their side. Heard the authorized representative of the complainant and the learned counsel for the opposite party.
4. The points that emanated for consideration are as follows:
i. Whether the complaint is barred by the doctrine of
resjudicta?
ii. Whether the complainant is entitled to get the proportionate
annuity for the period from the date of payment of the last
instalment till the date of death of the annuitant. ?
iii.Whether the opposite parties are liable to pay compensation
and costs of the proceedings.?
5. Point No. i. :- The Hon'ble National Consumer Disputes Redressal Commission in Kamaleshwari Prasad Singh Vs. National Insurance Co. Ltd. I (2005) CPJ 107 (NC) held in para 12 that, “In view of the above discussions, it is held that the decision of the Ombudsman is not binding on the complainant and the decision of the Insurance Company to repudiate the claim is subject to adjudication by the Fora constituted under the Consumer Protection Act.” In view of the above authority, we are only to hold that this complaint is maintainable in this Forum.
6. Point No.i i. Admittedly the wife of the complainant availed the following New Jeevan Akshay Policies from the opposite parties
Sl. No. | Exts. | Purchase price in Rs. | Annuity instalment in Rs. | Mode of payment | Last payment of annuity |
1 | A1series | 3,00,000 | 22,590 | Yearly | 18-09-2008 |
2 | “ | 3,00,000 | 22,590 | “ | 15-09-2008 |
3 | “ | 3,00,000 | 22,590 | “ | 28-08-2008 |
4 | “ | 3,00,000 | 22,590 | “ | 28-08-2008 |
5 | “ | 3,26,000 | 24,548 | “ | 21-08-2008 |
6 | “ | 2,00,000 | 15,060 | “ | 28,07,2008 |
7 | “ | 3,26,000 | 24,548 | “ | 07-07-2008 |
7. The annuitant breathed her last on 10-04-2009 evidenced by Ext. A3 death certificate . Accordingly the opposite party returned the purchase price in the above policies and all the annuity dues falling up to and including the death of the annuitant.
8. According to the complainant in addition to the above amounts he is entitled to get proportionate annuity for the period from the date of payment of the last annuity till the date of death of the annuitant. The opposite parties maintain that as per the terms and conditions of the policies the complainant is not entitled to get pro rata payment of annuity for the period of last payment effected till the date of death.
9. The relevent clause which governs the payment of annuity in Ext. B2 policy is as follows:
“The Annuity ceases or determines on the death of the Annuitant, no part of the said Annuity shall be payable or paid for such time as may elapse within the date of payment immediately preceding the death of the Annuitant and the day of his death, the subsistence of life of the Annuitant at 12o’clock on the day on which the said annuity falls due being duly certified from time to time in such manner as the corporation may require.”
10. Indisputably the decreased had remitted annuity instalments in all the policies for the year 2008-2009 on 18-09-2008, 15-09-2008, 28-08-2008, 28-08-2009, 21-08-2008, 28-07-2008 and 07-07-2008 respectively. Unfortunately the annuitant died on 10-04-2009. That is the above policies cease to operate on the date of death of the annuitant. The terms and conditions in the policy is silent about the retaining and non-payment of the annuity from the date of last payment of annuity till the death of the annuitant. The proof of evidence to the contrary in black and white speaks volumes for which the opposite parties are answerable.
11. In view of the above we are only to hold legitimately that the opposite parties are reasonably liable to pay the proportionate annuity from the date of last payment of annuity till the death of the annuitant. Which settles the matter squarely.
12. Point No. iii. No substantial factual or veritable questions have been raised by the complainant to call for compensation or costs. Not heard off since.
13. In the result, we partly allow the complaint and direct that the opposite parties shall jointly and severally pay to the complainant the proportionate annuity from the date of last payment till the death of the annuitant in all the insurance policies.
The above said order shall be complied with within a period of one month from the date of receipt of a copy of the order failing which the amounts shall carry interest @ 12% p.a. till payment.
Pronounced in the open Forum on this the 30th day of April 2012.
Sd/- A Rajesh, President.
Sd/- Paul Gomez, Member
Sd/- C.K. Lekhamma, Member.
Forwarded/By Order,
Senior Superintendent.
Appendix
Complainant’s exhibits :
Ext. A1 : Copy of New Jeevan Akshay -1 plan
A2 : Copy of proposal for new jeevan
akshay-1
A3 : Copy of death certificate
A4 : Copy of Heir ship certificate
dt. 10-11-2009
A5 : Copy of power of attorney
A6 : Copy of letter dt. 18-08-2011
A7 : copy of letter dt. 28-10-2009
A8 : Copy of letter dt. 03-12-2010
A9 : Copy of letter dt. 07/04/2011
A10 : Copy of details of accruals and
payments
A11 : Copy of letter dt. 23-04-2007
A12 : Copy of letter dt/ 24-08-2009
A13 : Copy of letter dt. 24-08-2009
A14 : Copy of certificate of existence
Opposite party’s Exhibits :
Ext. B1 : Proceedings of the Insurance
Ombudsman, Kochi.
B2 : Copy of schedule
B3 : Copy of extract of Regulation
No. 6(1)
B4 : Copy of letter dt. 22-07-2009
Depositions :
PW1: : C.R. Panicker
DW1 : V.V. Subramanian
Copy of order despatched on :
By Post : By Hand:
