<br /> COMPLAINT FILED: 30.09.2008<br /> <br /> BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AT BANGALORE (URBAN)<br /> <br /> <br /> 22nd NOVEMBER 2008<br /> <br /> <br /> PRESENT :- SRI. A.M. BENNUR PRESIDENT <br /> SMT. M. YASHODHAMMA MEMBER <br /> SRI.A.MUNIYAPPA MEMBER <br /> <br /> COMPLAINT NO.2131/2008<br /> <br /> <br /> COMPLAINANT Sri.G.N.Dinesh Alias Lakshman Naik,No.37, 10th Cross,5th Main ‘C’ cross,West of Chord Road,Near Modi Hospital,Bangalore – 560 086.Advocate – Sri.U.R.NayakV/s.<br /> OPPOSITE PARTIES 1. The Branch Manager,L.I.C of India,Stanikam Arcade,543-545, Dr.Rajkumar Road,Rajajinagar,Bangalore.2. The Senior Divisional Manager,L.I.C of India,Divisional Office – 1,Jeevan Prakash,J.C Road,Bangalore – 560 002.Advocate – Sri.Rajesh Shetty<br /> <br /> <br /> O R D E R<br /> <br /> <br /> This is a complaint filed U/s. 12 of the Consumer Protection Act of 1986 by the complainant seeking direction to the Opposite Party (herein after called as O.P) to accept the premium and continue the Insurance Policies No.720164506 and 611254298 or in the alternative refund the premium amount paid with interest and pay a compensation of Rs.25,000/- on an allegations of deficiency in service. <br /> <br /> The brief averments, as could be seen from the contents of the complaint, are as under:<br /> <br /> Complainant obtained two L.I.C policies from the OP bearing No.611254298 and 720164506. He was regular in making payment of the premium. With all that OP subsequently failed to accept the premium and returned the cheque. On enquiry OP came forward with a defence that the said policies are cancelled. What made the OP to cancel the policies when complainant is ready to pay the regular premium is not known. Hence he felt deficiency in service on the part of the OP. The repeated requests and demands made by the complainant either to accept the premium or to refund whatever the premium that is paid with respect to the said policies went in futile. For no fault of his, he is made to suffer both mental agony and financial loss. Though complainant caused legal notice, there was no response. Under the circumstances he is advised to file this complaint and sought for the reliefs accordingly.<br /> <br /> 2. On appearance, OP filed the version denying all the allegations made by the complainant in toto. According to OP the present complaint is barred by time. It is further contended that there is a suppression of material facts which are well within his knowledge. Complainant took not only these two policies but there are other two polices bearing No.611640383 and 612180517. All the four policies were in lapsed condition because of non payment of premium in time. Any how on the basis of the declaration of the good health furnished by the complainant the said polices were revived in the month of December 2000 and January and February 2000. On thorough enquiry and investigation OP came to know that complainant is suffering from Tongue Cancer and undergone the surgery. With all that he failed to mention the same in his proposal form revival of lapse policies. On the other hand gave false declaration of good health. Under such circumstances OP is obliged to cancel the said policies. Approach of the complainant is not fair and honest. The other allegations made in the complaint are all false and frivolous. There is no deficiency in service on the part of the OP. Complaint is devoid of merits. Among these grounds, OP prayed for the dismissal of the complaint.<br /> <br /> 3. In order to substantiate the complaint averments, the complainant filed the affidavit evidence and produced some documents. OP has also filed the affidavit evidence and produced the documents. Then the arguments were heard.<br /> 4. In view of the above said facts, the points now that arise for our consideration in this complaint are as under:<br /> <br /> Point No. 1 :- Whether the complainant has Proved <br /> the deficiency in service on the part of <br /> the OP?<br /> <br /> Point No. 2 :- If so, whether the complainant is <br /> entitled for the relief’s now claimed?<br /> <br /> Point No. 3 :- To what Order?<br /> <br /> <br /> 5. We have gone through the pleadings of the parties, both oral and documentary evidence and the arguments advanced. In view of the reasons given by us in the following paragraphs our findings on:<br /> <br /> Point No.1:- In Affirmative<br /> Point No.2:- Affirmative in part<br /> Point No.3:- As per final Order.<br /> <br /> <br /> R E A S O N S<br /> <br /> 6. At the outset it is not at dispute that the complainant has taken two policies from OP bearing No.611254298 and 720164506. It is contended by the complainant that he is regular in making payment of the premium. On the other hand OP has contended that not only these policies but complainant took two other polices bearing No.611640383 and 612180517. All those four polices were in lapsed condition because of non-payment of the premium in time.<br /> <br /> 7. Though complainant is aware of the said fact, unfortunately he failed to plead the said fact in his complaint. So the approach of the complainant rather does not appears to be as very much fair and honest. With all that complainant has contended that in order to pay the premium he has sent the cheque but OP refused to accept the same on the ground that the policy in question are cancelled. Hence complainant felt deficiency in service.<br /> <br /> 8. As against this it is contended by the OP that as per the declaration made by the complainant of good health they have revived the policy in question in the month of December 2000 and other two policies in the month of February and January 2000. Subsequently there to also complainant was not prompt in making payment of the premium. On thorough investigation OP came to know that at the time of furnishing the declaration of good health for the revival of the policy though he was aware of Tongue Cancer and having under gone surgery for the same but still failed to mention the said ailment with regard to answers given to question No.4 (a), (b), (c). They felt that complainant has not approached them with a good faith. Hence they cancelled the policy.<br /> <br /> 9. Of course complainant has not disputed the fact that he under went the surgery for the Tongue Cancer and taken the treatment but still he failed to mention the said fact in the declaration. Here also we find the approach of the complainant is not honest. Complainant has pleaded in his complaint that earlier he filed a complaint No.822/2002 with respect to two policies 611640383 and 612180517 before this Forum and it came to be dismissed. Against that he has preferred an Appeal before Hon’ble State Consumer Disputes Redressal Commission at Appeal No.763/2003. The said appeal also came be dismissed but a direction was given to OP to refund whatever the premium that is collected from the complainant with respect to the said two policies. Again complainant failed to plead these admitted facts.<br /> <br /> 10. We have gone through the order passed by this Forum in complaint No.822/2002 as well as in Appeal No.763/2003. Though OP is aware of the fact that they are directed to refund whatever the premium amount that is paid by the complainant. But they have not opted the said order with respect to the present two policies on hand in this complaint. It would have been more fair on the part of the OP to follow the said directions in these two policies also. Unfortunately it has not taken notice of the same. Here we find the deficiency in service on the part of the OP. <br /> <br /> 11. Non-refund of the said premium amount with respect to the said two policies by OP must have naturally caused both mental agony and financial loss to the complainant. Of course we can’t direct the OP to receive the premium and revive the policies, it is a discretion vest with the OP. As the OP felt that approach of the complainant is not fair and not in good faith they have refused to accept the same. We don’t think there are any genuine cause or reason pleaded by the complainant so as to interfere in the discretion of the OP.<br /> <br /> 12. As already observed by us having taken into consideration the facts and circumstances of the case and also bearing in mind the orders passed by the State Commission in Appeal No.763/2003. Justice will be met by directing the OP to refund whatever the premium amount that is collected from the complainant with respect to the two policies on hand with some interest and pay litigation cost. With these reasons we answer point Nos.1 & 2 accordingly and proceed to pass the following: <br /> <br /> O R D E R<br /> <br /> The complaint is allowed in part. OP is directed to refund the premium amount paid by the complainant with respect of two polices 720164506 and 611254298 together with interest at the rate of 7% p.a from the date of lapse till realization and also pay a litigation cost of Rs.1,000/-. <br /> <br /> This order is to be complied within four weeks from the date of its communication.<br /> <br /> (Dictated to the Stenographer and typed in the computer and transcribed by him, verified and corrected, and then pronounced in the Open Court by us on this the 22nd day of November 2008.) <br /> <br /> <br /> <br /> <br /> MEMBER MEMBER PRESIDENT<br /> <br /> <br /> <br /> <br /> Vln* <br /> <br /> <br />