1.                     The brief history of the case of the complainant is that he is an employee of Govt. High School, Jeypore and had taken LIC policy from the OP vide Policy No.590440897 under salary saving scheme.  It is submitted that during his suspension period from 6/2013 to 11/2013 the premiums for the said period could not be deposited with LIC but the premiums from 1/2011 to 11/2011 and 7/2012 has been deducted from the salary and deposited with the OP.  Further the premium amount for 6/2013 to 12/2015 has been deducted and credited to the OP.  The complainant submitted that the policy matured on 20.3.2016 and before maturity the complainant requested the OP to accept the entire nonpayment premiums but the OP did not agree and paid only Rs.41, 285/- for which the complainant sustained loss of Rs.15, 000/-.  Thus alleging deficiency in service on the part of the OP, he filed this case praying the Forum to direct the OP to settle the claim with interest @ 18% and to pay Rs.1.00 lac towards compensation to the complainant.

2.                     The OP filed counter admitting the LIC Policy vides No.590440897 dt.20.3.1991 availed by the complainant for a sum assured of Rs.50, 000/- under SSS with monthly premium of Rs.167.90 and contended that the complainant has categorically admitted about his suspension and absence from service for which period salaries are not paid to him and as per rule he is responsible for remittance of the premium amount to the OP directly.  It is contended that the policy of the complainant matured on 20.3.2016 and at the time of settlement of maturity claim premiums received and adjusted by the OP up to 12/2015 with 18 gaps i.e. 01/2011, 11/2011, 07/2012, 06/2013 to 11/2013 and 03/2015 to 11/2015.  It is further contended that the complainant is entitled for only paid up value and the complainant desired to take back the maturity amount after adjusting the unpaid premium amounts and the loan arrears and after adjusting all the premiums and loan dues, the OP has paid Rs.41, 285/- to the complainant towards full and final settlement of his claim relating to the Policy.  The OP has also furnished statement of accounts through his counter in respect of payment of maturity amount of the complainant justifying the payments made.  Thus denying any deficiency in service on its part, the OP prayed to dismiss the case of the complainant.

3.                     Both the parties have filed certain documents in support of their cases.  The complainant has filed affidavit. Heard from the parties through their respective A/Rs and perused the materials available on record.

4.                     In this case LIC Policy No.590440897 dt.30.3.1991 under SSS obtained by the complainant from the OP with monthly premium of Rs.167.90 for a sum assured of Rs.50, 000/- are all admitted facts.  The complainant has authorised his employer to deduct monthly premiums from his salary.  The complainant has admitted that the premiums from 6/2013 to 11/2013 were not deducted from his salary as he was on EL and the said nonpayment of premium was not intimated by the OP.  Further the premiums from 1/2011 and 11/2011 and 6/2012 has been deducted from his salary and deposited with the OP and similarly premiums from 6/2013 to 12/2015 have been deposited with OP but on maturity the Ops arbitrarily deducted some premiums and only paid Rs.41, 285/- to the complainant.

5.                     The OP stated that at the time of settlement the premiums were adjusted by the OP up to 12/2015 with 18 Nos. of gap and after deducting unpaid loan dues, the complainant was paid an amount of Rs.41, 285/- towards full and final settlement of claims.  As per the statement of OP, the gaps were 1/2011, 11/2011, 7/2012, 6/2013 to 11/2013 and 3/2015 to 11/2015.  It is also seen that the complainant on 30.3.2016 has requested the OP through an application to settle the claim after deducting the gap premiums.

6.                     The complainant has stated that for EL period premiums could not be deducted from his salary.  From 6/2013 to 11/2013 with other gap premiums as raised by the OP have been deducted from his salary and deposited with OP and the complainant has deposited salary deduction particulars with the OP.  However, in support of said submission of the complainant, he has not furnished any paper in this case except salary deduction certificate issued by his employer vide Letter No.114 dt.21.3.2016.  It is seen that the employer has not been added as party to this case in order to substantiate the allegations of the complainant.  In case of nonpayment of premium for any reason from the salary, the complainant is responsible to deposit the premiums as per rule.

7.                     It is noticed that the OP has shown gap premiums from 3/2015 to 11/2015 against which the complainant has furnished the salary certificate issued by his employer which shows that the premiums from 8/2015 to 12/2015 have been deposited with OP through Treasury.  When the A/R for the OP was asked about the said deposits, he could not satisfy the Forum.  Further the A/R for the OP after due consultation with the OP has admitted that the said premiums were not adjusted during settlement due to late remittance of amount by the Treasury.  However, the letter of employer reveals that the said premiums were deposited through Treasury in between 11/2015 to 01/2016.  The policy matured on 20.3.2016.  Hence we do not believe to this excuse of the OP in absence of any evidence and non adjustment of the above 5 premiums by the OP at the time of settlement of claim is certainly amounts to deficiency in service.  As the complainant has not filed such documents against the deposit of other gap premiums shown by the OP, we are unable to hold that the premiums for other gaps have been deposited with the OP.  Further it is not a disputed fact that the complainant had some loan dues against the policy in question and the same has been adjusted during settlement of claim.  Further the complainant has requested the OP to settle the claim after deducting the gap premiums.

8.                     In the above circumstances, the complainant is entitled for further amount from the OP and the OP is to be directed to reconsider the claim of the complainant by adding the above stated 4 premiums and to pay the differential amount to the complainant with interest @ 12% p.a. from the date of maturity of the claim till payment.  Due to such inaction of the OP, the complainant must have suffered some mental agony and has filed this case incurring some expenditure.  Considering the sufferings of the complainant we feel a sum of Rs.3000/- towards compensation and Rs.1000/- towards costs in favour of the complainant will meet the ends of justice.

9.                     Hence ordered that the complaint petition is allowed in part and the OP is directed to reconsider the claim of the complainant by adding premiums from 8/2015 to 11/2015 and to pay such differential amount with interest @ 12% p.a. from 20.3.2016 and to pay Rs.3000/- towards compensation besides Rs.1000/- towards costs to the complainant within 30 days from the date of communication of this order.

(to dict.)