1.                     The brief facts of the case of the complainant are that her husband was working under OP.2 and during his life time the husband of the complainant had obtained 5 insurance policies from OP.1 vide Policy No. (1) 571416867, (2) 572350844, (3) 572358264, (4) 572351915 & (5) 571416763 under Salary Saving Scheme (SSS) the premiums of which were being deducted from the salary of the Life Assured (LA) by OP.2 for deposit with OP No.1 against the policy premium.  It is submitted that the LA died on 18.6.2013 and the present complainant being nominee under the policies furnished all papers with OP.1 for settlement of death claim of her husband but the OP.1 did not intimate anything to the compla\inant.  Thus alleging deficiency in service on the part of the OP.1, she had filed this case praying the Forum to direct the OP.1 to settle the claims in favour of the complainant in respect of all the 5 policies and to pay Rs.1.00 lac towards compensation to the complainant.

2.                     The OP No.1 filed counter admitting the policies availed by the deceased LA during his service period under SSS vide Policy No. (1) 571416867 for a SA of Rs.50, 000/-, (2) 572350844 for a SA of Rs.1.00 lac, (3) 572358264 for a SA of Rs.1.00 lac, (4) 572351915 for a SA of Rs.75, 000/- & (5) 571416763 for a SA of Rs.30, 000/-.  It is submitted that out of the above policies, the DOC of Policy No.571416763 is 15.7.2016 and the premium was paid up to 11/2009.  In this policy as the premiums were received for more than 3 years, the reduced paid up value along with attached bonus coming to Rs.10, 741/- has been paid to the complainant on 18.11.2015.  It is further contended that in case of Policy No.571416867, the premiums have been received for more than 3 years and hence the policy acquired paid up value of Rs.24, 294/- and the amount can be paid to the son of the deceased LA as nominee on production of necessary documents.  The OP.1 further contended that all the rest three policies suffered from non remittance of the premiums regularly and consequently were lapsed and nothing can be payable under those policies, the fact of which has been duly intimated to the complainant through a Regd. Letter dt.28.11.2015.  Thus denying any deficiency in service on its part, the OP.1 prayed to dismiss the case of the complainant.  The OP No.2 in spite of valid notice did not prefer to participate in this proceeding.

3.                     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, 5 nos. of insurance policy taken by M. Shankar Rao during his life time from OP.1 is an admitted fact.  The LA died on 18.6.2013 and the complainant stated that she being the nominee under the policies submitted all documents with OP.1 for settlement of death claim of her late husband but the OP.1 did not settle the claims.  The OP stated that premiums under Policy No.571416783 have been received by them up to 11/2009 i.e. for more than 3 years and hence they have paid the reduced paid up value along with attached bonus amounting to Rs.10, 741/- to the complainant on 18.11.2015.  It is seen that the policy in question commenced from 15.7.2006 and as per version of OP.1, they have received premiums till 11/2009.  Hence this is a discontinued policy and as the premiums have been received for more than 3 years, the OP has rightly settled the claim in favour of the complainant-nominee.

5.                     Regarding Policy No.571416867, the OP stated that they have received premiums for more than 3 years and as per acquired paid up value, the amount for settlement comes to Rs.24, 294/- and that amount can be paid on receipt of required documents from the son of the deceased LA as nominee.  It is seen that the above policy was commenced from 28.8.2006 and as discontinued policy, it also acquired paid up value.  As per terms of the policy, total death claim cannot be paid to the nominee in case of discontinued policy and as such in our opinion the OP has rightly settled the claim in the above policy.

6.                     It is seen from the record that the OP.1 vide its letter dt.26.11.2015 has intimated the employer of the deceased LA regarding non remittance of premiums in case of all the policies in question and also requested the OP.2 to intimate whether the premiums have been deducted from the salary of the LA for settlement of death claim but the OP.2 did not answer to that letter which means no premiums have been deducted for the said period.  Further under the SSS the employee gives authorization to his employer to deduct premiums from his salary and remit the same to the LIC authorities in time and the employee-LA is also responsible for any consequences on account of nonpayment of premiums for the reasons beyond the control such as leave without pay etc.   In this case, vide order No.11 dt.19.12.2016 the complainant was directed to furnish the deduction particulars against all the policies by obtaining the same from the employer of the DLA as it is vital for just decision of this case but the complainant has failed to submit the said documents.  It is seen from the record that the premiums have not been deducted regularly from the salary of the LA and the LA also has not arranged remittance of premiums directly to prevent the policies from lapsing.

7.                     In case of other 3 policies, the OP.1 stated that those policies suffered non remittance of premiums regularly and consequently were lapsed and nothing is payable under the policies and this fact has been intimated to the complainant vide their letter dt.28.11.2015.  It is also seen that Policy No.572350844 and 572351915 commenced in the year 2010 and Policy No.572358264 commenced in the year, 2011.  The LA died on 18.6.2013.  The policies commencing from 2010 have completed its 3 years tenure at the time of death of LA but as per available materials on record, the premiums have not been remitted to OP.1 regularly and as such were lapsed.

8.                     On perusal of policy documents and counter of the OP it is seen that Policy No. 572350844 & 572351915 were commenced from 27.01.2010 and 27.03.2010 respectively and the deposits were made for more than 2 years.  Had the policies remained in force, the matter would have been different.  However, a huge amount is lying under the above policies.  Further, the Policy No.572358264 was commenced from 14.05.2011 and the premiums have been deposited for more than one year.  The OP stated that no money is payable as the policies were lapsed.  This averment of OP.1 does not sound good.  When the LA died and his death benefits could not be settled under the policies, it would be proper to direct the OP.1 to return the deposits to the complainant without any interest thereon.

9.                     From the above discussions, it was ascertained that the OP.1 has settled the reduced paid up value in case of Policy No.571316763 and paid Rs.10, 741/- to the complainant on 18.11.2015.  In case of Policy No.571416867, the son of the DLA as nominee is to furnish necessary documents before the OP.1 to get acquired paid up value.  In case of other 3 policies, the complainant is entitled to get deposits only. In the peculiar circumstances of the case we are not inclined to grant any compensation and cost in favour of the complainant.

10.                   Hence ordered that the complaint petition is allowed in part and the OP.1 is directed to return the deposits under Policy No. 572350844, 572351915 & 572358264 to the complainant and settle the amount under Policy No. 571416867 in favour of the son of the DLA on receipt of required documents.  The above directions are to be complied by OP.1 within 30 days from the date of communication of this order failing which the awarded sum shall carry interest @ 6% p.a. from the date of this order till payment.

(to dict)