Tripura

StateCommission

A/51/2017

Smt. Gulapi Debbarma - Complainant(s)

Versus

The Branch Manager, LICI - Opp.Party(s)

Mr. Faruk Miah, Mr. Sampad Choudhury

16 Jan 2018

ORDER

Tripura State Consumer Disputes Redressal Commission, Agartala.

 

Case No.A.51.2017

 

 

1. Smt. Golapi Debbarma,

W/o Padma Kr. Debbarma,

Vill - Rajchantaipara, P.O. Ram Chandra Nagar,

P.S. Bodhjungnagar, District - West Tripura

Pin: 799008.

… … … … … Appellant/ Complainant.

 

VS.

 

1. Branch Manager,

Life Insurance Corporation of India,

Agartala Branch No.1,

H.G. Basak Road,

Agartala, West Tripura,

Pin: 799001.

 

2. The Branch Manager,

Life Insurance Corporation of India,

Jirania Branch,

A.A. Road, Jirania, West Tripura.

 

3. Divisional Manager,

Life Insurance Corporation of India,

Silchar Divisional Office, 

Meherpur, Silchar, Assam,

Pin: 788015.

… … … … … Respondent/Opposite Parties.

 

Present

Mr. Justice U.B. Saha,

President,

State Commission, Tripura.

 

Mrs. Sobhana Datta,

Member,

State Commission, Tripura.

 

Mr. Narayan Chandra Sharma,

Member,

State Commission, Tripura.

 

 

For the Appellant:                                          Mr. Faruk Miah, Adv.

For the Respondents:                                     Mr. Prahlad Kumar Debnath, Adv.

Date of Hearing and Delivery of Judgment: 16.01.2018.

J U D G M E N T [O R A L]

 

 

U.B. Saha,J,

The instant appeal is filed by the appellant, Smt. Golapi Debbarma (hereinafter referred to as complainant/petitioner), challenging the judgment dated 21.08.2017 passed by the learned District Consumers Disputes Redressal Forum, West Tripura, Agartala (hereinafter referred to as District Forum) in Case No. C. C. 60 of 2015 whereby and whereunder the Ld. District Forum dismissed the claim of the appellant-complainant.

2. Heard Mr. Faruk Miah, Ld. Counsel appearing on behalf of the complainant Smt. Golapi Debbarma as well as Mr. Prahlad Kumar Debnath, Ld. Counsel appearing on behalf of the respondents-Insurance Company (hereinafter referred to as opposite parties/Insurance Company/ LICI).
3. The facts of the case needed to be discussed are as follows:-

Complainant filed a complaint case before the learned District Forum alleging that during the life time of her husband Late Padma Kumar Debbarma, he purchased an Insurance Bima Gold Policy being No.493755136 dated 10.01.2013 from the opposite parties-Life Insurance Corporation of India and the complainant was made nominee in the said policy. Her husband paid all the premiums before his accidental death. After the death of her deceased husband, the petitioner claimed the benefits of the aforesaid Bima Gold Policy for a sum assured of Rs.2 lacs with other benefits, but the opposite parties-Insurance Company denied the benefits of the said policy on the ground that the policy was lapsed, as the premium was not paid in due time. Complainant submitted that the premium was paid till before the death of her husband, but due to deficiency of service by the opposite party Insurance Company, she was deprived of. So she claimed compensation for Rs.4 lacs from the opposite parties-Insurance Company.

4. Opposite parties-Insurance Company appeared and filed written statement denying the claim of the complainant on the ground that the policy under reference was allowed to lapse by way of non-payment of premium due for April, 2014 even within the grace period of 30 days i.e. lastly up to 05/2014. But the life assured failed to pay the said installment of premium payable on 10.04.2014 and even before expiry of the grace period and thus allowed the policy to be in lapsed condition. It is also contended that on the date of accident i.e., 26.06.2014 and the date of death on 05.07.2014 at 3.15 P.M., the policy was kept in lapsed condition even without availing the scope for revival of said lapsed/discontinued policy during the life time of the life assured and without any basis, the unpaid premium for the month of April, 2014 was paid at 4.46 P.M. on 05.07.2014 i.e. after the death of the life assured. Thus, the complainant is not entitled to get any benefit in reference to the lapsed policy of the assured.
5. On the basis of the contention raised by the parties before the learned District Forum, the learned District Forum framed the following points for deciding the case:-

1. Whether the Bima Gold policy purchased by the husband of the petitioner was lapsed? 
2. Whether the petitioner is entitled to get the benefits of the policy and any other amount as compensation for deficiency of service?

6. Complainant in support of her case produced copy of the FIR lodged regarding the accident of her deceased husband, Charge sheet, Death Certificate of her husband deceased Padma Kumar Debbarma, Money Receipt, Claim Letter, Status Report of the Policy, Letters, Premium Receipts, which were exhibited and marked as Exhibit-1 series. Complainant also examined herself as a witness i.e. P.W.1.
7. On the other hand, the opposite parties produced some documents, which are exhibited on admission by the complainant.
8. After hearing the parties, the learned District Forum vide its judgment dated 04.04.2016 decided the above two points in favour of the complainant and allowed the complaint case directing the opposite parties-Insurance Company to pay the respondent-complainant, nominee of the deceased Padma Kumar Debbarma all death benefits of the Bima Gold Policy No.493755136 considering the policy not lapsed and also directed to pay an amount of Rs.25,000/- in addition to death benefits of the policy to the complainant as compensation. All the benefits have to be paid within two months from the date of judgment along with compensation amounting to Rs.25,000/-. If not paid within the aforesaid period, it will carry interest @9% per annum. 
9.  Being aggrieved by the aforesaid judgment of the learned District Forum dated 04.04.2016, the opposite parties-Insurance Company preferred an appeal before this Commission which was registered as Appeal Case No.A/26/2016. After hearing the parties, the judgment dated 04.04.2016 passed by the learned District Forum was set aside and the matter was remanded to the learned District Forum to decide the case afresh from the stage of evidence so that both the parties can get opportunity to adduce their evidence in support of their respective case, particularly, to examine the agent of the LICI, namely, Jari Debbarma.
10. After the remand of the case, the learned District Forum passed the impugned judgment.
11.  Aggrieved by the decision of the learned District Forum, the complainant filed the instant appeal.
12. Mr. Miah, Ld. Counsel while urging for setting aside the impugned judgment dated 21.08.2017 passed by the learned District Forum would contend that the learned District Forum failed to consider the premium receipt from which it would be evident that almost all the quarterly premium of the policy was paid except one premium which was although paid after the grace period yet accepted by the opposite parties Insurance Company. He further submits that the assured deceased husband of the complainant paid the premium for the month of April, 2014 on 05.07.2014 before his death, but after the grace period. Therefore, the opposite parties-Insurance Company liable to pay the benefit of the policy in question as well as the compensation for deficiency of service.     
13. Mr. Debnath, Ld. Counsel while supporting the impugned judgment submits that admittedly the assured deceased Padma Kumar Debbarma purchased a Policy being No.493755136 and he paid his quarterly premium almost all the time after the grace period and the said premium was also accepted in his lifetime, but question arose before the learned District Forum as to whether the premium for the month of April was paid by the deceased on 05.07.2014 before his death or after his death and the learned District Forum rightly considering the documents i.e. the death certificate and the time mentioned in the last premium receipt issued on 05.07.2014 held that the premium for the month of April, 2014 was deposited not only after the grace period, but also after the death of assured policy holder and thus dismissed the complaint petition. He has further contended that admittedly the time of death of assured Padma Kumar Debbarma was at about 03.15 P.M on 05.07.2014. and the last premium was deposited on that date at about 04.46 P.M. i.e. after the death. He has finally contended that from the FIR lodged by Sri Nakul Debbarma, father of the assured Padma Kumar Debbarma, before the Officer-in-Charge of Bodhjung Nagar P.S. (BJN P/S Case No.39/14 under Section 279/304 (A) IPC), it is evident that the assured Padma Kumar Debbarma faced accident on 26.06.2014 and admitted to the G.B.P. Hospital on that date and subsequently he died in the said Hospital on 05.07.2014 during the period of his treatment. Therefore, it can be easily said that the last premium was not deposited by the life assured within his lifetime and in such a case, the nominee of the assured is not entitled to get benefit of the assured policy and also to any compensation as claimed for. In support of his aforesaid contention, he has relied upon a judgment of the Hon’ble National Consumer Disputes Redressal Commission  in Revision Petition No.1205 of 2015 (Life Insurance Corporation of India Vs Dharamshila Kunwar) wherein the Hon’ble National Commission decided almost a similar case and dismissed the complaint petition setting aside the judgment of the State Commission of Bihar.
14. We have considered the contention of the Ld. Counsel appearing for the parties as well as the documents exhibited including FIR lodged by the father of the deceased assured.

In Condition No.2. “Payment of Premium”, it is specifically stated that “A grace period of one month but not less than 30 days will be allowed for payment of yearly, half-yearly or quarterly premiums and 15 days for monthly premiums. If death occurs within this period and before the payment of the premium then due, the Policy, will still be valid and the sum assured paid after deduction of the said premium as also unpaid premium/’s falling due before the next anniversary of the policy. If the premium is not paid before the expiry of days of grace, the Policy lapses.

The premium payable will be “total installment premium” which is inclusive of

1. Installment premium for basic plan,
2. Installment accident benefit rider premium’ if opted for.” 

In Condition No.3 of the Policy is relating to “Revival of Discontinued Policies” wherein it is stated that “If the Policy has lapsed, and the period of Auto Cover, if applicable, as defined in (4) below is over, it may be revived during the lifetime of the life assured, but within a period of 5 years from the due date of first unpaid premium and before the date of expiry of policy term, on submission of proof of continued insureability to the satisfaction of the Corporation and the payment of all the arrears of premium together with interest (compounding half-yearly) at such rate as may be prevailing at the time of the payment. The Corporation reserves the rights to accept at original terms or accept at revised terms or decline the revival of discontinued policy. The revival of the discontinued policy shall take effect only after the same is approved by the Corporation and is specifically communicated to the Life Assured. Revival of Accident Benefit Rider will only be considered along with revival of the Basic-Policy, and not in isolation.”

15.  In Life Insurance Corporation of India Vs Jaya Chander, 2008 CTJ 213 (Supreme Court) (CP), the Hon’ble Apex Court considering the above mentioned Conditions No. 2 and 3 of the Policy held that “A lapsed life insurance policy can be revived only during the life time of the insured. Revival takes effect only after the same is approved and this fact is communicated to the insured.”
16. In the instant case, admittedly, the last premium for the lapsed policy was deposited after the death of assured Padma Kumar Debbarma, who died according to the death certificate at 03.15 P.M. on 05.07.2014 and the premium was paid at about 04.46 P.M. on the same date.
17. In Dharamshila Kunwar (supra), the assured Shiv Narayan Singh, son of Dharamshila Kunwar met with an accident on 8.7.2005 allegedly at about 5.30 p.m. and succumbed to injuries on the same day and as per policy accidental risk was Rs.5,00,000/-.  In spite of every efforts claim has not been paid by the OP-Insurance Company.  The OP resisted complaint and submitted that insured deceased paid only one premium towards policy and policy was in lapsed condition and the accident took place at 12.30 hrs and the premium for revival of policy was deposited on the same day at 3.07 p.m. The Hon’ble National Commission considering all the documents including the final report held that “after accident premium along with late fee was deposited by someone with OP and this amount could not have been deposited by insured himself, as he sustained injuries on account of which, he died on the same day.” and finally set aside the judgment of the State Commission, Bihar and in consequent thereto, dismissed the complaint petition.
18. In the case at hand also, there is no evidence before this Commission that the last premium for revival of the lapsed policy was deposited by the assured himself, rather from the copy of the FIR it is admitted position that after the accident on 26.06.2014 the assured was admitted in the hospital on the same day and he was expired in the hospital on 05.07.2014 at about 03.15 P.M. during his treatment in the hospital and the premium for revival of the lapsed policy was deposited at about 04.46 P.M. of the same day. Therefore, it can be easily presumed that the premium for revival of the lapsed policy was not paid by the assured himself. More so, it is also admitted position that the premium which was deposited for revival of the lapsed policy was also not paid within the time as prescribed in the Conditions of the Policy.
19. In view of the above, we are of the considered opinion that the learned District Forum rightly observed that “…………..from the available evidence it is clear that the lapsed policy was not revived as per procedure. The premium received was refunded to the nominee of the deceased. Only after the death of the life assured, the premium was paid against the lapsed policy. So rightly O.P. Insurance Company denied the claim. There was no deficiency of service by the O.P. but the nominee Golapi Debbarma is entitled to get other benefits of the policy, the amount paid as premium and bonus accrued on it as per terms of the policy. She is not entitled to get death benefit as claimed as because the premium was paid against the lapsed policy after the death of the life assured. Accordingly the case is dismissed.” 

In view of the above, the instant appeal is dismissed being devoid of merit. No order as to costs.

Send down the records to the Ld. District Forum, West Tripura, Agartala.