J U D G E M E N T
Mr. Sankar Kumar Ghosh, President ─ This consumer complaint under section 12 of C.P. Act, 1986 has been filed by the complainant Bijendra Hela against the OP named above alleging deficiency in service on the part of the OPs.
Complainant’s case, in brief, is as follows: - That OP is an insurance company who sale the insurance products (polity) to the intending policy holder and complainant’s elder brother viz. Surendra Hela purchased one endowment Assurance Policy from the OP on 23/12/2011 being Policy No. 439897416 wherein the per month insurance premium was Rs.1077/- and sum assured amount was Rs.2,00,000/- and in the said policy Ashadebi Hela was a nominee.
That complainant states at the time of purchasing the said policy, the deceased policy holder was in service at Burn Standard Company Limited, Howrah and the premium of Rs.1077/- was paid by the deceased policy holder from the Salary Account of deceased Policy Holder.
That complainant states during continuance of the said Policy, the Policy Holder died on 07/12/2013 and as such since 23/12/2011 to till his demise, he made payment regularly to the OP.
That after death of Policy Holder, Bijendra Hela on 07/12/2013, the nominee Ashadebi Hela also died and as such complainant being a dependent brother by complying all formalities applied for getting benefits from the Policy but OP did not pay any heed.
That complainant again on 03/01/2019 requested the OP to make payment of the policy benefits but in spite of acknowledging the same OP did not make payment of the policy benefit to the complainant yet.
Under such circumstances and finding no other alternative way complainant filed this case before this Commission praying for direction upon OP to make payment the policy benefits including interest till realization in full also prays for compensation amounting to Rs.2,00,000/- (Rupees two lakh) for mental harassment & agony and Rs.10,000/- as litigation cost.
OP contested the case by filing W/V denying all material allegations against him and contending inter alia that: -
Complainant’s case is not tenable either in law or in fact that OP also stated many other technical points containing baseless allegations from the view points of facts and law in the said W/V.
That OP admitted that Surendra Hela purchased the endowment assurance policy from the OP and Ashadebi Hela was a nominee in the said policy being No. 439897416 dated 23/12/2011 but OP further stated that policy holder Surendra Hela (since deceased) applied for change of nomination in favour of Bijendra Kumar in lieu of recorded nominee Ashadebi Hela which was duly registered at LICI, Howrah City Branch 2 on 19/09/2012.
That OP also stated the fact that the Life Insurance Policy being No. 439897416 commenced on 23/12/2011 by payment of two monthly installments @ Rs.1077/- on condition that the premiums failing due in and from 02/2012 to 10/2028 or till earlier death shall be recovered from the salary of policy holder on monthly basis. As per policy records, the employer of the policy holder remitted premium up to 05/2013. So all the premiums received up to 05/2013 have been duly adjusted.
That OP denied the complainant being a dependent brother by complying all formalities applied for getting benefits from the said policy but OP did not pay any heed. But the fact is that policy in dispute is serviced by LICI, Howrah City Branch 2 and no claim was lodged with Howrah City Branch 2. So, question of not paying heed is baseless.
That OP further stated the said policy was in lapsed condition as the first unpaid premium is due on 23/06/2013. The fact is that at the time of death of policy holder i.e. 07/12/2013, the policy was in lapsed condition and without acquiring the paid up value as three full years premiums have not been received, as per Policy Bond the OP, LICI is not liable to pay any amount to the policy holder as death claim.
OP has clearly stated that there was no cause of action arose as mentioned in the petition of complainants and nothing is payable as Death Claim under the policy in question and as such, instant case is not maintainable. Finally, OP has prayed for dismissal of the case with cost.
POINTS FOR DECISION
- Whether the complainant is the consumer of the OP or not?
- Whether this Commission (formerly Forum) has territorial/pecuniary jurisdiction to entertain and try the case?
- Whether there is any unfair trade practice on the part of the OP or there is any deficiency of service on the part of the OP.
- Is the complainant entitled to get relief/reliefs as prayed for?
To prove his case complainant has filed evidence on affidavit, questionnaire against the evidence on affidavit of OP, reply against the questionnaire of OP and BNA.
OP also filed evidence on affidavit, questionnaire against the evidence of complainant, reply against the questionnaire of complainant and BNA.
DECISION WITH REASON
The points appear to be interlinked with each other and as such for easiness of discussion of the case all the points are taken up conjointly.
On close scrutiny from the materials on record, it reveals that the complainant is a consumer under Section 2(i)(d)(i)(ii) of the C.P.Act, 1986.
Complainant appears to be the resident of district Howrah. Office address of OP appears to be within district Howrah. Considering the nature of the case and the prayer of the complainant it straightway gives clear signal that pecuniary value of the case is within Rs.20,00,000/- i.e. within the limit of this Commission (formerly Forum). So, this Commission (formerly Forum) has territorial/pecuniary jurisdiction to entertain and try this case.
From the petition of complainant it appears that one Surendra Hela, since deceased, elder brother of complainant died on 23/12/2011 purchased the policy in question and it reveals from complainant that Ashadebi Hela, since deceased was a nominee at the time of purchasing said policy. The deceased Surendra Hela was an employer of Burn Standard Company Limited, Howrah. During continuance of the said policy, deceased policy holder, Surendra Hela died on 07/12/2013 and at present the said nominee, Ashadebi Hela also died and as such the complainant being a dependent and brother of deceased Surendra Hela by complying with all formalities had applied for getting benefits of the said policy but OP did not pay any heed to the claim of the complainant. The specific allegation of complainant is that in spite of repeated requests and also in spite of acknowledging such claim of complainant OP did not pay any heed to that and also did not make any payment of the policy benefits to the complainant.
On the other hand, OP alleged that the original policy holder, deceased Surendra Hela applied for changing for nomination in favour of Bijendra Kumar in lieu of recorded nominee, Ashadebi Hela since deceased, which was duly registered at LIC office, Howrah City Branch 2 on 19/09/2012. OP also states that the said policy was commenced on 23/12/2011 by payment of two monthly installments @ Rs.1077/- only on condition that the premium falling due on and from 2/2012 to 10/2028 or till earlier death. OP also state that as the policy was under salary saving scheme, premium will recovered from the salary of the policy holder on monthly basis and be remitted to LIC, Howrah, City Branch 2 for necessary appropriation and adjustment to the respective policy account. Further case of the OP is that as per policy records the employer of the policy holder remitted premium up to 5/2015 (May, 2013) and as such all the premium received up to 05/2013 have duly been adjusted and thus, the date of 1st unpaid premium stood on 23/06/2013. Further, specific case of the OP is that the policy in question is in dispute because it was in lapsed condition as the 1st unpaid premium is due on 23/06/2013. Further case of the OP is that it is a fact that at the time of death of Surendra Hela i.e. on 07/12/2013, the policy was in lapsed condition and without acquiring the paid up value as 3(three) full years of premium have not been received from the OP’s end and as such the policy clauses no. 2 & 4 of the policy bond the OP, LIC is not liable to pay any amount to the policy holder as death claim,
Complainant in his BNA has stated that during subsistence of the said policy, Surendra Hela died and accordingly the legal heirs of said deceased Surendra Hela entitled to get the benefit from the said insurance policy but OP did not make any payment. It is also attached by the complainant in the BNA that OP is liable to make payment the policy benefits including interest till realization of the amount and complainant is also entitled to have compensation towards mental harassment and complainant is entitled to have litigation cost as prayed for.
It may be noted in the contents of BNA as well as touching upon the submission of Ld. Counsel appearing for the complainant and also going through the contents of BNA of the OP and taking in view the submission of Ld. Counsel of OP, this Commission is finding that the defense case of OP is much more stronger than that of the case of complainant. It is very much clear that relating to the said policy the 1st unpaid premium became due on and from 23/06/2013. It also appears that the death of original policy holder, Surendra Hela was taken place on 07/12/2013 and the said policy became in lapsed condition without policy acquiring the paid up value as per the policy clauses No. 2 & 4 of the policy bond of the OP (LIC).
In view of the above discussion and considering the attending facts and circumstances of the case, this Commission finds that the case of the complainant is weak and feeble and appears to be has no leg to stand upon.
In the result, the instant case is liable to be dismissed.
Hence, it is,
O R D E R E D
That the instant Complaint Case No. 38 of 2019 be and the same is dismissed on contest against the OP without cost.
Let free copy of this order be given to the complainant and OP free of cost.
Dictated & Corrected by me
(Mr. Sankar Kumar Ghosh)
President, DCDRC, Howrah
