DATE OF DISPOSAL: 10.04.2019
Sri Karuna Kar Nayak, President.
The complainant Smt. Kuntala Swain, has filed this consumer complaint Under Section 12 of the Consumer Protection Act, 1986, alleging deficiency in service against the Opposite Parties ( in short the O.Ps) and for redressal of her grievance before this Forum.
2. Briefly stated the case of the complainant is that, the complainant is the mother of late Mangala Chandra Swain, Sepoy No. 60 working under Odisha Special Armed Police and was posted at 3rd SS OSAP, Gajapati. Accordingly an Identity card was issued in SL. No. 459/12 by the said Authority. The son of the complainant late Mangala Chandra Swain had insured the life under the O.Ps under Jeevan Mitra (Triple cover Endowment Plan) with profits (with accident benefit) for sum assured Rs.1,05,000/- in policy Number 572830458 and the date of commencement being 28.06.2009. Since the son of the complainant is an employee of the State Government of Odisha, the monthly premiums of Rs.452/- only was regularly deducted from the salary under salary saving scheme. There is no dispute that the monthly premiums were regularly deduced from the salary of the son of the complainant. While the matter stood thus, the son of the complainant met one road accident on 26.08.2013 who died on the same day in course of treatment in the M.K.C.G. Medical College and Hospital, Berhampur. The complainant obtained the Death Certificate from Berhampur Municipal Corporation, relating to death of late Mangala Chandra Swain. The complainant obtained the copy of legal heir certificate from the Tahasildar, Sheragada, Ganjam in Misc. Certificate No. 358 of 2013. The complainant being the nominee of the policy holder late Mangala Chandra Swain filed the claim application with the O.P.No.1 claiming triple benefits as per the conditions stipulated in policy No.572830458. The O.P. No.1 instead of making payment of Triple benefits alongwith profits and accident benefit has simply endorsed cheque for an amount of Rs.33,250/- to the Indian Overseas Bank account No. 261701000003200 which is credited on dated 03.10.2014. The complainant is entitled to the triple benefits as stated hereunder:
(i) Basic amount Rs.3,15,000/-
(ii) Vested Bonus Rs. 15,750/-
(iii) Interim Bonus Rs. 10,500/-
Rs.3,41,250/-
Besides above, the complainant is also entitled for the accident benefit of Rs.1,05,000/- only. The policy in question is under salary saving scheme and as such the O.P. Nos. 1,2 and 3 are legally bound to liquidate the aforesaid benefits as per law laid down by the Apex Court. Erroneously Smt. Sumitra Swain, the legally married wife of the policy holder late Mangala Chandra Swain filed the complaint under Section 12 of the C.P.Act, 1986 which was registered as CC No. 25 of 2015 and later the complaint case was disposed as not pressed. Due to non-payment of the insurance money under salary saving scheme policy No.572830458 the complainant suffered from harassment and mental agony for deficiencies of services on the parts of the O.P.No.1 to 3. Alleging deficiency in service on the part of the O.Ps the complainant prayed to direct the O.P.Nos. 1 to 3 to pay triple benefit of the policy amounting to Rs.3,41,250/- alongwith accident benefit of Rs.1,05,000/- totaling to Rs.4,13,000/-, compensation of Rs.30,000/- for harassment and mental agony and litigation cost of Rs.5000/- in the best interest of justice.
3. Upon notice the O.P.Nos. 1 to 3 filed version through his advocate. It is stated that the complainant has filed the above complaint with all false and frivolous allegations. The Opposite Parties denies all those allegations as vague and concocted. The complainant shall put to strict proof of the allegations those are not specifically admitted herein. The policy No. 572830458 was issued to late Mangala Chandra Swain by Aska B.O. of O.Ps with dates of commencement 28.06.2009, Plan/Term/Premium paying Term- 133/21/21(Jeevan Mitra Triple cover Endowment plan) premium paying mode : Mly (SSS), Premium installment:Rs.452/-, Sum Assured Rs.1,05,000/-, wherein Smt. Kuntala Swain, relation: Mother has been the nominee. The policy was issued after deposit of two initial premiums i.e. 06/2009 & 07/2009. As per the Authorization letter submitted by the D.L.A. premium with effect from 08/2009were supposed to be deducted and remitted to O.P. But in this case the D.D.O., S.P. Gajapati started deduction of premium w.e.f. March 2010 and remitted to O.P’s office up to July 2013. Premiums for the period from August 2009 to February 2010 and June 2010 (total 08) were not received from the D.D.O. by the O.Ps. The complainant has also not submitted the deduction certificate of premiums from DDO for the period i.e. August 2009 to February 2010 and June 2010. Further as per the condition mentioned in the “Letter of Authorization (OGSS) Form-A” the policy holder is entirely responsible for any consequences of account of non-payment of premium of the policy. On 08.02.2014 the complainant as the nominee of the D.L.A. had intimated about the death of the life assured due to road accident on 26.08.2013 and had submitted his death certificate. The O.Ps issued the claim forms in her favour on 15.02.2014. Thereafter she submitted the court certified copies of FIR, PMR and PIR, alongwith filled claim forms on 24.09.2014. But she has not submitted the premium deduction certificate for the period from August 2009 to February 2010 & June 2010. Accordingly, her death claim application was processed and as per the terms and guidelines of the policy and her entitlement, the O.Ps finally settled her claims and paid Rs.33,250/- through NEFT in Account No.261701000003200 of IOB, at Balipadar Branch. The special provision for the payment of additional amount equal to twice the sum assured is payable in case of in-force policy. The instant policy becomes paid-up as the premiums for the period i.e. August 2009 to February 2010 and June 2010 were not received. Clause 4 of the conditions and privileges of the policy indicates, the policy become paid-up in case the premiums were received for at least three years. In the instant policy, premiums for three and half years were received. Hence proportionate sum assisted (Paid up value) i.e. Rs.17,500/- and bonus for three and half years i.e. Rs.15,750/-(Total Rs.33,250/-) was paid to the nominee-claimant as per the calculation. The calculations put forth by the complainant is imaginary, erroneous and not true or correct and not sustainable. In fact as per the terms and conditions of the above policy, the complainant is not entitled to the same and as such the O.Ps are not liable to pay such vexatious claim. As contended above, the policy is paid-up as on date of death of life assured. It is not true that the complainant has suffered from harassment and mental agony for deficiencies of service of O.Ps No.1 to 3. Burden lies on her to establish the same. It may be submitted that the O.Ps rendered all types of qualitative services to her. No harassment or mental agony whatsoever has been caused to her. All her claims were settled and paid up expediently, as per terms and conditions prescribed. So her above belated and vexatious claims devoid of any merit are not maintainable and liable to be rejected.
4. Upon notice the O.P.No.4 filed written version. It is submitted that he has no role to play in this dispute. The complainant has not advanced any complain against O.P.No.4. It is a case relating to Salary Saving Scheme. The O.P.No.4 being the Drawing and Disbursing Officer is to deduct the premium amount of the policy from the salary of the concerned employee, namely late Mangala Chandra Swain after being informed by the L.I.C. OP No.1 vide letter No.PKD/PS/HGA by Regd. Post along with other two beneficiaries. It was deducted from the salary bill of Mangala Chandra Swain,Ex-Sepoy/605 and two others from the salary bill of October, 2010. Due to non receipt of original letter of authorization this office was moved to the Branch Manager, LIC of India, Paralakhemundi vide letter No.53/3rd (SS)Bn dt.16.01.2010 to provide original letter of authorization (O.G.S.S.) Form-A in favour of Mangala Chandra Swain and three other police personnel to effect premium recovery. A copy of the letter of P.Branch Manager without date alongwith original letter of Authorization (O.G.S.S.) Form-A received in this office on 28.09.2010 without mentioning salary month from which deduction is to start. The police office seal clearly indicates 28th September 2010. Accordingly the O.P. No.4 has diligently deducted the premium amount so far possible since there was no time to deduct the amount from the bill of September 2010 as intimation received on 28.09.2010 by the date the bills for September 2010 had already been submitted to treasury. There is no deficiency in service against O.P.No.4. Hence the O.P.No.4 prayed to drop the case.
5. On the date of hearing advocates for both parties are present. We heard argument from both sides at length and perused the complaint petition, written version, written arguments and citation placed on the case record. It reveals that deceased Mangala Chandra Swain was the policy holder of L.I.C. of India vide policy No.572830458 and the dates of commencement of the policy was 28.06.2009. The deceased life assured had insured the life under LIC of India under salary saving scheme in Jeevan Mitra (Triple Cover Endowment Plan) with profits (with accident benefit) for sum assured Rs.1,05,000/- and Rs.452/- was deducted from his salary towards monthly premium. It also reveals that O.P.No.4 being the Drawing and Disbursing Officer of the deceased life assured has deducted the premium amount from the salary of late Mangala Chandra Swain after being informed by O.P.No.1. Accordingly O.P.No.4 has deducted the premium from the D.L.A’s salary from October 2010. Further it is also admitted by O.P.No.1 to 3 that O.P.No.4 has started deduction of premium with effect from March 2010 and remitted the same to LIC office up to July 2013. It is pertinent to mention here that the D.L.A Mangala Chandra Swain succumbed to injury on 26.08.2013 during the force of the policy period. It also reveals that O.P.No.1 has sent authorization letter to O.P.No.4 to remit the premium of the D.L.A. Mangala Chandra Swain and 5 others on 21.12.2009 but O.P.No.4 has intimated to O.P.No.1 to send the original authorization letter on 16.01.2010. Law is well settled in case of Chairman of LIC versus S.K.Bhaskar reported in A.I.R. 2005, page- 3086 wherein Hon’ble Apex Court has hold that “even if the Employer has failed to make payment of the premium, the principal i.e. the LIC is liable to pay the assured amount to the complainant of the said salary savings scheme policy”.
6. On foregoing discussion it is crystal clear that the O.Ps are negligent in rendering proper service. Hence, in our considered view there is deficiency in service on the part of O.Ps. But liability is fixed only against O.P.No.1 to 3 and no liability is fixed against O.P.No.4 as he being the employer of D.L.A. acting as an agent of LIC of India. So far as compensation is concerned, the complainant is entitled to get it for the ends of justice.
6. In the result, the complainant’s case is partly allowed against O.P.No.1 to 3 and dismissed against O.P.No.4. The O.P.Nos 1 to 3 are directed to settle the claim of policy No.572830458 (Jeevan Mitra Triple cover Endowment Plan) in favour of the complainant after adjustment of Rs.33,250/- already paid to the complainant. They are also directed to pay Rs.20,000/-(Rupees Twenty Thousand) only towards compensation alongwith Rs.2,000/-(Rupees Two Thousand) only towards cost litigation to the complainant. The aforesaid order shall be complied by the O.Ps within 45 days of receipt of this order failing which all the due shall carry 12% interest per annum. This case is disposed of accordingly.
The order is pronounced on this day of 10th April 2019 under the signature and seal of this Forum. The office is directed to supply copy of order to the parties free of cost and a copy of same be sent to the server of www.confonet.nic.in for posting in internet and thereafter the file be consigned to record room.
