BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BAGALKOT.

                                                                                                                                                        C.C.No.117/2017

                 Date of filing: 02/11/2017

                                                                  Date of disposal: 03/10/2018

P R E S E N T :-

- V/S -

JUDGEMENT

By Smt. Sharada. K. President.

1.      This is a Complaint filed by the complainant under Section 12 of the Consumer Protection Act, 1986 (herein after referred to as Act) against the Opposite Parties (in short the “Ops”) directed the OPs to release the assured amount with accrued interest there upon to the complainant till realization and pay Rs.50,000/- towards mental agony and Rs.10,000/- towards the cost of the proceedings and any other reliefs etc.,

2.      The facts of the case in brief are that;

          The complainant is the wife of one Shri. Dyamappa Madar @ Bilakerur and said Dyamappa was working in education department i.e. OP.No.2 and further the said Dyamappa Madar was expired on 03.07.2012, while he was in service. During his life time he has opted for few numbers of life insurance policies, they were under the OP.No.1’s Corporation. It is learnt that, Dyamappa was also opted one more LIC policy bearing No.636454337 was not paid by OP.No.1, while the complainant is a nominee in the said policy. The husband of the insured died on 03.07.2012 and the complainant has filed the death claim form about the polices, 04 polices were settled by the OP.No.1, the above said Policy No.636454337 bond was not found, finally she started correspondence with Ops.

It is further contended that, the OP.No.1 on dtd: 18.07.2017 sent letter in the name of deceased Dyamappa Bilkerur and stating that, the policy bearing No.636454337 is in lapsed condition, since form 01.10.2012 and the corporation has made a special drive to revive the lapsed policies and requested to revive the said policy immediately by submitting the required documents and paying the premium dues. In this regard, the complainant has issued notice to the Op.No.1 on dtd: 11.10.2017, after receiving the said notice, the OP.No.1 has answered in reply on dtd: 09.11.2017 and stating that, the said policy is in lapsed condition from 31.07.2012 and nothing is payable on the said policy and had repudiated the claim of the complainant. Since there is a controversy between the letter of revival and the letter of status report is that, he had given the last amount received on 24.11.2012 and in his letter dtd: 09.11.2017 stating that, the policy is not in force from 31.07.2012 from the death of policy holder. It is clearly shows that, without ascertaining the accounts and remittances made for the policy, blindly the OP.No.1 Corporation is writing such letter to the complainant it amounts to deficiency in service on the part of the OP.No.1 and further the complainant enquired about the payment of policy premiums with Op.No.2, the OP.No.2 has issued one letter and stating that, the premiums for the above said policy is remitted till 24.11.2012. But in the meanwhile there are 5 numbers of premium gaps i.e. from May – 2010 to September – 2010. But during this gaps time, the policy holder has earned his wages, it is the bounden duty of the employer to deduct the premium amount and remit the same to the OP.No.1’s Corporation and this was not informed either to the OP.No.1 or to the policy holder. This act of the OP.No.2 clearly shows that, this is negligency on the part of the OP.No.2. Hence, the OP.No.1 & 2 jointly and severally liable in settling the case and releasing the assured amount to the complainant.

3.      The Forum registered a case and issued notice to the Ops. After service of the notices, the OP.No.1 has appeared through his counsel and filed his written version and OP.No.2 has remained absent. Hence, OP.No.1 placed Ex-parte.

The OP.No.1 has denies all the averments in the complaint that are expressly admitted by OP.No.1. It is true that, the deceased life assured had obtained a policy No.636454337 with this OP.No.1’s Corporation and admittedly this policy was obtained by the deceased Dyamappa under Salary Saving Scheme. After the gap of so many years, even then, the present complainant has claimed the policy amount; she is not entitled to get any of the amount, because this policy is under lapsed condition.  That, the monthly premiums for the period from May-2010 to September-2010, there are 5 gaps in remittance of the premium have not been remitted to this OP.NO.1 LIC from the deducting authority of OP.No.2 i.e. BEO or by the employee himself. Hence, due to non remittance of the premiums for 5 months as per terms and conditions of the policy and the authorization letter given by the deceased Dyamappa for the 5 gaps of the monthly premiums, the said policy is under lapsed condition and this OP.No.1’s corporation is not at all liable to pay anything to this present complainant.

It is further contended that, as per the contentions of the complainant to issue intimation about the gaps of the premiums to the policy Holder is not a mandatory one. It is the responsibility and lookout of the policy holder to keep his policy in force, when he had obtained this policy under the Salary Saving Scheme. He has to verify at his employee’s office regularly, whether the monthly premiums are deducted in his salary and remitted to the OP.No.1 Corporation or not. If the employer has not deducted the premium in his salary and not remitted to Op.No.1 as per his own Authorization letter, he himself had to make arrangements to remit the premium directly to the OP.No.1’s Corporation and there is no deficiency of service on the part of the OP.No.1 to release the assured amount. Hence OP.No.1 prayed for dismissal of the complaint with costs.

4.      The complainant has filed his chief affidavit along with documents which are marked as Ex.C-1 to Ex.C-9 in support of his case. The documents are as follows;

On the other hand Op.No.1 has filed his affidavit on behalf of his case and produced 5 documents which are marked as Ex.R-1 to R-5 are as follows;

5.      On the basis of above said pleadings, Written Arguments of both parties, oral and documentary evidence, the following points arises for adjudications are as follows;

1.  Whether the complaint filed by the complainant is barred by limitation as alleged by the OPs ?

2. Whether the complainant proved that, there is deficiency in service on the part of the Ops ?

3. Whether the complainant proved that, he is entitled for reliefs ?

4. What order?

6.      Our findings to the above points are as under:

1. Point No.1 Negative.
2. Point No.2 Affirmative.
3. Point No.3 Partly Affirmative.
4. Point No.4 As per the final order for the following:

R E A S O N S

7.     POINT NO.1:-  The complainant has filed this complaint against the Ops for payment of sum assured an amount of Rs.1,00,000/- which is in the name of her deceased husband Dyamappa Madar, who was an employee of OP.No.2 and further the complainant husband insured his life with OP.No.1, during his life time, he obtained few policies amount them and policy bearing No.636454337 was not paid by OP.No.1, while the complainant is a nominee in the said policy. The husband of the insured died on 31.07.2012 and the complainant filed the death claim form about the polices, 04 polices were settled by the Ops, the Policy Number as stated above, the bond was not found, finally she started correspondence with Ops. In this regard, the complainant has issued notice to the Op.No.1 on dtd: 11.10.2017, the Op.No.1 has answered the said notice in rely and repudiate the claim of the complainant on dtd: 09.11.2017.

On the other hand, the OP.No.1 has filed his written version and stating that, the deceased Dyamappa Madar had died on 31.07.2012, after a long time, the complainant has filed this complaint against the Ops for payment of sum assured an amount of Rs.1,00,000/- which is in the name of her deceased husband Dyamappa Madar. Hence, it is barred by limitation.

On scanning the records on file, it seems that, the complainant had corresponded with the Ops, when she got the knowledge that, her husband had taken another policy as stated above and further she stated about the same to the Ops and she sent request letter to both the Ops for her satisfaction of the assured amount of her husband. The OP.No.1 replied in the letter on dtd: 11.10.2017, simultaneously repudiated the claim of the complainant on dtd:09.11.2017 and stating that, the policy was not in force, the OP.No.2 issued a letter dtd: 16.09.2017, all these letters shows that, there is a continuous correspondence between the complainant and the Ops, hence when there is a continuous correspondence between the parties, the last correspondence letter holds its limitation from their onwards. Hence, the complaint filed by the complainant is well in time.  Therefore, we answer to the Point No.1 in the Negative.

8.      Point No.2 & 3:-  Since both the points are identical and interlinked together. Hence both the points are taken together.

          The complainant has filed this complaint against the Ops for seeking death claim from OP.No.1. The husband of the complainant deceased Dyamappa, who had insured his life with OP.No.1, working with the OP.No.2 and further the deceased Dyamappa account is salaried account and he had authorized to Op.No.2 to deduct the premium from his salary and pay to OP.No.1. As such, the deceased Dayamappa had obtained few policies with the OP.No.1 and he had paid the premium regularly by deducting the premium from his salary account by OP.No.2. After the death of her husband, the complainant submits that, she received the death claim amount of her husband for 4 policies only from OP.No.1, but another bond of the Policy No.636454337 was not found by the complainant, she thought that, it may be in the custody of OP.No.1. While she got the status of the policy she saw that, even after death of her husband, the premium was collected by OP.No.1 and deducted by OP.No.2. When she was enquired about this policy, the OP.No.1 himself sent the revival letter that, the policy was in force till 31.10.2012 and again the OP.No.1 has sent a repudiation letter and stating that, the policy was not in force. Hence, they repudiate the same. On the other hand the OP.No.1 submits that, they referred that, there are unpaid premiums on dtd: 25.05.2010 to 25.09.2010, there was a 5 gaps, hence they cannot make a payment and the OP.No.1 submits that, the complainant himself agreed that, he is the sole responsible for payment of premium. Moreover, the policy was not in force. So in our view, the OP.No.1 cannot pay the sum assured amount of the above said policy to the nominee i.e. complainant and filed some citations are as under;

1. 2017 (2) KCCR 1457, Hon’ble Karnataka High Court.

2. 2010 -2 – KCCR – 114, 2010-2 AIR (Kant) – 580.

3. Hon’ble State Consumer Disputes Redressal Commission, Chhattisgarh State in Appeal No.FA-12/598–dtd: 23.10.2012.

4. Hon’ble State Consumer Disputes Redressal Commission, Maharastra, Mumbai in First Appeal No.128/2007.

5. Judgement copy of Dist. Consumer Disputes Redressal Forum, Raichur in C.C.No.44/2002.

6. Judgement copy of Dist. Consumer Disputes Redressal Forum, Raichur in C.C.No.89/2006.

There are lot of citations filed by the OP.No.1 they are  not attract to the instant case.

          There is no dispute between the parties that, the deceased Dyamappa was the insured and the complainant is the nominee and agreed the policy also. The only dispute arises here that, the policy was commenced on 25.03.2010 and after that, the deceased Dyamappa had paid the premium on 25.04.2010 and also as per the submission of the complainant that, her husband was authorized, OP.No.2 to deduct his premium amount from his salary, since the policy is under the Salary Saving Scheme. The deceased Dyamappa died on 31.07.2012, complainant seeking information about the policy from OP.No.1 & 2, the Op.No.1 issued the revival letter on dtd: 18.07.2017, in this letter, the OP clearly stated that, he received the premium amount till 25.10.2012 and further he states in this letter as below;

      “ This is to inform you that, the first unpaid premium under your policy is 10/2012. As up to date premium under the policy are not received/adjusted the policy status is shown as “not in force”, we request you to make the policy upto date”.

          Such being the negligency made by the OP.No.1, the OP.No.1 issued another letter on dtd:21.02.2017 and stating that, they have to pay Rs.2,845/- the total gap premium on 05/10, 06/10, 07/10, 08/10 and 09.10.2010, there are total 05 gaps premium had not been paid and mentioned the total amount have to be paid. When the complainant received this letter from the OP.No.1, she issued legal notice through her counsel for the death claim of her husband, the OP.No.1 repudiated the claim of the complainant and stated that, the policy is not in force. It is the bounden duty of the OP.No.2 to deduct the policy premium amount from the salary of the deceased insured; surprisingly OP.No.1 had received the premium for the policy for the months of October-2010 to October-2012. But, the insured had died on 31.07.2012, the OP.No.1 had received 3 premiums after the death of the insured and when the complainant had claimed the death claim of her husband, the OP.No.1 repudiated the claim of the complainant and stated that, the policy was not in force. Due, to their work and paid premiums for the months of May-2010 to September-2010. It is crystal clear that, the negligency of OP.No.1, how they monitor the accounts of the customers. As per their contention, it is the responsibilities lies on the policy holder that, what is the responsibility of the Ops or the corporation to look after the welfare of the customer. They kept mum till today and they have received the letter from the complainant. Immediately, they sent the revival letter to pay the unpaid premiums dues, when they heard that the said insured died, they immediately sent the repudiation letter and stating that, the policy was not in force. If, the corporation do the robot work, simply uploading and downloading the data, what is the faith of his corporation, it is very necessary to discuss that, the customers have insured their lives for their difficult time or for their nominees who are left behind them such negligence had been made by the Op.No.1’s corporation, probably when premiums are paid they will be first adjust to the unpaid premiums, after that only, further premiums are taken by the insurer, since the premium paid is on 10/2012 were the insured died on 31.07.2012, it is clear that, policy was well in force. It is sorry to say that, corporations are working only to collect the premiums, but they are not looking the welfare of the customers. In this case, it is crystal clear that, if the negligency of Ops for which complainant is suffering, here we right on the letter issued by the OP.No.2 stating that, he had not deducted the premium for 6 months what was the hurdle Op.No.2 faced to deduct the premium form, the deceased account, when the deceased had already authorized to deduct the premium. Here there is negligency on the part of the Op.No.1 also, hence the OP.No.1 is negligency on the part of the Op.No.1 also, hence the OP.No.1 is directed to deduct the premium of 05 months with interest from the sum assured amount of complainant. Hence, we answer to point No.2 in the affirmative and the Point No.3 partly in the affirmative.     

Point No.4:  In view of our findings on the above point, we proceed to pass the following;

O R D E R

1. This above complaint is partly allowed with cost.
2. The OP.No.1 is directed to pay the sum assured amount to the complainant by deducting 05 months premium amount with interest from sum assured amount.
3. Further Op.No.1 & 2 are directed to pay compensation of Rs.2,000/- towards mental agony and harassment.
4. Further OP.No.2 is directed to pay Rs.2,000/- towards litigation charges.
5. Further both the Ops are directed to comply the order within 30 days, failing which, Op.No.1 is liable to pay interest at 12% p.a. from the date of filing this complaint till realization and OP.No.2 is directed to pay Rs.10,000/- to the legal aid of the Consumer welfare fund.
6. Send the copies of this Order to the parties free of cost.

(Dictated to the Stenographer, transcribed by him, corrected and then pronounced by me in the Open Forum on this 03^rd day of October, 2018).