DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, JHARSUGUDA

CONSUMER COMPLAINT CASE NO. 99 OF 2014

Mst. Sabita Chand ( 34 Yrs.),

W/O- Late Diandhar Chand,

R/O: Purunabasti, PO: Kalimandir Road, 

PS/Dist: Jharsuguda, Odisha…………………………….………..…………Complainant.

Versus

1. The Branch Manager,

LIC of India, Near Old S.P. Office, Jharsuguda,

PO- OMP Line, PS/ Dist: Jharsuguda-768 204, Odisha.

2. Block Education Officer, Lakhanpur,

At- Block Office, Lakhanpur PO/PS: Lakhanpur, 

Dist: Jharsuguda, Odisha.

3. Purusottam Dhurua,

At: ITPS Banharpali, PO/PS: Banharpali,

Dist: Jharsuguda, Odisha.

4. The Block Development Officer, Lakhanpur Block,

Dist: Jharsuguda, Odisha……...…………………………..….…...Opp. Parties.

Counsel for the Parties:-

For the Complainant                          Shri M.K.Kalo, Adv. & Associates.

For the Opp. PartyNo.1                     Shri B.N.Dutta, Adv. Associates.

For the Opp. Party 2, 3 & 4                None (Ex-Parte).

Date of Order: 04.07.2016

Present

                                                                                  1. Shri S.L.Behera, President.

                                                                                 2. Shri S.K. Ojha, Member.

Shri S. K. Ojha, Member :- The case has been filed by a widow ( being nominee ) seeking relief to get the insurance claim amount for her deceases husband, whose insurance premium  amounts were deducted from his salary from the date of commencement to till his death. 

The brief facts of the complainant’s case is that, the complainant’s deceased husband  had insured himself during his lifetime with the O.P.No.1 ( LIC of India ,Jharsuguda Branch) bearing policy No. 592132944, whose date of commencement was dtd. 10.11.2007 and the date of maturity dt.10.11.2022 having sum assured of Rs.70,000/- only with premium amount of Rs.437/- only per month.  The said husband of the complainant namely Diandhar Chand was working under the O.P.No.2, who was deducting the insurance premium amounts of the insured (deceased husband of complainant) from the monthly salary and was remitting to the O.P.No.1 in the said policy No. 592132944.  But instead of remitting the insurance premium amount of Rs.437/- to the account of policy No. 592132944  the   O.P.No.2 remitted Rs. 144/- only from the premium No.1 to 18. The insured had deposited Rs.23,598/- only to the O.P.No.1 through the O.P.No.2.  The said insured (the deceased husband of the complainant) died on dated 22.04.2012 and while claiming the insurance amount by the complainant before the O.P.No.1, the O.P.No.1 repudiated the insurance claim due to gape of insurance premiums, hence this case. 

After serving notices, the O.P.No.1 and O.P.No.2 appeared and filed their written version and show cause respectively admitting the fact of insurance but denied the allegations. The O.P.No.2 submitted that his office is functioning from dtd.05.02.2013 and prior to that the BDO, Lakhanpur was the DDO of the Primary Education Section and the record pertaining the fact of deduction of premiums of the insured is available  with the BDO.  As such the BDO is added as O.P.No.4 but he failed either appear of filing his written version and stand ex-parte so also the O.P.No.4. The O.P.No.1 submitted that, though the premiums of 18 months have not been received, the policy has been lapsed and Rs.3,212/- only has been returned vide cheque No. 34006, dtd. 09.02.2013 and prayed for dismissal of case. 

The matter heard from the complainant, O.P.No.1 and O.P.No.2 in length.  The deceased husband of the complainant (hereinafter referred as “the insured”) was working with the O.P.No.2.  As per the LIC calculation sheet of the insured filed by the O.P.No.2, insurance premium amount of Rs.146/- only per month were deducted from November’ 2007 to May’ 2009 (total 17 numbers) which were deposited in some other policy No. 592131577 and from June’ 2009 to November’ 2011 (28 numbers in total) were deposited in the policy No. 592132944 of the insured i,e in total Rs.14,718/- only.

While adjudicating the matter as per the above mentioned circumstances, following few issues are framed such as :-

1. Whether the O.P.No.1 has received the insurance premium amounts of the insured or not?
2. Whether the repudiation of O.P.No.1 is genuine or not?
3. Whether the O.P.No.2, 3 and 4 are liable for the repudiation of claim or not?
4. Whether the complainant should get relief or not?

For answering issue No. i, it has made clear from the said LIC calculation sheet of the insured issued by O.P.No.2 along with a letter bearing No. 372, dt.30.05.2014 issued to the O.P.No.1, dtd. 28.05.2014 that 17 numbers of insurance premium of Rs.146/- only per month deposited in the policy No. 592131577 which was in the name of one Purusottam Dhurua (O.P.No.3 who has expired as per the endorsement mentioned on the returned notice sent through this Forum).  And Rs.437/- only per month deposited in the policy No. 592132944 which was in the name of insured from June’ 2009 to November’ 2011.  As such the O.P.No.1 has received the insurance premium till November’ 2011.

While discussing issue No.ii, it is hard to ascertain the genuineness of repudiation. The O.P.No.1 repudiated the claim by issuing letter dtd. 10.09.2014 stating that, “Premium under the policy have been received up to Nov’2011 with 18 (Eighteen gaps). Due to gaps policy has not run for three years and was treated as lapse.”   Here the O.P.No.1 stated both the statements, i.e. receiving of premium up to November’ 2011 and repudiation of claim due to gaps of 18 months and the policy has not run for three years. Three years from the date of commencement should be upto November’ 2010 and after that the O.P.No.1 should not receive any premium amount from the insured and the policy should be blocked Suo Moto, but the O.P No.1 instead of blocking the policy, it continued in taking premiums or can say till the death of the insured. If in case (for instance), the insured would alive, the insurance premiums would be continuously deducting from his salary and depositing continuously with the O.P.No.1. But in between unfortunately death occurred with the insured and after that the lapse of policy came to the knowledge of the complainant.  After death of the insured, the O.P No.1 refunded Rs. 3,212/- only to the complainant but has not cleared the proper calculation.

 Receiving premiums after running of three years with gaps of 18 months ( said to be lapse of policy) and repudiation  afterwards, while claiming for the policy, is bad in the eye of law, thus, repudiation of claim is not genuine on the part of O.P.No.1.

So far as the issue No. iii, is concerned, the O.P.No.3 was also an insured person like the said deceased husband of the complainant who has also expired unfortunately. Premium amounts were wrongly deducting from the salary of the insured and were deposited in the policy account of the O.P No.3 by the O.P.No.4 as because the event of deductions were happened prior to the date of 05.02.2013 which is from the year-November,2007 thus, in this case particularly, the O.P.No.3 is not said to be liable at least for repudiation of claim.  It was the mistake of O.P.No.4 who has deposited the premium amount of complainant’s husband to the account of O.P.No.3.  The O.P.No.4 is added as an additional party to put some light on the matter for clarification of the incidence, but he also failed to appear. The O.P.No.2 who appeared and submitted the facts of deductions happened by the O.P.No.4. As the office of O.P.No.2 is functioning from dtd.05.02.2013 onwards and the event of deduction taken place in the year-November,2007 thus the O.P.No.2 cannot to be said liable for repudiation of claim

The gist / cause of whole incidence arrows towards the O.P.No. 4, as it is the O.P.No.4 or his concerned dealing subordinate staff has deducted premiums from the account of insured and deposited in some other ones account and dispute arisen afterwards.  As such the O.P.No.4 is said to be liable for repudiation of claim.

            As per the above mentioned discussions and observations, it is crystal cleared that, the complainant is definitely eligible to get the relief and the issue No. iv, is answered.

            The above mentioned circumstances and casual activities reveals nothing but the deficiency in service on the part of O.P.No.1 and O.P.No.4 towards complainant and the complainant is eligible to get the claim amount along with compensation, hence, the complaint case is hereby  allowed with directions to the Opposite Parties in the form of order as follows;-

                                                              ORDER

1. The O.P.No.1 is hereby directed to pay the sum assured amount of Rs.70,000/- (Rupees seventy thousand) only to the complainant along with Rs. 20,000/- (Rupees twenty thousand) only towards harassment.

2. The O.P.No.4 is hereby directed to pay a sum of Rs.5,000/- ( Rupees five thousand) only towards mental agony and litigation costs.

3. The above mentioned orders shall be carried out within 45 (forty five) days  from the date of receipt of this order, failing which both the Opposite Party No.1 & Opposite Party No. 4 shall be liable for  interest @ 10% per annum on the abovementioned respective awarded amounts till realizations.

Accordingly the case is disposed of.

Order pronounced in the open court today the 4^th day of July’ 2016 and copy of this order shall be supplied to the parties as per rule.    

                                           I Agree.                                                                                                          

                                     S. L. Behera, President                            S.K.Ojha, Member          

                                  Dictated and corrected by me

                                       S.K.Ojha, Member.