SRI JIBAN KRUSHNA BEHERA, MEMBER (I/C)

                The Complainant has filed this complaint petition, U/s – 12 of erstwhile Consumer Protection Act, 1986, read as U/s-35 of C.P.A.-2019 of the new Act (here-in-after called as the “C.P. Act - 2019”), alleging a “deficiency-in-service” by the Ops, where OP No.1 is the Chief Manager, LIC of India, Balasore and OP No.2 is the Divisional Manager (Legal & HPF), LIC of India, Cuttack Division, Cuttack.   

2.             The factual matrix of this case is that on 04.11.2014, he had opened two LIC policies on 22.6.1970 bearing policy No.010691261 & 010691262 (here=in-after called as the first policy & second policy respectively). Later on he obtained loan of Rs.7,800.00 from each policy by depositing original policy bond before the OIC. Apart from these policies, he has also opened other policies in LIC.

                The complainant had undergone by-pass surgery on 20.06.2008 in Asian Heart Institute, Mumbai and implanted a pace maker on 31.10.2008. For the above reason, he stayed at Mumbai for about more than one year at the house of his younger son and now undergoing treatment at Apollo Hospital, Bhubaneswar. So, he reposed faith on his staff for doing all his work on his behalf even depositing of premiums in different policies in LIC and other financial sectors and remained silent. The complainant receiving a letter No.596 dated 13.08.2010 from the OP No.1 regarding the fact that the premiums of second policy has not been deposited since June, 2008 and requested to deposit the outstanding loan amount of Rs.7,800.00 along with half yearly instalment of interest of Rs.53,642.00 within 30 days otherwise he will close the policy. Thereafter, the complainant sent two cheques bearing No.0452295 & 0452296 dated 01.09.2010 for Rs.1,964.00 as against unpaid premium and Rs.61,462.00 as against loan together with interest of Bank of Baroda, Balasore with a request letter to the OP No.1. But the OP No.1 returned back the aforesaid cheques with an intimation that the second policy has been matured on 22.06.2010 along with one blank maturity claim discharge voucher. Thus, the complainant sent a letter on 14.09.2010 to OP No.1 requesting to intimate him about the maturity value with bonus of his second policy, but the OP No.1 remained silent. Again on 25.11.2010, he sent another letter to OP No.1 on the self-same matter. On receipt of the said letter, OP No.1 issued one letter dated 29.11.2010 with discharge voucher and rough data sheet, which was disclosed that he was only entitled to get Rs.4,877.00. Being annoyed, the complainant sent a letter to OP No.1 on 20.12.2010 with a request to intimate about the maturity value with bonus of his first policy. On 23.12.2010, OP No.1 issued letter with data sheet expressing that he had already sent the original discharge voucher to him in the month of May, 2010 in respect of his first policy. But actually, the complainant had not received the above documents. The complainant, being aggrieved, sent a letter dated 5.1.2011 to Ops requesting them to give him accurate claim amount in respect of two policies. In reply dated 14.01.2011, OP No.1 denied his responsibility to intimate the complainant regarding non-payment of premiums and the reminder is not a mandatory condition and the contract of life insurance comes to an end after the date of maturity and that since the policy was not in force for full sum assured, no bonus of Rs.50,000.00 is payable.

                It is the further case of the complainant that he is a bonafide policy holder under the Ops and he has not intentionally neglected to deposit the premiums in respect of second policy, rather deposited the premiums of other policies. The LIC should have intimated the policy holder about non-payment of premiums. That apart, the Ops have not intimated about the maturity of the policy before its date of maturity to him, rather after lapse of two months the Ops intimated regarding non-payment of premiums and outstanding dues, thereby caused deficiency of service towards the complainant. When the Ops intimated the complainant and sent original discharge voucher in respect of first policy, then what prevented them to intimate him about the status of his second policy. Had they been intimated the complainant before its maturity, he could have regularized the matter. In the meantime, the complainant had received a sum of Rs.58,577.00 for the maturity of first policy.

                It is further averred that the complainant is entitled to get all benefits like his first policy, but the Ops have intentionally withdrew themselves from paying the actual maturity benefit to him and the Ops have illegally deprived the complainant to get the benefit of additional bonus of Rs.50,000.00 in respect of first policy.

                The cause of action arose for filing the case on 13.08.2010 when the Ops intimated the complainant regarding non-payment of premiums and on 29.11.2010 when the Ops issued the data sheet of Rs.4,877.00 in respect of second policy. Hence, this case.

To substantiate his case, the complainant has relied on the following documents, which are placed in the record, as mentioned hereunder-

1. Photocopy of letter No.596 dated 131.8.2010.
2. Photocopy of reply letter dated 1.9.2010.
3. Photocopy of discharge summary of Asian Heart Institute.
4.  Photocopy of medical certificate given Dr. P.C.Acharya.
5. Photocopy of letter No.596/PS/MA dated 4.9.2010.
6. Photocopy of acknowledgement receipt.
7. Photocopy of cheques dated 1.9.2010.
8. Photocopy of reply letter dated 14.9.2010.
9. Photocopy of postal receipt.
10. Photocopy of letter dated 25.11.2010.
11. Photocopy of letter dated 29.11.2010.
12. Photocopy of acknowledgement receipt.
13. Photocopy of letter dated 20.12.2010.
14. Photocopy of letter dated 23.12.2010.
15. Photocopy of duplicate discharge voucher.
16. Photocopy of letter dated 5.1.2011.
17. Photocopy of letter No.596/PS/MA dated 14.1.2011.

3.             As it appears from the case record, both the Ops have made their appearance and filed their joint written version. The Ops have stated, inter alia, that payment of premium on due date is the responsibility of the policy holder. So far as the policies are concerned, the date of commencement was 22.6.1970 and maturity was 22.6.2010. The complainant has stopped paying premium since June, 2008 for which the policy lapsed from June, 2008. The complainant was granted loan of Rs.7,820.00 under the said policies on 10.6.1988 advising him to pay broken period interest of Rs.27.00 on 22.6.1988 and thereafter to pay half yearly interest on 22^nd December and 22^nd June every year. But the complainant has not paid any interest accrued on the outstanding loan amount till the date of maturity, as a result half yearly interest got compounded since 10.6.1988.till the date of maturity on 22.6.2010. So, the letter dated 13.8.2010 was issued to the complainant informing about the outstanding loan dues and interest thereon due from June, 1988.

                With regard to the difference of maturity amount between the first policy and second policy, Ops have specifically stated that the premium in respect of first policy was paid till the date of maturity of the policy. Therefore, the first policy is treated as in force and as per valuation, final additional bonus for the policy term of 40 years has been paid @ Rs.50,000.00. But in respect of the second policy, the premium has been paid up to June, 2008 and the maturity was due on 22.6.2010. Hence, as per policy conditions, the second policy was in lapsed condition with reduced paid up value plus vested bonus accrued till 22.6.2008. As the period of unpaid due premium was more than one year, no recovery towards unpaid due premium was made. As the second policy was not in force, no final additional bonus was payable under the said policy. Therefore, the total maturity value after recovery of outstanding loan and accrued interest comes to Rs.4,877.00.

                It is further averred that payment of premium on due date is the responsibility of the policy holder and any reminder for the same from the Ops is not mandatory. Besides, for payment of interest on loan, the complainant has been advised to pay the broken period interest and half yearly interest, but he has not followed the instruction of the Ops, rather wilfully defaulted in paying the premium under the second policy since 22.6.2008 till the date of maturity as well as interest and principal with respect to the outstanding loan dues for which the interest got compounded. As the complainant has flouted the conditions of the payment of the premium and defaulted in payment of outstanding loan dues and interest thereon, deficiency in service does not attribute against the Ops, as alleged by the complainant. Therefore, it is prayed to dismiss the complaint with cost.     

4.             In view of the above averments of parties, the points for determination in this case are as follows:-

(i)            Whether the Complainant is a Consumer or not?

(ii)           Whether the complainant has cause of action to file this case?

(iii)          Whether this consumer case is maintainable?

(iv)          Whether there is any deficiency in service on the part of the OPs?

(v)           Whether the complainant is entitled to get the relief, as sought for?

(vi)          To what other relief(s), the Complainant is entitled to?

F  I  N  D  I  N  G  S

5.             First of all it is to be determined as to whether the complainant is a consumer or not. From the averments made in the pleadings of both the parties and document produced on behalf of the complainant vide Annexure- 1, 2 & 5 to 17, it is clear that the complainant had opened two LIC policies on 22.6.1970 bearing policy No.010691261 (first policy) & 010691262 (second policy). The Ops have not denied that the complainant has not opened the aforesaid policies. Therefore, the complainant is covered under the definition of a Consumer as defined under the provisions of the Consumer Protection Act, 1986.  

6.             Before delve into the merits of the case, it is required to be decided how far the complainant is able to prove his case with regard to cause of action and maintainability of the complaint. Learned counsel for the complainant vehemently urged that the complainant had undergone by-pass surgery on 20.6.2008 in Asian Heart Institute, Mumbai and implanted a pace maker on 31.10.2008 and stayed at Mumbai for about more than one year near his younger son. So, his staff used to deposit the premiums in different policies in LIC. It is further argued that the complainant received a letter No.596 dated 13.8.2010 from the OP No.1 to the fact that the premiums of second policy has not been deposited since June, 2008 and requested to deposit the outstanding loan amount of Rs.7,800.00 along with half yearly instalment of interest of Rs.53,642.00 within 30 days otherwise the policy in question would be closed. The complainant sent two cheques bearing No.0452295 & 0452296 dated 1.9.2010 for Rs.1,964.00 as against unpaid premium and Rs.61,462.00 as against loan together with interest of Bank of Baroda, Balasore with a request letter to the OP No.1. But the OP No.1 returned back the aforesaid cheques with an intimation that the second policy has been matured on 22.6.2010 along with one blank maturity claim discharge voucher. Thus, the complainant sent a letter on 14.9.2010 to OP No.1 requesting to intimate him about the maturity value with bonus of his second policy, but the OP No.1 remained silent. Again on 25.11.2010, he sent another letter to OP No.1 on the self-same matter. On receipt of the said letter, OP No.1 issued one letter dated 29.11.2010 with discharge voucher and rough data sheet, which was disclosed that he was only entitled to get Rs.4,877.00. Thus, the complainant sent a letter to OP No.1 on 20.12.2010 with a request to intimate about the maturity value with bonus of his first policy. On 23.12.2010, OP No.1 issued letter with data sheet expressing that he had already sent the original discharge voucher to him in the month of May, 2010 in respect of his first policy, which was not received by the complainant. The complainant, being aggrieved, sent a letter dated 5.1.2011 to Ops requesting them to give him accurate claim amount in respect of two policies. In reply dated 14.1.2011, OP No.1 denied his responsibility to intimate the complainant regarding non-payment of premiums and the reminder is not a mandatory condition and the contract of life insurance comes to an end after the date of maturity and that since the policy was not in force for full sum assured, no bonus of Rs.50,000.00 is payable. It is further argued on behalf of the complainant the complainant is a bonafide policy holder under the Ops and he has not intentionally neglected to deposit the premiums in respect of second policy, rather deposited the premiums of other policies. The LIC should have intimated the policy holder about non-payment of premiums. That apart, the Ops have not intimated about the maturity of the policy before its date of maturity to him, rather after lapse of two months the Ops intimated regarding non-payment of premiums and outstanding dues, thereby caused deficiency of service towards the complainant. When the Ops intimated the complainant and sent original discharge voucher in respect of first policy, then what prevented them to intimate him about the status of his second policy. Had they been intimated the complainant before its maturity, he could have regularized the matter.

7.             On the other hand, learned counsel for the Ops submitted that payment of premium on due date is the responsibility of the policy holder. So far as the second policy is concerned, the date of commencement was 22.6.1970 and maturity was 22.6.2010. The complainant has stopped paying premium since June, 2008 for which the policy lapsed from June, 2008. The complainant was granted loan of Rs.7,820.00 under the said policies on 10.6.1988 advising him to pay broken period interest of Rs.27.00 on 22.6.1988 and thereafter to pay half yearly interest on 22^nd December and 22^nd June every year. But the complainant has not paid any interest accrued on the outstanding loan amount till the date of maturity, as a result half yearly interest got compounded since 10.6.1988 till the date of maturity i.e. on 22.6.2010. So, the letter dated 13.8.2010 was issued to the complainant informing about the outstanding loan dues and interest thereon due from June, 1988. Learned counsel for the Ops further argued regarding the difference of maturity amount between the first policy and second policy. It is specifically stated that the premium in respect of first policy was paid till the date of maturity of the policy, therefore, the first policy is treated as in force and as per valuation, final additional bonus @ Rs.50,000.00 for the policy term of 40 years has been paid. But in respect of the second policy, the premium has been paid up to June, 2008 and the maturity was due on 22.6.2010. Hence, as per policy terms and conditions, the second policy was in lapsed condition with reduced paid up value plus vested bonus accrued till 22.6.2008. As the period of unpaid due premium was more than one year, no recovery towards unpaid due premium was made. As the second policy was not in force, no final additional bonus was payable under the said policy. Therefore, the total maturity value, after recovery of outstanding loan and accrued interest, comes to Rs.4,877.00. It is further argued that payment of premium on due date is the responsibility of the complainant and any reminder for the same from the Ops is not mandatory. Besides, for payment of interest on loan, the complainant has been advised to pay the broken period interest and half yearly interest, but he has not obeyed the instructions of the Ops, rather wilfully defaulted in paying the premium under the second policy since 22.6.2008 till the date of maturity as well as interest and principal with respect to the outstanding loan dues for which the interest got compounded. As the complainant has flouted the terms and conditions of the payment of the premium and defaulted in payment of outstanding loan dues and interest thereon, deficiency in service does not attribute against the Ops, as alleged by the complainant.

8.             From the above rival submissions of both the parties, first of all, it is seen that the complainant has no grievance against the Ops with regard to his first policy. As regards the second policy in question, it is the case of the complainant that he had undergone by-pass surgery on 20.6.2008 in Asian Heart Institute, Mumbai and implanted a pace maker on 31.10.2008 and used to stay at Mumbai for about more than one year near his younger son. So, his staff used to deposit the premiums in different policies in LIC. The complainant has further stated that he received a letter No.596 dated 13.8.2010 from the OP No.1 to the fact that the premiums of second policy has not been deposited since June, 2008 and requested to deposit the outstanding loan amount of Rs.7,800.00 along with half yearly instalment of interest of Rs.53,642.00 within 30 days otherwise the policy in question would be closed. In this aspect, Annexure-1, the letter No.596 dated 13.8.2010, does not speak itself that the complainant was asked to deposit the outstanding loan amount of Rs.7,800.00 along with half yearly instalment of interest of Rs.53,642.00 within 30 days otherwise the policy in question would be closed, as alleged by the complainant. Therefore, sending of two cheques bearing No.0452295 & 0452296 dated 1.9.2010 for Rs.1,964.00 as against unpaid premium and Rs.61,462.00 as against loan together with interest of Bank of Baroda, Balasore with a request letter to the OP No.1 is nothing but a futile transaction. That too, the above transaction was made after the maturity of the second policy in question. So, the OP No.1 has rightly returned back the aforesaid cheques. All the incidents that has been narrated by the complainant was happened after the maturity of the second policy in question. It is the responsibility of the complainant to make payment of the premiums on due date. If that be so, the responsibility cannot be shifted upon the Ops to remind the customers for payment of the premiums, rather, to inform the customers for repayment of the outstanding loan amount with interest thereon. Therefore, the dates of cause of action, as shown in the complaint petition, cannot be believable. Hence, it is held that the complainant has no cause of action to file the case. Consequently, the case is not maintainable.  

9.             From the discussions made in the foregoing paragraphs, it is held that deficiency in service cannot be attributed against the Ops and the complainant is not entitled to the reliefs, as claimed for.

    Hence, it is ordered –

O   R   D   E   R

                The complaint of the complainant be and the same is dismissed on contest against the Ops, but in the peculiar facts & circumstances of the case, no order as to cost.

                Pronounced in the open Court of this Commission on this day i.e. the 08^th day of August, 2023 given under my Signature & Seal of the commission.