Date of filing 06-12-2012
Date of Disposal : 21-05-2013
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, ANANTAPUR.
PRESENT: - Sri S.Niranjan Babu, B.A., B.L., President (FAC).
Smt. M.Sreelatha, B.A., B.L., Lady Member
Tuesday, the 21st day of May, 2013
C.C.NO.77/2012
Between:
K.Aswartha Narayana
S/o Late K.Ramappa
Retd. Govt.Employee
D.No.7/344-B, Malleswar Road,
Court Road, Anantapur. …Complainant
Vs.
1. The Chief Manager,
State Bank of India, Main Branch,
Sai Nagar,
Anantapur – 515 001.
- The Senior Manager (Claims),
Authorized Signatory, SBI Life Insurance Co. Ltd.,
Central Processing Centre, Kapass Bhavan,
Plot No.3-A, Sector No.10-C-B-C, Belapur,
Navi Mumbai – 400 614. … Opposite Parties
This case coming on this day for final hearing before us in the presence of Sri J.Chittaranjan, advocate for the complainant and Sri P.Venkatarami Reddy, Advocate for the 1st opposite party and Sri Y.Ramalinga Reddy, Advocate for the 2nd opposite party and after perusing the material papers on record and after hearing the arguments on both sides, the Forum delivered the following:
O R D E R
Smt.M.Sreelatha, Lady Member: - This complaint has been filed by the complainant under section 12 of Consumer Protection Act, 1986 against the opposite parties 1 & 2 to direct them to pay a sum of Rs.1,00,000/- towards assured amount with interest from the date of claim, Rs.10,000/- towards mental agony and grant such other relief or reliefs.
2. The brief facts of the complaint are that: - The complainant’s wife late Smt.P.Pushpalath (hereinafter called deceased) had Savings Bank Account No.10873562199 as her salary account. She also opened SBI Account Holders Scheme Account No.01593061744 and also availed personal loan of Rs.2,00,000/-. At the time of availing personal loan, the then Manager of 1st opposite party canvassed SBI Life Suraksha Plus Plan of 2nd opposite party by furnishing premium, terms and conditions of the same. Late Smt.P.Pushpalatha expressed her consent and availed SBI Life Suraksha Plus Policy No.010873417517. The 1st opposite party also furnished terms and conditions of the policy. The policyholder availed by opting single premium mode, regular premium mode and maximum term is 30 years. There are multiple premium payment mode options available such as Single Premium, Pay Regular by yearly or half yearly, quarterly or monthly with Free Cover Limit facility available. There is wide choice of sum assured available the minimum of Rs.1,000/- per member to maximum no limit. The deceased opted for Rs.1,00,000/- and opted her choice in the proposal form as agreed upon. The mode of premium opted by her is yearly. Being authorized for deducting of premium, the 1st opposite party used to withdraw the premium directly in S.B. Account of the deceased under whose control the account had been operating. Like-wise, the 1st opposite party deducted the premiums on 29-11-2004 for Rs.441, 28-06-2005 for Rs.662/-, 18-07-2006 for Rs.674/-, 05-10-2007 for Rs.674/-, 05-07-2008 for Rs.675/- and on 17-07-2009 for Rs.662/-. Unfortunately the wife of the complainant i.e. deceased died of breast cancer. She was diagnosed by Yashoda Hospital, Secundrabad and she was operated twice in the hospital, chemo-therapy, radiation, treatment, pulmonary therapies were given there and medication was given as prescribed. Eventually, the life assured/deceased died on 06-10-2010. The entire record of operations, bills, discharge etc., were sent to the opposite parties for claim. Being the husband or nominee or legal heir of his wife(deceased), the complainant claimed the assured amount of Rs.1,00,000/- with the opposite parties by furnishing Death Claim dt.11-01-2011 duly attested by the 1st opposite party vide letter dt.03-12-2010 denied to pay the assured amount as there was no such premium deducted for the Financial Year 2010-2011 for the letter wrote by the complainant. Then the complainant made the death claim from the 2nd opposite party and the 2nd opposite party denied to pay the same stating that the policy was lapsed as the premium was not paid vide letter dt.03-05-2011. Again the complainant made appeal by reminding the death claim dt.1-07-2011 to the 2nd opposite party through Chairman. However, the 2nd opposite party through Head of Claims again wrote a letter dt.25-08-2011 stating that the premium was received upto 30-06-2010 and cover was valid only up-to this date. Further premiums were not debited as the scheme was withdrawn and master policyholder informed not to recover/collect premium from April, 2010 onwards as IRDA withdrew the policy vide letter dt.30-03-2010. Hence there is no life insurance as on death of the said assured on 06-10-2010. The 2nd opposite party also regretted for the reasons vide letter dt.03-05-2011 and sought apologize for the same. The 2nd opposite party concocted a new story to avoid death claim and the same is contra to the fact of letter dt.03-05-2011. There was no information regarding withdrew of the policy and the same can not be done unilaterally. The complainant did not have any option except getting issued a legal notice dt.03-09-2012 to both opposite parties and the same was served on them. The 2nd opposite party issued a reply notice dt.11-09-2012 to the notice issued on behalf of the complainant stating that the company is not liable to pay any death benefit amount under Policy No.82001105904 for the reason that the Claims Review Committee upheld the repudiation of the claim of the company.
3. Counter filed on behalf of the 1st opposite party admitting that the deceased having Savings Bank Account and availed personal loan in 1st opposite party Bank and she availed SBI Life Suraksha Plus Policy by opting of paying yearly premiums. The deceased authorized the opposite party to remit yearly premiums of the insurance cover from the amount standing at her S.B. Account on 29-11-2004 for Rs.441, 28-06-2005 for Rs.662/-, 18-07-2006 for Rs.674/-, 05-10-2007 for Rs.674/-, 05-07-2008 for Rs.675/- and on 17-07-2009 for Rs.662/-. The 2nd opposite party by their letter dt.30-03-2010 informed the 1st opposite party that Group Insurance for deposit account-holders (Super Surakasha) Master Policy No.82001105904 was renewed on 01-07-2009 for the period from 01-07-2009 to 30-06-2010 that the said product has been withdrawn and IRDA has been and such scheme is not renewed on 01-07-2010. The 2nd opposite party further instructed in the said letter that the 1st opposite party shall not recover/collect any premium from the members of the scheme from April, 2010. Adverting to the above advice, no premium was collected/recovered from any member subsequent to April, 2010. All the members in the scheme were also informed of the non-renewal of scheme beyond 01-07-2010 and requested not to pay the premium and also that no amounts will be deducted from the respective S.B. Accounts of the Members, the deceased was aware of the situation and as such she did not question when the yearly premium beyond July, 2010 was not recovered from her S.B. Account. As claimed by the complainant himself, his wife/deceased died on 06-10-2010. The insurance policy covered only upto 30-06-2010 and does not extend to a period beyond 30-06-2010. As no risk is covered beyond 30-06-210, the complainant is not entitled to any payment for the death of his wife. As per terms and conditions of the scheme, the premium has to be recovered/paid within appointed date with a grace period of 30 days. The complainant or his wife did not question when the amount is not deducted from her S.B. Account for the year 2010-2011 for the reason that they are aware of the fact that the scheme is withdrawn by the 2nd opposite party and the risk is covered only upto 30-06-2010. Taking advantage of death of his wife, the complainant has come up with acclaim for which is not legally entitled. The 1st opposite party is only an agent between the end opposite party and the members of the scheme. The 2nd opposite party, who founded the scheme and he is entitled to renew the scheme year after year or decline to renew some of his option. The risk if any is covered by the 2nd opposite party and once he decides to withdraw the said scheme, the 1st opposite party is not entitled to question the decision. The only option available to the 1st opposite party is not to collect/recover the premium us advised by the 2nd opposite party. It can not be said that the 2nd opposite party is liable to pay the amount muchless claimed in the complaint. As submitted above claims if any has to be settled/refused for genuine reasons by the 2nd opposite party and the 1st opposite party is nothing to do with the same and not obliged to pay any risk coverage to ments. He can only submit the claims of the members to the 2nd opposite party, who shall process and settle the claims. As the 1st opposite party is nothing to do with the claim in question, he is not a necessary and proper party to the complaint. The complaint is bad for mis-joinder of party. On this ground the complaint is liable to dismissed against this opposite party. There is no cause of action for filing the complaint and the complainant is not entitled to any relief. Hence prayed this Forum to dismiss the complaint with costs.
4. Counter filed on behalf of the opposite party No.2 stating that SBI Life Insurance Co. Ltd/2nd opposite party has granted a Master Policy bearing No.82001105904 to cover the eligible members of deposit account-holders of State Bank of India. The policy was effective from 01-07-2004 and the annual renewal date is July every year. The deceased Smt.P.Pushpalatha was admitted as a member into SBI Life Super Suraksha – Depositors Group Insurance Scheme with effect from 29-11-2004, the mode of premium was annually and the insurance cover for Rs.1,00,000/- .SBI Life Super Suraksha Group Insurance Scheme was withdrawn with effect from 01-04-2010. Hence, the Master policy was not renewed after 01-04-2010 and the risk cover for the members covered under the Master Policy No. 82001105904 expired on 30-06-2010 because the last premium due on 01-07-2009 under the master policy was received i.e. before the withdrawal of the policy and hence the risk cover was available for one year because the insurance premiums are paid in advance. The risk cover was valid only upto 30-06-2010. The deceased Smt.P.Pushpalatha was reported to have died on 06-10-2010 and as the risk cover automatically expired on 30-06-2010, there was no risk cover available as on her date of death. The 2nd opposite party is not privy to what transpired between the deceased and the Master Policyholder (O.P.1) and in Group insurance contracts, the privity of contract is between the master policy holder/1st opposite party and 2nd opposite party is the insurer. The relationship between the 1st opposite party and 2nd opposite party is that of insurer/Master policy holder. The master policy holder will remit consolidated premium on behalf of all the members of the scheme. In the instant case the risk cover expired on 30-06-2010 as the product, SBI Life Super Suraksha itself was withdrawn with effect 01-04-2010 and hence nothing is payable. Premium is the sole consideration for the insurance contract. A contract without consideration is void. In the instant case the product SBI Life Super Suraksha itself was withdrawn with effect from 01-04-2010 and hence all the benefits under the Master Policy got terminated. The 2nd opposite party has not renewed the policy on 01-07-2010 due to withdrawal of the policy with effect from 01-04-2010. The complainant himself admitted that the last premium was debited on 17-07-2009.Hence there is no dispute on the fact that the premium due on 01-07-2010 was not received and there was no insurance cover as the date of death. This opposite party accepted to the extent that the claim was declined as the premium due on 01-07-2010 was not received as the product itself was withdrawn on 01-04-2010. There was no information regarding withdrawal of policy and the same can not be done unilaterally. The renewal of the policy is not automatic and has to be mutually decided between the Master Policy-holder and the insurer. In group insurance policies the pvirty of contract is between the Master Policy-holder and the insurer and the insured member has no locus to negotiate the contractual terms under the policy. Once a Master Policy is granted the individual insured members are just admitted to the benefits under the policy provided the policy is in force subject to the terms and conditions of the Master Policy. The renewal or non-renewal of Master Policy has to be mutually determined between the Master Policyholder and the insurer and the renewal is not automatic and insured members can not demand the renewal of the policy because they are not basically parties to the contract. A policyholder can not demand the extension of the term of the policy once the given term of policy is over. The master policy is issued with a term of one year only initially and subsequent extension of term is not automatic. The members can avail the risk cover only as long as the Master Policy is in force. The legal notice was duly replied. Even the representation received was also placed before the claims review committee and the reply to the same was also duly sent. The claim was declined as the said group insurance scheme itself was withdrawn with effect from 01-04-2010 . Hence no cause of action has arisen for the complainant to file this complaint. It is specifically submitted that the insurer is responsible to settle the claim only if the insurance cover is available. The risk cover on the lives of the members under the Master Policy automatically expired on 30-06-2010 and hence there was no risk cover available on the life of the deceased. Smt.P.Pushpalatha as on her date of death i.e. 06-10-2010. Hence nothing is payable towards claim amount. The complainant is not eligible for any amount towards claim amount, compensation, mental agony, costs, interest etc., or whatsoever amount as claimed for . There is no deficiency of service on the part of the 2nd opposite party. The complainant does not have any right or whatsoever to challenge the decision of 2nd opposite party because the decision of 2nd opposite party was just and legal and no cause of action has arisen and the complainant is not entitled to file the present complaint. The relief prayed for in the complaint ar unjust, illegal and unfair on the part of the complainant and the present complaint is frivolous and vexatious and is an abuse of the process of law. The complainant is not entitled to any relief of whatsoever because the contract of insurance as per se got expired on 30-06-2010. Hence prayed this Forum to dismiss the complaint with costs.
5. Basing on the above pleadings, the points that arise for consideration are:
1. Whether the policy was in force on the date of death of the policyholder ?
2. Whether there is any deficiency of service on the part of the opposite parties 1 & 2?
3. To what relief?
6. To prove the case of the complainant, the evidence on affidavit of the complainant has been filed and marked Ex.A1 to A11 documents. On behalf of the 1st opposite party, evidence on affidavit of 1st opposite party has been filed and no documents have been marked on behalf of the 1st opposite party. On behalf of the 2nd opposite party, evidence on affidavit of 2nd opposite party has been filed and marked Ex.B1 to B5 documents.
7. Heard both sides.
8. POINT NO.1 – The counsel for the complainant argued that the complainant’s wife by name Pushpalatha had Savings Bank Account with 1st opposite party i.e. salary account and she also opened S.B.Acounter holders scheme bearing No.01593061744 and also availed personal loan for Rs.2,00,000/- at the time of availing personal loan the Manager of the 1st opposite party convinced that SBI Life Suraksha + plan of the 2nd opposite party is a good one. Hence she expressed her consent and she had taken the above SBI Life Surakasha policy with the 2nd opposite party. The policyholder availed the above said policy by opting single premium mode regular premium and maximum terms of 35 years. There is a wide choice of some assured available a minimum of Rs.1,000/- per member to maximum no limit. However the wife of the complainant opted for Rs.1,00,000/- and she agreed for the proposal of the opposite party and she opted for yearly premium payable and to that effect the 1st opposite party used to withdraw premiums directly through her account No. and used to send the same to the 2nd opposite party. Like-wise the 1st opposite party deducted premiums on respective dates. Unfortunately the policyholder died by taking treatment at Yasoda Hospital, Secunderabad on 06-10-2010. The complainant is nominee and he claimed the sum with the opposite party by furnishing all document on 11-01-2011 and the same was denied by the opposite party as there was no such premium deducted for the financial year 2010-2011. Then the complainant made a claim with 2nd opposite party. The 2nd opposite party also denied the claim and stated that the policy was lapsed as premium was not paid through their letter on 03-05-0211. Again the complainant made several representations on 15-07-2011. The 2nd opposite party denied the claim through letterdt.25-08-2011stating that the premium was received upto 30-06-2010 only and the policy was also withdrawn by the 2nd opposite party and the same was informed to the 1st opposite party as per IRDA Rules dt.30-03-2010. No premium was deducted as the 2nd opposite party withdrawn the above said policy. The complainant states that there was no information regarding withdrawal of the policy and the same can not be done unilaterally. The complainant had no option except to issue legal notice dt.03-09-2012. The opposite party also replied for the above said letter by denying the claim as no premium was deducted for the Financial Year 2010-2011. Hence the complainant claiming compensation before this Forum of Rs.1,00,000/- and Rs.10,000/- towards mental agony. The counsel for the opposite party No.1 admitted that late P.Pushpalatha is having account with them and they have deducted premium through her S.B. Account from 29-11-2004 to 17-07-2009 on different years. The 1st opposite party also submitted that she had taken the policy with the 2nd opposite party and the 1st opposite party was Master Policy-holder and the premium has to be paid on yearly basis and the 2nd opposite party has withdrawn the above SBI Life Suraksha policy on 30-03-2010 and the same was intimated to the complainant and his wife while she was alive. The 2nd opposite party also sent a letter stating that no premium was collected from any member subsequent to April, 2010. Basing on the above said letter, the 1st opposite party did not deduct premium for the financial year 2010-2011 and the 1st opposite party also enquired that the policyholder died on 06-10-2010 and the policy was covered only upto 30-06-2010 and no risk is covered beyond 30-06-2010 , whereas the wife of the complainant/policyholder died in the month of October, 2010. Hence the policy was not in force as no premium was deducted though there is grace period of 30 days was given for payment of premium and the 1st opposite party is only agent between the opposite party No.2 and members of the claim and it is the risk only covered against the 2nd opposite party as the 2nd opposite party decides to be withdrawn the scheme and the opposite party is not in a position to question the decision of the 2nd opposite party. Due to that the opposite party has not collected premium for the year 2010-2011. There is no liability against this opposite party as no premium was paid for the year 2010. Hence this opposite party is not liable to pay any amount as claimed by the complainant and the complaint is liable to dismissed as this opposite party is automatically joined as party.
9. The counsel for the 2nd opposite party argued that the deceased was the member of group policy of 1st opposite party and the contract between the Master Policy-holder and insurer. Insured member has no locus-standi to negotiate contractual terms under the policy. Once Master Policy is issued the individual insured towards just admitted the benefits under the policy with subject to terms and conditions of Master Policy and renewal of master policy has to be mutually determined between the master policyholder and the insurer and the renewal is not an automatic one. SBI Life Surakash Group Insurance Scheme was withdrawn with effect from 01-04-2010. Hence the master policy was not renewed on 01-07-2010 and risk cover for the members was expired on 30-06-2010. The master policy was renewed on 01-7-2010 for a period of one year i.e. 01-07-2009 to 30-06-2010 and the deceased Pushpalatha was died on 06-10-2010. Hence no risk cover automatically continued after expiry of 30-06-2010. The 2nd opposite party is not privy to what transpired between the complainant and the opposite party. The relationship between the opposite parties 2 & 1 is that of insurer and master policy-holder. SBI Life Suraksha policy was withdrawn on 01-04-2010 nothing is payable. Thus the opposite party No.2 is not a necessary party and the complaint is liable to be dismissed for misjoinder of party. The opposite party also argued that as per section 64(v)(b) of the Insurance Act, no insurer shall assumed any risk in India in respect of any insurance business unless and until the premium is received by him in advance his guarantee to be paid to the insurer in any manner prescribed by the rules. In the insurance case, the master policy was withdrawn with effect from 01-04-2010. Hence the cover automatically expired on 30-06-2010. There was no insurance cover available under the Master Policy as on the date of death of the insured. The counsel also argued that under point No.1 of the master policy it was mentioned that subject to the payment of the appropriate premiums specified herein and on the proof of happening of the contingencies then only the beneficiaries entitled the claim and No.4 of the master policy it was mentioned that this policy was in force for the period of one year from the effective date. Thus it is very clear that the renewal of the insurance cover is not automatic and also as per clause 5(a) of schedule I of Master policy in the event of death of the member at any time after 45 days from the date of commencement of risk subject to the policy being in full force. As per schedule-I the point No.8 effective date is 01-07-2004. Thus it is clear that master policy is a contract which has to be renewed every year. In the present case the master policy was not renewed on 01-07-2010 as the policy was withdrawn from 01-04-2010 and it is automatically expired on 30-06-2010. The counsel also submitted a ruling reported in Revision Petition No.234/1992 between LIC Vs. Kusum Lata. In the above case, “ the Apex court held that the repudiation of the claim on the ground of non-payment of renewal premium is valid and there is no deficiency in service on the part of the opposite party and the repudiation of the claim was rightly done. “ The counsel also submitted another ruling reported in 1996 (3) SCR Page 500 between General Assurance Society Limited Vs. Chandumall Jain & Anr . In the above case the Apex Court observed that “ In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contractis expressed by the parties, because it is not for the court to make a new contract. “ Hence, the 2nd opposite party has rightly repudiated the claim of the complainant as the policy was not in force by the time of death of the policyholder. Hence there is liability on the part of the 2nd opposite party to pay any claim as claimed by the complainant.
10. POINT NO.1 – It is an admitted fact that the deceased Pushpalatha is having Savings Bank Account with the 1st opposite party and she had also taken policy with the 2nd opposite party and the 1st opposite party is the Master Policy-holder and there is dispute with regard to commencement of the policy i.e. year 2004 and the 1st opposite party also admitted in its counter and affidavit that they have deducted the premiums for the insurance through Savings Bank Account of late P.Pushpalatha on different dates i.e. 29-11-2004, 28-06-2005, 18-07-2006, 05-10-2007, 05-10-2008 and 17-07-2009. The opposite party failed to explain from which date to which date the policy was covered. As per the arguments and documents produced by the 2nd opposite party it was mentioned in the counter that the policy will commence from every year to 1st July. If this is the date for the policy, then why the 1st opposite party has deducted first premium on 20-11-2004, there was no explanation for the same. As per the arguments of the 1st opposite party, the opposite party argued that the policy will commence from every year of 1st April from 01-04-2004 to 31-03-2005. So they have collected first premium on 29-11-2004. Whereas the 2nd opposite party argued that as per Ex.B1 an effective date is July 1st 2004. There was a contra arguments between the 1st opposite party and 2nd opposite party. The 1st opposite party argued that the policy will commence from 01-04-2004, whereas the 2nd opposite party argued that it starts from 1st July, 2004 and it is every year renewal policy. The last premium was deducted by the 1st opposite party on 17-07-2009. For this there was no explanation in the counter nor they have not filed any document to show that when the policy was commenced. If the arguments of the 2nd opposite party is taken into consideration, the premium has to be deducted on or before 01-07-2009 but last premium was deducted on 17-07-2009. The 2nd opposite party argued that the members has given grace period to pay premium even after expiry of date and the 2nd opposite party has given 30 days grace period for payment of the premiums. If it is taken into consideration that to receive last premium by giving grace period, the 1st opposite party has deducted the premium for the financial year 2006-2007, 4th premium was collected on 05-10-2007 if effective date is considered as 01-07-2006 for that year the premium has to be deducted on or before in the month of September, but premium was deducted on 05-10-2007 and the 1st opposite party also failed to explain why they have deducted the amounts on different heads, like for the first premium they have deducted Rs.441/- whereas last premium was deducted for Rs.662/- and there was no explanation at all for the same. The counsel argued that if the 1st opposite party failed to convince the Forum why they have not deducted the amounts for the year 2010-2011 as the 2nd opposite party argued that as the policy was not in force. Hence the claim was repudiated by the 2nd opposite party as policy was not in force and the policy itself was withdrawn on 01-04-2010 and the same was intimated to the 1st opposite party. For this the 2nd opposite party filed a letter dt.30-03-2010, but the 1st opposite party failed to explain about the withdrawal of the policy by the 2nd opposite party was intimated to the policyholder or to the complainant. There was no iota of evidence to show about the withdrawal of the policy was intimated to the policyholder. The opposite party No.1 simply mentioned in the counter and affidavit that they have intimated about the withdrawal of the policy to all the members of the above said policy. The counsel argued that the 1st opposite party negligently, irresponsibly and intentionally they have not deducted the premium for the year 2010-2011 though there was sufficient amount in the account of the policyholder. If we have taken into consideration the premiums deducted by the 1st opposite party, the policy will commence on 29-11-2004 as the 1st premium was deducted on 29-11-2004 and ends on 28-11-2005. Like-wise for the year 2009-2010 taken into consideration the renewal was from 29-11-2009 to 28-11-2010. The death of the policyholder was on 06-10-2010. Hence the policy was in force as per the observations made by us and it is the duty of the 1st opposite party to inform about the withdrawal of the policy by the 2nd opposite party. As per documents there was no proof about the intimation. Hence, we feel that the policy was in force. The 1st opposite party intentionally not deducted the premium from the account of the policyholder. Hence this point is answered accordingly in favour of the complainant and against the opposite parties.
11. POINT NO.2 - About deficiency of service the counsel for the complainant argued that when the policy was in force the opposite parties intentionally evading to pay the claim amount for which the complainant is entitled legally. The counsel for the 1st opposite party argued that after death of the policyholder the complainant being nominee submitted the claim form to the opposite parties, but the 2nd opposite party through its letter stated that as the policy itself had withdrawn as per rules of IRDA and the same informed to the 1st opposite party through letter dt.30-03-2010. Hence the 1st opposite party is not liable to pay claim as 1st opposite party has no right to question about withdrawal. But neither the master policyholder nor the 2nd opposite party intimated the same to the complainant. The counsel for the 2nd opposite party argued that when the policy was not in force, the opposite party is not liable to pay any claim as the master policy itself was withdrawn before expiry of the policy period and directed the 1st opposite party not to deduct premiums from the year 2010. Hence the 2nd opposite party is not at all liable to pay any amount. As per our observations the 1st opposite party failed to deduct the premiums from the account of the policyholder though there was sufficient amount in her account. For this also the 1st opposite party was not denied that the policyholder was having sufficient means to deduct the premiums when the policy was withdrawn by the 2nd opposite party. It is the bounden duty of the 1st opposite party to publish in wide circulated newspapers about the withdrawal of policy by the 2nd opposite party. For this there was no proof from the 1st opposite party. When the premiums were deducted by the 1st opposite party on irrelevant dates, it is difficult to the Forum taken into consideration when the policy was in force. In previous paras observations we are of the opinion that the policy was commenced on 29-11-2004. When we are of the opinion that the policy was in force at the time of death of the policyholder, the 1st opposite party has to deduct the premium or to intimate withdrawal of the policy by the 2nd opposite party. Both was not done by the 1st opposite party. The reasons best known by the 1st opposite party for non-deduction of the premiums for the year 2010. It is a clear negligent act on the part of the 1st opposite party and 1st opposite party also failed to explain and convince the Forum that the claim of the complainant was rightly rejected by the 2nd opposite party. When the policy was taken with 1st opposite party, it is the bounden duty of 1st opposite party to deduct premiums regularly. The 1st opposite party should not escape that the insurer had to verify whether the premiums were deducted or not. Hence, we feel that it is clear case of negligence and deficiency of service on the part of the 1st opposite party. This point is answered in favour of the complainant and against the opposite parties.
12. POINT NO.3 - In the result, the complaint is allowed and the 1st opposite party is directed to pay a sum of Rs.1,00,000/- towards policy amount and Rs.2,000/- towards mental agony in the circumstances no costs. The 1st opposite party is liable to pay the above said amount within one month from the date of this order other-wise the complainant is entitled to receive interest @ 9%p.a. from the date of death of the policyholder till the date of realization. Claim against the 2nd opposite party is dismissed.
Dictated to the Steno, transcribed by him, corrected and pronounced by us in open Forum, this the 21st day of May, 2013.
LADY MEMBER PRESIDENT (FAC)
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
ON BEHALF OF THE COMPLAINANT: ON BEHALF OF THE OPPOISITE PARTIES
-NIL- - NIL-
EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT
1. Ex.A1 – Photo copy of SBI Life Suraksha Plus .
2. Ex.A2 - Photo copy of SBI Savings Bank Account Pass Book relating to
deceased P.Pushpalatha.
3. Ex.A3 – Photo copy of entries of Savings Bank Account of deceased P.Pushpalatha.
4. Ex.A4 - Photo copy of letter of 1st opposite party sent to the complainant.
5. Ex.A5 - Photo copy of letter dt.03-05-2011 sent by the 2nd opposite party to the
1st opposite party.
6. Ex.A6 - Letter dt.25-08-2011 sent by the 2nd opposite party to the complainant.
7. Ex.A7 - Office copy of legal notice dt.03-09-2012 got issued by the complainant to
the opposite parties 1 & 2.
8. Ex.A8 - Postal Receipts.
9. Ex.A9 - Postal acknowledgment signed by the 1st opposite party.
10. Ex.A10 – Postal acknowledgment signed by the 2nd opposite party.
11. Ex.A11 – Reply notice dt.11-09-2012 got issued by the 2nd opposite party to the
Complainant.
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.1
- NIL -
EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY NO.2
1. Ex.B1 - Duplicate SBI Life Super Suraksha Master Policy No.82001105904.
2. Ex.B2 - Photo copy of letter dt.30-03-2010 sent by the 2nd opposite party to the
1st opposite party.
3. Ex.B3 - Photo copy of letter dt.03-05-2011 sent by the 2nd opposite party to the
1st opposite party.
4. Ex.B4 - Photo copy of letter dt.25-08-2011 sent by the 2nd opposite party to the
Complainant.
5. Ex.B5 – Reply notice dt.11-092012 got issued by the 2nd opposite party to the
Complainant.
LADY MEMBER, PRESIDENT (FAC),
DISTRICT CONSUMER FORUM DISTRICT CONSUMER FORUM
ANANTAPUR ANANTAPUR.
Typed by JPNN
