Karnataka

Kolar

CC/3/2015

Smt.Sharada - Complainant(s)

Versus

The Chief Post Master General Postal Life Insurance - Opp.Party(s)

K.Rajkumar

27 Aug 2015

ORDER

Date of Filing: 21/01/2015

Date of Order: 27/08/2015

BEFORE THE KOLAR DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, D.C. OFFICE PREMISES, KOLAR.

 

Dated: 27^th DAY OF AUGUST 2015

PRESENT

SRI. N.B. KULKARNI, B.Sc., LLB,(Spl.)    …….    PRESIDENT

SRI. R. CHOWDAPPA, B.A., LLB               ……..    MEMBER

SMT. A.C. LALITHA, BAL., LLB         ……  LADY MEMBER

CONSUMER COMPLAINT NO: 03 OF 2015

Smt. Sharada @ Ammayya,

W/o. late Krishnappa. A.M,

Aged About 40 years,

R/at: Avani Village,

Mulbagal Taluk.

 

(Rep. by Sriyuth. K. Raj Kumar, Advocate)                 ….  Complainant.

 

- V/s -

1) The Chief Post Master,

General Postal Life Insurance,

Karnataka Circle,

No.1, Palace Road,

BANGALORE-560 001.

 

2) The Head Post Master,

Head Post Office,

Gowripet, Kolar-563 101.

 

3) The Assistant Post Master,

Devarayasamudra Post Office,

Mulbagal Taluk, Kolar District.

(OP Nos.1 to 3 are represented by

Sriyuth. P.N. Krishna Reddy, Advocate)             …. Opposite Parties.

 

-: ORDER :-

BY SMT. A.C. LALITHA, MEMBER

01.   The complainant having submitted this complaint Under Section 12 of the Consumer Protection Act, 1986, against opposite parties has sought issuance of directions to them to make payment of Insurance claim in the sum of Rs.2,00,000/- along with interest at the rate of 18% per annum from the date of filing of this complaint till the date of realization and compensation towards mental agony and harassment.

 

02.   The facts in brief:-

It is contention of the complainant that, Late. Sri. Krishnappa A.M., husband of complainant was the policy holder of the Postal Santhosh Endowment Assurance Policy bearing No. KT-413952-CS issued on 16.05.2009 for a sum of Rs.2,00,000/- for a tenure of 16 years risk commencing from 31.03.2009 to till maturity date or death of insured whichever is earlier.

 

(a)    It is contended that, the complainant was the nominee under the said policy.  The insured has regularly paid premium amount of Rs.1,070/- per month as per the premium receipts produced and the insured died on 27.06.2010 due to severe fever and lack of medical treatment in time.  And that, the death of the insured was natural.

 

(b)    It is also case of the complainant that, she being nominee and also the widow/legal heir of the insured claimed the policy amount from the Ops on 01.02.2011.  And that the Ops repudiated the claim of the complainant on the ground of non-payment of premium by the insured/deceased policy was lapsed as per the letter dated: 23.08.2013.  And that, being aggrieved by the said decision she got issued legal notice through her counsel on 08.01.2014 same has been duly served to Ops for which there could be no response.  So contending the complainant has come up with this complaint seeking the above set-out reliefs.

 

03.   In response to the notices issued with regard to the case on hand, Ops have put in their appearance through their said learned counsel.  They have submitted written version.  The main contention raised by the Ops is that, the deceased/insured has not paid premiums regularly.  And that on account of non-payment of premiums policy was lapsed.  And suppression of facts under Rule 56(1) of post office life insurance Rules 2011 was also cause for repudiation.  And that OP-3 ought not to have accepted the premium for the lapsed period.  Hence, they to contend that, they repudiated the claim of the complainant.  And that, they were not deficient in rendering the services.  So contending dismissal of the complaint with exemplary costs has been sought.

 

04.   The complainant on 08.06.2015 has submitted her affidavit evidence and on this day along with Memo on behalf of the complainant following Xerox copies of documents have been submitted :-

(i) Insurance policy

(ii) Letter issued by the Ops

(iii) Legal notice

(iv) Postal receipts and acknowledgements

(v) claim form and mahazar

(vi) Premium receipt book

(vii) Letter dated: 04.08.2010 to ASP Kolar issued by department of posts.

(viii) Discharge summary of St. John’s Hospital, Bangalore, dated: 17.05.2010

(ix) Discharge summary of St. John’s Hospital, Bangalore, dated: 09.05.2009.

 

05.   On 22.06.2015 the learned counsel appearing for Ops have submitted affidavit evidence and on 25.08.2015 submitted and relied on report of department of posts.

 

06.   The learned counsels appearing for the complainant as well as Ops have submitted written arguments and citations.  Citations relied by the learned counsel for the complainant

“Revision Petition No.4150 of 2007 passed by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi, between Life Insurance Corporation of India & Others –V/s- Smt. Ram Sakhi & others”

 

07.   Copy of postal report has been relied by the learned counsel for Ops.

 

08.   Heard the oral arguments of both the counsels.

 

09.   Therefore the points that do arise for our consideration in this case are:-

1.   Whether there is any deficiency in service on the part of the Ops in settling the claim of the complainant?

 

2.   Whether the complainant is entitled for the policy amount?

 

3.   What order?

 

10.   Findings of this District Forum on the above stated points for the following reasons are:-

POINT No.1:  In the Affirmative

 

POINT No.2:  In the Affirmative

POINT No.3:  As per the final order

  for the following:-

 

REASONS

POINT NOS.1& 2:-

11.   As these points do deserve common course of discussion and to avoid repetition in reasonings they are taken-up for consideration at a time.

(a)    It is contention of the learned counsel for the Ops that, under Rule 39(1) of the Post office Insurance fund Rules the policy was treated as lapsed and there was no application for its revival.  However there is nothing to show that prior to lapse of the policy through notice there was communication asking to pay the premium to the deceased if not to face consequence of lapse of policy as per Section 50 of the Insurance Act, 1938.  And if it was case of lapse of policy, why were payments of outstanding premia together with penalty amount were accepted ?  Therefore it cannot be said that policy holder was in default.

 

(b)    Rule. 18, 39, 44, 52, 56, 57 cannot be pressed in to service on the part of the Ops, for, they have violated provisions of Section 50 of Insurance Act 1938.  For, we are of the definite opinion that, these Ops were statutorily duty bound to give notice to the insured drawing his attention to pay the due premiums.  Had they complied this then they could have invoked provisions of the said rules and not otherwise.

 

(c)    Hence an attempt to refund accepted premium is an afterthought on the part of the Ops to defeat the legitimate claim of the complainant. 

 

(d)    Further reveals that the premium for the months from November-2009 to June-2010 has been paid with fine amount of Rs.300/-, total meaning there by that, the said policy is not lapsed rather the Ops have charged the fine on account of not depositing the premium in time, when the Ops have charged fine amount from the insured, they are estopped from contending that policy was lapsed.  Once the Ops have received the premium with fine amount, the policy cannot be said to be void and in-active.  The contentions put forth on behalf of the complainant have weight and she has been able to prove that she has suffered mental agony and harassment on account of negligence and deficiency in service on the part of the Ops by rejecting her legitimate claim.

 

(e)    Further with regard to the contention of suppression of facts taken-up by Ops we hold that, contention is bald.  For, the discharge summary and medical certificate submitted by complainant reveal that due to fever and some common gastric ailments due to infection of fever he succumbed.  Admittedly the said sudden illness of the insured was subsequent event and not pre-existing at the time of subscribing the policy.  Thus it reveals uncertainty of human life, as such we do not accept lame contention of the Ops that the Insurant was guilty of suppression of facts.

 

(f)     There is deficiency in service on the part of the post office in repudiating the claim, though all the premiums were deposited by policy holder as per terms and conditions of the policy, premiums were accepted with penalty.  Therefore in our view the complainant is entitled to policy amount with all admissible benefits.

 

(g)    For the reasons and finding recorded above we allow the complaint of the complainant and direct the Ops to pay a sum of Rs.2,00,000/- (Two Lakhs) to the complainant along with the interest of 9% per annum from 21.01.2015 the date of filing of the complaint till its realization.  The Ops are further directed to pay Rs.10,000/- in lump-sum as compensation to the complainant for mental agony and harassment, which to carry interest at the rate of 9% p.a. from 21.01.2015 being the date of the complaint.

 

POINT 3:-

12.   In the result, we proceed to pass the following:-

 

ORDER

01.   For foregoing reasons, this complaint stands allowed with costs of Rs.3,000/- as hereunder:-

(a) The complainant is held entitled to recover Rs.2,00,000/- (Two Lakhs) being the maturity value of the insurance policy together with admissible benefits as well as Rs.10,000/- towards compensation together with interest @ 9% pa from 21.01.2015 being the date of complaint till realization from the Ops jointly and severally.

02)   Send a copy of this order to both parties free of costs.

 

(Dictated to the Stenographer in the Open Forum, transcribed by him, corrected and then pronounced by us on this 27^th DAY OF AUGUST 2015)

 

 

 

MEMBER                             MEMBER                     PRESIDENT