Order No. 11 Dt. 07.01.2015
This is an application under section 12 of the C.P. Act, filed by the petitioner Pratima Mondal, praying for an order to pay Rs. 17000/- (Rs.10200/- as maturity sum + Rs.6800/- as cost of mental agony) by O.Ps for their refusal the claim of petitioner for a product of LIC by name “ LIC’s Jeevan Madhur (with profits) Micro Insurance’’ made in 2008.
The further case of the petitioner is that she is a permanent resident of village Raypur of Mokdumpur P.O. of Malda District and the O.Ps 1 and 2 and O.P.4 are officials of LIC India Jalpaiguri Division, O.P. 3 a NGO and is the Premium Collection Agency (PCA) under LIC and O.P.6 a staff is attached to NGO and O.P. 5 is an another NGO and the new PCA under LIC. The further case of the petitioner is that she being allured by LIC, took up three “Jeevan Madhur” policy’s and paid monthly premiums of 34 months for each but on maturity of the said policies she claimed maturity amounts from O.P.s 1 and 2 which were refused by O.Ps 1 and 2. Being aggrieved by the deficiencies on the part of O.Ps she filed this case.
The O.Ps 1,2 and 4 jointly contested the case by filing a single written version denying the allegations made in the complaint petition and submitted that the case is not maintainable having no cause of action and also the case is barred by limitation. O.Ps further submitted that the scheme of the policy taking by the petitioner is true but the appointment of O.P. No. 3 and policy taking by petitioner is denied although consented to the fact of misappropriation of premium amount by O.P.3 and action taken for termination of O.P. 3 by LIC. O.Ps also agreed to the system of Micro Insurance Product Policies running through intermediate channels for reaching to the poorest of the poor and wherein such Micro Insurance Agent (MIA) who are also in binding as per guided laws and they are to collect premiums from policy holders and to deposit the same at LIC Divisional Office on regular basis for tracking of policy holders deposit statement by LIC and MIAs are allowed to recruit some persons at their end as intermidiataries for the fruitful operation of the whole system and also submitted that LIC terminated the said O.P.3 as per advertisement in the Telegraph and Ananda Bazar Patrika on 21.04.2014 and also initiated legal proceedings against the alleged O.P.3 and also submitted that LIC can never make any unfair trade practice and the charges leveled against O.P. 1, 2 and 4 by plaintiff is baseless, false, frivolous and therefore, prayed for dismissal of the case against LIC with cost to O.P.
O.P. 3 and O.P.5 did not appear and thus did not contest the case and they are being treated as ex parte.
O.P. No.6 has contested the case by filing a written version separately denying all allegations except admitting that he worked as a Manager of O.P.3 compelling to deposit Rs.25000/- to O.P. 3 as surety money and filed a criminal case against O.P.3 who is said to be absconded as per petitioner’s version which is not true and he is being not connected directly and indirectly to any offence, thus the case be dismissed against him.
Following issues are framed:
- Whether D.F.C. Case No. 42/2014is maintainable in its present form?
- Whether the petitioner has any cause of action to file the case?
- Whether there is any deficiency in service or unfair trade practice on the part of the O.Ps ?
- Is the complainant entitled to get any relief/reliefs as prayed for?
DECISION WITH REASONS
Issue Nos.1 2 3 & 4
All the issues are taken up together for the sake of convenience and brevity of discussion and to skip of reiteration.
In support of her case the petitioner submitted three LIC policies in the name of LIC Jeevan Madhur (with profits) Micro Insurance Product and also premium receipt of 34 months for each policy but on maturity she did not get her claim from O.P. 1 and 2 which were refused by O.P. 1 and 2 and being aggrieved by the deficiency on the part of the O.P.s she filed this case. O.Ps 1,2 and 4 contested the case denying all allegations of the complainant but admitted appointment of O.P. 3 as MIA of LIC and termination of O.P.3/MIA for misappropriation of funds tantamount to be deposited to LIC. O.P.6 filed written version denying all allegations made by complainant against him but admitting his engagement as worker of O.P.3 for the management of various jobs related to LIC policies and he also confirmed misappropriation of premium fund by O.P.3 initiating a case against O.P.3 by him but he did not inform such misappropriation act of the MIA to the principal i.e. LIC.
This Forum heard the Ld.Counsels of both the petitioner as well as the O.Ps. Ld. advocate on behalf of the petitioner argued that LIC terminated O.P.3, the accused MIA viz. UDG,HRD, Raiganj as per LICs Central Office Guidelines when they received complaints from valued customer for misappropriation of funds by O.P.3 and published advertisement for termination of O.P.3 in Telegraph and Ananda Bazar Patrika on 21.04.2014 but the question is that what LIC did before this advertisement in 2014 all though the DOC of policy is 2008. He also raised questions how common customers will know all these actions and norms and therefore, for the contract made between LIC and UDG-HRD, LIC must have liability, at least up to 21.04.2014 the date of advertisement for termination of MIA. On the other hand, O.Ps 1,2 and 4 argued for the various faults of O.P.3 which is the reason that is why the case has come and laid emphasis for not having any obligations on the part of LIC for the case of the complainant and also denied Principal – Agent relationship and preached for non-applicability of Vicarious liability of LIC for O.P. -3 but confirmed that O.P. 3 paid some premiums to LIC barring other premiums and submitted that O.P.3 cheated LIC and therefore O.P. 3’s fault is to be examined bringing O.P.3 as added party in the Forum but also LIC cannot be responsible for a person’s misdeed and there is no question of vicarious relationship between LIC and O.P. 3. O.P. 6 in his argument put up him as a staff of UDG, HRD under a sum of security deposit and he filed a criminal case against O.P.3 for her misdeed in insurer’s premium money and also left the service of O.P.3 and also prayed for relief as a party to the case.
It is a fact that the petitioner filed this case when she came to know that she has become treated as a premium defaulter for LIC and the person, to whom, she paid her all installments receiving premium receipts, had not credited all the premiums to LIC though the person was a MIA for Jeevan Madhur Micro Insurance Product Policies being powered by LIC for collecting premiums from insured persons under deed of contract between the LIC and the MIA. The petitioner and the public at large came to know noticing the advertisement wherein LIC cancelled O.P.3 as MIA as per advertisement published on 21.04.2014 related to the issue on which LIC entrusted to O.P.3 through an agreement and instructed LIC Policy Holders to deposit premium money to O.P.5 instead of O.P.3 and also mentioning cancellation of MIA power and code number of O.P.3 to be cancelled w.e.f. 19.02.2014.
It is to be noted that the agreement between the LIC and MIA is a Deed of Agreement between the LIC and that person and on the face of that agreement question appears whether LIC is bound to take responsibility as they forwarded their hand to the poorest of the poor and brought them under the same umbrella of the insurance policy through the MIA.
Ld.advocate for LIC – O.P. 1,2 and 4 tried to draw our attention by adducing several rules, acts, and regulations related to LIC functioning, viz. 1) Insurance Act, 1938 2) The Insurance Regulatory and Development (Insurance Advertisement and Disclosure) Regulations, 2000. 3) IRDA Act, 1999 4) IRDA (Licensing of Corporate Agent ) Regulations, 2002 5)IRDA (MICRO Insurance Regulation, 2005) but the very fact is that the insured, who deposit premiums, gets one receipt for each premium from the person to whom they deposited the premium for transferring to LIC as per norms, has taken that step accordingly.
LIC admits the realization of premium money for cases and also admits to make distribution of policy documents through some persons as agents. They also admit in their Agreement that LIC used to give a percentage of the premium money to the concerned agent and the code of the conduct of the person / agent is also regulated u/s. 8 of IRDA 2000 which is meant for insurance advertisement and disclosures. It is also admitted that in the said agreement they only mentioned Rule 7 related to termination of the MIA by LIC and wherein LIC have option to terminate agreement. Rules for the renewal of licence is also there.
When a person is terminated by LIC, he is surely an active agent of LIC, be it MIA or the other. The unadorned people in general will have no idea regarding the termination clause until the Insured is educated by Insurer and also bringing that in public domain because only on good faith such Insured persons purchase LIC Policy and same is true for this case also. It is an established principle that when the Insurer terminates a person as MIA they actually appointed the same person otherwise the advertisement for the termination of the person could not have appeared. It is very certain that the Insured had obviously no knowledge regarding the clauses of appointment terms for the MIA and in that situation Insured being not taught in absence of Insurance Policy Awareness Scheme and she is not generally not being an educated consumer as should be felt by LIC but there is obviously no deficiency on the part of the insured paying premium to MIA. The person O.P. 6 who claimed to be an employee of the said MIA/O.P.3 submits that he filed criminal case against O.P.3 under IPC 406 and IPC 409 but did not inform the fact of misappropriation of fund by O.P. 3 to LIC though he had the information and should have duty bound to place all facts to LIC. It is crystal clear that the premium money was collected by LIC through MIA and this person i.e. O.P.6 though not appointed by LIC but joined the band wagon as per getting appointment from O.P.3 under agreement between LIC and MIA and thus he cannot be scot free of the liabilities of the misappropriate premiums which were collected from the insured persons at large and some of the premium money deposited to LIC and some money are in the hand of such O.P. and as per the provision of law though he is not a servant of LIC but in a chain he is to act as he did not discharge duty properly for depositing money to LIC. Though Ld.Advocate for Insurance Company argued, which is also true, that LIC spread this business for reaching at giving coverage to the poorest of the poor and the grassroot level of the society, still the obligation for vicarious liability stands here positively. In certain cases the liability of one person arises for the act done by another person which is called vicarious liability. Thus when one MIA who was appointed by LIC, commits a wrong in course of performance of his duty as an agent then the reliability of the principal arises for such wrongful act of the agent, because there is an inbuilt system in LIC for tracking premium status of every insured of the LIC in the scheme. The agent is liable because he has committed the wrongful act and the principal is liable vicariously because of the Principal – Agent relationship between the two. This is also particularly true that in this age of high science and technology proper monitoring of premium datum is very easy and thus the status of the premiums paid by insured and also payment made by MIA can be judged at any time easily thus both of them can be made liable for the same wrongful act as they are considered as joint tort feasors and they are liable jointly and severally. In the instant case, the question arises whether LIC took initiative for inspection of his agent or the hands by which they spread their wing all over the country. It is certainly straight that LIC in their deed with MIA did not take any special measures and accountability clause. Thus the stand of vicarious liability is very much existing here in this case.
Further question appears that whether LIC can shirk responsibility and transfer onus on O.P.3 i.e. MIA. It also appeared from the depth of the case that LIC vehemently tried to avoid the responsibility and liability of LIC attempting to wash their hand by denying all responsibilities / things making O.P.3 fully liable for all the deficiencies brought under this case, although the policy deed showed straight relationship between the life assured and LIC. Actually, all the three persons (LIC, MIA and the worker) are tied up and they are equally liable to pay the petitioner who actually suffered a lot and paid insurance premium through fasting for the stake of security.
In view of the above discussions and findings all the issues are decided in favour of the petitioner as against the O.Ps.
In the result, the case succeeds.
Court fee, paid on the petition is correct.
Hence, ordered
that Malda D.F.C. Case No. 42/2014 be and same is allowed on contest against the O.P. Nos. 1,2,4 and 6 but with cost. and ex parte against O.P. 3 and O.P.5.
The petitioner is entitled, to receive a sum of Rs.10200/-as per the premium receipts which are served by O.P.3, from O.P.s 1, 2 and 4 and O.Ps 3 and 6 jointly and severally liable who are directed to pay the above amount to the petitioner within 60 days from the date of this order with interest @ 9% p.a. from the date of filing of this case failing the petitioner would be liberty to put the final order in execution.
A copy of this order be given to each of the parties free of cost.
