IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Saturday the 16th day of June, 2018
Filed on 17.11.2017
Present
1. Sri.E.M. Muhammed Ibrahim , BA,LLM (President)
2. Sri. Antony Xavier (Member)
3. Smt. Jasmine D (Member)
in
CC/No.307/2017
Between
Complainant:- Opposite parties:-
Smt.V.Soorya, 1. The Divisional Manager
D/o D.Mini, represented by Ernakulam, Divisional Office
Father Vasavan, LIC of India, P.B.No. 1133,
Residing at Mattathi Veedu, Jeevan Prakash, M.G.Road,
Muhamma P.O., Ernakulam- 682011
Alappuazha.
(By Adv.P.V.Satheesh) 2. The Manager,
LIC of India Branch No.2
Kidangamparambu
Alappuzha- 688013
(By Adv. Devalal)
ORDER
SMT. JASMINE D. (MEMBER)
This case based on the complainant filed by Smt. Soorya against two opposite parties under section 12 of the Consumer Protection Act, 1986. The averments in complaint in short are as follows.
2. The complainant’s mother had two policies with the opposite parties bearing numbers 395169566 and 395169567 and the policy holder was died on 16-10-2015. Complainant is the nominee in both the policies. The complainant approached the second opposite party through agents on several times and placed all the relevant record for claiming the policy benefit but the opposite parties informed that the said policies were lapsed due to non payment of premium and hence claim cannot be entertained. As per the policy records the policy holder had paid premium amounting to Rs.21,344/- in policy No. 395169566 and Rs.28,689/- in policy No. 395169567. According to the complainant she is entitled to get the paid up value of the policies, since the opposite parties do not process the claim the complainant has issued a lawyers notice to the opposite parties. But the opposite parties in their reply notice stated that since the policies were lapsed the complainant is not entitled for any claims. The act of the opposite party caused much mental agony to the complainant and hence filed this complaint.
3. The opposite party resisted the complaint by filing detailed version raising the following contentions.
It is true that D.Mini, Mattathil Veedu, Muhamma was the holder of two policies bearing numbers 395169566 and 395169567 issued by LIC of India. The policies were issued on 06-12-2010 under Jeevan Saral Plan (Plan 165). The term of both policies is 20 years and the Sum Assured for each policy is Rs.2,50,000/-. The mode of payment of premium is quarterly and the last premium instalment remitted was on 06-09-2012. The next instalment was due in 12/2012, which was not paid. The policy holder expired on 16-10-2015. Both the policies were in lapsed condition since 12/2012, as no premium was paid to keep the policies in force, both the policies were in lapsed condition as on date of death and nothing is payable under the policies. As the premium were paid only for 2 years both policies do not have any paid up value as per the policy condition. The policy attends paid up value if and only at least 3 fully years premiums have been paid. In the instant case the premiums were paid only for 2 years and thereafter discontinued. As a result the policies were lapsed without any paid up value. Further, in the schedule to the policy it has been clearly spelt out that death benefit sum assured will be payable provided the policy is in full force on the date of death. As the policies were lapsed from December 2012 itself, no amount is payable under the policies. Hence no amount is liable to be paid to the nominee on any account with respect to the two policies. There is no defect or deficiency in service and the complainant is not eligible for any relief. The death claim was rightly rejected by the opposite parties. This was explained in detail in the reply dated 14-10-2016 to the advocate notice. It is further submitted that the Life Insurance Corporation of India is a statutory Corporation, an instrumentality of the State, dealing with the public money and the officers and employees are to abide by the terms and conditions of policy while dealing with claims and they are bonafidely implementing the conditions in the policy with utmost good faith doing justice to the customers and at the same time protecting public interest. On processing the claim the opposite party has not done anything illegal and there is no deficiency in service or unfair trade practice on the part of opposite parties and hence the complaint may be dismissed.
4. In view of the above pleadings the points that arise for consideration are:-
(i) Whether there is any deficiency in service on the side of the opposite party.
(ii) Whether the complainant is entitle to get compensation and costs as prayed for.
5. Point No. I & II
Point number 1 and 2 can be considered together. According to the complainant the complainant’s mother Late Smt.Mini had two policies with the opposite party and in both the policy the complainant is the nominee. After the death of the policy holder the complainant claimed for policy benefits but they rejected the claim stating that the policy were lapsed due to non payment of premiums.
6. Complainant was examined as PW1 and documents Ext.A1 to A5 series are marked. Ext.A1 is the copy of policy bearing No. 395169566. Ext.A2 is the copy of policy bearing No. 395169567. Ext.A3 is the copy of legal notice issued to the opposite parties dated 1-10-2016. Ext.A4 is the registered dated 14-10-2016. Ext.A5 series is the statement issued by the opposite parties. The opposite party produced 2 documents which are marked as Ext.B1&Ext.B2. Ext.B1 is the original policy bearing No.395169567. Ext.B2 is the original policy with terms and conditions bearing No. 395169566.
7. Admittedly the policy was taken in the year 2010 and the mode of payment of premium is quarterly and the last premium remitted on 06-09-2012 and the next premium was due on December 2012. But there after no premiums were remitted in both the policies and both the policies become lapsed from December 2012 onwards and no effort has been made by the policy holder to revive the policy. The policy holder has died on 16-10-2015 so the said policies were not live at the time of the death of the policy holder and the policy holder is well aware of the fact.
The specific case of the complainant is that the policy holder was remitted an amount of Rs.21,344/- in policy No.395169566 and an amount of Rs.28,689/- in policy No. 395169567 and the complainant being nominee in both the policies is entitled to get the refund of the premiums paid. According to the opposite party since the policy holder has not remitted the premiums for at least 3 years period they could not provide any policy benefits to the complainant. No where it mentioned under what circumstances the policy holder could not remit the subsequent premiums. On going through Ext.B1 & Ext.B2 policy conditions there is no provision for such refund of premium paid. It is pertinent to note that the policy holder has not made any effort to revive the policy and also no reason was explained for non payment of subsequent premium. As per clause No.4 and 7 of Ext.B1 & B2 policy conditions the policy holder is not entitle for any paid up value or surrender value if the premiums has not
been paid for at least 3 years. Nothing is on record to show that any provision exist for refund of premium of a lapsed policy. According to the opposite party the insured enjoyed the risk coverage when the policy was in existence. The policies were lapsed without remitting the premium for at least 3 years. On going through the entire documents placed before us we cannot see any deficiency in service on the part of the opposite parties. Hence we find no merit in the compliant and the same is only to be dismissed.
In the result the complaint stands dismissed. Parties are directed to suffer their respective costs.
Dictated to the Confidential Assistant, transcribed by her corrected by me and pronounced in open Forum on this the 16th day of June 2018.
Sd/-Smt. Jasmine.D. (Member) :
Sd/-Sri.E.M.Muhammed Ibrahim (President)
Sd/-Sri. Antony Xavier (Member) :
Appendix:-
Evidence of the complainant:-
PW1 - V.Soorya
Ext.A1 - Copy of policy bearing No.395169566
Ext.A2 - Copy of policy bearing No.395169567
Ext.A3 - Copy of legal notice, dated 1-10-2016
Ext.A4 - Registered, dated 14-10-2016
Ext.A5series - Statement issued by the oppo. parties
Evidence of the opposite parties:-
Ext.B1 - Original policy certificate with conditions- Policy No. 395169567
Ext.B2 - Original policy certificate with conditions- Policy No. 395169566
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite parties/S.F.
Typed by:- Sa/-
Compared by:-
