Per Shri P.N. Kashalkar, Hon’ble Presiding Judicial Member
This is an appeal filed by org. complainant whose complaint was dismissed by the District Consumer Disputes Redressal Forum, Central Mumbai by passing judgement in consumer complaint No.59/1998 on 22/05/2000.
2. The facts to the extent material may be stated as under :-
The complaint was filed by appellant for claiming death claim under policy No.880371746 with interest @ 24% p.a. from the date of intimation of the death till the actual payment. According to the complainant, she is mother of deceased Shri Dilip Raghuvir Prabhu, who died under tragic circumstances on 18/09/1996 at Kalyan and Police had registered offence under Section 302 of IPC. The complainant pleaded that during his lifetime, Dilip Raghuvir Prabhu had insured his life under Money Bank Policy with Profit on 01/07/1995 with assured sum of `50,000/-. Half-yearly premium of `1,394/- was paid by the assured to the LIC. After acceptance of first premium receipt, opponent delivered policy on 09/02/1996 to the assured. Second half-yearly premium was due on 01/01/1996. Said Dilip Raghuvir Prabhu did not receive premium notice for the same. Father of the deceased deposited amount of `1,394/- with opponent on 06/02/1996 as per the Challan given by the opponent. Father of the deceased inquired with opponent about non-receipt of premium notice. However, opponent did not inform the deceased policy holder nor did they issue the official receipt till his death and also did not refund excess amount of `45/-. Meanwhile, Mr.Dilip Raghuvir Prabhu died on 18/09/1996. On 24/09/1996 the complainant informed the opponent about death of said deceased assured and also informed that she was nominee under the policy. On 27/09/1996 she submitted original policy, death certificate, claimant’s statement to the opponent. Opponent, however, by letter dated 28/09/1996 informed the complainant that the half-yearly premium due on 01/07/1996 was not paid within grace period and the policy was not in force for minimum period of two years since it was issued on 01/07/1995. Therefore, no amount could be payable to the complainant. Complainant sent another letter dated 26/10/1996 and informed the LIC that policy was not issued in time. She had not received premium notice for the premium due on 01/01/1996. Therefore, they had paid the premium on 06/02/1996 personally. According to the complainant, in the receipt issued by the LIC it was wrongly mentioned that they had received `1,394/- instead of `13,49/-. Opponent in turn sent a letter on 06/11/1996 informing the complainant that the excess amount of `45/- would be refunded shortly. However, till the date they had not refunded said amount. They also alleged that the complainant did not make payment due on July 1996 under said policy and therefore, policy had lapsed. According to the complainant, neither she nor deceased had ever received notice from the LIC after payment of installment of January 1996 made by the complainant. The complainant therefore, pleaded that the LIC was guilty of deficiency in service in not issuing notice in advance asking policy holder to pay premium which was due on 01/07/1996 and since the notice was not issued they had deposited the amount on 06/02/1996 for the premium due on 01/01/1996 and in fact opponent had not refunded amount of `45/- to the complainant. Therefore, they filed consumer complaint and claimed a sum assured under the policy.
3. Opponent filed written version and admitted that deceased son of complainant had insured his life under the Money Bank Policy No.880371746 for `50,000/- and receipt was issued on 15/09/1995 for the premium of `1,394/-. In the said receipt it was clearly stated that next due date of premium was 01/01/1996. The policy holder was aware that next premium was due on 01/01/1996. He had agreed to pay half-yearly premium of the said policy, so, deceased policy holder was knowing that after interval of every six months, he has to pay premium amount. Opponent admitted that the policy document issued on 09/02/1996 mentioned the correct premium amount of `1,349/- and in para 2 of the said policy under caption payment of premium, it was stated that grace period was allowed under the policy for payment of premium. According to the opponent, contention of the complainant that premium notice was not issued is baseless. In as much as, in the policy document it was clearly mentioned that half-yearly premium payable was `1,349/-. It also pleaded that since the premium was received after the days of grace, late fee was chargeable and `34.88 was to be refunded to the claimant and same was refunded vide cheque No.123867 dated 30/09/1998. Opponent denied that the policy holder did not receive premium notice. Opponent pleaded that due date of premiums were shown in the policy schedule and sending of notice was not obligatory on the part of the opponent. Since, half-yearly premium due on 01/07/1996 was not paid within grace period by the policy holder, policy was in lapsed condition. Opponent pleaded that they are not liable to make payment of death claim under the policy to the complainant being nominee because the policy was in lapsed condition due to non-payment of premium. Therefore, it pleaded that it was not guilty of deficiency in service and prayed that complaint should be dismissed with costs.
4. District Consumer Forum on considering the affidavits and documents placed on record and relying on the terms and conditions of the policy held that it was not obligatory on the part of the LIC/opponent to send notice of premium to the life assured because life assured was knowing that this is a policy purchased by him with half-yearly premium payable under the policy. Premium amount was `1,349/-. Next installment payable was on 01/07/1996 and within grace period the premium could have been paid i.e. upto 01/08/1996, but premium was not paid on or before 01/08/1996 and life assured died on 18/09/1996. District Consumer Forum held that the policy was rightly held to be in lapsed condition on account of non-payment of premium due on 01/07/1996 and as such, nothing was payable by the LIC since the lapsed policy was not got revived during the life time of the life assured. In the circumstances, District Consumer Forum noted that for want of payment of premium, policy was in lapsed condition when the life assured had died and therefore, District Consumer Forum agreed with the contention of the LIC that no death claim can be paid to the nominee of the policy holder since the policy was in lapsed condition. LIC therefore sent repudiation letter rightly on 06/12/1996 about the same. As such District Consumer Forum found that the complaint was devoid of any substance and it was pleased to dismiss the complaint. Aggrieved by this dismissal, org. complainant has filed this appeal.
5. This appeal was pending in this Commission on sine-die list. We have taken out it from sine-die list and have issued notices to both the parties on 25/07/2011 and matter was kept today for hearing. Mr.Mahendra Vaze, Administrative Officer of the LIC is present. None appeared for the appellant. Therefore, we perused the impugned judgement and appeal memo and other documents on record. We are finding that the deceased life assured had taken policy No.880371746 from the LIC on 01/07/1995 for the assured sum of `50,000/-. As per policy, deceased had agreed to pay premium of `1,349/- half-yearly. Next half-yearly premium was due on 01/01/1996 and within grace period premium should have paid on or before 01/02/1996, but according to the appellant, opponent/LIC delivered said policy on 09/02/1996 in which the half-yearly premium was shown as `1,349/- and second half-yearly premium was due on 01/01/1996. Since deceased did not receive notice from LIC about the premium payable on or before 01/01/1996, deceased did not make the payment, but father of the deceased deposited the amount of premium on 09/02/1996. In the meanwhile, deceased died on 18/09/1996. The death of the policy holder was intimated to the LIC, but LIC repudiated the claim on the ground that the policy was in lapsed condition after 01/07/1996 and therefore, nothing was payable to the nominee of the deceased policy holder. According to the appellant she had sent revival letter to the opponent/LIC, but opponent turned down to revive the policy and asserted that since the policy was in lapsed condition when the policy holder died, policy cannot be revived and no payment towards death claim under said policy could be made to the appellant.
6. We are finding that the District Consumer Forum has rightly dismissed the complaint since the deceased policy holder had not paid second premium under the policy on or before 01/07/1996. According to the LIC, receipt issued for the policy to the deceased policy holder dated 15/09/1995 clearly stipulated that next due date of the premium was 01/01/1996. So, deceased policy holder was having notice in terms of first premium receipt dated 15/09/1995 that next due date for half-yearly premium was payable on 01/01/1996 and despite knowing this fact the premium due on 01/01/1996 was not paid on behalf of life assured, but same was deposited only on 06/02/1996. For quarterly, half-yearly premium under the Rules & Regulations of the LIC, grace period of one month is available after the due date. Due date under this policy was 01/01/1996 for payment of next installment of the premium, but it was paid on 06/02/1996 i.e. 5 days after the grace period was over. Moreover, next premium due for the said policy was on 01/07/1996, which was not paid by the policy holder within grace period and therefore, policy was in lapsed condition within two years from the date of issuance of policy. We are therefore finding that since the policy was in lapsed condition on the day when the deceased had expired i.e. 18/09/1996 LIC rightly repudiated the claim by sending letter to that effect and District Consumer Forum had rightly dismissed the complaint on this ground alone. We are finding no substance in the appeal preferred by the org. complainant. Hence, we pass the following order :-
-: ORDER :-
1. Appeal stands dismissed.
2. No order as to costs.
3. Copies of the order be furnished to the parties.
Pronounced
Dated 29th August 2011.
