BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM RAICHUR.
COMPLAINT NO. (DCFR) CC. 76/2012.
THIS THE 18th DAY OF MARCH 2013.
P R E S E N T
1. Sri. Pampapathi B.sc.B.Lib. LLB PRESIDENT.
2. Sri. Gururaj, B.com.LLB. (Spl) MEMBER.
3. Smt. Pratibha Rani Hiremath,M.A. (Sanskrit) MEMBER.
*****
COMPLAINANT :- Smt. Jamalamma W/o Shankrappa, age: 50 years, Occupation: household R/o H. no. 190 Railway quarters, Railway Station Raichur.
//VERSUS//
OPPOSITE PARTIES :- The Manager, LIC of India, Branch,
Raichur, Tq: & Dist: Raichur.
CLAIM :- For direct the opposites to pay a sum assured of 2,00,000/- with interest.
Date of institution :- 06-09-12.
Notice served :- 25-09-12.
Date of disposal :- 18-03-13.
Complainant represented by Sri. C. Pandu, Advocate.
Opposite represented by Sri. Basavaraj Sakri, Advocate.
This case coming for final disposal before us, the Forum on considering the entire material and evidence placed on record by the parties passed the following.
JUDGEMENT
By Sri. Gururaj, Member:-
This is a complaint filed by the complainant smt. jamalamma W/o Shankrappa against the Opposite U/sec. 12 of Consumer Protection Act for direct the opposites to pay a sum of Rs. 2,00,000/- with interest,
2. The brief facts of the complainant case are that, the son of the complainant by name Laxmipathi has purchased NEW BHEEMA GOLD vide Policy bearing No. 665319971 dt. 28-02-2011 for a sum of Rs. 2,00,000- from the opposite. That, after purchasing said policy and after laps of 7 months, the said Laxmipathi was died on 29/9/2011. After his death the complainant has submitted all relevant papers along with application for making payment of the sum assured under the said policy. But instead of settling the claim opposite has sent claim repudiation letter dt. 21-12-2011 by intimating denial of complainant claim on the ground that, the policy was lapsed on account of non payment of premium.
3. Further it is the case of the complainant that, it is the bounded duty of the respondent to inform about the non payment of the future premiums either to the son of the complainant or to the complainant. But, the opponent has not made so, that itself is an deficiency on the part of the opposite. If, the deceased Laxmipathi alive, he would have renewed the said policy. In his absence if the insurance company would have informed same thing to the complainant, she could have renewed the policy by paying due premiums or future premiums. The non information regarding due over the policy itself is a deficiency in service on the part of the opposite.
Further, it is also contended that, the said life assured Laxmipathi did not pay the quarter premium of Rs. 1,862/- for the period of May 2011, August 2011, and November 2011. This is clearly shows that, the life assured has failed to pay premium regularly, and also the violation of policy contract. That, made the opposite compels to reject the claim, as it was lapsed in condition for non payment of premiums.
4. Further, it is also contended that, as per the insurance company policy condition No. 2 a grace period of 1 month, but less than 30 days is allowed for payment of yearly, half yearly, and the quarterly premium. If death occurs within this grace period and before the payment of premium, then due, the policy will be still be valid and that, claim will be paid after deduction of the said unpaid premium. If premium is not paid even before the expiry of grace period, then the policy lapses. A lapsed policy is devoid of all benefits under the policy. Further it is also made very clear and also printed on the policy bond itself under clause (5) that, in case, premiums are due, the policy shall be void and all claim to any benefits, shall be ceased. Therefore, under such position of law, the opposite insurance company acted properly and the claim of the complainant is not tenable and liable to be dismissed.
5. Further it is contended that, the complaint of the complainant is liable to be dismissed on the ground that, the complaint is after gross delay of 243 days. As such, there is no deficiency in their services, the complainant is not entitled for any of the reliefs and prayed for to dismiss the complaint among other grounds along with cost.
6. In-view of the pleadings of the parties. Now the points that arise for our consideration and determination are that:
1. Whether the complainant proves that, there is a deficiency in service on the part of Respondent as alleged.?
2. Whether complainant is entitled for the reliefs as prayed in her complaint.?
3. What order?
7. Our findings on the above points are as under:-
(1) In Negative.
(2) In Negative.
(3) In-view of the findings on Point Nos. 1 & 2, we proceed
to pass the final order for the following :
REASONS
POINT NO.1 & 2:-
8. To prove the facts involved in these two points, affidavit-evidence of the complainant was filed, she was noted as PW-1. The documents Ex.P-1 to Ex.P-8 are marked.
9. On the other hand affidavit-evidence of Manager (L&HPF) of Opposite Insurance Company was filed, he was noted as RW-1. Two documents were filed, same are marked as Ex.R-1 & Ex.R-2.
10. From the pleadings of the parties and their respective evidences it is a fact that opposites have not disputed regarding the policy obtained by the son of the complainant during his lifetime from the opposite. Further it is also not in dispute that, the said Laxmipathy son of the deceased was died leaving behind the complainant as a nominee to the said policy. It is also not in dispute that, there was a due quarterly future premiums for the period of May, August & November -2011 and on that ground the claim of the complainant has been repudiated/rejected by the opposite on the ground that, the policy is/was under the lapsed condition.
11. On going through the pleadings of the parties and documents, now the question before us is that, whether the opposite has rightly repudiated the claim of the complainant on the ground that, the policy in question is under lapsed condition as the premium was due as contended by the opposite. In this regard we have perused the document Ex.P-1 = Ex. R-1 i.e, the policy of the deceased Laxmipathy wherein, it has clearly mentioned that, under the said policy the premium has to be paid quarterly i.e, on February, May, August & November in a year. Further, it is very clear that, the deceased has obtained the said policy, on 28-02-2011 and commencement of risk starts from 31-03-2011 and the premium payable dates are February, May, August & November.
12. It is the case of the opposite that, the life assured Laxmipathy was due further premiums, hence policy has been lapsed and for that, reason the claim has been rejected. In this regard, the opposite Insurance company mainly relied upon the Ex.R-2 history of premium transactions. We have gone through the said Ex.R-2 wherein it is clearly mentioned that, the deceased Laxmipathy was due from February-2011. The same fact was also admitted by the complainant in his complaint. Further it is also not in dispute that, the deceased was also due future premiums for the period of May, August & November as contended by the opposite. Further we have also perused the Ex.P-4 death certificate which speaks about the date of death of the deceased as 29-09-2011, it means with in a span of near about six months the deceased has lost his breath from the date of obtaining the policy. This fact is also not in dispute. Under the above circumstances, the rejection of the claim by the opposite on the ground that, the policy was under lapsed condition due to non payment of the premiums cannot be said that, illegal or un-called for as contended by the complainant. The complainant in her complaint contended that, the Insurance company was not informed about the due of the premiums. If they would have informed earlier she could have paid the premiums or his son could have cleared it during his life time. But this contention of the complainant cannot be accepted, because the payment of the premium is directly by the policyholder and not by way of deduction of any salary of the deceased. Under such circumstances, it is the duty of the policyholder to make the payment of the premiums wherever they are due. We do not find any reasons to believe that, the Insurance Company has to inform the policyholder regarding due of the premiums in respect of the policy in question. Further on perusal of the Ex.R-2 it is very clear that, except first premium no other premiums for the month of May, August was not paid by the deceased, though he was very much available and alive. No doubt, he died in the month of September, he was very much available for to make the payment of premiums above said dates/months premiums. Further it is not the case of the complainant that, he was paid premiums upto August month and not for the September month. On perusal of the documents of the complainant we do not find any piece of evidence to show that, even after lapse of said restricted time to make the payment the premiums, have paid within extra one month grace period. Under such circumstances, making allegation against the opposite in respect of non information about the non payment of the premiums holds no water. Hence, we have rejected the claim of the complainant.
13. We have perused the rulings of our own State Commission submitted by the opposite in support of this case. The Hon’ble State Commission in Appeal No. 2659/2008 in LIC V/s. Smt. Ambika & Others case by referring the Hon’ble National Commission Case reported in CPJ 156 NC of Insurance Corporation of India V/s. Prasad Dash (Dr) case, it is held that, “when the policy was in lapsed condition, the complainants are not entitled for the refund of the premium paid by the insured. In the present case also there was a due in making the payment of premiums and on the same ground the opposites have rejected the claim as per the clause 45 of Insurance Act of 1938. Hence, we have accepted the dictum laid down under the rulings of Hon’ble State Commission and rejected the claim of the complainant. Further we have also rightly appreciated the act of the opposite as they were right enough to reject the claim of the complainant as it is under lapsed condition. Hence, we have answered Point No-1 in negative.
POINT NO.2:-
14. The complainant failed to prove the fact involved in Point No-1 and thereby he is not entitled for to get any one of the relief’s as prayed in this complaint, accordingly we answered Point Nos.1 & 2 in Negative.
POINT NO.3:-
15. In view of our findings on Point Nos. 1 & 2, we proceed to pass the following order:
ORDER
This complaint filed by the complainant against opposite is dismissed.
Intimate the parties accordingly.
(Dictated to the Stenographer, typed, corrected and then pronounced in the open Forum on 18-03-13)
Smt.Pratibha Rani Hiremath, Sri. Gururaj Sri. Pampapathi,
Member. Member. President,
District consumer Forum Raichur District consumer Forum Raichur District consumer Forum Raichur
*PRL*
