Complaint filed on: 14-03-2023

                                                      Disposed on: 13-09-2023

BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION, TUMAKURU

DATED THIS THE 13^th DAY OF SEPTEMBER 2023

PRESENT

SMT.G.T.VIJAYALAKSHMI, B.Com., LLM., PRESIDENT

SRI.KUMARA.N, B.Sc. (Agri), LL.B., MBA., MEMBER

SMT.NIVEDITA RAVISH, B.A., LL.B.(Spl)., LADY MEMBER

Consumer Complaint No. 35/2023 

Shri. Sunil M.N. A/a 30 years,

S/o Late Narasimhamurthy M.N.

Resident of Muniyur Village at Post,

Kasaba Hobli, Turuvekere Taluk,

Tumakuru District.

(By Sri.N.Basavaraju, Advocate)

V/s

1.       The Manager ( P & GS Unit)

          LIC of India,

          2^nd Floor, Popular Building, K.S. Rao Road,

          Mangalore.

2.       The Manager, Karnataka Bank,

          Dabbeghatta Road, Turuvekere Town.

3.       Pradhan Mantri Jeevan Jothi Bima Yojana,

          (PMJJBY) Life Insurance, Turuvekere,

          Under Karnataka Bank, Turuvekere.

(OP No.1 – Served – Absent)

(OP No.2 – By Sri. M.C.Prabhu, Advocate)

(OP No.3 – By Sri. A.C.Mamatha, Advocate)

:O R D E R:

BY SMT.NIVEDITA RAVISH –  LADY MEMBER

            This complaint is filed by the complainant Under Section 35 of Consumer Protection Act, 2019 against the Opposite Parties to direct them to pay a sum of Rs.2,00,000-00 (two lakhs only) as per Pradhan Mantri Jeevan Joti Bima Yojana (PMJJB) Scheme along with interest towards mental agony suffered by the complainant with cots.

2.        The First Opposite party is the Manager (P and G.S Unit) LIC of India Mangalore (hereafter called as OP No.1). The Manager, Karnataka Bank, Turuvekere is the Second Opposite Party  (hereinafter called as OP No.2). The third opposite party is Pradhan Mantri Jeevan Jyothi Bima Yojana (PMJJBY) Life Insurance, Turvekere (hereinafter called as OP No.3).

3.        The case of the complainant is that, late Shri Narasimhamurthy M.N S/o Narashimaiah, father of the complainant has submitted Consent Cum Declaration Form to OP No.2 for Pradhan Mantri Jeevan Jyothi Bima Yojana (hereinafter called as PMJJBY) by paying Rs.330-00 and same Rs.330-00 was transferred from bank account of complainant’s father on 14-07-2016 towards premium to PMJJBY to OP No.1 and last premium amount transferred to OP No.1 on 26-5-2021. Father of the complainant died on 27-1-2021 and the complainant, who is the nominee of late shri Narashimamurthy, submitted the claim form for claiming death benefit of Rs.2,00,000-00 under PMJJBY to OP No.2. The complainant was surprised to receive letter from OP No.1 stating that, premium amount for the year 2019-2020 was recovered on 19-07-2019 i.e., after renewal date i.e, 01-06-2019 and it is treated as new date of joining i.e., 19-07-2019 and further, age of late Shri Narashimamurthy was 51 years 6 month 18 days, hence deceased was not eligible to join under the said scheme. Though the complainant has wrote letter on 18-6-2021 to OP No.1 as stating that, the OP No.2 has deducted the premium amount premium for every year from 14-07-2016 towards PMJJBY, the OP No.1 or OP No.3 has not settled the claim. Hence, this complaint.

4.        After receipt of notice from this commission OP No.1 has remained absent and OP No.2 and OP No.3 were appeared before this Commission with their respective counsels and filed their respective versions.

5.        OP No.2 has admitted that,  Rs.330-00 was deducted every year from 14-7-2016 from the complainant father’s account and further submitted that, OP No.2 has send the premium of amount of Rs.330-00 for PMJJBY to OP No.1 and 3. Further submitted that, the OP No.2 is the played only the intermediatory role and when the father of complainant was aged as 51 year 6 months 18 days as on 19-7-2019, the OP No.1 and 3 should repay the premium amount to account of complainant’s father. The OP No.1 and 3 were did not do the same and kept the premium amount with themselves. Hence, OP No.2 has submitted that there is no any deficiency of service on the part of OP No.2 and prayed for dismissal of the complaint against the OP No.2.

6.        OP No.3 has also admitted about premium paid amount every year from 14-7-2016 from account of complainant’s father and denied all other allegations made by the complainant as false. Further OP No.3 has submitted that, as per eligibility criteria maximum age for new enrollment is 50 years nearer birthday and premium for the year 2019-2020 (Annual Renewal year 1-06-2019 to 31-05-2020) was not auto debited by the OP No.2 in time i.e., before 31-05-2019 and also not within the grace period (i.e., from 01-06-2019 to 30-06-2019). The premium was deducted later on 19-7-2019. i.e.,  after the annual renewal date of 01-06-2019. And it considered as new entry for the scheme. Further OP No.3 has submitted that, on new date of joining i.e., 19-07-2019 the person was 51 years 6 months and 18 days as per the age proof submitted by the OP No.2. Hence complainant’s father was not eligible to enter in to the scheme as per the conditions of the scheme. Further OP No.3 has submitted that they were acted as per the rule and regulations framed as per the Memorandum of Agreement. Hence, OP No.3 has prayed for dismissal of the complaint against OP No.3.

7.        Complainant filed his affidavit evidence with fourteen documents, which are marked as Ex.C1 to Ex.C14. One Shri Subramanya Prabhu, Branch Manager of OP No.2 has filed his affidavit evidence on behalf of OP No.2 with one document which is marked as Ex.R2 and one Smt.M.N.Meenakshi, Administrative Officer, legal Department. LIC of India, Benglore Division filed her affidavit evidence on behalf of OP No.3 with one document which is marked as Ex.R1.

8.        We heard the arguments of complainant counsel and respective counsels of OP Nos.2 and 3. Peruse the written arguments filed by OP Nos. 2 and 3.

9.        The points that would arise for determination are as hereunder:-

1. Whether complainant proves the deficiency of service on the part of OP Nos.1 to 3?

2. Is complainant entitled to the relief sought for?
10.       Our findings on the aforesaid points are as under:

Point No.1:  Partly affirmative?

Point No.2: Affirmative, as per the final order

                        for the following;

:REASONS:

Point Nos.(1) & (2):-

11.      Counsel for the complainant has argued that, the Shri.Narasimhamurthy.M.N S/o Narashimaiah, father of the complainant has taken/purchased the Policy No.90010036 from OP No.1 and 3 by submitting the Consent-Cum-Declaration form to OP No.2 by paying premium amount Rs.330-00 on 14-7-2016. The same was admitted by the all OPs and Ex.C1/ copy of the Consent-Cum-Declaration form, Ex.C2/ copy acknowledgment slip cum certificate of insurance reveals the same. Further the counsel for the complainant has argued that, the OP No.2 has deducted Rs.330-00 from the account of the complainant’s father every year from 14-7-2016 to 26-5-2021. OPs are admitted this arguments of the complainant and Ex.C12/ bank account statement of the complainant’s father reveals that Rs.330-00 was deducted towards PMJJBY insurance premium every year from 14-7-2016 to 23-6-2022. Further counsel for the complainant has argued that, the complainant’s father, Shri.Narasimhasmurthy died on 27-01-2021 and Ex.C3/ copy of the death certificate of Shri.M.N Narasimhamurthy establishes the same. Further counsel for the complainant has submitted that, the complainant who is the nominee of his father for PMJJBY insurance policy was submitted the claim form for death benefit of his father under PMJJBY. Ex.C1/ copy of the consent-Cum-Declaration Form reflecting that, the complainant is the nominee of said policy and Ex.C4/ copy of claim form establishes that, the complainant has submitted claim form to OP No.1 and 3 through OP No.2. Further the counsel for the complainant has argued that, the OP No.1 has repudiated the claim of the complainant and wrote letter on 24-4-2021 by stating that, the premium amount for the year 2019-2020 was recovered on 19-7-2019 was treated as new date of joining and as on new date of joining i.e., 19-7-2019, the age of complainant’s father was 51 years 6 months 18 days, hence deceased was not eligible to join under the said scheme. Ex.C5/ copy of the letter Ref:P&GS/PMJJBY/POL NO.900100036 establishes the same. Further counsel for the complainant has argued that, it is the duty of the OP No.2 to send premium every year promptly to OP No.1 and it is the duty of the OP No.1 and 2 to provide benefit under the insurance policy when premium of was deducted every year regularly.  

12.      Counsel for OP No.2 has admitted about insurance policy under PMJJBY taken/purchased by complainant’s father late Shri. M.N Narsimhamurthy and also admitted that, the premium of Rs.330-00 was debited automatically every year from 14-07-2016 to 26-05-2021. Further counsel for the OP No.2 has submitted that, every premium amount was being transferred to the OP No.1 by OP No.2. Ex.C13/ copy of amount transferred details of OP No.2 bank, produced by the complainant and Ex.R2/copy of amount transaction of complainant’s father’s account in OP No.2 bank are establishing that the OP No.2 has send premium amount of Rs.330-00 towards PMJJBY to OP No.1 and 3. Further counsel for OP No.2 has admitted that, the complainant, who is the nominee for insurance policy of PMJJBY of his deceased father, submitted claim form during the month of March 2021 claiming death benefit of Rs.2,00,000-00. Further counsel for the OP No.2 has submitted that, OP No.2 has sent claim form along with relevant documents to OP No.1 through OP No.3. Ex.C4/ copy of the claim form, Ex.C5/ copy of letter from P and GS unit Mangalore of OP No.1 and 3, produced by the complainant proves the same. Further counsel for the OP No.2 has argued that, OP No.2 has played intermidiatory role in this transaction and OP No.2 has acted properly by sending all premium amount of OP No.1 through OP No.3, hence OP No.2 has not done any deficiency in service and further counsel for OP No.2 has argued that, though collecting premium amount from complainant through account maintained in OP No.2 bank, the OP No.1 and 3 were not settle the claim of the complainant. Further argued that, it is the duty of only OP No.1 and 3 to settle the insurance claim and not the duty of the OP No.2.

13.      In contrary counsel for the OP No.3 has argued that, PMJJBY scheme covers eligible individual lives having bank account and as per eligibility criteria maximum age for new enrollment is 50 years nearer birthday. Point No.A(a) of Ex.R1/ copy of the Memorandum of understanding establishes same by explaining as “NOW THIS MEMORANDUM OF UNDERSTANDING WITNESS AS UNDER: (A) LIC will provide following under the scheme:- A life cover of Rs.2,00,000/- only on death to the Saving Bank Account holder of the bank, subject to the following conditions:- (a) Saving bank account holders should be aged between 18 years (completed) and 50 years (age nearer birthday) on the date of enrollment”. Further, counsel for the OP No.3 has argued that, premium for the year 2019-20 (Annual Renewal year 1-06-2019 to 31-05-2020) was not auto debited by the OP No.2 in time i.e., before 31-05-2019 and also not within the grace period (i.e., from 01-06-2019 to 30-06-2019) and the premium was deducted later on 19-07-2019 i.e., after the annual renewal date (ARD) of 01-06-2019. Ex.C2/ copy of bank account statement of complainant’s father Ex.C13/ copy of transfer details from bank account of complainant’s father produced by the complainant, Ex.R2/ copy of transfer details from bank account of complainant’s father produced by the OP No.2 are establishing that, the premium for Rs.330-00 for year 2019-20, has deducted by the OP No.2 from the account of complainant’s father on 19-7-2019 and transferred to OP No.1 through OP No.3 on the same day. As per point No.A(f) in page No.2 and details of “Renewals” under point No.B in page No.3 of Ex.R1/ copy of the Memorandum of understanding, produced by the OP No.3 revealing that, date of renewal for premium is 1^st June of every year. Further counsel for the OP No.3 argued that, on new date of joining i.e., 19-7-2019, the complainant’s father late Shri. M.N. Narashimahamurthy was 51 years, 6 months, 18 days as per the age proof submitted by OP No.2. Hence the father of the complainant was not eligible to enter in to the scheme as per the condition of the scheme. On perusing the Ex.C14/ copy of the school Transfer Certificate issued to complainant’s father, it is reflecting that, the date of birth of the complainant’s father is 19-06-1969. Hence, it confirms that, on 19-07-2019 the father of the complainant has crossed the age 50.

14.      On perusing the Ex.R1/ copy of Memorandum of Understanding it is reveals that, this conditions of this MOU are agreed between Life Insurance Corporation (OP No.1 and 3) and OP No.2. The policy holders of the PMJJBY were not aware about conditions which are agreed between OP No.1, 3 and OP No.2.  point No.A(f) in page NO.2 of Ex.R1 reads as “The Annual Premium of Rs.330-00 or any amount as decided from time to time (plus service tax, if applicable) per member per annum, is to be deducted and remitted by the Bank to LIC on annual renewal date, i.e. June 1^st every year. Change in Premium, if any, will be intimated to the Bank by LIC before Annual Renewal date.     Hence, as per above condition the OP No.2 should deduct and remit the premium amount of Rs.330-00 to OP No.1 and 3 before or on 1^st June every year. But in this case the OP No.2 has debit and remit the premium amount on 19-7-2019 for the year of 2019-20. Ex.C2/ copy of Bank account statement showing that, there was sufficient balance in the account of complainant’s father. Though there was sufficient balance in the account  of the policy holder, the OP No.2 has deduct and remit the premium amount to OP No.1 and 3 with delay of 49 days from last day of renewal of insurance for the year 2019-20.    Further point No.D(2) of Ex.R1 reads as: “Termination of assurance: The assurance on the life of the member shall terminate on any of the following events and no benefit will become payable there under:

(2) Closure of account with the Bank or insufficiency of balance to keep the insurance in force.

Bank shall remit the premium on or before 30^th of June every year, failing which the insurance will cease”.   Hence, as per above condition the OP No.2 should remit the premium amount before 30^th of June every year, which was not done by OP No.2 for the year of 2019-20 in the complaint’s father’s case. Further point No.E in page No.4 of Ex.R1 is reads as, “Reinstatement of Insurance Coverage:- If the Insurance cover is ceased due to any technical reasons such as insufficient balance to keep the insurance in force on due date or due to any administrative issues, the same can be reinstated on receipt of premium during the grace period and a satisfactory statement of good health”. As per above condition OP No.1 and 3 were given assurance about reinstated on receipt of premium during the grace period and a satisfactory statement of good health. Counsel for the OP No.2 has submitted that,  the premium of complainant’s father for year 2019-2020 was deducted and remitted on 19-07-2019, after grace period by technical problems in auto debit system. But OP No.2 has failed to produce to any document to show that, whether OP No.2 has informed about technical problems which occurs during renewal period for 2019-2020 to OP No.1 and 3 and it is the duty of the OP No.2 to correct the technical problem in time. Hence we do not found any deficiency in service on the part of OP No.1 and 3. Hence complaint is liable to be dismiss against OP No.1 and 3.   

15.      The memorandum of understanding of PMJJBY (Ex.R1) was agreed and executed in between OP No.1 and OP No.2.  The policy holders of PMJJBY have not been aware about the terms and conditions of the said MOU.  The complainant’s Father, who was the policy holder of PMJJBY has given consent cum declaration on believing OP No.2.  the OP No.2 should follow the terms and conditions of the MOU.  The OP No.2 has violates the conditions by sending the premium of complainant’s Father after grace period for the renewal of the policy of the complainant’s Father for the year 2019-20.   If OP No.2 would have sent the premium amount to the OP No.1 and 3 in time i.e. before 01.06.2019 or in between grace period i.e. 30.06.2019, then complainant’s father had been remained eligible person for the said policy. The complainant’s father was become not eligible person for negligent act of the OP No.2. Hence, OP No.2 is liable for the loss occurred to the complainant as nominee of his deceased father’s PMJJBY policy benefit. Hence OP No.2 shall liable to pay the Rs.2,00,000/- which is the benefit under the PMJJBY insurance policy with interest @ 8% p.a from the date of repudiation of the claim of the complainant i.e., 21-4-2021 till the payment to the complainant.  By considering the mental agony caused to the complainant and deficiency of service, the OP No.2 is liable to pay the compensation of Rs.5,000-00 to the complainant.  Further OP No.2 has compelled the complainant to approach this commission, hence, OP No.2 shall liable to pay Rs.10,000-00 as litigation cost to the complainant. Accordingly,

:ORDER:

The complaint filed by the complainant is allowed against the OP No.2 with cost.

The complaint against OP No.1 & 3 is dismissed.

It is directed that OP No.2 shall pay Rs.2,00,000-00 (Rs.Two lakhs only) to the complainant with interest at 8% p.a from 21-04-2021 till the payment.

 It is further directed that OP No.2 shall pay compensation of        Rs.5,000-00 and litigation cost of Rs.10,000-00 to the complainant.

The OP No.2 is further directed to comply the above order within 45 days from the date of receipt/knowledge of this order. 

Furnish copy of this order to both parties at free of cost.