Punjab

Sangrur

CC/306/2016

Smt. Rashidan - Complainant(s)

Versus

The Manager - Opp.Party(s)

Shri Ajay Aggarwal

19 Sep 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

                                                             

                                                Complaint No.  306

                                                Instituted on:    25.02.2016

                                                Decided on:       19.09.2016

 

1.Smt. Rashidan wife of Satar Khan 2. Maveen alias Mubeen daughter of Sattar Khan 3. Razia Parveen daughter of Sattar Khan 4. Nazma daughter of Sattar Khan, residents of Mohalla Hazanwala, Jarg Road, Bye Pass, Malerkotla and 5. Shukria daughter of Sattar Khan now wife of Sazid Thind, resident of Dhob Ghat, Malerkotla.

                                                        …Complainants

                                Versus

1.             The Manager, Life Insurance Corporation of India, Satta Bazar, Malerkotla.

2.             The Divisional Manager, Life Insurance Corporation of India, Chandigarh.

3.             The Punjab State Power Corporation Limited, The Mall, Patiala through its Secretary/Chairman.

4.             Executive Engineer (XEN), Punjab State Power Corporation Limited, Malerkotla.

                                                        …Opposite parties

 

For the complainant  :               Shri Ajay Aggarwal, Adv.

For OP No.1&2         :               Shri Amit Goyal, Adv.

For OP No.3&4         :               Shri Mohit Verma, Adv.

 

Quorum:   Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

               

Order by : Sukhpal Singh Gill, President.

 

1.             Smt. Rashidan and other complainants (referred to as complainant in short) have preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that Nazran daughter of late Sattar Khan (referred to as DLA in short) took an insurance policy bearing number 164967259 under SSS (Salary Saving Scheme) from the Ops number 1 and 2 and the sum insured was Rs.2,00,000/- and the monthly premium was Rs.901/-. It is further averred that the premium was being deducted from the salary of the DLA by the Ops number 3 and 4 and paid to the OPs number 1 and 2.

 

2.             Further case of the complainant is that the DLA died on 24.9.2012 due to kidney failure at Hazrat Halima Hospital Malerkotla after an illness of three months. It is further averred that after the death of the DLA, the complainants lodged the claim with the OPs and completed all the formalities. It is further averred that the DLA took also two other policies under SSS scheme bearing number 162849632 and 3000820767.  Further case of the complainants is that they visited the Ops so many times to get the claim, but the claim was not paid despite serving of legal notice upon the OPs, but in the reply to notice dated 29.1.2016, the Ops intimated the complainants that “denied premium due 8/12 not paid and policy was in lapsed condition as on date of death”.  Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the OPs be directed to pay Rs.2,00,000/- on account of insurance claim along with interest @ 18% per annum and further claimed compensation and litigation expenses.

 

3.             In reply filed by the OP number 1 and 2, preliminary objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no cause of action and locus standi to file the present complaint and that the complainants have dragged the Ops into unwanted litigation. On merits, it is admitted that the DLA was insured for Rs.2,00,000/- under the policy bearing number 164967259 under the salary saving scheme under table 93-25 with date of commencement 28/11/2011. Further it is admitted that the DLA died on 24.9.2012 as per death certificate submitted by the complainants.  The case of the Ops is that premium for the months of 8/2012 and 9/2012 was not paid to the Ops by the Ops number 3 and 4, as such, the policy in question was in lapsed condition as on date of death of the DLA. It is further averred that information about the deduction of premium by Ops number 3 and 4 was sought by the OPs and OP number 4 vide letter dated 19.3.2015 has intimated that the premium for the policy in question was deducted only till the month of 7/2012 and not afterwards, hence there were two gap premiums i.e. 8/2012 and 9/2012 and the policy was in lapsed condition.  It is stated further that due to gap premiums for the months of 8/2012 and 9/2012, the policy in question was in lapsed condition, hence no claim is payable.  The other allegations levelled in the complaint have been denied in toto.

 

4.             In reply filed by Ops number 3 and 4, legal objections are taken up on the grounds that the complainant is not a consumer, that the complaint is false, frivolous one, that the complainant has no cause of action and that the complaint is not maintainable in the present form. On merits, it is admitted that the DLA was an employee of the PSPCL and Nazran get the policy from the LIC under SSS category and the policy in question was obtained by the DLA in the year 2011 and as per the policy, the Ops number 3 and 4 deposited the premium to the LIC as per policy and the last premium was paid by the Ops number 3 and 4 to LIC on 30.8.2012.  The other allegations levelled in the complaint have been denied.

 

5.             The learned counsel for the complainant has produced Ex.C-1 copy of death certificate, Ex.C-2 copy of medical record, Ex.C-3 and Ex.C-4 copies of postal receipts, Ex.C-5 copy of legal notice, Ex.C-6 copy of reply, Ex.C-7 and Ex.C-8 copies of report of policies and Ex.C-9 affidavit and closed evidence. On the other hand, the learned counsel for OPs number 1 and 2  has produced Ex.OP1&2/1 affidavit, Ex.OP1&2/2 and Ex.OP1&2/3 copies of insurance policies, Ex.OP1&2/4 and Ex.OP1&2/5 copies of intimation letter, Ex.OP1&2/6 copy of letter dated 19.3.2015, Ex.OP1&2/7 copy of certificate, Ex.OP1&2/8 copy of reply to legal notice, Ex.OP1&2/9 and Ex.Op1&2/10 copies of payment details and closed evidence. The learned counsel for the Ops number 3 and 4 have produced Ex.Op3&4/2 copy of sanction leave, Ex.OP3&4/3 copy of sanction leave memo, Ex.OP3&4/4 copy of sanction leave memo, Ex.OP3&4/5 copy of insurance policy and closed evidence.

 

6.             We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits acceptance, for these reasons.

 

7.             It is an admitted fact between both the parties that the DLA, Nazran was insured for Rs.2,00,000/- with the OPs number 1 and 2 under policy number 164967258 under the salary saving scheme and the premium of Rs.901/- was being paid to the Ops number 1 and 2 through the Ops number 3 and 4 after deduction from the salary of the DLA.  It is further an admitted fact that the DLA died on 24.09.2012, as is evident from the copy of death certificate, which is on record as Ex.C-1, whereas Ex.C-2 is the copy of case history sheet of the DLA issued by Hazrat Haleema Maternity and General Hospital.

 

8.             In the present case, the claim of the complainants is on account of death of the DLA to the tune of Rs.2,00,000/-, which has been repudiated by the OPs number 1 and 2 saying that at the time of death of the DLA, the premiums for the months of 8/2012 and 9/2012 were not paid to the Ops by the Ops number 3 and 4 and as such the policy in question was in lapsed condition, which fact is also admitted by the Ops number 3 and 4.  It is contended further by the learned counsel for the Ops number 1 and 2 that the claim has rightly been repudiated.  On the other hand, the learned counsel for the OPs number 3 and 4 has stated that the PSPCL has paid the premium upto 30.8.2012, but the Ops number 3 and 4 are silent on the point that why they did not pay the premium to the Ops number 1 and 2 and what was the actual reason for not paying the premium.  Now, the question which arises for determination before us is whether the claim is payable to the complainant or not.

 

9.             It is an admitted fact on record that the policy of the DLA was under salary saving scheme and the premium was being paid by the Ops number 3 and 4 to the Ops number 1 and 2.  It is an admitted fact on record that the Ops number 3 and 4 did not pay the premium for 8/2012 and 9/2012 and as such, the OPs number 1 and 2 repudiated the claim saying that the policy was in lapsed condition.  But, the fact remains that the DLA, who was ill at that time and was unable even to know about the fate of payment of the premium to the OPs number 1 and 2 and lastly, she died on 24.9.2012 due to kidney failure.  After carefully perusing the whole case file, we feel that the fact remains that the DLA died during the subsistence of the insurance policy, whose premium was paid upto 7/2012, whereas the premiums for the months of 8/2012 and 9/2012 were not paid by the Ops number 3 and 4 to OPs number 1 and 2.  The learned counsel for the complainant has contended vehemently that even if the employer of the DLA did not pay the premium to the LIC then in that case also, the Ops number 1 and 2 are liable to pay the death claim to the nominee. To support such a contention, the learned counsel for the complainant has cited LIC of India and others versus Krishna Devi and others 2013(1) CLT 22 (NC), wherein it has been held that the claim cannot be rejected on the ground that the insurance policy stood lapsed for non deduction and non remittance of premium of policy to the concerned office of the LIC from the salary of the husband of the complainant by PSEB.  It is further held that authority of PSEB is as an agent of the petitioners to collect the premium on its behalf through deduction from salary and then to remit to the LIC. The contention of the petitioner as regard liability of the PSEB repelled and held that the LIC would be liable to pay out on the policy in question even if the premium had not been paid due to default of the employer i.e. PSEB. It clearly shows that the claim is payable by the LIC of India.  The same is the position in the present case and we are of the considered opinion that the claim is payable to the complainant by the Ops number 1 and 2.

 

10.           Now, coming to the point that who is the nominee in the present case and who is entitled to get the claim from the OPs number 1 and 2.  Further a bare perusal of the policy on record Ex.OP1&2/2 clearly reveals that the nominee under the policy was ‘Maveen’ sister of the DLA.  As such, we feel that the claim is payable only to Maveen, who is complainant number 2 in the present policy.

 

11.           Further it is worth mentioning here that the complainant had to file the present complaint only due to the act of the Ops number 3 and 4. Had the Ops number 3 and 4 paid the premium to the OPs number 1 and 2 in time, then there was no question of filing of the present complaint by the complainant.  As such, we are of the considered opinion that the complainant is entitled to get the compensation and litigation expenses from the Ops number 3 and 4.

 

12.           In view of our above discussion, we allow the complaint and direct the Ops number 1 and 2 to pay to the complainant number 2 Ms. Maveen, an amount of Rs.2,00,000/- on account of insurance claim on account of the death of the DLA along with interest @ 9% per annum from the date of filing of the present complaint i.e. 25.02.2016 till realisation.  Further the Ops number 3 and 4 are also directed to pay to the complainant an amount of Rs.25,000/- on account of compensation for mental tension, agony and harassment and Rs.10,000/- on account of litigation expenses. 

 

13.           This order of ours be complied with within a period of thirty days of its communication. A copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                September 19, 2016.

 

                                                (Sukhpal Singh Gill)

                                                     President

                               

 

                                                   (K.C.Sharma)

                                                        Member

 

 

                                                  (Sarita Garg)

                                                         Member