Complaint filed on: 03.02.2017
Complaint Disposed on:13.10.2017
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT CHICKMAGALUR.
COMPLAINT NO.11/2017
DATED THIS THE 13th DAY OF OCTOBER 2017
:PRESENT:
HON’BLE SRI RAVISHANKAR, B.A.L, LL.B., - PRESIDENT
HON’BLE SMT B.U.GEETHA, M. COM., LL.B., -MEMBER
HON’BLE SMT H. MANJULA, B.A.L., LL.B., - MEMBER
COMPLAINANT/S:
Sri Channakeshavaiah S.C.,
S/o Sri Channabeeraiah,
Aged about 46 years,
R/o Sindigere Village,
Lakya Hobli, Chikmagalur.
(By Sri/Smt. S.Prakash., Advocate)
V/s
OPPONENT/S:
The Superintendent,
Head Post Office,
Chikmagalur.
(Op -By Sri.C.J.Manjunath, advocate)
By Hon’ble President Sri. Ravishankar,
:O R D E R:
The complainant filed this complaint U/s 12 of the Consumer Protection Act 1986 against Op alleging deficiency in service in not paying the entire value of the policy. Hence, prays for direction against Op to pay the value of the policy along with compensation of Rs.50,000/- for deficiency in service.
2. The brief facts of the complaint is that:
The complainant had obtained Santhosh (endowment assurance) rural postal life insurance policy from Op vide policy No.R-KT-EA-928611 in the month of October 2011, the date of commencement is 4th October 2011, maturity date is 14th October 2014. As per the policy terms and conditions complainant has to pay the monthly premiums till 31.07.2014, subsequently, complainant could not paid the policy premiums for the subsequent installments due to his ill-health as he was suffering from K/C/O,CAD. Now the complainant is recovering slowly from the said illness. After recovery he approached the Op to pay the balance premiums towards the policy, but the Op refused to receive the premiums towards the policy, having no option complainant has requested the Op to pay the value of the policy, but even Op had not paid the value of the policy by closing the policy. The Op has not given any valid reasons to repudiate the claim of the complainant. Hence, Op rendered deficiency in service in not paying the value of the policy.
Complainant subsequently issued a legal notice and called upon the Op to pay the value of the policy on 09.01.2017, even inspite of receipt of the legal notice also instead of comply the notice Op replied untenably. Hence, complainant filed this complaint and prays for direction against Op to pay the value of the policy along with compensation for deficiency in service as prayed above.
3. After service of notice Op appeared through his counsel and filed version and contended that, they have issued a rural life insurance policy bearing No. R-KT-EA 928611 to the complainant, but it is false that due to his ill-health complainant could not paid the balance premium amount till maturity and it is also false that complainant approached this Op for payment of the premiums and then they repudiated the claim of the complainant.
The notice issued by complainant was suitably replied through the reply notice dated 16.01.2017.
The Op further contended that, the policy issued to the complainant is rural life insurance policy which commence from 04.10.2011 and complainant has to pay monthly premium of Rs.2,588/- for three years and maturity date of the said insurance policy was on 14.10.2014, the assured amount of the policy is Rs.1,50,000/-. The terms and conditions of the policy is binding on both complainant and Op, as per the terms and conditions of the policy the complainant had to pay regular monthly premium of Rs.2,588/-without fail for three years to get the benefits under the policy, but the complainant had paid only 34 premiums instead of 36 premiums, he had paid only up to July 2014 and not paid the remaining premiums towards the policy. Due to non-payment of the premiums policy became lapsed. Further complainant had not made any efforts to renew the policy as per the rules by giving an application to this Op by within the stipulated time of six months from the last date of premium. Further the complainant has not provided his medical certificate towards good health in order to renew the policy. Due to non-payment of the premium the policy was lapsed and as per the rules of the policy the entire premium paid by complainant has been forfeited. Hence, the request made by complainant was repudiated. The complainant is not entitled to get any claim under the policy as he had not renewed the policy within six months from the date of last premium. Hence, there is no any deficiency in service on the part of this Op in rejecting the claim of the complainant. Hence, prays for dismissal of the complaint.
4. Complainant filed affidavit and marked documents as Ex.P.1 to Ex.P.11. Op also filed affidavit and marked documents as Ex.R.1 to Ex.R.3.
5. Heard the arguments.
6. In the proceedings, the following points do arise for our consideration and decision:
- Whether the complainant is entitled to get the value of the policy?
- Whether complainant entitled for any relief & what Order?
7. Our findings on the above points are as follows:-
- Point No.1: Affirmative.
- Point No.2: As per Order below.
: R E A S O N S :
POINT NOs. 1 & 2:
8. On going through the pleadings, affidavits and documents produced by both complainant and Op, it is admitted that the complainant had obtained rural postal life insurance policy in the month of October 2011 vide policy No. R-KT-EA 928611 which matures on October 2014. It is also not in dispute that the complainant had paid 34 premiums towards the policy, but further two premiums were not paid by complainant as because the complainant underwent a treatment towards his ill-health. Complainant sworn affidavit that he suffering from heart problem since from long time and due to ill-health he was unable to pay the last two premiums towards the policy. Now he is recovering slowly from ill-health and attempted to make the payment of due premiums, but Op refused to accept the premiums and submits a deficiency in service on the part of Op.
Complainant in support of his case has produced premium receipt book marked as Ex.P.1, policy issued by Op marked as Ex.P.2, office copy of the legal notice marked as Ex.P.3, reply to the legal notice by Op marked as Ex.P.5 and hospital records marked as Ex.P.6 to Ex.P.11 to show that he was suffering from heart disease since longtime.
Op also produced specimen of policy marked as Ex.R.1 and legal notice and reply marked as Ex.R.2 and Ex.R.3 in support of their defence.
On going through the premium receipt book we observed that since from obtaining the policy the complainant was regular in paying the premiums towards policy and he had paid policy premiums up to July 2014, the premiums were paid by complainant without any breaks or belated. This clearly goes to show that he was regular in paying the premiums, but the ill-health of the complainant might be the genuine reason for non-payment of the last two premiums towards policy, which resulted in lapse of the policy. The complainant has produced Ex.P.6 to Ex.P.11 to establish that he was suffering from heart disease since long time. Hence, we are of the opinion that, the non-payment of the premiums by complainant is for just cause and on looking at the medical records the complainant still undertaking treatment. Of course, the complainant failed to pay the last two premiums towards the policy. Hence, he is not eligible to getting policy benefits, but considering his ailment and previous regular payments towards premium under ex- gratia the complainant is entitled to get entire premium amount from Op. Therefore, the Op is directed to consider the just cause given by complainant for non-payment and by ex-gratia they are directed to pay the entire premium amount to the complainant. No compensation is liable to be paid to complainant as we found there is no any irregularity on the part of Op as alleged. As such for the above said reasons, we answer the above Point No.1 and 2 in the Affirmative and proceed to pass the following:-
: O R D E R :
- The complaint filed by the complainant is partly allowed.
- Op is directed to pay the entire paid premiums under ex-gratia to the complainant within one month from the date of receipt of this order, failing which the payable amount shall carry interest @ 9% P.A. till realization.
- Send free copies of this order to both the parties.
(Dictated to the Stenographer transcribed typed by her, transcript corrected by me and then pronounced in Open Court on this the 13th day of October 2017).
(B.U.GEETHA) (H.MANJULA) (RAVISHANKAR)
Member Member President
ANNEXURES
Documents produced on behalf of the Complainant/S:
Ex.P.1 - Premium receipt book.
Ex.P.2 - Original insurance policy.
Ex. P.3 - Office copy of legal notice.
Ex. P.4 - Postal Ack. due.
Ex. P.5 - Reply to legal notice.
Ex. P.6 & 7 - Two discharge summary.
Ex.P.8 - Test Reports of complainant.
Ex.P.9 - Upper GI Scopy.
Ex.P.10 - ECG.
Ex.P.11 - Medical bills.
Documents produced on behalf of the OP/S:
Ex.R.1 - Specimen policy.
Ex. R.2 & 3 - Legal notice and reply notice.
Dated:13.10.2017 President
District Consumer Forum,
Chikmagalur.
RMA
