State Consumer Disputes Redressal Commission
Lic Of India, Cooch Behar Branch & Ors. vs Shri Bhajan Barman, Son Of Shri Paresh ... on 7 May, 2013
State Consumer Disputes Redressal Commission State Consumer Disputes Redressal Commission West Bengal BHABANI BHAVAN (GROUND FLOOR) 31, BELVEDERE ROAD, ALIPORE KOLKATA 700 027 S.C. CASE NO FA/425/2012 (Arisen out of Order Dated 31.05.2012 in Case No.CC/52/2011 of District Cooch Behar DF, Cooch Behar) DATE OF FILING :24.07.2012 DATE OF ORDER: 07.05.2013 APPELLANTS : 1. LIC of India, Cooch Behar Branch, represented by Branch Manager, P.o. & Dist.-Cooch Behar. 2. The Branch Manager, Life Insurance Corporation of India, P.O. & P.S. Falakata, Dist- Jalpaiguri. 3. The Divisional Manager, Life Insurance Corporation of India, Jalpaiguri Division RESPONDENT : 1. Shri Bhajan Barman, son of Shri Paresh Chandra Barman, Vill & P.O. Kushiarbari, P.S. Ghoksadanga, Dist Cooch Behar. PROFORMA REPONDENT : 2. Shri Sujit Kumar Deb, Development Officer,CodeNo.350, LICI(Falakata Branch), P.O. & P.S. Falakata, Dist-Jalpaiguri BEFORE HONBLE MEMBER : Sri Debasis Bhattacharya. HONBLE MEMBER : Sri Jagannath Bag. FOR THE APPELLANTS : Ms. Sumita Roy Chowdhury, Ld. Advocate FOR THE RESPONDENT : Mr. Arnab Saha, Ld. Advocate Sri Debasis Bhattacharya , Member
Being aggrieved by and dissatisfied with the judgment dated 31.05.2012 in Case No. 52/2011 passed by Ld. District Forum, Cooch Behar, this appeal has been preferred by the OP Nos. 1, 3 & 4 thereof.
It is the case of the Complainant in his petition of complaint that his deceased wife, Pramita Barman, made 02 insurance policies bearing No. 1456389840 and 456389839 of Falakata Branch of L.I.C.I. and he was made nominee of the same. She died on 07.03.2010 due to snake bite. Her death claim was filed with OP No.3 which was transferred to OP No.4 for disposal. But, the Sr. Divisional Manager, L.I.C.I., Jalpaiguri Division repudiated the said claim on the sole ground that the insurer made false declaration regarding her income at the relevant time. Thereafter, he rushed to the Zonal Claim Review Committee at Kolkata, but no relief was granted. Said Pramita Barman died leaving behind one minor son viz., Subhajit Barman, aged about 06 years and the Complainant as her legal heirs. Lastly, finding no other alternative, the Complainant has filed the complaint case.
On the other hand, the case of the L.I.C.I. in its W.V. is that life assured died due to Acute Myocardial Infection (sic) with circulatory collapse, but not due to snake bite. At the time of submission of proposal for insurance, she declared that her total yearly income was Rs.50,000/- and her occupation was LICI Agency and Private School Teacher. But, as per official enquiry report, her total yearly income from agency commission for the year 2009-10 was Rs.4,827.85 and from school, her monthly income was Rs.1650/-, i.e., her total yearly income was Rs.24,627/-. The total premium for 02 policies was Rs.19,282/- and those policies were accepted on the basis of her yearly income of Rs.50,000/-. As there has been suppression of material facts, the Complainant cannot claim any sort of relief and the petition of complaint be dismissed.
It is to be considered if the impugned judgment suffers from any defect or anomaly so as to reverse the findings.
Decision with reasons.
Ld. Advocate for the Appellants has submitted that in the proposal forms the life assured declared that she is an Agent of LICI and Private School Teacher, whereas her source of income was only as an Agent. Subsequently, she has added Private Teacher in the proposal No. 10254. The contract of insurance is based upon utmost good faith. The basis of the contract is the proposal form. She was not a School Teacher at all within the knowledge of the life assured at the time of taking the policy. So, the repudiation was done by the LICI Divisional Office and the same was upheld by the Zonal Claim Review Committee. She has made out that the enquiry of records in respect of her agency gave out that for the year 2006-07 she earned Rs.4,827.85 as commission and for the year 2009-10, she earned Rs.4,598.75 as commission, whereas Rs.19,282/- was the premium cost of both the policies yearly. If the life assured made out such things correctly, the LICI policies would not have been issued. A fraud was practiced to get the policies. Further, her death was due to myocardial infarction and not for snake bite. She has also assailed the impugned judgment on the ground that two cost of Rs.5000/- was awarded in favour of the Complainant by the Ld. District Forum and there was no basis for the order to pay and deposit Rs.100/- per day to the Station Commission Welfare Fund for each days delay beyond the stipulated period for payment. There is no deficiency on the part of LICI. The Consumer Protection Act is not meant for enrichment of the consumer nor the Ld. District Forum a charitable dispensary. She has relied upon a decision of the Honble Supreme Court reported in 2006 (7) Supreme 156.
Ld. Advocate for the Respondent No.2 has supported the submissions of the Ld. Advocate of the Appellants.
Ld. Advocate for the Respondent No.1 has submitted that admittedly the death of the life assured was on account of Acute Myocardial Infarction, as also stated in the BNA of the Respondent No.1. No question was raised as to any infirmity in the two policies, and consecutive premiums were taken and enjoyed by the Insurance Company, and as such the dissension when contingency arrived and called for performance by Insurance Company is totally barred by estoppel. It is the legitimate burden of the LICI, who cannot walk out or wash out its hands, and no mercy is called from the LICI. The proposal forms were filled up by the OP No.2. The life assured lived in a joint family and enjoyed the usufructs of the joint family as well as the earnings of her husband in business. It is a case of simple death benefit claim, and not also double benefit for accident as accidental benefit. Such kind of assertion of suppression of material fact cannot be raised only at the time of such contingency. He has relied upon a decision of the Honble National Commission reported in II (2009) CPJ 149 (NC).
There was no dispute raised by the LICI in their W.V. regarding life assureds income as a Private School Teacher, as reflected in paragraph 6 of the W.V. So, it cannot be disputed now. Further, there has been a note of joint declaration given by the husband and wife in the proposal bearing no. 10253 of another policy of the husband of the life assured which was also effected on the same date. It also mentioned that there has been no objection given as regards medical done by a male doctor. It has been approved by the Officer of LICI on 27.01.2010. So, all these 03 LICI polices, including one of the husband of the present life assured were taken at the same time and approved as such. The question of addition of Private School Teacher in the proposal form no. 10254 is meaningless as the LICI is the custodian of such proposal form after submission to it by the life assured; only change of ink or pen does not signify anything to the contrary. This is an exercise in futility by the Appellants. Annual income of the Life Assured was shown as Rs.50,000/- which was taken for granted by the LICI at the time of giving the policy. It is not a case of an outsider, not connected with the LICI at the relevant Branch Office, but an active Agent of LICI there. The paper filed by the Appellants to show the annual commission also does not reflect the true picture. Whereas it is stated in the W.V. that her agency commission for the year 2009-10 was Rs.4827.85 but actually it corresponds with the year 2006-07, basing upon which also the repudiation was made. This shows a kind of lackadaisical attitude of the Appellants in the matter. Further, in any way of the matter, the annual income out of commission cannot be fixed at a rate, which is always variable. No question was raised during the life time of the life assured regarding her income. Such a proposition raised in respect of this particular case who is very known to the LICI officials of the locality is without any jurisdiction and justification. Consequent repudiation of the claim made in respect of these two policies has no justification and in-consequential. When knowingly the officials of the LICI at the place accepted these policies, they cannot bar the claim in this particular case. In fact, the policies were issued with the full and active support and connivance of the LICI officials towards their very own and known Agent. So, the LICI hierarchy cannot shirk their responsibility and liability in the matter. The decision relied upon by the Appellants does not go to benefit them in this particular case when factually the life assured was working as an Agent at the said LICI Branch office and knowing well about her credentials, they have accepted her proposal forms. Regarding cause of death of the life assured, it is found to be for Acute Myocardial Infarction with circulatory collapse, but it is not disputed that she was admitted to M.J.N. Hospital on 29.01.2010 for snake bite, as per paragraph 5 of the W.V. Considering all these aspects of the matter, there is found to be deficiency in service of the Appellants which has been properly noted by the Ld. District Forum in the impugned judgment. The findings of the Ld. District Forum is based upon due consideration of the facts and the law, but in view of this appeal preferred by the LICI, the effective date for implementation of the impugned order is to be counted from this date.
Accordingly, the appeal fails.
Hence, Ordered that the appeal be and the same is dismissed on contest against the Respondent No.1 but without cost. The impugned judgment and order is affirmed subject to the observations made earlier in the body of this judgment.
MEMBER MEMBER