State Consumer Disputes Redressal Commission
Gopagani Swathi Alias Manga vs 1.Life Insurance Corporation Of India on 31 March, 2022
BEFORE THE TELANGANA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION: HYDERABAD.
FA.NO.550 OF 2017
AGAINST ORDERS IN cC.NO.49/2015, DISTRICT CONSUMER
COMMISSION, KARIMNAGAR
Between:
Gopagani Swathi@ Manga,
W/o.Late Rajkumar
Aged about 34 years,
Occ: Housewife,
R/o.H.No.9-74/6, Vidyanagar
Naspur, Mancherial Mandal,
Adilabad District.
Appellant/Complainant
And
1. Life Insurance Corporation of India,
Manchirial Branch,
Rep. by its Manager,
Post Mancherial, Ädilabad District.
2. The Divisional Manager,
Divisional Office,
The Life Insurance Corporation of
India, 2-7-105, Jeevan Prakash,
Dr.B.R.Ambedkar Stadium Road,
Karimnagar District.
Respondents/Opposite Parties
Counsel for the Appllant/Complainant: Sri V.Gourisankara Rao
Counsel for the Respondent/Opp.Party: Sri Srinivas s.Rajan
QUORAM: SRI JUSTICE M.s.K.JAISWAL, HON'BLE PRESIDENT,
HON'BLE SMT.MEENA RAMANATHAN...LADY MEMBER
THURSDAY,{THE THIRTY FIRST DAY OF MARCH TWO THOUSANDTWENTY TWO ******* Order
1. This is an appeal filed U/s. 15 of Consumer Protection Act, 1986 against the order dated 25.10.2017 .of the District Consumer Commissjon, Karimnagar, made in Cc.No.49/2015. The Appellant. is the Complainant. and the, Respondents are the Opposite Parties in CC.No.49/2015.
2. For the' sake jof convenience, the parties are described as arrayed in the complaint.
3. Briefly stated, the facts are:
The Complainant is the wife and nominee of late Rajkumar who had obtained several Life Insurance Policies during his life time from the Opposite Parties under the Salary Saving Scheme vide policy Nos.684016384, 684008996 and 682983459.
Unfortunately, the Complainant's husband died on 27.03.2010o and thereafter, the Complainant submitted her claim under the above policies. It is her contentiorn that the Opposite Parties have only paid the installments instead of the sum assured of the said policies.
i) For policy bearing No.684016384 only a sum of Rs.21,735/- was paid instead of sum assured being Rs.75,000/-.
For policy bearing No.684008996 only a sum of Rs.26,130/- was paid instead. of sum assured being Rs.1,00,p00/-
ii) For policy bearing No.682983459 only a sum of Rs.12,782/- was paid instead of sum assured being Rs.1,00,000/-
Despite repeated requests and demands to pay her the entitled benefits.the Opposit Parties have neither complied nor repudiated her claim. Hence, she has filed the present complaint seeking redressa.
A. The Opposite Parties filed their written version denying the averments made in the complaint and have submitted that on the date of death of the life assured i.e., 27.03.2010, the above policies were in a lapsed condition. But these policies had acquired paid-up value. Hence, the pajd-up value under these' policies was settled as per the policy terms Since the payment was already made and the Complainant has accepted the same in the year 2010 in full and 3 final settlement as per policy terms and conditions. They have also Submitted that it is a time- barred/stale claim and therefore, the jurisdiction of the District Forum could not be invoked.
5 Before the District Farum, the Complainant filed evidence aiidavit and Ex.Al to A7 marked on his behalf. Evidence affidavit of Opposite Parties filed. No documents marked on their behalf
6. The District Forum after hearing both sides and considering the material on record dismissed the complaint with no order as to Costs.
the 7 Aggrieved by the said order of the District Forum, Complainant filed this appeal contending that the Commission below had failed to consider the following:
The Forum erred in dismissing the complaint on the ground that it is barred by limitation.
The Forum below failed see that the judgment of the Hon'ble Chattisgarh State Commission is not binding on the District Forum in the presence of various judgments rendered by the A.P.State Commission and Telangana State Commission. While the Opposite, Parties hàve settled other claims to the Complainant, they are needlessly denying this claim.
8. The Appellant/ Complainant is the wife and nominee of the policy holder who quring his life time had obtained several Life Insurance Policies from the Respondents/Opposite Parties under the Salary Saving Scheme. The details of the policies are submitted by the Respondents/Opposite Parties in the tabular column reproduced below:
SI.No.Policy No. Date of Sum Premium
commencement Assured Received
Upto
684016384 15/03/2005 75,000 f05/2008
684008996 28/08/2004 1,00,000 01/2009
3 682983459 28/09/1995 1,00,000D 07/2009
9 Although the Appellant/Complainant/nominee is entitled to
receive the death benefits covered under the policies, the
Respondents/0pposjte Parties have only settled the claim as per "paid-up value", since the policies were in a lapsed condition. Paid- up value is calculated as: number.of premiums paid+ number of premiums payable xsum assured
10. It is their contention that since 'all the claims were paid to the Appellant/Complainant as per polioy terms and conditions, the Appellant/ Complainant cannot seek release of the death benefits under the same policies. The Appellant/Complainant, they further submit, accepted the payments in full and inal settlement of all claims under these policies. She was silent for more than five years and has now filed the present complaint. Hence, it is a time barred complaint.
11. The impugned order, failed to distinguish that policies issued under the Salary Saving Scheme are on a different footing from other Insurance Poliçies. The fact that the said policies were issued under the Salary Saving Scheme, is not in dispute. This point requires due empha_is and further elaboration.
12. The Respond nts/Opposite Parties never repudiated the policy when the premiums were not being paid regularly. But only when a claim was made, they have raised the ground of limitation and lapsed status of policy.
13. At this juncture, it would be appropriate to understand Salary Saving Scheme of LIC. It. is a simple economical plan whereby employees pbtained a Life Insurance protection for their familics and retirement income for themselves under advantageous conditions which might not be available to, them otherwise. Having issued the policy under the Salary Saving Scheme, the Respondents/Opposite Parties cannot escape their liability to pay the sum assured jpn the ground of non-receipt of monthly premiums. This view is further fortified by the judgment reported 5 in "DESU Vs. Basanthi Devi" reported in II (1999) CPJ 15 SC-
the Hon'ble Supreme Court while considering the relationship of employee and the Insurance Company in the matter of Insurance Policy issued under Salary Saving Scheme, held that the employer is an agent of the Insurance Company in terms of Section-230 of the Indian Contract Act and any lapse on the part of the employer while acting as the agent of the Insurance Company was made basis to fasten the liability on the Insurance Company.
status
14. Although: the: Appellant/Complainant received the she shóuld report vide Ex.A1 to A3 on 14.09.2010 and 09.09.2010, be provided a fair opportunity to contest the matter as the policies are issued as a welfare measure.
was never
15. The fact that premiums were not paid regularly the policy holder. Only the employer is responsible as intimated to the agent of the Respondents/Opposite Parties. The consequences of non-payment of premiums were never informed to the Insured.
This action on the part of the Respondents/0pposite Parties is when their acceptance letter has the extremely unfair, especially following clauses:
a) The employer will, receive list of premiums to be deducted called his demand invojce in duplicate each month on the specified date.
b) One copy of the invoice is to be returned along with the remittance and second copy is to be retained by the employer for his record.
c)Reconciliation Sttement in a specified form to be supplied by Respondents/Opposite Parties/LIC will accompany the statement.
16. The Respondents/Opposite Parties have not complied with their terms and conditions and clauses as speciied above. Therefore, the plea taken by Respondents/Opposite Parties/LIC that due to non-receipt of premiums, the policy was considered as per "paid-up value" and time barred is unjustified.
17. We have no hesitation in holding that the impugned order grossly erred in concluding that the. Complainant is not entitled to any relief on the sole ground of limitation when discussing the nature of the. Salary Saving Scheme and the responsibility of Respondents/Opposite Party/LIC.
18. Hence, weallow the appealand hold the Respondents/Opposite Parties as being deficient and direct them to pay the sum assured after subtracting the amount already paid to the Complainant in the following manner:
Sl.No. { Policy No. Sum Amount paid Balance assured amount to be paid.
684016384
75,000/ 21,735/- 53,265/-
2 684008996 1,00,000/- 26,130/- 73,870/-
3 682983459 1,00,000/- 12,782/-
87,218/-
Total: 2,14,353/
19 In the
result, the Respondents/Opposite Parties should pay Rs.2,14,353/- to th Appellant/Complainant. Time for compliance is six weeks, failing which, the said amount shall carry interest @ 6% p.a. from that date till payment. The Appellant/Complainant is also entitled to costs of Rs.10,000/-