Document Fragment View

Matching Fragments

It is to be considered if the impugned order suffers from any material and factual irregularity and inconsistency so as to make an interference in this appeal.

Decision with reasons.

Ld. Advocate for the Appellant has submitted that it is solely a case of First Unpaid Premium. Though the Complainant boasts of being a retired School Teacher, he purposely and motivatedly by taking advantage of an human error, made this test case. The Complainant did not produce the relevant money receipt against cash payment made by him in respect of the alleged policy no. 417050050, which he did not purchase and did not pay. He miserably failed to prove his case. The impugned judgment is based upon misconception and not a speaking one and done without proper perspective in the matter, and a very cryptic in nature.

Ld. Advocate for the Respondent has submitted that in between 04 (four) years have elapsed since the origin of the said policy in question. In fact, by the status report obtained on 09.02.2011, it was shown that it is a case of Cheque Dishonoured (DC), while it was paid by cash. There has been sheer/gross negligence on the part of the OP No.1.

It has been wholesomely shown by the OP No.1 that on the basis of a cheque issued in favour of the Complainant dated 14.02.2007 of Rs.1,47,056/-, the complainant obtained/purchased the Market Plus Policies amounting to Rs.1,47,000/-, which do constitute the cost of 06 (six) such policies, on 28.02.2007. The Complainant falls short of producing any paper to the effect that he purchased the Policy Bond bearing no. 417050050 by cash. Otherwise, why he did not purchase the said policy also by way of a singular cheque. It almost befell that taking advantage of an human error on the part of the establishment of OP No.1, he made this adventurous venture for wrongful gain in the matter. In fact, by a letter dated 07.02.2011, he only pressed the 02 (two) concerned policies bearing nos. 417050369 and 417050050 for getting surrender value with an evil mind and motive and immediately obtained sanction of hand delivery of the cheque. But, he mentions in his petition of complaint that on 07.02.2011 he applied for surrender of all his 07 (seven) Market Plus Policies to the OP No.1, which is a blatant lie. The status report of policy no. 417050050 dated 14.02.2011 shows clearly that there is no payment history for this policy and the status is cancelled. The order of the Insurance Ombudsman in regard to the dispute with premium of policy no. 417050050 made by this Complainant against the OP No.1, is elaborative and lucid in nature, in which the Complainant stated that he paid Rs.25,000/- to his Agent in cash for obtaining a seventh policy, but the Agent did not give him the money receipt and instead he was given the Policy Bond, whereas the Insurer produced their records to show that LA had applied for 06 (six) policies and the premium for the same was paid by recycling the matured proceeds of policy no. 412540371. The representative of the Insurance Company submitted a letter from Sri Sukhendu Bikash Giri, the Development Officer, confirming that the policyholder proposed for only 06 (six) policy, whose premium was paid after recycling the maturity amount of Rs.1,47,056/- by cheque no. 32289 dated 14.02.2007 against the policy no. 412540371. It was further seen that the cash deposit of Rs.25,000/- under policy no. 417050050 was an inadvertent mistake of the Cashier, and on discovering the same, the Insurer cancelled the policy and issued a fresh policy no. 417050369 to the policyholder. But, even after cancelling the policy, the Insurer committed further mistake in printing the Policy Bond of the cancelled policy, which is a serious service lapse on the part of the Insurer. However, it being human error, the policyholder cannot be allowed to derive any benefit from this error. This is a well reasoned order in the matter. It cannot be taken for granted that the Agent did not give him the money receipt and instead gave him the policy bond. The Development Officer, who made such policies of the Complainant also confirmed about only 06 (six) policies made by the Complainant. The case of purchasing the 06 (six) Market Plus Policy by the Complainant by way of a cheque of Rs.1,47,000/- is a proper one, in absence of production of the concerned money receipt. Such money receipt could also have been obtained by the Complainant by way of applying for duplicate of it from the OP No.1, which does not appear to have been applied for by him. There is gross abuse by the Complainant in using a wrong Policy Bond, which is a non-entity. Of course, there has been lapse on the part of the OP No.1 in the matter, who should have informed the Complainant in the matter forthwith or within a reasonable time and calling back the questioned Policy Bond, which was not done at all. It shows sheer callousness and negligence on the part of the OP No.1. There is also at least a conscious and active collaboration of the Agent in question, Gopal Nath, with the Complainant, who though named as OP No.2, did not venture out to contest the claim of the Complainant, if not complicity of the Development Officer concerned, Sukhendru Bikash Giri. Accordingly, the matter is required to be brought to the notice of the Chairman, Life Insurance Corporation of India for taking necessary action against the erring officials. The Complainant acted mischievously taking advantage of faux pas, which was not corrected by the OP No.1. There was no animosity, or enmity of the OP No.1 with the Complainant. It was rather a test case of the Complainant to which the Ld. District Forum faulted. The impugned order is a lopsided one and without due consideration of the materials on record. The Ld. District Forum was misled in the matter. The nationalized Insurance Company is not a charitable institution to give away money to an unscrupulous claim. As the complaint is a frivolous/vexatious one, the Complainant is to pay a cost of Rs.10,000/- (Rupees ten thousand) only to the Consumer Welfare Fund of the Ld. District Forum concerned within one month. Accordingly, the impugned order does not hold good.