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2009(4) CPR 1
MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MUMBAI
S.G. Deshmukh, Presiding Judicial Member and Mrs. Uma S. Bora, Member
Branch Manager, Life Insurance
Corporation of India and Anr. —Appellants
versus
Smt. Sandhya Durgadas Ghadge
and Ors. —Respondents
First Appeal No. 318 of 2004
Decided on 15.10.2008
Counsel for the Parties:
For the Appellants:Shri K.D. Pande, Advocate.
For the Respondent No. 1:Shri J.S. Jagdale, Advocate.
For the Respondent Nos. 2 and 3: None.
IMPORTANT POINT
Amounts of the premium due can be deducted from the insurance claim.
Headnote:(i) Consumer Protection Act, 1986—Jeevanmitras with profit for Rs. 50,000—Salary savings scheme—Installments to be deducted from insured’s salary and paid to insurer—In accident, insured injured and died—Heirs claim repudiated on ground that policy had lapsed during the insured’s life time.
(ii) Consumer Protection Act, 1986—Section 12—Complaint for “deficiency in service”.
(iii) Consumer Protection Act, 1986—Section 14—District Forum allowed complaint and directed the opposite parties to pay Rs. 50,000 with interest @ 7.5% p.a. w.e.f. 9.6.2000 and costs of Rs. 1,000.
(iv) Consumer Protection Act, 1986—Section 15/17(a)(ii) —Appeal against Forum’s directions—Held: Insurer did not intimate the insured that the premium had not been received from his employer and his policy was lying lapsed—According to special provision, insured was entitled to Rs. 2,00,000 (Rs. 50,000 + Rs. 1,50,000)—In view of Order 41, Rule 33, CPC LIC is directed to pay Rs. 2,00,000 as per policy documents with interest @ 7.5% p.a. w.e.f. 1.6.2006 instead of Rs. 50,000. Appeal is dismissed.
S.G. Deshmukh, Presiding Judicial Member— The present appeal is filed by L.I.C. against the judgment and order dated 08.01.2004 in complaint case No.87 /02 passed by. District Forum, Osmanabad.
2. Respondent No.1/Complainant’s case before the Forum is that, deceased Durgadas Ramrao Ghadge husband of complainant had obtained life insurance policy under Jeevanmitra (Double Cover Endowment Plan) with profit (with accident benefit) for sum assured of Rs.50,000 for the period 3.1.2000 to 3.1.2015. It is contended that, first 2 instalments had been paid by deceased Durgadas. It is contended that, the policy was under salary savings scheme. Complainant’s husband was serving as primary teacher in Z.P. School, Morda, Tq. Tuljapur. It is contended that, respondent No.2 & 3 were to deduct the monthly premium from the salary of deceased Durgadas and were to remit the same to present appellant. It is contended that, Durgadas husband of complainant met with an accident on 11.4.2000 while going on motor-cycle towards Tuljapur from Osmanabad and he was severly injured and died on 15.4.2000. Complainant being nominee and legal heir of deceased Durgadas preferred the claim before the appellant.. The claim was repudiated by the appellant vide its letter dated 9.6.2000 on the ground that, premiums of the policy were not deposited since 3.3.2000 onwards and thus the policy was in lapsed condition at the time of death of Durgadas. Thus, complainant approached the Forum.
3. Present appellant appeared before the Forum and resisted the claim. Appellant is not at dispute that the policy in question was under salary saving scheme. It is contended that, appellant had issued letter to respondent No.2 & 3 on 21.2.2000 for the premium amount even then appellant did not receive the premium amount as per policy contract. Thus, the policy in question was in lapsed condition at the time of death of policy holder. It is contended that they have rightly repudiated the claim. It is further contended that, undertaking was given by life assured that in case of non payment of premium by employer, in that event life assured himself is to pay premium amount.
4. Respondents No.2 & 3 appeared before the Forum. It is contended that, deceased Durgadas did not inform them to deduct the premium for March 2000 from his salary and thus, the premium was not deducted. It is contended that, they did not receive any letter from the appellant about the premium of the policy.
5. The Forum below after going through the papers and hearing the parties allowed the complaint and directed the appellant to pay Rs.50,000 with interest @ 7.5% p.a. from 9.6.2000. Forum also directed the appellant to deduct the premium which were not paid from the policy amount. Forum also directed respondent No.2 & 3 to pay amount of Rs.l,000 towards cost.
6. Being aggrieved by the said judgment and order passed by District Forum, Osmanabad, LIC came in appeal.
7. Notices were issued to the appellant as well as respondent. Learned counsel Shri Pande appeared on behalf of appellant whereas learned counsel Shri J. S. Jagdale appeared on behalf of respondent No.1. None appeared on behalf of respondent No.2 & 3. We heard both the counsels at sufficient length. Learned counsel Shri Pande submitted that, policy in question was in lapsed condition at the time of death of policy holder. He submitted that, life assured himself had undertaken that he will be responsible for consequences under contract of policy in case of non payment of premium from the employer. Learned counsel further submitted that, as the policy was in lapsed condition they have rightly repudiated the claim in question. Learned counsel submitted that, ratio in Basanti Devi’s case relied by the Forum is not applicable in the instant case. According to him in Basanti Devi’s case premiums were deducted by the employer, but same were not remitted to the appellant. He submitted that, in the instant case no premium was deducted by employer.
