A.N. Chaturvedi, President:
1. The case of complainant Smt. Indu Sinha is that her husband, Mithlesh Kumar Sinha was Reader in J.N. College, Madhubani under Mithila University. He had taken several policies on his life from the Life Insurance Corporation of India. The last policy taken by him was Policy No. 530094508 dated 29.3.1990 for Rs. 50,000/-. The aforesaid policy was under Salary Saving Scheme, premium of which was payable every month. In all the policies the complainant was nominee of her husband. On 22.4.1991, her husband died due to Carcinoma (Cancer) of lever at All India Institute of Medical Sciences, New Delhi. After the death of her husband, the complainant requested the Branch Manager of L.I.C. at Madhubani to settle all the claims for several insurance policies taken by her husband. A letter dated 8.10.1991 was received by the complainant from the Divisional Office of L.I.C. at Muzaffarpur, whereby she had been intimated that all her claims had been settled. A cheque for Rs. 2,36,054.60 (Rs. two lacs thirty six thousand fifty-four and paise sixty only) was attached with the said letter in full and final settlement. In the said letter it had been lastly written that the said amount also includes refund of Rs. 719.40, received after the death in lapsed Policy No. 530094508. On 19.10.1991, she (complainant) made a representation before the Branch Manager of Madhubani Branch of L.I.C. stating therein to issue claim form for Policy No. 530094508 which had been taken by her husband under Salary Saving Scheme and the monthly instalment whereof had been paid by the employer, J.N. College, Madhubani, under Salary Saving Scheme. The premium of the said policy had been received by the L.I.C. upto November, 1990 and the same had been posted in the ledger. The premium for the month of December, 1990 alongwith premium for other six policies of her husband and for the policy of other staff of the college under the Salary Saving Scheme was sent by the college vide Cheque No. 031394 dated 13.4.1991 to the Branch Manager of L.I.C. at Madhubani, which was duly accepted and entered in the individual policy ledger, but subsequently deleted in the case of the aforesaid policy. In the same fashion the premium for the month of January, 1991 alongwith premium of other six policies of her husband and that of policy of other employees of the college under Salary Saving Scheme was sent by the college vide Cheque No. 031403 dated 13.5.1991 and posted in the individual ledger, but subsequently deleted in the case of above mentioned policy only. Similarly the premium for the month of February, 1991 was sent by the college vide Cheque No. 031438 dated 28.6.1991, which was accepted by the Branch Manager. College used to send the premium cheque pertaining to any month for all the policies under Salary Saving Scheme, as and when the State Govt. made payment of the salary for that particular month and the Branch Manager used to accept the cheque against the premium due for the particular month and no policy ever lapsed due to delay in payment of the premium except the policy mentioned above.
2. Further case of the complainant is that the opposite party neither issued claim form for the aforesaid policy inspite of repeated request nor acknowledged the letters and reminders sent by her. They have arbitrarily considered the aforesaid policy as lapsed. The Branch Manager (opposite party No. 3) forced her (complainant) to accept refund of three months premium paid for the policy in question for the months of December, 1990, January, 1991 and February, 1991 by including the amount with the claim amount of other six policies. When she wanted to accept the said cheque with a note of protest, the same was not delivered to her and was sent by Registered Post. No other policy of any other person of the college under Salary Saving Scheme and suffering from delay in payment of premium had been considered lapsed by the opposite party. Her husband was in no way responsible for delay in payment of his premium. On 19.12.1991, the Branch Manager of L.I.C. at Madhubani intimated her (complainant) regarding receipt of her letter dated 3.12.1991 and informed that her case had been referred to the Divisional Office for consideration. On 14.12.1991, Sr. Divisional Manager (opposite party No. 2) sent a letter to her that officials were endevouring to settle the claim and assured for reply from Branch Office at Madhubani shortly, but no communication was received from the Branch Office. On 9.4.1992 she sent a letter to opposite party No. 2 requesting to settle the claim at the earliest, failing which she would have no alternative, but to take shelter of a Court of competent jurisdiction. But no reply was received from him. By treating the policy in question as lapsed, the opposite parties have acted arbitrarily and have adopted double standard in settling the genuine claim. On the aforesaid allegations the complainant has prayed for the following reliefs :(i)Â Â Issuance of claim form.(ii) Â Settlement of the claim by paying the insurance amount to the tune of Rs. one lac or more, as per terms and conditions enshrined under the Salary Saving Scheme with interest @ 18% till the payment of the full amount.(iii) Damages for non-settlement of the claim for such a long period as well as for mental shock and harassment caused to her.
3. Opposite party Nos. 1 to 3 have filed joint show-cause and have contested the case. The opposite party No. 4 (Principal J.N. College) has filed separate written statement. The case of opposite party Nos. 1 to 3 is that the complaint is not maintainable and the complainant being nominee is not a consumer in terms of the Consumer Protection Act and hence she cannot maintain the complaint in respect of policy, which lapsed prior to the death of the life assured. The policy in question was for a sum of Rs. 50,000/- with double accidental benefit and it commenced with effect from 28.3.1990. The premium for the policy in question was to be paid on monthly basis through employer of the life assured. According to the terms of contract, the premium money was payable on 28th day of every month and a grace period of 15 days was allowed under the terms. This was the seventh policy taken by the life assured. Earlier six policies had been taken during the period 1982 to 1987. The premium towards the policy in question could not be paid in time by the employer of the life assured. The premium for the month of November, 1990 was received on 30.3.1991, which was entered in the premium ledger. Since the life assured died on 22.4.1991, and as such the policy in question lapsed on account of non-payment of the premium prior to the death of the life assured. On 22.4.1991 (the date of death of life assured) the premium payable for the month of December, 1990, January, 1991, February, 1991 and March, 1991 had not been paid even within the grace period and remained outstanding. On 29.6.1991, two cheques dated 24.4.1991 and 14.5.1991 were received in the office of the Branch Manager towards the payment of premium under Salary Saving Scheme. On 4.7.1991, the Branch Manager had received an intimation regarding the said demise of the life assured under the signature of the complainant and on the same date, six claim forms were issued by the Branch Manager. No claim form was issued for the lapsed policy in question.
4. Further case of the opposite parties 1 to 3 is that on 31.7.1991, the Branch Manager received a cheque from the employer of the life assured towards the payment of the premium under Salary Saving Scheme. Since on that date the Branch Manager was aware of the death of the life assured, the premium paid in respect of the policy in question remained unadjusted and was kept as deposited in suspense account. On 30.8.1991 the Branch Manager forwarded the case of the life assured under all the seven policies to the Divisional Office (opposite party No. 2). The Divisional Office took no time and on 21.9.1991, decided to pay the amount assured in respect of the six policies and to refund the three premium amounts paid in respect of the policy in question after the death of the life assured, which had not been adjusted. The amount of three premiums come to Rs. 719.40. The complainant was paid the claim amount to which she was found entitled. On 8.10.1991 sum of Rs. 2,36,054.60 paise which included refund of Rs. 719.40 was paid to the complainant vide Cheque No. 187413 dated 8.10.1991 and the complainant received the aforesaid amount in full and final settlement of death claim under all the seven policies without reserving her right to claim any amount in future. On 23.10.1991, they (opposite party Nos. 1 to 3) received a letter dated 19.10.1991 from the complainant in which the claim concerning the policy in question had been agitated. On 3.12.1991 another letter was received from the complainant to which opposite party No. 2 replied under letter dated 14.12.1991 informing her that the Branch Manager was being intimated to hear the grievances as contained in her letter dated 3.12.1991. The Branch Manager reported to the Divisional Manager that the policy in question had lapsed and the amount received as premium after death had been refunded under the instruction of opposite party No. 2. As will appear, the opposite parties have acted promptly in settlement of the claim forms for which were received on 10.7.1991 and made payment of the aforesaid amount on 8.10.1991, i.e. within 90 days. It is not a case where the claim has been repudiated arbitrarily without application of the mind or by taking irrelevant facts into consideration. It is a case of lapsed policy and hence the question of settlement of the claim in respect thereof does not arise. After receipt of the aforesaid amount in full and final settlement of the policy the complainant did not raise any dispute for more than three months from 4.7.1991, when the claim form in respect of the policy in question was not issued and under the circumstances she should not be allowed to raise the dispute after receiving the amount. After the death of life assured, the complainant purposely and deliberately did not inform the opposite party for more than two months about the death of the life assured. The Branch Manager got intimation regarding death after receipt of two cheques dated 24.4.1991 and 14.5.1991. The complainant waited for more than two months in giving information regarding death only for the reason that mistake may be committed by the opposite party by accepting the premium in respect of the policy in question. Now the complainant wants to take benefit of her own wrong, which she should not be allowed to do. Under the circumstances this Commission has no jurisdiction to entertain the instant complaint. Apart from that, it is not a case where the opposite parties were sitting over the matter concerning claim of the complainant, rather it is a case whereby the opposite parties have made payment to the complainant within 90 days from the date of receipt of the claim form and have refunded the amount of three premiums received after the death of the life assured.
5. Further case of opposite party Nos. 1 to 3 is that under the Salary Saving Scheme the employer is required to pay the premium on monthly basis as and when the same is payable. On various occasions the employers were even reminded by the opposite party that failure to deposit the premium in accordance with the terms of contract will be pre-judicial to the interest of the life assured. As and when the State Govt. made payment of the salary, the employer deposited the same and the opposite party accepted the same against the premium, but in the instant case even adjustment will not save the policy from lapsing. Apart from that, the question of adjustment of premium received after the death of the life assured does not arise. Further case of opposite party Nos. 1 to 3 is that it is the usual practice of opposite party to send cheque after settlement of claim through registered post and this has been followed invariably in all the cases. The complainant was never informed to receive the cheque personally in the office of the opposite party and so the allegation that she wanted to accept the cheque after making a note of protest is concocted and after thought on her part. The policy in question having lapsed prior to the death of the life assured, there cannot be claim in respect thereof. On the basis of the aforesaid allegations the opposite parties 1 to 3 have prayed for dismissal of the complaint case filed by the complainant.
6. Opposite party No. 4 has filed written statement but he neither himself appeared at the time of hearing to contest the case nor engaged any Advocate to do so on his behalf. The case of opposite party No. 4 (Principal, J.N. College, Madhubani) is that the complainant has no cause of action or right to file the complaint against him and the case against him is not maintainable. Apart from that, the case against him is barred by estoppel, limitation and acquiescence and is also bad for misjoinder of parties. Further case of opposite party No. 4 is that the husband of the complainant was insured under Salary Saving Scheme vide policy No. 5300945081 and he died on 22.4.1991. The premium of the said policy for the month of December, 1990 alongwith premium of other six policies of the employees of the college under Salary Saving Scheme was sent to the Branch Manager (opposite party No. 3) vide cheque No. 031394 dated 13.4.1991 and the same was accepted by opposite party No. 3. Similarly the premium amounts of the said policy for the months of January, 1991 and February, 1991 alongwith the premium amounts of other policies of the employees of the college were sent to the opposite party No. 3 vide cheque No. 031403 dated 31.5.1991 and cheque No. 031438 dated 28.6.1991 respectively which were duly accepted by opposite party No. 3. The college used to send the premium of any month of the policy under Salary Saving Scheme through cheque as and when the State Govt. made payment of the salary for that particular month and opposite party No. 3 used to accept the same and never made any objection for the same. Opposite parties 1 to 3 never informed him (opposite party No. 4) regarding lapse of any policy of any employee of the college covered under Salary Saving Scheme. The delay in payment of the premium was caused due to delay in payment of salary to the employees by the State Govt. and the University and he (opposite party No. 4) is in no way responsible for delay in payment of the premium. On the allegations aforesaid opposite party No. 4 has prayed for dismissal of the complaint case against him with cost.
7. The complainant has filed reply to the written statement of opposite parties 1 to 3. Apart from that, she has also filed affidavits dated 13.12.1993 and 30.4.1994 in support of the statements made in her complaint petition and Annexures thereto as well as in support of the statements made in the reply to the written statement of opposite parties 1 to 3. Opposite parties 1 to 3 have filed affidavit in support of the statements, made in their show-cause (written statement), but there is no affidavit in support of the contents of the written statement filed on behalf of the opposite party No. 4 (Principal of the college).
8. Opposite parties 1 to 3 in their written statement have pleaded that the complainant being nominee is not a âconsumerâ in terms of the Consumer Protection Act and hence she cannot maintain the complaint in respect of the policy in question, which according to them, had lapsed prior to the death of the life assured. It may be pointed out that the word âConsumerâ as defined in the Consumer Protection Act also includes a beneficiary and perhaps it is due to this that the L.I.C. paid the amount concerning the six undisputed policies of the deceased to the complainant who undisputedly is the nominee of her deceased husband. So there appears no merit in the plea to the aforesaid effect. Moreover no argument was advanced with regard to this plea at the time of hearing of this case.
9. In paras 16 and 17 of the written statement of opposite party Nos. 1 to 3 it has been pleaded that the complainant purposely and deliberately did not inform the opposite party for more than two months about the death of her husband and that intimation regarding death of the life assured was received by the opposite party No. 3 on 4.7.1991, i.e. after receipt of two cheques dated 24.4.1991 and 14.5.1991. It has been further stated that the complainant awaited for more than two months in informing the opposite party only for the reason that mistake may be committed by the opposite party by accepting the premium in respect of the policy in question. It has been further stated that the complainant wants to take the benefit of her own wrong and as such she should not be allowed to do so. It has been further stated that according to the complainant the cheque concerning premium was dated 13.4.1991, which is not true as the said cheque was in fact drawn on 24.4.1991 after the death of the life assured with a plan to bind the opposite party in case of acceptance and this mala fide approach of the employer and the complainant should not be allowed to prevail as the same is against the principle of utmost good faith. It has been further stated that in view of what has been stated in para 16 of the written statement, this Commission has no jurisdiction to entertain the instant complaint. A perusal of the definition of the word âServiceâ as given in Section 2(1)(o) of the Consumer Protection Act would leave no room for doubt that facilities in connection with insurance can also be subject-matter of dispute before the Consumer Forum and that being so, there is no merit in the plea that this Commission has no jurisdiction to entertain the instant complaint. Moreover, no argument was advanced with regard to this plea at the time of hearing.
10. Now it has to be considered if the complainant is entitled to the reliefs sought for by her. Certain facts are not disputed. It is not disputed that the husband of the complainant had taken the policy in question in March, 1990 under the Salary Saving Scheme, premium of which was to be paid by the college after deducting the same from his salary. It is also not disputed that the premium for the policy was to be paid every month and there was grace period of 15 days for payment of the premium. It is also not disputed that some other employees of the same college had also taken insurance policy under Salary Saving Scheme and the College Authority (opposite party No. 4) used to send the premium cheque pertaining to any month for all such policies as and when payment of salary to the employees was made for the particular month and opposite parties 1 to 3 used to accept the same. It is also not disputed that the complainant was the nominee of her husband in the policy in question. It is also not disputed that there were six other policies in the name of the husband of the complainant which are not disputed. It is also not disputed that the amounts concerning undisputed policies were paid to the complainant by the Insurance Company. It is also not disputed that the husband of the complainant died on 22.4.1991 and at the time of his death, on the said date the premiums for the months of January, 1991 to March, 1991 were outstanding for payment which were paid by the College Authority to the Insurance Company vide cheques dated 13.5.1991, 28.6.1991 and 29.7.1991 respectively. As is apparent, the premiums for the said three months were sent to the Insurance Company by the College Authority not only after the death of the husband of the complainant but also after the expiry of grace period for payment of premium. Moreover these fats are also apparent from Annexures 4, 5 and 6 to the complaint petition, annexures to the reply of the complainant to the written statement of opposite parties 1 to 3. Joint written statement of opposite parties 1 to 3 and written statement of opposite party No. 4 (Principal of the college). Due to payment of premium of the policy in question for the said months after the expiry of the grace period and after the death of the life assured, the policy undoubtedly lapsed.
11. It was contended of behalf of the complainant that the premium amounts of the other employees of the college had also been sent by the Principal (opposite party No. 4) with the premium amounts of the husband of the complainant but their policies were not treated as lapsed, whereas the policy in question was treated as lapsed. It was further contended that the Insurance Company by treating only the policy in question as lapsed on the ground of delayed payment has adopted double standard. The fact that delayed payment of the premiums for the months of January, February and March, 1991 was in breach of the terms of the insurance policy was not disputed, but it was contended that the husband of the complainant was in no way responsible for the delayed payment and that being so, the Insurance Company should have accepted the premiums for the said months with regard to the policy in question as was done in respect of policies of other employees. It was further contended that the College Authority was the agent of the Insurance Company for the purpose of sending the amounts of premium to the Insurance Company after deducting the same from the salary of the life insured and if the agent delayed the payment of premium to the Insurance Company the life assured or his nominee cannot be made to suffer for that and hence the treating of the policy in question as lapsed by the Insurance Company is not justified. In support of this contention the learned Counsel for the complainant referred to a decision of the Supreme Court reported in VIII (1999) SLT 279=AIR 2000 SC 43, Delhi Electric Supply Undertaking v. Basanti Devi and Anr. In this connection it was rightly pointed out by the learned Counsel for the opposite parties 1 to 3 that in the case before the Apex Court premium had been collected by the employer by deduction from the salary of the life assured prior to his death but had not remitted the same to the Life Insurance Corporation and under the circumstances the Apex Court held the Insurance Company liable to pay the amount of insurance to the representative of the deceased employee. It was further rightly pointed out that in the instant case before this Commission it is neither the case of the complainant nor of the Principal of the college (opposite party No. 4) that the premium amounts for the months of January, February and March, 1991 had been deducted from the salary of the life assured prior to his death nor there is any evidence to that effect and under the circumstances the aforesaid decision of the Apex Court is distinguishable. It was also pointed out by the learned Counsel for opposite party Nos. 1 to 3 that there is no question of adopting double standard in the matter of the husband of the complainant and other employees of the college. Since the other employees of the college were alive at the time of deduction of premiums by opposite party No. 4 from their salary, their premiums for the months of January, February and March, 1991 were accepted even though remittance of premiums by college was delayed but the husband of the complainant having died prior to deduction of the premium for January to March, 1991 from his salary, the policy in question lapsed and hence there was no question of accepting and adjusting the premium after his death and that being so, the question of adopting double standard does not arise. Apart from that, the policy in question was to be governed by its own terms and conditions agreed upon between the life assured and the Insurance Corporation. So even if the Insurance Company accepted the delayed premiums of those, who were alive, that cannot have the effect of changing the terms and conditions of the policy in question. Since the premiums of the policy in question for the said three months were not paid during stipulated period, the policy was rightly treated as lapsed.
12. It was not disputed that the three premium amounts received from college in respect of the policy in question after the death of the husband of the complainant were refunded back to the complainant by the Insurance Company while paying the amounts concerning other six policies of the life assured. It was contended on behalf of opposite parties 1 to 3 that the complainant received an amount of Rs. 2,36,054.60 paise which included refund of Rs. 719.40 of the three premiums in question towards full and final settlement of death claim under all the seven policies without reserving her right to claim any amount in future and hence she cannot be allowed to raise a dispute after receiving the money. In this connection it was contended on behalf of the complainant that the entire amount of Rs. 2,36,054.60 paise had been sent vide one cheque dated 8.10.1991 and hence the complainant had no option but to receive the entire amount and hence after acceptance of the cheque for the said amount, she entered into correspondence with the officers of the Insurance Company. In view of our finding that the policy in question had lapsed on the death of the life assured, it has become immaterial if the acceptance of the said amount by the complainant was in full and final settlement of the claim with regard to all the seven policies or not.
13. From the above discussions, it is apparent, that the policy in question had lapsed prior to the death of the husband of the complainant. That being so, the reliefs sought for by the complainant cannot be allowed. In the result, this complaint case is hereby dismissed. There is no order as to cost.
Complaint dismissed.