O R D E R
MISS S.L.PATTNAIK, MEMBER
Heard learned counsel for both the parties.
2. This Appeal is filed U/S 15 of erstwhile Consumer Protection Act,1986 (here in after called the Act). Hereinafter, the parties to this appeal shall be referred to with reference to their respective status before the Learned District Forum.
3. The brief fact of the case is that the, complainant no.1 is the wife of the deceased Madhu Singh and the complainant no.2 is the mother of the deceased. The complainant stated that the deceased was working as handling labourer in Food Storage depot of F.C.I ,Jaleswar under the supervision of O.P.No.1 .During tenure of service, the deceased obtained three life Insurance policies from O.P bearing No.583665658 (2) 583619323 and (3) 583665859 with sum assured of Rs. 2 lakh, Rs.60,000/- and Rs.1 lakh commencing on 24.02.2003, 28.03.2003 and 15.06.2003 respectively. The complainant no.1 is the nominee for policy No.1 and 3 and the complainant no.2
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is the nominee for policy no.2.The complainants have stated that all these three policies were made under salary savings scheme. As per scheme, the premiums were deducted from his husband's salary every month by the employer of the insured and was being remitted to the L.I.C. The complainant no.1 further alleged that her husband died on 19.01.2013 due to jaundice. After death of her husband the complainant approached O.P.no.2 and 3 for settlement of the claim but they informed the complainant about the gap in payment of premium of all the three policies and no deduction was made from the salary of the deceased. The complainant further stated that, they received Rs.1,49,067/- out of total Rs.2,93,200/- from policy No.1 bearing No.583665658, Rs.40,173/- out of total payable amount of Rs.87,060/- from policy No.2 bearing No.583619323 and Rs.39,586/- out of Rs.1,26,692/- from policy No.3 bearing No.583665879 in total Rs.2,28,826/- out of Rs.5,06,952/- from O.P Branch Manager L.I.C. The complainants claimed the balance amount of
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Rs.2,78,126/- along with death benefits from O.Ps. Hence they filed this complaint.
4. Upon notice O.Ps filed their written version. The O.P.no.1 in his version contended that,Late Madhu Singh was working as a handling labourer under FCI and he was irregular in his duty. He was a labourer engaged is no work no pay basis. The O.P.no.1 further averred that the policies were not salary savings scheme and the OP No.1 never deducted premium from his salary and never remitted to L.I.C. The O.P.no.1 further contended that, the premiums under L.I.C policies, were deducted from the remuneration and were being paid to the L.I.C. During his absence period he was not paid any salary and premium could not be deducted from his salary. In such case the insured was to make such payment. The O.P.no.1 admitted that the deceased was suffering from jaundice and died on 19.01.2013 while he was in service. The O.P.no.1 further submitted that no such payment was due against the salary of Madhu Singh, therefore the O.P.no.1 did not deduct any
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amount from the deceased salary. Hence there is no deficiency of service on the part of the O.P.no.1.
5. The O.P.no.2 and 3 in their written version contended that life assured Madhu Singh obtained three policies and the complainants are nominees in these policies. The O.Ps have stated that the premiums under the policies of the deceased life assured were not deducted from his salary even if he was in service. The premium only deducted on 04/2010 with gap of 05/2007,05 & 06/2008, 12/2008, 06 & 07/2009,
10/2009,12/2009, 01 & 02/2010 from his salary. The O.Ps further averred that, as per status report under three policies no.583619323,583665879 and 583665658, there are 10 numbers of gap under two policies and 9 numbers of gap under one policy. The O.Ps further contended that, premiums were not deducted from 05/2010 till death of the life assured. Due to non-payment of premium, the policies were lapsed.The O.Ps further contended that the cause of death was due to suicide instead of jaundice. The O.Ps have settled the death claim on
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receipt of the death intimation from the nominees and discharge voucher has been fully executed by the complainant to the full and final satisfaction of the claim, hence the complaint petition filed by the complainants are liable to be dismissed with cost.
6. After hearing both the parties the District Forum passed the following order:-
"xxx xxx xxx The consumer case is dismissed on contest against the O.ps, but in the peculiar circumstances without cost".
7. The learned counsel for the appellant submitted that the learned District Forum has committed error in law having not followed the procedures prevailing in case of salary savings schemes. The salary savings schemes are introduced for permanent employee and the deceased was also a permanent employee for which question of regular appointment of daily labourer does not arise.The appellant further stated that, when she approached Branch Manager of L.I.C for payment of
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Insurance money including death benefits, they paid her Rs.2,28,826/- out of Rs.5,06,952/- against three policies. The appellants are claiming balance amount of Rs.2,78,126/- more along with death benefits as the policies were made under salary savings scheme.Hence prayed to set aside the impugned order.
8. The learned counsels for the respondents were present and reiterated the same thing as they were pleaded in their written versions.
9. Considered the submissions of both the parties.Perused the DFR and impugned order. The onus lies on the complainant to prove their case.
10. It is admitted fact that the Insurance policies in question were obtained by the deceased Madhu Singh under the salary savings scheme from O.Pno.2 and 3. It is also admitted fact that the deceased was working under O.P.no.1. It is also admitted fact that the policy holder died on 19.01.2013. It is also
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admitted fact that due to non-payment of premiums the policies were lapsed.
11. It is admitted fact that deceased policy holder obtained three policies bearing No.583619323,583665879 and 583665658 for sum assured Rs.60,000/-, Rupees two lakh and Rupees one lakh respectively. It is also admitted fact that the complainant no.1 was the nominee in two policies and complainant no.2 was the nominee in one policy. Perused the status report of three policies and salary pay slip of Madhu Singh issued by FCI,District office, Balasore. It reveals that monthly premium of Rs.887/- ,Rs.299/- and Rs.639/- were deducted from the salary of deceased policy holder by L.I.C. For the above said policies total amount of
Rs.1,49.067/,Rs.40,173/- and Rs.39,586/- were deducted for the respective policies from the salary of the deceased policy holder. So the O.P.no.1 cannot deny that the premiums were not deducted from the salary of the deceased. The policies were lapsed due to non-payment of premium from the period
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of 05/2007, 05/2008 and 06/2008,12/2008, 06/2009 and 07/2009,10/2009, 12/2009 ,01/2010 and 02/2010. As per the scheme the deduction of premium was to be made by the employer and get it remitted to the O.Ps(L.I.C). However, OP No.1 took pleas that since the insured was absent in his duty, the deduction of premium could not be made from the salary, as the salary have not been paid during the period of absence from duty. But OP No.1 has not pleaded in written version exactly for which period he remained absent in duty. Only pay particulars were filed but no such relevant document is filed by OP No.1.
Moreover, Hon'ble Supreme Court in Chairman, LIC of India Vrs.Rajiv Kumar Bhaskar, Civil Appeal No.6028 of 2002 decided on 28.07.2005 and Delhi Electric Supply under taking V.Basanti Devi and another, Civil Appeal No.6113 of 1995 ,date of judgement on 28.09.1999 have observed that where the insurer repudiated the claim of the beneficiaries under the 'salary savings scheme' on the ground that the employer had
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failed to pay the premium deducted from the salary of the employee, the employer was acting as the gent of the insurance company in collecting the premium from the employee and remitting it to the account of the insurer. Since the employer, as the agent, had failed to pay the premium, the insurance company, as the principal, had to take up the responsibility.
It is made out that it was the primary duty of the employer - OP No.1 to have deducted the premium out of the salary of the deceased insured. In case, they were not able to do so, on account of non- payment of the salary, it was the duty of the employer as well as the L.I.C to provide appropriate information to the insured, who could have then taken the requisite steps to ensure that the policy did not lapse for non payment of the premium. But same has not taken place in this case.
The O.Ps have failed to produce the discharge voucher of full and final settlement showing the date and signature of the
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complainant, which could prove that the complainant had received the claimed amounts in full and final settlement. When the O.ps are unable to furnish any evidence to substantiate this plea, they are liable to pay the balance amount of Rs.2,78,126/- as claimed by the complainant because it is the duty of the employer to deduct the premium from the salary of the employee from his account or in case of non-payment for the absence period, it was the duty of the employer to intimate the employee for payment of premium. In the instant case LIC also liable because he has not provide appropriate information to employer for non-payment of premium from the salary of its employee. In this case all the O.Ps are held jointly responsible for the policy lapses which caused non-payment of rest of sum assured.
We are of the view that the complainant's are entitled to get balance amount of Rs.2,78,126/-. Hence order.
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O R D E R
The O.ps are jointly and severally directed to pay the complainant Rs.2,78,126/- as balance sum assured within 45 days from date of receipt of this order failing which the awarded amount shall carry 9% interest per annum from the date of order till the realisation of the entire amount. The impugned order is set aside. The appeal stands allowed. No cost. DFR be sent back forthwith.
Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.
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(Dr.D.P.Choudhury J)
President
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(Dr.P.K.Prusty)
Member
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(Miss S.L.Pattnaik)
Member
Date: 17.11.2022 Cuttack