JAICHAND DEWANGAN v. REGIONAL MANAGER, LIC, RAIPUR
2006-11-10
R.S.AWASTHI, V.K.AGARWAL, VEENA MISRA
body2006
DigiLaw.ai
ORDER As per Hon'ble Smt. Veena Misra, Member :- 1. This appeal has been preferred u/s.15 of the Consumer Protection Act, 1986, against the order dated 28,04.2006, passed in Complaint NO.191-2004 by the District Consumer Disputes Redressal Forum, Durg (hereinafter referred to as the 'District Forum' for short) whereby the complaint was dismissed by the District Forum. 2. The facts not presently in dispute are that the son of the complainant, late Dameshwar Prasad Dewangan, had obtained Bima Kiran insurance policy for a sum of Rs.1,00,000/- (Rs. One lakh), bearing No.581581981 dated 10.12.1999 from the respondent /opposite party No.2. Amount of premium of Rs.965/- was payable on half yearly basis. It is also not in dispute that the insured Dameshwar Prasad Dewangan died on 31.07.03 and further that the claim filed by the appellant/complainant was repudiated by the insurer on 15.11.2003 on the ground that the policy was in a lapsed condition on the date of death of the life assured . 3. Brief facts necessary for disposal of this appeal are that as per averments in the complaint, it was the OP No.3 who had, as agent of the OP Nos.1 and 2, got Dameshwar Prasad Dewangan insured under the Bima Kiran Policy. The OP No.3 also used to collect the half-yearly premium from the insured and deliver receipt after depositing the amount. It is further averred in the complaint that the OP No.3 used to collect the amount of premium well in advance of the due date. The said OP had collected RS.965/- on 3.06.2003 to be paid towards premium and had assured that he will handover the receipt after depositing the premium with the LIC. Subsequently, the insured met with a fatal accident on 31.07.2003 and succumbed to his injuries. Thereafter, the complainant had given due intimation to the OP NO.2 through the OP No.3 and had also laid claim with his assistance and had duly complied with the necessary formalities. However; the OP NO.2 vide letter dated 15.11.2003 repudiated the claim on the ground that at the time of death of the life assured, the policy was lying in a lapsed condition and had also refunded the amount of last premium. It is averred in the complaint that this attitude on part of the OPs amounts to deficiency in service.
However; the OP NO.2 vide letter dated 15.11.2003 repudiated the claim on the ground that at the time of death of the life assured, the policy was lying in a lapsed condition and had also refunded the amount of last premium. It is averred in the complaint that this attitude on part of the OPs amounts to deficiency in service. It is also averred in the complaint that the OP No.3 had, during his visit to the village, assured that he will see that the assured sum is paid and further assured that in case the amount is not paid by the insurer he himself will pay the same. The complainant, besides filing his own affidavit, has filed affidavits of Hemlal Thakur, Ram Chandra, Gomti Bai Dewangan, Khumanlal, and has also filed various documents in support of complaint 4. The opposite parties no.1 and 2 had filed joint reply and averred that last premium was paid on 1.08.2003 whereas the life assured had already died on 31-7.2003. Hence, there remains no doubt that the policy of the deceased insured was lying lapsed at the time of his death and premium paid subsequent to death of the life assured cannot revive the policy and cover the risk of death occurred prior to payment of revival premium. It is also averred that the agent is not authorized to receive revival premium and in case the agent had done so, he did it as his own peril and the LIC cannot be bound by the aforesaid unauthorized act of the agent. In the circumstances, the complainant is not entitled to any relief against the OP Nos. 1 and 2. 5. The opposite party No.3 in separate written version admitted that the life assured had taken policy through him but denied collection of renewal premium. It is averred in the written version that the deceased life assured often met him in the office of OP No. 1 and 2 and he used to assist him in depositing the instalment of premium and used to hand over the receipt immediately. It is specifically denied in the written version that he had either received the amount towards the last premium or had deposited the same on 1.08.2003 as has been alleged by the complainant. The OP No.3 has further denied giving any assurance regarding the claim amount.
It is specifically denied in the written version that he had either received the amount towards the last premium or had deposited the same on 1.08.2003 as has been alleged by the complainant. The OP No.3 has further denied giving any assurance regarding the claim amount. It is admitted that he had helped the complainant if: laying claim before the insurer but this does not fasten any liability on him. He prayed that the complaint may be dismissed. 6. The learned District Forum dismissed the complaint vide the impugned order. Being aggrieved by the said order, the complainant has preferred this appeal. Final arguments heard and record perused. 7. Learned counsel for the appellant assailed the impugned order and urged that the learned District Forum failed to appreciate the material an record in Its proper perspective. He submitted that the complainant is the father of the life assured and it is impassible that the complainant or any one else from the family would even think of paying premium on the very next day of death in the family and that too of the young man, the san of the complainant. He submitted that as the agent had received premium but had failed to deposit the same, he must have deposited it on 1.08.2003. He further submitted that the life assured always used to pay premium in advance to the agent / OP No. 3 who used to hand aver the receipt after depositing the same. Since/ during his life time; the life assured load paid the premium to the agent, it amounts to payment to. LIC The learned counsel far the appellant prayed that the appeal may be allowed and the order of the District Forum may be set aside. 8. As against this, the learned counsels for respondent reiterated the stand taken before the District Forum and submitted that the impugned order is a reasoned order and is just and proper. There is no. need far any interference with the order passed by the District Forum. 9. The preliminary question to be decided is - Whether payment of premium to LIC after death of the life assured would bind the LIC even if the renewal premium was paid to the agent prior to death of the life assured? 10.
There is no. need far any interference with the order passed by the District Forum. 9. The preliminary question to be decided is - Whether payment of premium to LIC after death of the life assured would bind the LIC even if the renewal premium was paid to the agent prior to death of the life assured? 10. The appellant/ complainant has averred in complaint that the agent i.e. the OP, Na.3 had collected premium from the deceased insured an 3.06.2003 hence, the insurer was liable to pay the assured sum. Indisputably, the premium was paid to the insurer an 1.08.2003 i.e. after the death of the life assured. It is an this very ground that the insurer has denied their liability. It was submitted by the learned counsel far the insurer that even if the life assured had paid premium to the agent, the insurer was not liable as the agent Jas not authorized to collect renewal premium and such unauthorized act an part of the agent does not bind the insurer. In this regard, he relied an Harshad T. Shah & another Vs. LIC of India and others. 11. Learned counsel far the respandentNa.3 agent submitted that the agent had neither collected the renewal premium d6r was liable far any deficiency in service, He further submitted that the agent /OP No.3 had collected only the first premium and not renewal premium, The life assured used to go personally to the office of the insurer to deposit renewal premiums where he used to meet the agent and he helped him in making payment. 12. In above regard, it is noted that several receipts have been placed an record. In each and every receipt, the agency code and the made of payment and the amount paid towards the renewal of the policy in the name of the life assured are mentioned in very clear and unambiguous terms. It is further noted that in all the aforesaid receipts the policy No. is mentioned as 381581981, agency code as 05456383 and indisputably, the aforesaid numbers relate to the relevant policy and the agency code of the OP No.3.
It is further noted that in all the aforesaid receipts the policy No. is mentioned as 381581981, agency code as 05456383 and indisputably, the aforesaid numbers relate to the relevant policy and the agency code of the OP No.3. It appears from the receipts placed on record that the consolidated amount paid is in thousands and out of the said consolidated, amount a sum of Rs.965/- has been paid towards renewal premium for the policy in the name of the life assured Dameshwar Prasad Dewangan. From some of the receipts, it further appears that some amount has also been charged towards late fee. Consolidated amount mentioned in each receipt is different and runs into 14,000; 15,000; 17,000 and odd rupees and one of the receipts goes to show consolidated sum of Rs.45,007.10. There is no reason to believe that the life assured would pay such huge sums whereas the renewal premium was only Rs.965/-. We are of the opinion that all this goes to show that the contention of the agent that he did not collect renewal premium is not worthy of credence. The material on record shows that it was he who used to deposit the consolidated amount towards premium for several persons. Moreover, as submitted by the learned counsel for the appellant/complainant, we also feel on the basis of common knowledge and experience that a person who suddenly lost his young son in an accident would not be in a mental frame to deposit or direct some one to deposit the renewal premium on the very next day of the death of his young son and the more so when the cremation took place on the next day i.e. the day of deposit of premium. We have no reason to disbelieve the affidavits filed by Hemlal Thakur, Ramchandra Deshmukh and Khomanlal who are independent witnesses and have stated on oath that Gunnukh Singh Joshi had told at Jaichand Dewangan's place in presence of many people that he would see that the death claim of Dameshwar is paid and had further assured that in case the insurer fails to make payment, he himself would do so. It appears that he was probably feeling guilty conscience. 13. Since, the agent is not permitted under the rules to accept premium, there is no doubt that the agent i.e. the OP No.3 has exceeded his authority.
It appears that he was probably feeling guilty conscience. 13. Since, the agent is not permitted under the rules to accept premium, there is no doubt that the agent i.e. the OP No.3 has exceeded his authority. As held in Harshad T Shah & another Vs. LIC of India and others, payment of premium to agent deposited with the LIC after death of the life assured does not bind the LIC. Facts of Harshad's case are similar to the facts of the casein hand. 14. In the facts and circumstances of the case, we are of the opinion that the LIC is not liable for making payment of the assured sum to the complainant. However, since it was due to default and deficiency in service on part of the agent that the interest of the policy holder could not be secured by revival of the policy, we are of the opinion that the agent is liable for making payment of the assured sum to the complainant/appellant. 15. It is noted that LIC has refunded the last premium to the complainant. Since the complainant I appellant could not get the assured amount from the LIC due to default on part of the agent, who used to receive commission out of the premium paid by the deceased, the agent I respondent NO.3 is directed to pay the amount of the assured sum after adjustment of the amount of last premium refunded as above, by LIC to the complainant/appellant, within a period of two months failing which interest@9%shall also be payable from the date of complaint to the date of payment. Appeal Allowed.