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2009 DIGILAW 33 (CHH)

BRANCH MANAGER, LIC OF INDIA v. ANIL GAJBHIYE

2009-01-30

S.C.VYAS, V.K.PATIL, VEENA MISRA

body2009
ORDER Hon'ble Shri S.C. Vyas, President:1. This is an appeal of Life Insurance Corporation 0f India, who felt aggrieved by order dated 02.07.08 passed in complaint case No.282/07 by which District Consumer Disputes Redressal Forum, Durg (hereinafter called "District Forum" for short) has directed the appellant as well as respondent No.2 Municipal Corporation, Durg to pay Rs.20,000/-, which was the sum assured under the insurance scheme as well as Rs.2,000/- more by way of compensation for mental harassment to respondent No.1, who was complainant before District forum. 2. In nutshell the facts of the case are that father of the complainant Anil Gajbhiye, namely Kushan Cajbhiye became member of Minil11ata Urban Poor Group Insurance Scheme on 27.05.04 and deposited Rs.25/- in that scheme. Thereafter, on 23.06.04 Kushan Gagbhiye died and claim was preferred by the complainant nominee for Rs.20,000/-, which was payable under terms of that policy, but the claim was repudiated by the insurance corporation i.e appellant, on the ground that the amount of premium was deposited in the Office of the appellant on 08.07.04. whereas Kushan Gajbhiye had already died on 23.06.04, thus no amount of premium was deposited during lifetime of Kushan Gajbhiye ane so he was not insured under that scheme by the appellant. Same was the written version of insurance corporation before District Forum. 3. Learned District Forum after considering the material placed before it by both parties, ultimately allowed the complaint and passed award as aforesaid in paragraph No.1. 4. The only ground pressed by learned counsel for the appellant is that during lifetime of the deceased Kushan Gagbhiye, he was never insured by the appellant and so no liability can be fastened on the appellant for payment of any amount, as insurance amount under the scheme. Learned counsel for the appellant submitted that it is now a settled view of this Commission as well as Hon'ble National Commission also, that unless premium is paid and policy document executed between the parties, during lifetime of the insured, the insurance company cannot be ordered to pay any amount under the insurance policy. 5. To counter these arguments learned counsel for respondent No.1 complainant submitted that deceased during his lifetime has paid Rs.25/- as his share of the premium, of the insurance scheme. 5. To counter these arguments learned counsel for respondent No.1 complainant submitted that deceased during his lifetime has paid Rs.25/- as his share of the premium, of the insurance scheme. He submitted that this scheme was sponsored by Government of Chhattisgarh, as per the tri-party agreement between Nodal Agency, LIC and Government of Chhattisgarh. It has been submitted that as per the scheme some portion of premium was to be paid by the insured, some amount was to be added by Nodal Agency and then a sum equal to total of the amount paid by insured and Nodal Agency was required to be added by the LIC as one time premium of that insurance policy and then the benefit of the policy was to be given all those beneficiaries who have been insured under the scheme. Learned counsel for the appellant has also agreed to this argument. Both parties has no dispute on this question that respondent No.2 was working as Nodal Agency in the case of deceased Kushan Gajbhiye and his name was included in the list of such persons, in capacity of Nodal Agency by the Municipal Corporation and its part of premium was paid by the Municipal Corporation. 6. After considering aforesaid arguments and perusing documents produced before District Forum, it appears that as per the objects of the scheme, it has been specifically sponsored for the benefit of poor and backward class of the society, residing in slum areas and those who are self employed, in order to give them social security. The papers which have been filed by both parties shows that in the case of deceased Kushan Gajbhiye, the amount of Rs.25/- was obtained from him on 27.05.04 and receipt was also issued bearing No.041 from Receipt Book No.0238 by the Nodal Agency. It also appears that similarly share of premium was obtained from many other persons by the Nodal Agency and then that amount was collectively sent to the appellant. The letter of sending such amount to the insurance corporation is available on record, which is Ex.-D1, this letter shows that it was prepared on 24.06.04 and was also signed by the Municipal Commissioner on the same date, but was dispatched on 28.06.04. The letter of sending such amount to the insurance corporation is available on record, which is Ex.-D1, this letter shows that it was prepared on 24.06.04 and was also signed by the Municipal Commissioner on the same date, but was dispatched on 28.06.04. It is worth mentioning that on 23.06.04 the Kushan Gajbhiye died, this letter shows that on the date of death of Kushan Gajbhiye the amount of premium was lying with the Municipal Corporation and could not be sent to the insurance corporation. Amount was forwarded after 4 days, and it reached on 08.07.04 in office of the insurance corporation, which can be seen from Ex. D2 & D3, which shows that collective Bank Draft of the amount received nom different beneficiaries were prepared and contribution of the Government and contribution of insurance corporation was also added in the month of July, 04 and then the entire sum was sent. These all shows that whole exercise were done after death of the deceased Kushan GCYbhiye. From these facts, it is clear that till death of Kushan Gajbhiye, he had not become an insured person because no amount of premium had reached till that date to the LIC. The procedure fixed by the Government in respect of the scheme vide letter of Secretary Government of Chhattisgarh, Department of Urban Development dated 27.04.02 also says as para 7 that a person will be treated insured under the scheme after receipt of list of group of 25 persons along with draft, sent by Nodal Agency. This also shows that Kushan Gajbhiye was not insured on the date of his death. 7. In these circumstances we find that no insurance premium had reached to the insurance corporation and insurance umbrella could not be provided by the Corporation to Kushan Gajbhiye and so no amount is payable by the insurance corporation to the complainant. Thus we find that the appeal preferred by the insurance corporation is full of merits and needs to be allowed. 8. So, we allow this appeal and set aside the order passed by the District Forum, so far as it relates to the appellant LIC. It is made clear that no interference has been made in rest part of the impugned order, which relates to the Municipal Corporation, Durg, because no appeal has been preferred by Municipal Corporation. No orders as to the cost. Appeal Partly Allowed.