This is a complaint made by one Jayanti Saha, wife of late Badal Saha of Nabapally, P.O.-Joka, P.S.-Haridevpur, Kolkata-700 104, against (1) Life Insurance Corporation of India, Divisional Office, KMDO-II,23A,/44X, Diamond Harbour Road, P.S.-New Alipore, Kolkata – 700 053, (2) Life Insurance Corporation of India, Direct Agents Branch, Queen Mansion, 12, Russel Street, P.S.-Park Street, Kolkata – 700 071 and (3) Life Insurance Corporation of India, Branch Manager, Sarsuna Branch, 620, Diamond Harbour Road, P.S.-Behala, Kolkata – 700 034, praying for direction upon the OPs to pay Rs.1,00,000/- in respect of Policy No.416006371 dt.25.3.2006, Rs.5,00,000/- in respect of Policy No.579903832 dt.21.2.2012 and compensation of Rs.2,00,000/- and litigation cost of Rs.25,000/-.

            Facts in brief are that Complainant is wife of late Badal Saha and she is residing at Nabapally, P.O.-Joka along with her two minor daughters. OP is a company registered under Company’s Act,1956. Badal Saha was the policy holder of policy No.416006371 dt.25.3.2006 for the sum assured of Rs.1,00,000/-. Complainant is the nominee of the said policy of her husband Badal Saha. In addition to that Badal Saha had another policy being No.579903832 dt.21.2.2012, issued by the OP No.3, having sum assured to the tune of Rs.5,00,000/- on 6.8.2012. The premium amount of Rs.17,258/- was paid.  Badal Saha, husband of the Complainant, suddenly died on 19.1.2013 and the death certificate is annexed with the complaint as annexure ‘C’. After the death of Badal Saha, Complainant being wife and nominee on the two policies, submitted her claim with a document including the original certificate of policies to OP No.1 who received the policies and issued receipt. Badal Saha had other policies also.

             After the death of the husband of the Complainant, OPs intentionally and wrongfully did not pay her legitimate claim and finally on 13.5.2015 illegally repudiated the claim. OPs filed written version wherein they have denied the allegations made in the complaint petition. They have alleged that the policy was taken by false representation of case and in view of the judgment in Satwant Kaur Sandhu v. New India Assurance Company Ltd., IV(2009) CPJ 8(SC) Volume 8 it has been decided that if the policy holder suppress any material fact he is not entitled to any claim.

             Further, OPs have stated that Complainant suppressed about his disease. It is further stated that the policy No.416006371 which commenced on 25.3.2006 with a sum assured of Rs.1,00,000/- did not continue and lapsed in June, 2010. This policy was revived on 28.5.2012 by signing a declaration of good health along with necessary documents. The policy No.579903832 had a commence date of 21.2.2012 with sum assured of Rs.5,00,000/- did not continue for more than one year. Further, the OPs have stated that Policy No.4511303749 did not belong to the husband of the Complainant, but, was in the name of Hemanta Narayn Sanyal and as such any payment to that policy does not touch the merit of the complaint case. The claim for both policies were made less than a year of revival of Policy No.416006371 and commencement of Policy No.579903832, the complainant is not entitled to the claim. It is because Complainant suppressed the health condition of the deceased. In the circumstances, OPs have prayed for dismissal of the claim.

Decision with reasons :

              Complainant filed a petition praying for treating the complaint as his evidence and the prayer was allowed, against which OPs put certain questionnaire to the Complainant. Complainant answered to these questions, where Complainant has admitted that there was revival of the policy. Further, Complainant has stated that last premium was made on 6.8.2012.

              Main point for determination is whether Complainant is entitled to the reliefs mentioned in the complaint.

              On perusal of the prayer portion, it appears that Complainant has prayed for direction upon the OP for payment of Rs.1,00,000/- for policy No.416006371 of which sum assured was Rs.1,00,000/-. It is admitted by the Complainant that this policy lapsed and it was revived for another policy bearing No.579903832 which was issued on 21.2.2012 and sum assured of this policy is Rs.5,00,000/-  which was also claimed by complainant.

             Now, the question is whether the repudiation of the claim of the Complainant by the OPs is in accordance with law. OPs have repudiated claim on the ground that Complainant did not answer truly in the proposal form of the policy bearing No.579903832 and he suppressed that at the relevant time he was suffering from hyper tension and blood sugar. In this regard, it is submitted that Complainant’s husband purchased many other policies also and OPs being a statutory corporation of Govt. of India, constituted by a special act accepted and issued the policy. So, it is their obligation to pay the sum assured after the policy holder dies after giving even one premium.

            However, surprisingly we find in the written version that a wrong statement has been furnished by the OP stating that Policy No.411303749 did not belong to the husband of the Complainant but was in the name of Hemanta Narayan Sanyal. This appears to have been mentioned by the OPs in order to camouflage the proceeding, it is most unwanted on behalf of a statutory corporation.

            Other ground is that OPs have stated that neither of the policies ran for one year. If contention of revival is accepted policy No.416006371 commenced till 25.3.2006 and ran up to 2010 and thereafter it was revived. So, we do not find any merit in the contention that Complainant is not entitled to the prayers which she has made except the prayer for payment of Rs.1,00,000/- because this policy having sum assured of Rs.1,00,000/- revived into the other policy. Hence, OPs cannot take a ground that neither of the policies ran for one year.

             In the aforesaid facts and circumstances the prayer of the Complainant is allowed in part.

Hence,

ordered

Complaint case CC/235/2016 and the same is allowed in part on contest. OPs are directed to pay Rs.5,00,000/- to the Complainant with interest of 10%p.a. from the date of 22.2.2013 till realization within two months of this order. In addition, OPs are directed to pay compensation for deficiency in services to the extent of Rs.40,000/- and litigation cost of Rs.10,000/- within this period, in default this will also carry interest of 10%p.a. after two months till realization.