:    J U D G M E N T    :
The brief fact of the case is that Raju Nandi has obtained an insurance policy viz. LICI’s New Bima Gold bearing No. 428433133 on 10.03.2010.  The said policy will expire on 10.03.2030.  The sum assured under basic Plan of Rs. 50,000/-.  The extended term cover benefit is of Rs. 25,000/- and sum assured of Rs. 50,000/- has been fixed towards the accident benefit rider.  The complainant has filed this application u/s 12 of Consumer Protection Act, 1986 as a nominee of the said policy as Raju Nandi died on 05.08.2012 in Andhra Pradesh when he was working as a mason.  In the instant case, the complainant in relation is a sister of deceased assured viz, Raju Nandi.  After death, Post Mortem was held at local Hospital at Andhra Pradesh.  Thereafter, the complainant being a nominee of the above noted policy, sent her claim form duly filled up on 22.08.2014 which was acknowledged by OP office.  The OP Insurance Company has failed to settle the matter, though the complainant visited the OP office on several occasions.  The OP has enough knowledge about the said incident but negligently kept the matter pending causing clear gross negligence and deficiency in service on the part of OP.   Hence, the complainant has knocked at the door of OP for getting her relief as prayed for. 
    OP / LICI contested this case by filing written version stating, inter alia, that all the statements made in the claim petition are true and it is very much pertinent that it has been stated by way of affidavit on 22nd day of April, 2015.  In written version, OP also stated that the complainant was asked to submit the required documents for settlement of claim, but she did not do so.   There was no latches / negligence on the part of OP regarding settlement of the claimant.  So the present petition is liable to be rejected with costs.  
An amendment petition was filed by OP LICI by way of affidavit on 16.11.15 praying for inserting the word ‘not’ before the word true in first line of Para- 6 of written version and also praying for inserting the word ‘not’ before the word true in the 1st line of Para- 1 of OPW 1/LICI.  But as per order No. 21, dtd.  23.11.15 it is ordered that the amendment petition ‘not pressed’ orally and fix 30.11.15 for argument / BNA.

Now the Forum is to consider the following points:-
Whether the complainant is to be treated as consumer or not as per  
Consumer Protection Act 1986.
Whether there is any gross negligence or deficiency in service on the part of OP or not,
Whether the complainant is entitled to get any relief as prayed for.

    DECISION WITH REASONS

Point No. 1.
     We have perused complaint, written version, affidavit-in-chief filed by complainant, OPWs, written argument of complainant and OP / LICI along with all relevant documents filed by both parties.  We have carefully perused the original policy certificate filed by the complainant.  It is admitted position that Raju Nandi obtained a New Bima Gold Policy bearing No. 428433133 on 10.03.10, which will expire on 10.03.2030.   The sum assured under basic plan is of 50,000/-, the extended term cover benefit is of Rs. 25,000/- and sum assured of Rs. 50,000/- has been fixed towards the accident benefit.  The said policy obtained from OP LICI after payment of necessary premium (consideration) amount.   It is admitted that Raju Nandi died on 05.08.2012 in Andhra Pradesh due to accident.  As a nominee his sister namely Swapna Nandi claimed all benefits arising out of said policy from the OP LICI.   So as a nominee of the said policy, Swapna Nandi is to be treated as consumer as per Consumer Protection Act, 1986.

Point Nos. 2 &3:
    It is admitted that the complainant filed number of documents such as a letter addressed to Manager, Krishnagar Br. I, dtd.  22.08.2014 written by complainant, certificate of Pradhan Gobindapur Gram Panchayat dtd. 04.09.12 regarding death of Raju Nandi, certificate of death, voter I. Card, charge-sheet / final report bearing No. 11/2012 dtd.  22.08.2012, Post Mortem Report, Case diary etc. in the office of LICI on 22.08.2014 as it is clearly evident that one Assistant Administrative Officer, Mr. D. Dutta, LICI of India, Krishnagar Br. I endorsed his signature upon all documents along with marking ‘Pl accept’ on the letter dtd.  22.08.2014 written by complainant Swapna Paul.   From this endorsement of his signature, it is clear that all the documents were kept in the office of OP / LICI.  So the complainant has failed to supply all documents in the office of LICI – is not correct one, rather we can easily presume that the OP / LICI knew all facts regarding death of Raju Nandi but unfortunately after getting all necessary documents they have failed to settle the said claim of complainant. 
    It is admitted that Raju Nandi died on 05.08.2012 which is clearly revealed from certificate of death and certificate issued by Pradhan, GGP, Nadia.
    From the Police Report / Case Diary it is found that on 04.08.2012 at about 4 pm Raju Nandi working as a helper in a plant / factory fell down from 6 mtr height and got grievous injury in the back side of the head.  He treated at Balaji Hospital at first.  But for providing better medical treatment it was necessary to approach Hyderabad Hospital, but before reaching the said Hospital, he expired.  The Post Mortem was held on 05.08.2012.  The death certificate issued by Osmania General Hospital is stating that Raju Nandi died due to ‘multiple injury’.
    At the time of argument Ld. Counsel for OP / LICI stated that the complainant did not file the original policy certificate.   It is true the said fact.  The order No. 22 dtd.  30.11.15 speaks that the ld. counsel for complainant filed original policy certificate being No. 428433133 in the Forum.  But mere non-submission of original policy certificate in the office of OP / LICI does not cause any disturbances for settlement of the claim of complainant as this case was very much genuine one.  Moreover the insurance is a contract between the both parties which is based upon the principles of uberima fide i.e., utmost good faith.  When the case is genuine one & the policy is in force then it is the duty of OP / LICI to pay the assured amount to the complainant.   Non-payment of assured amount to the complainant causes gross negligence & deficiency in service on the part of OP / LICI.  So as per our view the complainant is entitled to get relief against OP / LICI.  So the case succeeds.  
     Hence, 
Ordered,
          That the case CC/2015/11 be and the same is allowed on contest against OP / LICI with cost of Rs. 1000/-.    
        That the complainant is hereby directed to submit the original Policy certificate bearing No. 428433133 in the office of OP / LICI within 15 days from the date of order & the OP / LICI is bound to receive the same with acknowledgment.  
    That thereafter, the OP / LICI is hereby directed to pay assured sum of Rs. 1,25,000/- plus Rs. 1,000/- towards cost i.e., total of Rs. 1,26,000/- to the complainant within 30 days from the date of receiving the original policy certificate, i.d., interest @ 10% p.a. shall be charged upon the amount till full realization.  
    Furthermore that  the OP / LICI is bound to pay Rs. 50/- per day in Consumer Welfare Fund / Legal Aid Fund after expiry of said stipulated period of time mentioned above.     
     Let the copy of this order be supplied to the parties free of cost.