1. The case of the complainant is that her late husband availed one insurance policy from the O.Ps vide policy no. R-OR-EA-746646 on 24.11.2014 for S.A. of Rs. 3,00,000/- with premium of Rs. 885/- per month and deposited the premiums till 01.10.2015 and complainant was the nominee in the said policy.  It is submitted that her husband was died on 20.10.2015 and she intimated the fact to the O.Ps and applied for the insurance benefits and also submitted all the relevant documents as per requirement of the O.Ps.  It is alleged that inspite of her best approaches, the O.Ps did not take any action to release the insurance benefits and she contacted all the O.Ps but no result came out. It is also alleged that on February, 2020, she received a letter dated 05.02.2020 from the O.P. No. 4  mentioning that to deposit the due premium against the insurance policy with interest since 30.09.2015 and on being asked to O.P. No.1 who assured for not to deposit the further premiums and also to settle the insurance claim at as early as possible, but no appropriate action taken by them, thus showing deficiency in service, she filed this case with a claim to settle the insurance benefits alongwith Rs. 1,00,000/- and Rs. 20,000/- towards compensation and costs of litigation.

2. O.Ps appeared through the A.G.P. and filed their counter admitting the issuance of alleged insurance policy vide no. R-OR-EA-746646 in favour of the deceased policy holder but denied the other allegations contending that though the complainant has submitted all the documents but did not submit the certificate towards cause of death since the insurant died before the completion of three years from the date of procurement of the said policy as required under section 53 of Postal Life Insurance Rules, 2011.  Further contended that complainant was asked for submit such certificate as on 13.01.2016, since she did not submit the said certificate to the Inspector of Posts, Malkangiri, the insurance benefits could not settled, and with other contentions, they prayed to dismiss the case.

3. Complainant filed certain documents like :

1. Copy of acceptance letter of RPLI proposal dated 25.03.2015
2. Copy of letter dated 05.02.2020 issued by Dy. Divisonal Manager (PLI)
3. Copy of Insurance policy vide no. R-OR-EA-746646
4. Copy of premium receipts
5. Copy of death certificate
6. Copy of affidavit sworn before the Notary, Malkangiri
7. Copy of letter dated 04.11.2020
8. Copy of letter dated 17.11.2020

O.Ps have filed documents like  :-

a.     Copy of letter dated 13.01.2016

b.      Copy of insurance claim rules,

c.      Copy of letter dated 13.10.2016

d.     Copy of letter dated 04.11.2020

perused the case record and material documents available therein.  For better perusal the documents are marked as exhibits as Ci to Cviii on behalf of complainant and O.P.(a) to O.P. (d) on behalf of O.Ps.

4. In the case in hand, issuance of insurance policy vide no. R-OR-EA-746646 dated 24.11.2014 in favour of Dinabandhu Baroi, deceased husband of the complainant, is an admitted fact.  It is also an admitted fact that Dinabandhu Baroi has deposited an amount of Rs. 9,931/- in total consecutively @ 885/- per month from 11/2014 to 10/2015 and during in force of the said policy, Dinabandhu Baroi was died on 20.10.2015.  It is also not disputed that complainant has submitted all the relevant documents to avail the insurance benefits of her late husband and tried her level best to that effect.  Complainant filed documents to that effect also.  It is also not disputed that due to non submission of the “cause of death” certificate, the insurance claim could not settled in time. Both parties have filed documents to that effect in support of their submissions.  Now the only question is to arose is that whose duty it is to obtain and submit the “cause of death” certificate to the department for settlement of insurance claim.

5. We have gone through the documents filed by the O.Ps and ascertained that the O.P. has filed one document i.e. letter dated 13.01.2016 vide no. RLI Claim/266/01/2016 marked as O.P (a) which clearly indicate that the O.P. No.3 has issued the said letter to the SDI (P), Malkangiri Sub Division asking for obtaining the Cause of Death certificate at their end with a copy to complainant for her cooperation in that regard.  But no documents have filed by the O.P. to prove that the concerned SDI (P), Malkangiri has obtained the said certificate or not and also not filed any document to prove that complainant has not cooperated to them, though there is specific provision under section 53 of the Postal Life Insurance Rules, 2011 to be carried out by the person of the concerned department.  But nowhere, the O.Ps have raised any single word stating that the concerned person of their own department has not obtained the cause of death certificate from the complainant or else the complainant has not cooperated them.  We feel, though the O.P. No. 3 has directed the concerned person of their department at SDI (P) at Malkangiri, but the said person has not taken any interest over to obtain such certificate to settle the insurance claim of complainant.

           Further we have gone through the documents filed by the O.P. i.e. letter dated 13.10.2016 marked as O.P.(c) and ascertained that               the said letter was issued by the Inspector of Posts, Malkangiri to the complainant after lapse of nine months from the date on                     which the O.P. No.3 has issued letter to the SDI (P), Malkangiri Sub Division on 13.01.2016 asking for to obtain the cause of                    death certificate from the complainant, but nowhere the SDI (P), Malkangiri or the Inspector of Post, Malkangiri has stated that                  what cause them for such delay of nine month and no single evidence brought out by them, and as per our view, the said delay                    caused by the department is not in accordance with law and the same is clear case of deficiency in service on the part of O.Ps.

          It is also ascertained that as per letter dated 04.11.2020 marked as O.P. (d), the SDI(P), Malkangiri was also directed to submit his              enquiry report, which clearly evidence that the concerned person of the department has not completed the enquiry report since                   13.01.2016, and no evidence was brought out by the O.Ps to show that what make them to cause delay for obtaining the aforesaid             certificate.Futher, as the direction was made to the SDI (P), Malkangiri to obtain the cause of death certificate, as per our view,                   being the insurer, it is the duty on the part of the O.Ps to obtain the cause of death certificate from the complainant to settle the                   insurance claim over the death Dinobandhu Baroi.Whereas complainant has submitted the cause of death certificate through                       affidavit on 24.11.2020, marked as Cvi to the concerned department for settlement of insurance claim as per their further letter                   dated 04.11.2020 (Cvii & O.P.(d)).

6. Further it is ascertained from the documents filed by the complainant i.e. letter dated 23.01.2020 issued by Dy. Divisional Manager (PLI) marked as Cii that the O.P. No.4 has demanded the pending dues of insurance premiums with interest from the complainant, which is matter of surprise, whereas the O.Ps are well aware about the death of the policy holder Dinobandhu Baroi since 2015. We think that the O.Ps have no coordination between them prior to issue a letter and the O.P. No.4 being the higher authority, it is the prime duty on his part to go through the status and details of subject matter of death claim, but without doing the same, he has issued a letter demanding further premium against the alleged insurance policy for such person who is already dead 5 years back, hence the O.P. No.4 is herewith directed not to issue such type of bogus letter to anybody without verifying the documents and such type of grave misconduct definitely cause severe mental agony to the complainant. 

7. On observation of the above discussions, the complainant has established the deficiency in service on the part of the O.Ps and also the O.Ps have not brought out any evidence which makes them free from their liabilities.  Hence this order.

                                                                                         ORDER

        The complaint petition is allowed in part.  The O.Ps, being the insurer of alleged policy, are herewith directed to release the insurance claim of Rs. 3,00,000/- with interest as applicable from the date of claim till payment and to pay an amount of Rs. 25,000/- towards compensation and Rs. 2,000/- towards costs of litigation towards causing mental agony and physical harassment and costs of litigation to the complainant, within one month  from the date of receipt of this order, failing which the insured amount shall carry interest @10% from the date of insurance claim till payment.   

        Pronounced the order on this the 7^th day of April, 2021 in the open Court.

        Issue free copy to the parties concerned.