The complainant’s case in a nutshell runs as follows. The complainant’s husband since deceased purchased policy covered from 18.12.2012 to 3.3.2028 and  20.3.2015 to 30.3.2028. The premium against the said policy was given by Kartick Chandra Das, since deceased. Kartick Das died on 8.10.2013 due to Myocardial Infection. Prior to that said Kartick Chandra Das never suffered any disease. Death certificate has been issued by Sub Registrar. This complainant is the legal heirs of the said policy holder. The complainant filed death claim along with all relevant papers before Op no.2 but the Op no.1 repudiated the claim on the allegation of violation terms conditions of the Insurance Act. OP /Insurance company issued the policy after full satisfaction . The complainant served notice on 28.10.2014 . Cause of action arose on 8.10.2013 when Kartick Das died. Hence this case as OP repudiated the claim.

            Op no.1 and 2 contested the case by filing Written version denying inter alia all material allegations. It is stated that the complainant does not fall within

the definition of Consumer Dispute. It is also stated that the deceased did not disclose the existence of other Life Insurance policies in his name at the time of filling the proposal form. The policy was issued as per consent and information provided by the complainant in the proposal form . The Op has no negligence and deficiency in service. It is therefore prayed that complainant’s case should be dismissed.

            The complainant has filed Insurance policy and Evidence in chief and answer to the interrogatories. The oP has also filed Written version, Evidence in chief and Written Notes of Argument.

                                                            POINTS FOR DECISION

1. Whether the complainant is a consumer?
2. If there is any deficiency on the part of the oP ?
3. If complainant is entitled to get any relief?                                           

DECISION WITH REASONS :

All the points are taken up together for easiness of discussion.

Point no.1

            It is admitted fact that the complainant’s husband paid premium and accordingly Op issued the Insurance policy on 30.3.2013 mentioning the nominee so the complainant is a consumer under the definition of C.P.Act 1986 because the complainant is the legal heir of Kartick Chandra Das, since deceased. Thus, the point no.1 is answered in favour of the complainant.

Point no.2 and 3

            Both the points are taken up together for easiness of discussion.

            The complainant in her complaint as well as evidence in chief stated regarding the facts and allegation that her husband since deceased purchased two policies from Op no.1 and 2. Her husband died on 8.10.2013 due Cardio Respiratory Failure , to that effect complainant filed photo copy of Death certificate issued by Dr.H.Manna due to Cardio Respiratory Failure. He died in the Jeevandeep Seva Sadan , Kamarkundu, Hooghly. The complainant filed photocopy of Insurance policy issue by Reliance Life Insurance Guaranteed Money Back Plan. The policy schedule described Death benefit, Maturity Benefit and Money Back

benefit. Sum assured 7,39,500/-. Besides the short note death benefit , “on death of life assured at any time prior to 30^th March, 2028 Rs.7,39,500/- will be payable plus maturity benefit and Money back benefit as specified below” “On accidental death of life assured at any time prior to 30^th March, 2021 Rs.1,47,930/- will be payable plus maturity value and Money back benefit a specified below” . In this place, Maturity benefit and Meoney Back benefit has also been mentioned. Nominee U/s 39 of Insurance Act is Mr.Tanushree Mallick. In another letter issued by Reliance addressed to Nilima Das dated 16.3.2014 it has been written “we understand that late Ms. Kartick Chandra Das had proposed with various insurance companies before proposing to us and the tune of Rs.9,70,030/-. If Mr. Kartick Chandra Das had disclosed the same in proposal form, we would have been issued after considering the underwriting guidelines. In the light of suppression of material fact, where glaring omission to answer especially the question no.(22) relating to details of the life insurance policies held by the life assured we are constrained to repudiate the claim under the policy in terms of Section 45 of the Insurance Act 1938”.

            Therefore, knowing fully well the facts and circumstances of the policy holder the Opposite party company issued the above policy in favour of the Kartick Chandra Das, since deceased on 30.3.2013. Moreover, in reply by the complainant against the questionnaires filed by the Opp no.1 and 2   it is stated by the complainant in respect of the questionnaire no.2 that the agent of policy holder did not read out the all terms and condition of the Policy certificate  . Answer in question no.3 of Op the complainant states that her husband did not suppress anything when he filled the proposal form and in questionnaire no.4 the complainant stated that her husband disclosed all his policies and health condition in the said proposal form.

            Moreover, the oP did not adduce any evidence to rebut the contentions of the complainant . Op did not adduce any evidence that complainant suppressed the material fact inspite of his attention was drawn by the oPs representative or agent. So, there is nothing to disbelieve the complainants case and material produced by the complainants before this Forum. So , it is stands that Op issued the Policy in question fully being conversant with the complainant. Now, the Op must keep his promise of contract to pay the sum assured as shown in the policy.

            So, we are fully convinced that the complainant has succeeded to prove his case and complainants case succeeds on contest.  Complainant is entitled to get relief as per provision of C.P.Act, 1986. Hence it is –

                                                            Ordered

            That the CC no. 101 of 2015 be and the same is allowed on contest. Both the Ops are jointly and severally liable to pay Rs.8,51,900/- to the complainants towards death claim and matured value of the policy in question. Both the Ops are jointly and severally liable to pay Rs.20,000/- towards compensation for their unnecessary mental agony , harassment and pain. Both the Ops are jointly and severally liable to pay Rs.10,000/- towards litigation cost to the complainants .

            The Ops shall comply the above order within 45 days from the date of this order i.d. Rs.200/- shall be imposed per day upon the oPs and that amount will be deposited in the Legal Aid Fund after the statutory period of 45 days is over.

            Let a copy of this order be made over to the parties free of cost.