The Complainant has filed this case alleging deficiency-in-service by the O.Ps, where O.P No.1 is the SBI Life Insurance Co. Ltd., Balasore and O.P No.2 is the SBI Life Insurance Co. Ltd., being represented by its Authorized Signatory, Corporate & Registered Office, Andheri(E), Mumbai.

                    2. The case of the Complainants in brief is that the Complainants being the legal heirs of the deceased Duryodhan Bhoi, S/o. Late Hari Narayan Bhoi, who died due to road accident on 18.07.2014. The deceased Duryodhan Bhoi had two nos. of “SBI Life Unit Plus-III pension” policies vide Policy No.38005554009 and 38005553406 with the O.P No.1 on payment of premium for Rs.6.00 Lacs (Rupees Six lacs) only and Rs.4.00 Lacs (Rupees Four lacs) only respectively on 29.06.2010, where Complainant No.1 is the nominee as well as the Complainants are the legal heirs of the said deceased Duryodhan Bhoi. Neither the said insured nor the Complainants have violated terms and conditions of the said insurance policies. The legal heirs of the deceased life assured (in short D.L.A) requested the O.Ps for settlement of their claim and submitted all the required documents before the O.Ps as per their direction. Thus, the O.Ps have paid Rs.8,47,111/- (Rupees Eight lacs forty seven thousand one hundred eleven) only to the Complainants against the Policy No.38005554009 on 23.08.2014, but they have not settled the claim of the Complainants in respect of Policy No.38005553406 till date. The Complainants have submitted all required documents (including legal heirs certificate) before the O.Ps and there is no dispute with regard to this claim, rather the O.Ps are demanding further additional documents. It is pertinent to note that the O.Ps have already settled claim of the Complainants in respect of above noted policy on the basis of the documents submitted earlier, but the O.Ps are avoiding to settle the claim in respect of remaining policy as stated above, which amounts to deficiency-in-service and harassment on the part of the O.Ps. Cause of action arose on 17.04.2015. The Complainants have prayed for settlement of claim with interest for Policy No.38005553406 along with compensation towards mental agony and harassment plus litigation cost.

                    3. Written version filed by the O.Ps through their Advocate denying on the point of maintainability as well as its jurisdiction. The O.Ps have further submitted that the O.Ps are willing to disburse the claim amount of Rs.4,08,498/- (Rupees Four lacs eight thousand four hundred ninety eight) only against Policy No.38005553406 to the beneficiaries, subject to clearance of title of said Policy. The said policy is terminated as per the terms and conditions of the policy before death of policy holder and the title under the policy is open, which is to be decided by a Civil Court of competent jurisdiction. Moreover, Duryodhan Bhoi is reported to have died on 18.07.2014. The said policy was a regular premium policy and premium periodicity was yearly, but the O.Ps have received one premium of Rs.4,00,000/- (Rupees Four lacs) only on 12.07.2010, where first unpaid premium date was 12.07.2011. The policies were unit linked in which the fund value may increase or decrease as per the performance of financial market. In this policy, the investment risk in investment portfolio is borne by the Policy holder. As per Policy Clause No.5.1, discontinuance of premiums in first three policy years. 5.1.1- If you have not paid all premiums due in the first policy year and do not revive your policy, you will not get your fund value or any other benefits. 5.1.2- If you have not paid the 2nd or 3rd policy years’ premiums and do not revive your policy, then you will pay the fund value minus the surrender charges, if any, at the end of the revival period. 5.1.3- On the expiry of grace period, the rider covers, if any will end. 5.1.4- we will continue to deduct FMC and policy administration charges. As per Clause No.6, Revival of the policy document, the revival period is 3 years from the due date of the earliest premium not paid. In the instant case, the first unpaid premium date under the policy was 12.07.2011 and the revival period ended on 11.07.2014. As per the terms and conditions of the policy as stated above, fund value minus the surrender charges are payable. Accordingly, an amount of Rs.4,08,498/- (Rupees Four lacs eight thousand four hundred ninety eight) only is payable under the policy. As per Clause No.12.3, surrender charges, the same is ascertained based on the number of completed years’ premium paid. In the instant case, only first year premium is paid. Hence, the surrender charges applicable are 15% of the fund value. Thus, an amount of Rs.4,08,498/- (Rupees Four lacs eight thousand four hundred ninety eight) only is payable under the policy towards lapse terminated refund amount. The policy terminated before the death of the policy holder i.e. on 12.07.2014 and the date of death is 18.07.2014. As the policy terminated during the lifetime of the policy holder, the nomination under the policy also became ineffective on 12.07.2014. As the policy holder died on 18.07.2014, the title under the policy is open. Hence, the O.Ps called for a succession certificate vide letter dtd.09.09.2014 and the same has not been received yet. The O.Ps are ready to pay Rs.4,08,498/- (Rupees Four lacs eight thousand four hundred ninety eight) only to the legal heirs. As the title under the policy is open, the O.Ps were constrained to call for a succession certificate to ensure that the policy money is paid to the right person. The Complainant is required to prove her title to claim benefits under the policy.

                    4. In view of the above averments of both the Parties, the points for determination of this case are as follows:-

(i) Whether this Consumer case is maintainable as per Law ?

(ii) To what relief the Complainants are entitled for ?

                    5. In order to substantiate their claim, both the Parties have filed certain documents as per list. Perused the documents filed. It has been argued on behalf of the Complainants that out of two policies, the Complainants had received amount towards one policy vide No.38005554009. But, the O.Ps have not settled the claim against the Policy No.38005553406 till yet. The Complainant No.1 is the nominee of the said policy, which stood in the name of deceased Duryodhan Bhoi. He has paid the premium amount of Rs.4.00 Lacs (Rupees Four lacs) only towards the said policy. But, the O.Ps are not settling the death claim in respect of the said policy, which amounts to deficiency-in-service on the part of the O.Ps, which compelled the Complainant to approach this Forum for relief for settlement of the claim along with compensation and litigation cost. Further, it has been argued that the Complainants are the legal heirs of the deceased and the legal heir certificate has been duly furnished by the Complainant. On the other hand, it has been argued on behalf of the O.Ps that the disputed policy is an unit linked based policy, in which the fund value may increase or decrease. It is a regular yearly premium policy and premium amount should be paid periodically. The O.Ps have only received premium amount of Rs.4.00 Lacs (Rupees Four lacs) only on 12.07.2010 and there was discontinuance from 12.07.2011, for which the policy was terminated before the death of the policy holder i.e. on 12.07.2014 and the death of the policy holder was on 18.07.2014. So, the nomination became ineffective on 12.07.2014 and the title under the policy is open, which requires succession certificate from competent court for settlement. In the instant case, instead of succession certificate, a legal heir certificate has been furnished by the Complainant in the Forum, but nothing has been clearly specified by both the Parties whether it was furnished by the Complainant before the O.Ps for settlement. However, during argument, the Advocate for O.Ps have admitted that there is no dispute to settle the claim on the basis of the legal heir certificate. On perusal of the legal heir certificate produced in the Forum, it shows that it has been granted for the purpose of withdrawal of the insurance money having names of the Complainants. It has been admitted by the O.Ps in their pleading that a sum of Rs.4,08,498/- (Rupees Four lacs eight thousand four hundred ninety eight) only is payable under the policy. So, in this circumstances, there is no dispute on such amount and the Complainants are entitled for the same with up-to-date fund value till payment and the Complainants are to produce the legal heir certificate and other required documents, if not furnished before the O.Ps for settlement of the claim.     

                    6. So, now on careful consideration of all the materials available in the case record and hearing both the sides, this Forum come to the conclusion that it is a fit case to allow the same and the Complainants are entitled for the claim amount with up-to-date fund value till payment and the Complainants are to produce the legal heir certificate and other required documents, if not furnished before the O.Ps for settlement of the claim and the O.Ps are directed to pay compensation of Rs.5,000/- (Rupees Five thousand) only along with litigation cost of Rs.2,000/- (Rupees Two thousand) to the Complainants and failure to comply the same will carry interest @ 10% per annum on the total amount including the claim amount along with compensation and litigation cost, which will meet the ends of Justice in this case. Hence, Ordered:-     

                                                     O R D E R

                        The Consumer case is allowed on contest against the O.Ps with cost. The O.Ps are directed to pay the claim amount with up-to-date fund value till payment and the Complainants are to produce the legal heir certificate and other required documents, if not furnished before the O.Ps for settlement of the claim against policy No.38005553406 and the O.Ps are also directed to pay compensation of Rs.5,000/- (Rupees Five thousand) only along with litigation cost of Rs.2,000/- (Rupees Two thousand) to the Complainants, failing which it will carry interest @ 10% per annum on the total amount including the claim amount along with compensation and litigation cost from the date of order till realization. The Complainants are also at liberty to realize the same from the O.Ps as per Law, in case of failure by the O.Ps to comply the Order.

                        Pronounced in the open Forum on this day i.e. the 29th day of December, 2017 given under my Signature & Seal of the Forum.