The complainant Sri Arjun Mahato has filed this complaint petition against the Branch Manager, Bajaj Allianz Life Insurance Company Ltd. Muzaffarpur and one another (o.ps) for realization of Rs. 8,36,050/- as sum assured, Rs. 50,000/- for compensation of physical and mental harassment and Rs. 25,000/- as litigation cost. with 18 % p.a. interest on the total sought amount since the date of death of life assured person till the date of final payment/ realization.

The brief, facts of the case is that the  father of the complainant  Late Sudish Mahto purchased  policy bearing No.-0318636257 from o.p company for sum assured Rs. 8,36,050/- on 10-09-2014. The further case is that on 02-07-2015, L.A. Sudish Mahto died with heart attack. The further case is that after death of insured the complainant filed death claim against  above policies with all relevant documents but the o.p company repudiated the claim of the complainant on the ground that the L.A. had died prior to taking  policy. It has been further mentioned that regarding the death, death certificate is a documentary & conclusive proof until & unless the said death certificate is cancelled by the competent authority after hearing both the parties. It has been further mentioned that in this case neither any application/petition has been filed by the said insurance company to the competent authority nor the death certificate has been got cancelled by the competent authority. It has been further mentioned that on the basis of table report of private investigator,  it is to say that the L.A. died prior to taking policy is baseless and concocted story by the insurance company to embezzele the claimed amount.

The complainant has filed the following documents with the complaint petition- Photocopy of First Premium receipt –annexure-1, photocopy of Death Certificate -annexure-2, photocopy of repudiation letter annexure-3.

On issuance of notices, o.p. no. 1 & 2 appeared and filed their w.s. on 11-03-2019 with prayer to dismiss the complaint with cost.  It has been further mentioned the in w.s. that the L.A. had not disclosed his age in the proposal  form and had filed fake school leaving certificate in support of his age. It has been further mentioned that present complaint does not raise any “Consumer Dispute” as defined under the Consumer Protection Act, 1986. It has been further mentioned that the complainant has fraudulently  tried to make easy  money on life of the L.A. Filing of Proposal form by DLA Sudish Mahato is an admitted fact. Photocopy of proposal form dated 09-09-2014 has been annexed by the o.ps as annexure-1. ( which will be read as A) for easy reference) Issuance of policy certificate bearing no. 0318636257 for sum assured Rs. 7,27,000/-is also an admitted fact. Receiving  of death claim on 21-10-2016 is also an admitted fact. O.ps have annexed the photocopy of death claim application as annexure-2. ( which will be read as annexure-B) It has been further mentioned that the death claim of the  father of the complainant being an  early claim, the insurance company got the claim investigated through his authorized  investigator namely  ‘Abhyodya Investigation services Pvt Ltd.’ and only after investigation, o.p. company came to know that the life insured died on 22-08-2014 prior to signing proposal application on 09-09-2014 and it was confirmed that it is an pre-deceased case. The investigator  has obtained written statements of Anganbari  and death Registrar which confirmed the actual death of the life insured caused on  22-08-2014 and not on 02-07-2015. It has been further mentioned that the investigator during investigation came to know that the death certificate was issued by previous Registrar, death and birth, who was suspended for some irregularities committed by him and assured to cancel the death certificate on receipt of the register from the previous authority but it was not cancelled on repeated contact showing his connivance in favour of the complainant.  It has been further mentioned that the complainant  himself has obtained the policy after death of his father Sudish Mahto by submitting fake Voter I.D. stating his age as 53 years with the only intention to obtain the policy by hook or by crook, as the maximum entry age for the Bajaj super gain plain is fixed  as 60 years and real age of the life insured was beyond the insurable age and hence the complainant  fabricated a false voter I.D. to fit his age under the policy terms to obtain the policy by fraud. O.ps have annexed the photocopy of repudiation letter. Photocopy of repudiation letter dated 30-12-2016 has been annexed as  annexure-3 and the same will be read as ‘C’. They have also annexed the investigation report with relevant documents as annexure-4. Which will be read as annexure-‘D’. It has been further mentioned that no cause of action arose to the complainant  against the o.ps and there is no deficiency  in service on their part.

The complainant Arun Mahto has examined himself as Aw-1.

No oral evidence has been filed on behalf of o.ps.

The claim of the complainant has been repudiated by the o.ps on the ground that the claim is preferred with fabricated death certificate and taking policy on pre-deceased life, resulting into a fraud with dishonest  intention  to deceive the insurer. The o.ps have mentioned in para-7 of their w.s. that the L.A had not disclosed her age in the proposal and had filed a false S.L.C in support of her age. On perusal of proposal form (annexure-A), it transpires that the death of birth of Sudish Mahto has been mentioned as 01-01-1963 and in proof of his case, he had submitted PAN card, So the allegation of the o.ps in his w.s. that the life assured has not disclosed his age in the proposal form and had filed a fake S.L.C certificate in support of his age becomes falsify  by annexure-A (proposal form). In support of their contention, o.ps have also filed the photocopy of death certificate  of Sudish Mahto issued  by Secretary Gram Panchayat Bhagawanpur Ratti. The same certificate has also been filed on behalf of complainant as annexure-2. The date of death of Sudish Mahato is 02-07-2015. The complainant    has mentioned in the complaint petition that the same certificate has not been cancelled by proper authority. The o.ps have annexed the photocopy of  certificate of one Sabitva Devi of Aaganbhari Kendra -29 of Bhagawanpur Ratti Toll Free Saidpur which shows, date of death of Sudish Mahto as 22-08-2014. The o.ps have not examined Sabita Devi in support of their contention. The proper  Forum for cancellation of  the death certificate, already issued on        11-07-2014 vide registration No.-18/2015. has not cancelled the death certificate so  there is presumption of its correctness. Learned Lawyer for the complainant relied on the observation of Hon’ble N.C.D.R.C. New Delhi as observed in Agoen Religare Life Insurance Company Ltd. V/s Rejendra Rai first Appeal No.-1696/2016 order passed on 31-05-2018. In the above case the Hon’ble N.C.D.R.C. New Delhi has observed in para-8 of the above order that the Panchayat Secretary is the competent authority to issue Death Certificate on proper proforma under Panchayat Raj Act.  The opposite party  has not produced any other death certificate  proper proforma of the L.A. Randhir Kr and his elder brother Sudhir Kr. Hence, the  allegation of o.p  that the Insurance Policy was obtained of a dead person Sri Randhir Kr is not proved. It  become a baseless allegation. “

The o.ps have also not produced any other death certificate of Sudish Mahato in proper proforma by cancellation of previous death certificate issued by competent authority. The investigator has also not been examined. The complainant  Aw-1 has  examined himself on  affidavit and supported his contention. So, the allegation  of the o.ps in their w.s. and repudiation letter becomes baseless.

On the basis of above discussions we are of the considered opinion that  there is deficiency on the part of the o.ps and they are liable to pay compensation.

In the circumstances the complaint petition is allowed with direction to o.ps  to pay  Rs. 8,36,050/- as sum assured on death with 8 % interest p.a  from the date of filing of complaint petition that is on 3-04-2018,  Rs. 20,000/- as physical and mental harassment and Rs. 10,000/-  as litigation cost within two months from the date of  order, /, on failure they shall be responsible  to pay the above amount   with 9 %  p.a. interest till realization. Let a copy of this order be furnished to both the parties as per rule.