The Complainant has filed this case alleging deficiency-in-service by the O.Ps, where O.P No.1 is the Branch Manager, Shriram Life Insurance Company Limited, Balasore and O.P No.2 is the Vice President-Corporate Service Sri G Vaidyanathan, Shriram Life Insurance Company Limited, Hyderabad.

                    2. The case of the Complainant in brief is that the Complainant is the son and nominee of the policy holder/ deceased namely Purnima Das, who had one insurance policy bearing Policy No.NP141400047175 under the O.Ps-Company and she has deposited Rs.16,170/- (Rupees Sixteen thousand one hundred seventy) only for the policy as yearly premium amount on dtd.15.03.2014. The sum assured for the policy is Rs.1,50,000/- (Rupees One lakh fifty thousand) only. But, on dtd.07.06.2014, the policy holder had died and after the death of the insured/ policy holder, the Complainant/ nominee as per the provision of the insurance company submitted relevant documents in the Office of the O.Ps for death claim of the insured/ policy holder. The O.Ps had received all the relevant documents of death claim in the office, but intentionally, the O.Ps had not paid the death claim to the nominee till date instead of several reminders in writing and they did not pay any heed to the request of the Complainant, which causes financial loss and mental agony to the Complainant. Cause of action arose on 18.05.2015. The Complainant has prayed for payment of death claim with interest along with compensation.

                   3. Written Version filed by the O.Ps denying on the point of maintainability, limitation as well as its cause of action. The O.Ps have further submitted that the deceased life assured Purnima Das had applied for an insurance policy by submitting the proposal form and paying the proposal deposit amount and a policy was issued in the name of the deceased life assured, commencing risk from 28.03.2014 for a sum assured amount of Rs.1,50,000/- (Rupees One lakh fifty thousand) only under the plan “Shriram  New Shri Life Plan” for a period of 15 years. The said policy was issued as per information with regard to age, income and occupation submitted by the insured as required in that regard in proposal form, wherein the insured had disclosed her age to be 57 years at the time of proposal and D.O.B was to be 05.01.1957. Furthermore, in support of the same, the Complainant had submitted the school leaving certificate (issued by Remuna High School), wherein the D.O.B is mentioned as 05.01.1957 and accordingly, premium was calculated and policy was issued considering the age as declared by the insured. Furthermore, during investigation, the O.Ps came to know that the actual age of the deceased life assured was more than 57 years at the time of insurance. As per Voter list-2009, the deceased life assured was 57 years, which means as on date of proposal i.e. on 15.03.2014, she should be about age of 62 years. According to the   old age pension card, the deceased life assured should be 66 years as the deceased life assured was receiving the old age pension since its date of sanction i.e. from  01.04.2008 (pension is sanctioned to people who are 60 years and above), then her age at the time of proposal i.e. on 2014 should be 66 years. Further, as per Parivar Card, the age of the deceased life assured was 68 years, which was not an insurable age as per the terms and conditions of the policy. But, in the proposal form, the deceased life assured had mentioned her age is to be 57 years and submitted her SLC as proof of age, which later on verification was found to be fake one. So, it can be clearly stated that the deceased life assured at the time of proposal was more than 62 years of age. Further, the deceased life assured belonged to BPL category family, but in the proposal form, she had mentioned as doing business with an annual income of Rs.80,000/- (Rupees Eighty thousand) only. After death of the insured, the Complainant has submitted that the cause of death of deceased is due to cardiac failure in claim forms, whereas no such supporting medical document has been filed along with claim forms in that regard by the Complainant to the O.Ps in support of cause of death, but it is mandatory provision to ascertain the cause of death to proceed further in death claim. Although, the Complainant has submitted the medical attendance certificate in claim form, the said from is not duly filled in by the doctor. The policy was obtained by the deceased life assured by suppressing the real material facts with regard to her actual age and occupation and income at the time of proposal. So, the death claim of the Complainant is not payable according to the terms and conditions of policy and rightly repudiated by the O.Ps. Moreover, there is no deficiency of service on the part of the O.Ps and the claim of the Complainant being illegal bears no merit is liable to be dismissed with cost.

                    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) Whether there is any cause of action to file this case ?

(iii) Whether the case is barred by law of limitation ?

(iv) To what relief the Complainant is 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 Complainant that he was the nomine of the policy holder namely Purnima Das, who is his mother for the insurance policy of sum assured amounting  to Rs.1,50,000/- (Rupees One lakh fifty thousand) only and after her death, when the Complainant has filed death claim, the O.Ps have repudiated the same on the ground of not submitting the correct age at the time of proposal and furnishing of wrong H.S.C. certificate and name of the relevant school as wrong. But, the age mentioned in the proposal form is correct, being supported by the document that is certificate, but nothing has been clearly mentioned that which certificate is related to it. On the other hand, it has been argued on behalf of the O.Ps that this being an early claim, it has been entrusted for investigation and while verifying the details in the proposal form and the school certificate given as age proof at the time of proposal and showing the age as 57 years is a fake certificate. The school authorities have given a certificate stating that there is no such information about the certificate. The investigator also verified the details of the family with ages and found that the deceased life assured was aged 68 years according to Parivar card, which is not insurable age as per policy terms and conditions. Further, it has been argued that providing wrong information, the contract is void and un-enforceable and not legally binding on the Company, for which they are repudiating the claim for payment of death benefit under the policy. A Xerox copy of H.S.C certificate of the policy holder has been filed by the O.Ps, which shows the date of Birth as 05.01.1957. The Headmaster of Remuna High School vide letter No.66, dtd.19.02.2015 has disclosed that no information was found in the name of Late Purnima Das, D/o. Khakara Das in the school record, but that evidence has not been substantially proved and it cannot be said to be conclusive proof. On the proposal from, it is mentioned to be certificate, which may be related to H.S.C certificate as discussed earlier. In the policy schedule, the date of birth mentioned as 05.01.1957, which is admitted by the authority. So, at the time of settlement of death claim, repudiating it on the allegation of furnishing wrong date at this stage is not believable.

                    6. So, now on careful consideration of all the materials available in the case record, I am of the opinion that repudiation of death claim is not genuine and the Complainant is entitled for death claim being the nominee from the O.Ps, who are jointly and severally liable for the same, followed by compensation of Rs.5,000/- (Rupees Five thousand) only and litigation          cost of Rs.1,000/- (Rupees One thousand) only within 60 days of receipt of this order, which will meet the ends of justice in this case and failing which, it will carry interest @ 9% per annum on the total amount including the death claim, compensation and litigation cost from the date of order till realization. Hence, Ordered:-

                                                     O R D E R

                         The Consumer case is allowed on contest against the O.Ps with cost. The O.Ps are jointly and severally directed to settle the death claim of the Complainant being the nominee of the policy holder along with payment of compensation of Rs.5,000/- (Rupees Five thousand) only and litigation cost of Rs.1,000/- (Rupees One thousand) only to the Complainant within 60 days of receipt of this order, failing which it will carry interest @ 9% per annum on the total amount including the claim amount along with compensation and litigation cost from the date of order till realization. The Complainant is 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 9th day of August, 2018 given under my Signature & Seal of the Forum.