The Complainant has filed this case alleging deficiency-in-service by the O.Ps, where O.P No.1 is the Chief Manager, Life Insurance Corporation Ltd., Balasore Branch, O.P No.2 is the Divisional Manager, Life Insurance Corporation Ltd., Cuttack Divisional Office and O.P No.3 is the Zonal Manager, Life Insurance Corporation Ltd., Patna.

                    2. The case of the Complainant in brief is that the Complainant is the husband of Late Premalata Nayak, who died on 11.05.2013 and the wife of the Complainant had two nos. of LIC Policies bearing No.598015588 and 598017223 issued on 30.06.2010 and on 29.07.2010 respectively with the O.Ps, where the Complainant is the nominee. The wife of the Complainant had submitted relevant documents along with her S.L.C (T.C) issued by the then Headmaster, Chhanpur M.E School, Chhanpur on 04.07.1986 in support of her date of birth as well as signed the proposal form, where date of birth was mentioned as 22.04.1962 before the O.Ps through their agent, thus policy certificates were issued in her favour. Insured Premalata Nayak was known as Premalata Barik being the daughter of Laxmidhar Barik before marriage. Thus, Premalata Nayak and Premalata Barik is one and same person. So, after the death of Premalata Nayak, the Complainant submitted claim form along with relevant documents and original policy documents for payment of assured amount of the above said policies before the O.Ps. The O.Ps disbursed assured amount of Rs.2.00 Lacs (Rupees Two Lacs) only against Policy No.598015588, dtd.30.06.2010 to the Complainant, but repudiated the death claim of Policy No.598017223, dtd.29.07.2010 for sum assured of Rs.1.25 Lacs (Rupees One lakh twenty five thousand) only vide their letter dtd.16.03.2015 on the plea that the insured has submitted fake certificate in support of her date of birth and advising her to represent the O.P No.3 within three months for reconsideration of death claim of the Complainant vide above said policy. Thus, the Complainant represented to O.P No.3 along with other relevant documents and correct date of birth proof through regd. Post with A.D with a copy to O.P. No.2, which was received by them on 03.06.2015 and 01.06.2015 respectively, but the O.Ps have not taken any steps in the matter. Though the correct date of birth i.e.22.04.1962 is mentioned in both the policy certificate, but non-payment of above said policy is highly illegal under provision of Law. The O.Ps except their letter of repudiation dtd.16.03.2015 have not communicated any documentary evidence regarding submission of fake school certificate by the insured with respect to proof of her date of birth. In spite of all sincere efforts taken by the Complainant, the O.Ps repudiated the claim arbitrarily, thus amounts to deficiency-in-service on the part of the O.Ps, thereby the Complainant is harassed and sustained mental agony along with financial loss, filed this case for appropriate relief. The Complainant has prayed for payment of claim amount (assured amount) with interest along with compensation for mental agony and litigation cost.

                    3. Written Version filed by the O.Ps through their Advocate denying on the point of maintainability as well as its cause of action. They have admitted that Life Assured had taken two policies vide policy no.598015588 with date of  commencement dtd.28.06.2010 for Rs.2.00 Lacs (Rupees Two Lacs) only and policy no.598017223 with date of commencement dtd.29.07.2010 for Rs.1.25 Lacs (Rupees One lakh twenty five thousand) only. At the time the submission of proposal form the policy No.598015588, the Life assured had submitted Xerox copy of T.C of Kuruda High School having IX Class pass and on the basis of that particulars the 2nd policy was issued in favour of Life assured Premalata Nayak. The said  T.C of Kuruda High School was signed by the Life assured and the concerned agent of the corporation which is available with O.Ps No.1. After death of Life assured, the Complainant applied for death claim in respect of policy No.598015588 and it was considered and the some assured Rs.2.00 Lacs (Rupees Two Lacs) only have been paid to the Complainant. Later on while considering the death claim of Life assured in policy No.598017223 the matter was enquired regarding the date of birth of Life assured and it was found that the copy of T.C of Kuruda High School is not genuine one. There is no such school in name and style of Kuruda High School, Kuruda is existed in the vicinity. Hence, the Complainant was asked to produce the correct document in respect of date of birth and qualification of Life assured. Accordingly, the Complainant submitted one T.C of Chhanpur M.E School, wherein date of birth of Life assured is same as 22.04.1962, but the qualification is class VII. On consideration of the documents and the rules and circular of corporation, the O.P No.1 repudiated the claim on the ground of suppression of material facts. Hence, had the Life assured produce the correct certificate the 2nd policy would not have accepted vide corporation circular actuarial/1994/4, dtd.01.03.2005. A lady having VII standard of qualification is entitled to take a policy of Rs.1,00,000/- (Rupees One lakh) only maximum. If the certificate of Chhanpur M.E School is taken into correct the Life assured is not entitled to take the 2nd policy benefit. Accordingly, the death claim in respect of policy No.598017223 rightly repudiated without any evil intention and the same was intimated to the Complainant on dtd.16.03.2015 with a suggestion “If  he is dissatisfied with the decision, he may send his representation to the Zonal Manager, LIC of India, East Central Zonal Office, Jeevan Deep Building, 6th Floor, Exhibition Road, Patna-80001”. Thereafter, the Complainant made representation to the Zonal Manager for reconsideration of the claim. But, Zonal Office upheld the decision taken by the Division Office and the same was intimated to the Complainant vide letter No.CD/Claims/repudiation dtd.28.10.2015. Hence, there is question of deficiency of the service in settlement of the death claim of Life assured Premalata Nayak. The O.Ps have not harassed the Complainant mentally and financially nor take any decision arbitrarily as per the rules and circular of the corporation. They have taken decision legally without any ill intention.

                   4. In view of the above averments of both the Parties, the points for determinations 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 repudiation of death claim by the O.Ps in respect of policy No.598017223 is justified ?

(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 his wife Late Premalata Nayak had two LIC policies and after death of his wife on 11.05.2013, he filed death claim application, out of which Policy No.598015588, dtd.30.06.2010 has been settled and Policy No.598017223, dt.29.07.2010 for Sum Assured of Rs.1.25 Lacs (Rupees One lakh twenty five thousand) only has been repudiated by the O.Ps on the ground that the birth certificate produced by her is a fake one. After several request by the Complainant to the O.Ps when he failed, he has filed this case praying for payment of claim amount with interest along with compensation and litigation cost. On the other hand, it has been argued on behalf of the O.Ps that at the time of submission of proposal form in the policy No.598015588, xerox copy of Transfer certificate of Chhanpur M.E School having 7th class reading has been furnished. But, at the time of settlement of claim, the Complainant has filed Transfer certificate of Kuruda High School, in which the Life assured has signed. But, it was denied by the Advocate for the Complainant by giving endorsement in the xerox copy of such transfer certificate available in the case record. According to the O.Ps, a lady having 7th standard qualification is entitled to take a policy of Rs.1 Lakh (Rupees One lakh) only. But, in this case, by suppressing the material fact, she has availed two policies. However, in the instant case, the date of birth of the first policy is same as in the second policy and when the O.Ps have settled the first policy, why they are complaining for settlement of the second policy having the same document. In support of his argument, the Advocate for the Complainant has relied upon the Authority reported in 1998 (I) OLR (CSR)-11 in the case of Divisional Manager, Life Insurance Corporation of India, Sambalpur Division, Sambalpur (Vrs.) Smt. Bhagabati Acharya & 2 others, wherein it has been held that when the Complainant claiming compensation and the benefits of life insurance policy obtained, stand taken that the insured had taken the policies virtually by suppressing material facts in the proposal form, mere omission of certain facts would not amount to fraudulent suppression of material facts within the meaning of Section-45 and repudiation of the claim of the Complainant by the Insurance Company without any legal basis.

                    6. So, now on careful consideration of all the materials available in the case record and on the basis of principle laid down by the above Authority as discussed earlier, this Forum come to the conclusion that it is a fit case to direct the O.Ps to release the death claim of the policy bearing No.598017223 for Sum Assured of Rs.1.25 Lacs (Rupees One lakh twenty five thousand) only along with consequential benefits, if any and the O.Ps are jointly or severally liable to pay the sum assured amount. Further, the O.Ps are also jointly or severally liable to pay 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 and failure to comply the same will carry interest @ 10% per annum, 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 O.Ps with cost. The O.Ps are jointly or severally directed to pay the Sum assured of Rs.1.25 Lacs (Rupees One lakh twenty five thousand) only vide Policy No.598017223 along with consequential benefits, if any and the O.Ps are also jointly or severally liable to pay 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 @ 10% per annum 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 20th day of October, 2017 given under my Signature & Seal of the Forum.