DATE OF FILING                    :   24-01-2012.

DATE OF FINAL ORDER      :   23-03-2012.

Nasirun Bibi,

wife of late Ali Afzal Shaikh,

residing at 261/9, Belilious Road, P.S. Howrah,

District –Howrah---------------------------------------------------------------  COMPLAINANT.

-          Versus   -

                                                P   R    E     S    E    N     T

                         1.     Hon’ble President    :     Shri T.K. Bhattacharya.

                                C      O      U       N        S        E        L

Representatives for the complainant           :    Sri Samanta Sannyal,

                                                                              Sri Sauvick Samanta,   

                                                                              Ld. Advocates.

Representative for the opposite parties       :    Shri Sambhunath Samanta,

                                                 F  I   N   A    L       O   R   D    E     R

1.         The instant case was filed by complainant U/S 12 of the  C.P.  Act, 1986, against O.Ps. alleging deficiency in service.

2.         The complainant, Nasirun Bibi, widow of late Ali Afzal   Shaikh, has come up before this Forum with the prayer for a direction upon the o.ps. to pay up the death maturity amount of postal life insurance initiated by her husband, as an employee of the Postal Department.  The Policy No. WB – 151350 -P of a term EA/ 60 dated 08-02-2008 assured a sum of Rs. 1,00,000/- with monthly premium  of Rs. 1,035/- and the date of maturity being 08-02-2017.   During the continuance  of the policy, the policy holder  Ali Afzal Shaikh expired on 25-06-2009. After the demise of her husband the complainant submitted the death claim against the P.L.I. Policy before the competent authority on 06-08-2009 but all her attempts to pursue the o.ps. ended in fiasco. Hence the case.

3.         The contention of the o.ps. in the written version as well as in the brief note of argument is that after inspection of the documents and conducting confidential enquiry it is detected that the policy holder was suffering from Myelofibrosis  during the period from 08-02-2005 to 08-02-2008 and prior to three years from the date of purchase of the policy he was hospitalized in the year 2007. This fact was suppressed by the policy holder in contravention to the term of 15/C of the proposal form and as such he is not entitled to the death benefit.

4.         Upon pleadings of both parties   two questions arose for determination :

1.                  Is there any deficiency in service on the part of the o.ps. ?

2.                  Whether the complainant is entitled to get any relief as prayed for ? 

DECISION  WITH   REASONS      :

5.         Both the points are taken up for consideration. Admittedly the husband of the complainant is the policy holder of P.L.I.  Policy being no.  WB – 151350 –P having an assured sum of  Rs/ 1,00,000/- with the E.M.I. of Rs. 1,035/-. The pertinent question as raised by the o.ps. is that the policy holder suppressed his ailment and hospitalization while initiating the policy in dispute. But the fact remains that the policy holder was a post man, that means he was an employee under the Postal Authority. The postal authority had ample opportunity to scrutinize and verify the terms as embodied in the policy vis -a- vis  the statement of the policy holder. In not verifying the statements of the policy holder at the time of commencement of the policy, the postal authority who is the employer of the deceased policy holder, in fact, allowed the wrong as alleged, to continue. The policy holder was a lay man with poor pay as a postman and did not have the knowledge if he was suffering from any complicated disease or ailment before three years of the commencement of the policy. That apart in normal cases the agent of the insurance companies fills up the form on behalf of the policy holder. If he was hospitalized in the year 2007 and if it is suppressed while declaring the terms against 15C of the policy, the policy holder cannot be to blame. A person may be hospitalized for simple diarrhea, malaria, high fever, typhoid etc. Non- declaration of the reason of hospitalization cannot if so facto  disentitle the policy-holder  from claiming the maturity benefit of the policy. Be it noted that the policy holder Ali Afzal Shaikh could not foresee his untimely death on 25-06-2009 at the age of 52 years. It is the common rule  of the insurance company that a policy holder if pays up at least one premium is entitled to the death benefit in the event of his death. We are to bear in mind that the deceased policy holder was an employee under the postal authority and it was their boundant duty  to clear up the maturity benefit to his widow without adopting delaying tactics. When the only bread winner meets sudden death, the plight of the bereaved family is unfathomable. The widow in our case at hand was pushed into deep trouble and difficulty after losing her husband. She expected a  bit sympathy from the employer of her husband who ought to have handle  the case of death claim with due tolerance and deep feeling. On the contrary she had to run from pillar to post abegging her bonafide claim.

6.         The postal authority in the letter dated 26-03-2011 admitted that the deceased policy holder paid Rs. 16,560/- towards 16^th premium against the policy and such amount was deducted from his salary. Therefore, it is clear that the policy holder had strong intention to continue his policy. If the cruel hands of death snatched him from this earthly world, compelling his family to be thrown away in totally helpless condition, the policy holder cannot be to blame. The suppression of facts as alleged, does not appear to us to be a deliberate one. If the postal authority started scrutinizing the policies of the thousands of policy holders, in 90% cases it will be detected that the policy holders are suffering from various ailments which are repugnant to the terms as embodied in the reverse of the policy itself. Therefore, the postal authority are not be so selective in adopting a policy of pick and choose and therefore, we are of the considered opinion that this is a fit case for allowing the petition together with prayer of the complainant.

      Both the points are accordingly disposed of.

      Thus the application succeeds.

Hence,

                                    O  r  d  e  r  e  d         

      That the C. C. Case No. 23 of 2011 filed  U/S 12 of the C.P. Act, 1986 as amended till date is allowed on contest with cost against the o.ps.   

      That the complainant is entitled to the death benefit against the Policy No. WB – 151350 –P dated 08-02-2008 initiated by the policy holder, her husband, amounting to Rs. 1,00,000/- together with interest @ 10% per annum since 25-06-2009 till realization of the amount.

      That the complainant is  further entitled to a compensation to the tune of Rs. 40,000/- towards the harassment and mental agony perpetrated upon her by the o.ps. in delaying the release of the death maturity and for deficiency in service.  

      That the complainant is further entitled to a litigation cost of Rs. 5,000/- from the o.ps.

      That the o.ps. do pay the aforesaid amounts within 30 days from the date of this order failing the sum shall carry interest @ 10% per annum till full satisfaction.

      That the complainant is at liberty to put the decree into execution after the expiry of the  appeal period.           

      Supply the copies of the order to the parties, free of costs, as per rule.