Satya Swarup Banerjee,

son of late Satya Gouri Sankar Banerjee,

residing at Village & P.O. Khanyan,

Khanyan Dakshinpara, P.S. Pandua District,

Hooghly, represented by his guardian

Sri Satya Deb Banerjee of

Village & P.O. Pandua,

District – Hooghly.-------------------------------------------------------------  COMPLAINANT.

-          Versus   -

1                The Manager,

IDBI Federal Life Insurance Company Ltd.

Howrah Branch, 1^st floor,

Krishna Enclave, 2/1, Bhanjanlal Lohia Lane,

Howrah – 711101.

2.         The Sr. Manager ( Claims ),

IDBI Federal Life Insurance Co. Ltd.

Tradeview,  Oasis Complex,

Kamala City, P.B. Marg, Lower Parel ( West ),

Mumbai – 400013.

3.         The Manager,

Customer & Sales Support,

IDBI Federal Life Insurance Co. Ltd.

Tradeview, Oasis Complex, Kamala City,

P.B. Marg, Lower Parel ( West ),

Mumbai – 400013. ------------------------------------------------OPPOSITE PARTIES.

                                                P   R    E     S    E    N     T

President     :     Shri T.K. Bhattacharya, M.A. LL.B. WBHJS.

Member      :      Shri P.K. Chatterjee.

Member       :     Smt. Jhumki Saha.

                                                 F  I   N   A    L       O   R   D    E     R

1.                  Complainant Satya Swarup Banerjee represented by his guardian Sri Satya

Deb Banerjee by filing a petition U/S 12 of the C .P. Act, 1986 ( as amended up to date ) has prayed for a direction to be given upon the o.ps. to release the death benefit of two insurance policies for an amount of Rs. 3,31,794/-, to pay an amount of Rs. 1,50,000/- as compensation together with a litigation costs of Rs. 18,000/- along with other relief or reliefs as the Forum may deem fit and proper.

2.                  Brief facts of the case is that Satya Subhas Banerjee, since deceased, took two

insurance policies for which he paid 1^st premiums for both the policies on 31-03-2011 and 27-04-2011 for the amounts as sum insured of Rs. 1,51,654/- and Rs. 1,80,140/- respectively. And O.Ps. also issued two policy documents being numbered as 4000300386 and 4000307531 respectively. And the complainant, Satya Swarup Banerjee,  being the younger brother of Satya Subhas Banerjee, was incorporated as nominee vide annexures copy of policy document. And the complainant is a mentally retarded and physically handicapped person vide annexures running pages documents 59 to 71. And the deceased Satya Subhas Banerjee was his guardian. But suddenly on 14-05-2011, Satya Subhas Banerjee died vide annexure running page nos. 45 to 52. Thereafter, it was informed to O.Ps. in a proper manner by way of submitting  death claim vide annexures running page nos. 53 to 58. And O.P. no. 2 also sent many letters on different dates such as 15-07-2011, 29-07-2011, 12-08-2011 with a request to send all necessary papers along with original policy documents and money receipts for processing the claim forms. Even O.P. no. 2 informed the complainant over phone that one, Sri Bikramjit Sarkar would visit his place for necessary enquiry of the fact. And the said person came to the complainant and advised him to send all necessary documents as per para 10 of the complainant. And all those documents were sent through a private courier on 07-09-2011, 16-09-2011 and 14-10-2011 vide annexures running page nos. 49 to 51. And it is also stated by the complainant that O.Ps. promised to pay the death claim within 15 days after receiving all the original documents. But it is very unfortunate that a long period has passed away since then but no payment has been made by the O.Ps. And it is also alleged that as the complainant is not in a position to move here and there frequently, O.Ps. are taking that advantage and they are not at all willing to pay the death benefit of Satya  Subhas Banerjee, since deceased, to his nominee, Satya Swarup Banerjee, the younger brother of the deceased. And O.Ps. have not even returned any original document to the complainant . After death of Satya Subhas Banerjee, Sri Satya  Deb Banerjee, another brother of the complainant, became his guardian. And being frustrated, complainant through his guardian has filed this instant petition against O.Ps. alleging deficiency in service.

3.                  Notices were served. O.ps. appeared and filed written version. Accordingly,

case heard on contest.

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

i)          Is there any deficiency in service on the part of the O.Ps.  ?

ii)                  Whether the complainant is  entitled to get any relief as prayed for ? 

DECISION  WITH   REASONS      :

5.                  Both the points are  taken up together for consideration.            We have carefully

gone through written version and its annexures filed by O.Ps. and noted their contents. It is the specific plea of the O.Ps. that the DLI ( Deceased Life Insured ) i.e., Satya  Subhas Banerjee did not disclose his actual health condition while taking both the policies, although he was having full knowledge of his high blood sugar as he did his blood sugar test on 14-02-2011 vide annexure dated 14-02-2011. Moreover, Dr. A.K. Roy, the treating physician engaged at the death bed of Satya Subhas Banerjee in an annexure dated 19-10-2011 vide Annexure O.P.  5, that Satya  Subhas Banerjee was previously a diagnosed case of T2DM and Ischemic Dilated Cardiomyopathy. But no such medical document could be annexed by the O.Ps.  showing the deceased person, Satya Subhas Banerjee having such problem for a long time. And it is also to be noted that while taking the policies by Satya Subhas Banerjee, since deceased, he was running his 51 years of age but O.Ps. did not care to do the medical check up at their end. Although they were in a hurry to receive the two amounts of Rs. 10,103/- and Rs. 12,000/- as premiums for two policies, they did not care to know about his actual health condition other than proposal forms. This is also to be noted that in blood test report dt. 14-02-2011 his blood sugar P.P. was 157.00 mg./dl. Whereas the allowable  range is 70-140 mg./dl. Now a days, blood sugar is a very common problem in all families. Again, Sri Bikramjit Sarkar, the investigator appointed by the O.Ps. in his report dated 26-08-2011 remarked on pages 2 & 3 in different paras that as per his investigation, DL 1 i.e., Satya Subhas was not suffering from any long term disease and he was not having any bad habits like smoking and drinking. And the attendance and leave register of the school where deceased Satya  Subhas was working also showed that during March,2008 to March, 2011, he did not avail himself of any medical leave vide annexure running pages 56 -58. There was no previous sign and signal of his ailment. Suddenly on 13-05-2011, he felt chest pain and he was taken to a hospital where on 14-05-2011 he died. A person who was working regularly in a school, doing all his daily work, taking normal flood died out of heart failure. Can it already be known to any person ? He was quite a healthy person. But O.Ps., on some pretext or other, wanted to repudiate the claim and they did it vide their letter dated  29-10-2011, annexure O.P.-8. Satya Subhas did not have any knowledge of his critical disease. How he could disclose ? And in our opinion, he did not suppress any material fact for which his death benefit could not be given to the nominee, Satya Swarup Banerjee.  A person takes a life insurance policy with this hope that even on his sudden death, his dependents should not suffer from monetary problem at least. Here in this case, nominee is even a mentally retarded and physically handicapped person, which should be given the upmost  priority. O.Ps. acted arbitrarily and adopted unfair means to repudiate a genuine claim. Accordingly, we hold that O.Ps. are found be negligent in discharging their duties to the nominee, Satya Swarup Banerjee.

      Points under consideration are accordingly decided.

      Hence,

                                    O     R     D      E      R      E        D

      That the C. C. Case No.  122 of 2012 ( HDF 122 of 2012 )  succeeds on merit against O.Ps. t with  costs. 

      That the  O.Ps. are jointly and severally directed to release the sum insured of two  policies  being Rs. 3,31,794/- in favour of Satya Swarup Banerjee by way of giving an a/c payee cheque for the same amount drawn in favour of Satya Deb Banerjee, guardian of Satya Swarup Banerjee.

      That the o.ps. are further directed to pay an amount of Rs. 50,000/- as compensation and Rs. 10,000/- as litigation costs to the complainant within one month from the date of this order. The entire amount Rs. 3,91,794/- shall be paid to Satya Deb Banerjee by the O.Ps. within one month from this order, i.d., it shall carry an interest @ 10% p.a. till actual payment.

      Satya Deb Banerjee is hereby directed to deposit the entire amount of Rs. 3,91,794/- in a fixed deposit for a minimum period of six years  with the quarterly interest pay out facility to meet up the daily expenses of Satya Swarup Banerjee and also directed to submit the report compliance within one week on receipt of such amount from O.Ps.

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

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

DICTATED  &    CORRECTED

BY   ME.  

      (  Jhumki Saha  )                                                                  

  Member, C.D.R.F.,Howrah.

 ( Jhumki Saha )                         ( P. K. Chatterjee )                (T.K. Bhattacharya  )

 Member,                                     Member,                                President,

 C.D.R.F.,Howrah.                     C.D.R.F.,Howrah.                 C.D.R.F.,Howrah