1. The complainant has filed this case against O.P for non-payment and refusing to give the claim amount to the complainant on false and imaginary allegation.       
2. The petitioner’s case in brief is that the petitioner’s husband, Late Md. Najim was the policy holder of L.I.C being Policy No. 526831057 of Rs 1,00,000 commenced from 04.02.16. It is further submitted that the husband Md. Najim died on 29.02.16 due to heart attack. Thereafter the petitioner sent a claim petition that all relevant papers along with form B and B1 of the deceased Late Md. Najim on 09.01.2018. Thereafter O.P vide his letter reference BDO/claim/requirements/PBD/01 dt. 21.11.17 informed that as per their internal investigation I was found that the petitioner had not given correct information about the deceased and habit of the deceased at the time of taking the policy and further stated that the deceased was suffering from cancer at the time of his death.
3. It is further submitted that the petitioner enclosed all the relevant papers such as original policy certificate, death certificate, medical prescription etc. along with Form B and B1. The O.P did not settle the claim and further remarked that as per the internal investigation it was found that deceased was not given his correct information about his disease and habit of D.L.A at the time of taking the policy and further informed that D.L.A was suffering from Cancer at the time of taking policy and asked to provide the details of the case history, prescription and Form B and B1.
4. The petitioner is the nominee in the under the Insurance Policy appointed by the policy holder being a beneficiary in the event of death of policy holder is the Consumer u/s 2(i)d of C.P Act. As such the insurance company failed to settle the claim of the Insurer after a long gap of time. It amount to deficiency in the services in spite of pleader notice to the O.P dt. 16.05.18. The petitioner has claimed that O.P may be directed to settle the claim filed by the petitioner and therefore pleased to pay sum of Rs 1,00,000 for negligency and deficiency in the services and mental harassment and also cost of litigation of Rs 20,000 with 12% interest may be awarded to the petitioner from the date of filing the claim of the petitioner.   
5. The Opposite Parties appeared and filed his Written Statement on 29.11.18 stating therein that it is true that the deceased, Md. Najim, was the policy holder of L.I.C being Policy No. 526831057 for Rs 1,00,000 commenced from 05.02.16 and as per the complaint petition, Md. Najim, the policy holder died on 29.02.16 due to heart attack. It is therefore submitted that L.I.C of India through his reference BDO/claim/requirements/PBD/01 dt. 21.11.17 informed the complainant that as per their internal investigation it was found that he has not given correct information about the death and suppressed the fact at the time of filing up of the policy form at it is also deducted during investigation by the L.I.C that deceased/L/A was suffering from cancer at the time of taking policy. It is submitted fact that the policy was taken on 05.02.15 from Dumka  T/T814/21. Sum assured Rs 1,00,000, DOB – 06.01.1973, A/P – SC correct FUP 04.02.16, DOD – 29.02.16 and cause of death shown as CPF.
6.  It is further submitted that as per report submitted by I.O Mr. Kedar Das  dt. 21.10.17 as narrated by neighbors DLA was suffering from cancer since one and a half year before his death. And at the time of the report of I.O the department sent a letter to the claim on 21.11.17 asking for treatment details of the cancer(case history, prescription and claim form B and B1) and the O.P has not received any required documents and papers that is treatment of cancer of D.L.A as yet for the last 3 years to the month of the deceased. And despite the several requirement letters, mentioned above the claimant has not submitted requisite/ requirements of the O.P  for consideration of claim so question does not arise for negligency and deficiency in the services as well as relief sought by the claimant. As the policy contract could not be completed hence no claim is made at the end of L.I.C of Insia as such the claimant may be directed to submit the above mentioned requirements for the consideration of the claim. And prayed to accept the so cause and claim may be directed to submit the petition requisite documents for consideration of the claim.                                 
7. The main point for the determination in this case that whether the complainant is entitled for the relief or reliefs as claimed !                                                                                                    Findings

8. The petitioner in support of his case filed documentary and oral evidence both. The following are the documents filed on behalf of      the complainant :-

Exhibit 1 – is the photocopy of the application of Tarannum Khatoon address to the Branch Manager L.I.C Dumka regarding death claim of her husband. Enclosed some documents issued by Dr. Dilip Kumar keshri.

Exhibit 2 – is the claim form B and also claim form C along with other documents (Total 6 sheets)

Exhibit 3 – is the L.I.C New Endowment Plan in favor of Md. Najim.

   Apart from that the affidavit of the witness were also filed on behalf of the complainant as a witness. They are :-

 CW1 -  Md. Chand, CW2 -  Md. Abid Ali and CW3 - Dr Dilip keshri. Apart from that the petitioner has not filed  any other oral or  documentary evidence in support of his case.                    

9.  The O.P in his defence has not filed any documentary evidence but he has filed simply the affidavit of his witness as O.P witness     No. 1 namely Sunil Kumar Marandi only.   
10.  Heard the Learned Counsel on behalf of both the parties and also perused the case records documents available on the record and evidence and other materials produced by both the parties and also carefully scrutinizing the documents.                                       
11. It is also admitted fact that Md. Najim deceased was policy holder issued by O.P as policy No. 526831057 which commenced from 04.02.16 and assured amount was Rs 100000. From carefully going through the so cause if the O.P it is also admitted and clear that the O.P has not stolen closed the claim of the petitioner. He is still ready to pay the claim of the petitioner if the petitioner files some required documents it means O.P has not repudiated the claim of the petitioner till today. This claim is still alive. Secondly it is also admitted fact that Md. Najim policy holder died on 29.02.2016. Means death of the deceased is admitted one. Only dispute is that whether Md. Najim died due to heart attack or due to cancer. Petitioner claims that death of Md. Najim was cause due to heart attack and the O.P alleged that death of Md. Najim was caused due to cancer. It means the cause of death of Md. Najim is disputed one. Whether it is due to heart attack or due to cancer. The petitioner has filed some medical prescription and the certificate of Dr. Dilip Kumar keshri who is the doctor of the deceased prior his death. And Dr. Dilip Kumar Keshri was also examined as CW3 in this case. He has proved his certificate as Exhibit 1 and has clearly stated that death of Md. Najim was due to cardiac respiratory failure. This certificate was issued by Dr. Dilip Kr. Keshri on 02.04.17. The prescription is also on the record issued by Dr Dilip Kr. Keshri on 27.02.16 which is before 2 days from the date of death of Md. Najim. It appears that deceased was under the treatment of Dr. Dilip Kumar keshri prior to his death.   
12. From the perusal of claim Form- B that is Exhibit 2 it appears that cause of death was written in this document as cardiac respiratory failure that is heart attack. And in column- 6, of this Exhibit there is clearly mentioned that there was no other disease to the deceased and in claim form name was also mentioned that the cause of death of Md. Najim was heart failure and the claim form which was submitted by the petitioner before O.P there is also mentioned that the cause of death was heart failure. There is also a confidential report of the agent which was given at the time of taking the policy in this report and it is mentioned that the claim is genuine and cause of death is heart failure in chest. Apparently from the above documents and discussions, it appears that deceased died due to cardiac failure that is heart attack.  
13. On the other hand the O.P claims that deceased Md. Najim died due to cancer as he was suffering from cancer much before taking policy about 1 and a half years. The O.P witness No. 1 Sunil Kumar Marandi in his statement in Para 5 he has clearly stated that claim is early in nature so the department setup an inquiry Mr. Kedar Das, Dumka and after inquiry he submitted the report which showed that deceased was suffering from cancer since last one and a half year before his death and therefore in Para 6, stated that on the basis of report, the department on 21.11.17 sent the claim with request to submit the details of cancer that is case history,  prescription and claim form B and B1 but till 06.08.17 no such requirement was submitted by the claimant to the department. This fact is also corroborated by so cause of the O.P in Para G that I.O, Mr. Kedar Das in his report dt. 21.10.17 has signed that by neighbor and it said that deceased was suffering from cancer since last one and a half year before his death and on the basis of the report of I.O the department has sent a letter on 21.11.17 asking him to submit the details of the case history, prescription and other forms but O.P has not submitted this form.
14. The report of the I.O on which the O.P demands treatment details of the cancer from complainant neither he produced Kedar Das as a witness nor he produce the affidavit of Kedar Das as a witness before this Forum. Apart from that the O.P has not adduced the cheat of papers regarding this fact that deceased was suffering from cancer much before from taking policy that is one and a half year. It is submitted by the O.P that the fact that Md. Najim was suffering from cancer it was stated by neighbors of the deceased. Apart from that CW2 is near relative of the deceased, he is brother in- law of the deceased and CW1 Md. Chand is also near relative of the deceased and CW3 is Dr. Dilip Kumar Keshri, both clearly stated deceased died due to heart attack, he was not suffering from any other disease. Apparently the O.P failed to establish this fact that deceased died due to cancer not by heart attack and on the other hand the petitioner has established this fact that deceased died due to heart attack. And from the perusal of records it also appears that claimant has already filed claim form properly before O.P and no other defects, requirement was pointed by the O.Ps.
15.  From the aforesaid discussion, we come to the conclusion that O.Ps negligently and arbitrarily withheld the claim of the petitioner. The petitioner is none other but the nominee and the beneficiary of the death policy holder. It is also admitted fact and the O.Ps is on the default in giving the proper services to the petitioner. As such it is therefore,

       Ordered

                      That the O.Ps is hereby directed to pay sum of Rs 100,000/- to the petitioner as a death claim and also directed to pay   Rs 20,000/- to the petitioner as cost of litigation and pay 12% p.a. from the date of filing the claim till realization.

             Thus this case and the same is allowed on contest with cost. Thus, this case is disposed off accordingly.

            Office is directed to supply the copy of this order to both the parties free of cost.