Life Insurance - Gbic.co.in

produced the father of the assured to substantiate the facts stated in the allegedstatement. As stated by the complainant the assured had no grocery shop of her own andas such was not a self employed woman. Admittedly husband of the assured was notholding any insurance at the relevant time . The policy issued on the statement of theassured that she was self employed woman carrying on business in grocery, has beenproduced false as per the admission of her husband (the complainnant.) It thus appears theassured had managed to obtain the policy with false declaration that she was a selfemployed woman.Held that the repudiation can not be faulted on any score.Bhubaneswar Ombudsman CentreCase No. I.O.O. / BBSR / 24 - 216Ms. Mita ChhinchaniVs.Life Insurance Corporation of IndiaAward Dated 21.01.2005Happened that Late Smt. Ranjani Chinchani of Bijipur Tank Road, Berhampur, Dt. Ganjamhad obtained a policy bearing No. 570444985 from the Career Agents Branch of LifeInsurance Corporation of India on 28.1.2003 for an assured sum of Rs. 1,00,000/- Table &Term 14 - 21 & mode of payment of premium yearly. Unfortunately she died on 13.4.2003.Smt. Mita Chhinchani, the nominee submitted required documents in December 03. As theinsurer sat over the matter, the complainant moved this forum for redressal. The insurerrepudiated the claim pendentlite on the ground interalia that the insured had intentionallysuppressed material facts relating to her age and income while mooting the proposal.Complained that the insurer has made inordinate delay in settling the death claim. Theircontention of suppression of material facts regarding age and income of her mother is notcorrect.Countered by LIC that school leaving certificate submited by the assured at the time ofproposal is forged one and she had understated her age by 12 years. She was also not aself employed woman. As her husband had nil insurance, she was not insurable.Observed that the insured had produced a school leaving certificate allegedly issued byHeadmaster, Serango High School, Gajapati on 20.8.73, where-in her date of birth is statedas 17.8.61. The headmaster of the school in his letter No. 44 dt. 23.3.04 has informed thatno transfer certificate dtd. 20.8.73 wa issued in favour of the insured. The investigationreport of B.M., LICI Parlakhemundi insurer reveals that Gajapati district was not formed inthe year 1973. It is this manifest that the S. L. C. Produced in proof of the age is a forgedone. The insurer has produced the voter’s list for the year 2004 (S18,Orissa) of BijipurNaidu Sahi in Berhampur municipality published on 1.3.2004, wherein age of the insuredhas been stated as 54. In absence of any standard age proof as provided in the insurer’sunderwriting, the age stated in the voter list is to be accepted as non standard age proof. Itis therefore held that at the time of submission of the proposal the insured was 53 years ofage. There is a rider in the insurer’s underwriting that in case of non standard age proofmaximum age at entry will not exceed 50 years. Had the insured not suppressed materialfacts relating to her actual age by producing a forged S. L. C. the policy under Table &Term 14 - 21 would not have been issued in her favour. Secondly in the proposal form theinsured had stated tailoring and running parlour as her occupation. The complainant hascandidly admitted that the insured was neither running a beauty parlour nor was a tailor butworking in a parlour. She drew a blank when asked to name the beauty parlour and itsowner. Evidently therefore insured does not come under category of self employed woman.Admittedly, the husband of the insured had no insurance so as to make her eligible forholiding the policy.Held that the repudiation action of the insurer can not be faulted on any score.