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Life Insurance - Gbic.co.in

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questionnaire <strong>in</strong> the proposal form. This amounts to suppression of material facts relat<strong>in</strong>gto al<strong>co</strong>holism of the assured.Held that the repudiation action taken by the Insurer can not be faulted on any s<strong>co</strong>re.Chandigarh Ombudsman CentreCase No. LIC / 138 / Chandigarh / Nangal / 24 - 05Smt. Supari DeviVs.<strong>Life</strong> <strong>Insurance</strong> Corporation of IndiaAward Dated 21.10.2004Facts : Shri Dharam Chand purchased four policies under Salary Sav<strong>in</strong>gs Scheme atdifferent <strong>in</strong>tervals dur<strong>in</strong>g 1990 to 1993. He died on 26.8.94. His wife/ nom<strong>in</strong>ee Smt. SupariDevi lodged the claim with BO Nangal, which was not settled for many years on the pleathat re<strong>co</strong>rds had been misplaced. She filed a <strong>co</strong>mpla<strong>in</strong>t <strong>in</strong> this office on 15.7.04.F<strong>in</strong>d<strong>in</strong>gs : It was <strong>co</strong>nfirmed that all four policies were <strong>in</strong> force on the date of death ofpolicyholder. However, the claimant failed to submit requisite documents despite repeatedrem<strong>in</strong>ders. Last rem<strong>in</strong>der was reportedly sent on 8.2.96 to submit orig<strong>in</strong>al death certificateand the policy bonds with<strong>in</strong> a period of 10 days.After receipt of a <strong>co</strong>py of <strong>co</strong>mpla<strong>in</strong>t from this office on 20.7.04, the Divisional Office soughtpolicy dockets and detailed report from the branch office to proceed further <strong>in</strong> the matter.The branch office <strong>in</strong>formed that the basic re<strong>co</strong>rd <strong>co</strong>uld not be traced, as it was destroyed <strong>in</strong>Sept 1990 dur<strong>in</strong>g Mandal Commission agitation. However, orig<strong>in</strong>al ledger sheets were sentto the DO. Claim papers were also <strong>co</strong>llected from the claimant and the matter was underactive <strong>co</strong>nsideration for payment.Decision : Held that the claimant cannot be held responsible for misplacement ordestruction of re<strong>co</strong>rd. The <strong>in</strong>surer was liable to settle the claims. Directed to do so with<strong>in</strong> aperiod of three weeks.Chandigarh Ombudsman CentreCase No. LIC / 208 / Chandigarh / Mandi Gob<strong>in</strong>dgarh / 21 - 05Smt. Harjeet KaurVs.<strong>Life</strong> <strong>Insurance</strong> Corporation of IndiaAward Dated 21.10.2004Facts : Smt. Harjeet Kaur’s husband Late Shri Gurdev S<strong>in</strong>gh had taken a policy for sumassured of Rs. 1,00,000/- on 15.5.99 from B.O. Mandi Gob<strong>in</strong>dgarh. It lapsed on 15.5.01 andwas got revived on 30.3.02. The deceased life assured expired on 28.9.02. The claimlodged by his wife/nom<strong>in</strong>ee was repudiated on 28.2.03 on the ground that the LA hadwithheld material <strong>in</strong>formation at the time of revival of policy. She filed a <strong>co</strong>mpla<strong>in</strong>t alleg<strong>in</strong>gthat her claim was repudiated on flimsy grounds and that she was not aware of thesickness of her husband.F<strong>in</strong>d<strong>in</strong>gs : It was noted that the <strong>in</strong>surer repudiated the liability after due <strong>in</strong>vestigation,which revealed that DLA had availed of medical leave for 109 days dur<strong>in</strong>g July 99 toNovember 2000 prior to revival of policy. This was further supported by the fact that he hadsubmitted bills for reimbursement. It also transpired that he was a chronic al<strong>co</strong>holic andsuffered from liver disease for two years as per <strong>in</strong>formation given <strong>in</strong> form No. 3784 by themedical attendant. He failed to disclose this <strong>in</strong> DGH while apply<strong>in</strong>g for revival of policy on30.3.02.Decision : Held that the supportive evidence with the <strong>in</strong>surer was sufficient to warrantrepudiation of the claim. Hence the <strong>co</strong>mpla<strong>in</strong>t was dismissed.Chandigarh Ombudsman Centre

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