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Life Insurance Corporation of IndiaAward Dated 31.1.2005Smt. Maheshwari, w/o Late Shri M. Manivasagam, complained that L.I.C. of India, theInsurer repudiated her claim under the policy on the life of her late husband allegingmaterial suppression of information in the personal statement of health given at the time ofrevival of the policy. The Insurer repudiated the claim on the ground that the assured didnot divulge his suffering from and treatment for Right Ischiorectal Abscess while revivingthe policy.All the case records have been called for and perused. A personal hearing of both theparties was also arranged. It came out therefrom that the assured suffered from‘Tuberculus Prostatic Abscess, Phenobarbitone Poisoning and Immuno Compromised State’He was tested for and diagnosed to be HIV+ ve and a thorough reading of the hospitalrecords of Christian Medical College Hospital threw out the possibility that his tubercularabscess could directly be related to his HIV infection. The various diagnostic tests doneand the medicines prescribed strongly suggested HIV infection and other Opportunisticdiseases of HIV. The treatment therefor continued right from 09/2000. there was surgicaltreatment of the abscess also. All these treatments were well before the revival of thepolicy. These vital pieces of information were not divulged in the personal statement ofhealth while reviving the policy. Hence material suppression of the information with fullknowledge of the same, hence fraudulent, was proved with irrefutable documentaryevidence by the Insurers thus satisfying the requirements of Sec. 45 of Insc. Act.However, since the policy has already acquired paid up value before revival, the Insurersare directed to settle the paid-up value with accrued bonuses, which they have alreadyoffered to settle.The Complaint is dismissed.Chennai Ombudsman CentreCase No. IO (CHN) / 21.08.2447 / 2004 - 05Smt. C. RajendranVs.Life Insurance Corporation of IndiaAward Dated 31.1.2005Shri C. Rajendran, H/o Late S. Premalatha, lodged a complaint with this forum seeking theintervention of this forum in making available to him the policy monies under the policy onthe life of his wife, which the insurer refused to give alleging material suppression. TheInsurer’s contention was that the assured suffered from Tuberculosis and Chronic HeartDisease and underwent treatment therefor in a hospital before proposing. The repudiationwas challenged by the complainant.All the necessary case records were called for and perused. The contending parties werecalled for a hearing and their submissions recorded. It emerged therefrom that the assuredwas first admitted in Bethedsa Hospital, Ambur on 03/95 for treatment of Tuberculosis andIschemic Heart Disease. The treatment for these ailments was almost continuous in thesame hospital upto 2002. The Proposal was submitted in 02/2003 and the policycommenced on 28/02/2003. The assured died of Chest Pain on 21.03.2003 within a monthof taking the policy. All the hospital case records giving details of treatment takenthroughout the period were submitted by the insures, which amply proved the chronicity ofthe ailments refferred from which the assured suffered for well over 8 years. Death alsoresulted due to relatable causes. Thus the policy was taken at a time when the assuredwas chronically ill without divulging the ailments and treatment for the same. Hence therewas a clear material suppression of vital information.It is worth noting here that the provisions of Sec. 45 of Insc. Act are not applicable inentirety in view of the repudiation action having been taken well within two years of the