Death Claim - Gbic.co.in

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documents submitted and also the medical attendant’s certificate issued byDr.J.C.Kothari of Bombay Hospital on 19.02.1998 which are as follow:-4(c) How long had he been suffering One year from date offrom this before his death ? : Diagnosis, that is,date of death 06.04.1994(d) What were the symptoms : Aden carcinoma lungof the illness?with Pleural effusion and fever(e) When were they first observed : When he was admittedby the deceased ?in Bombay: Hospital on 01.04.1993The insured had revived the policy No.180378317 on 23.04.1993 after his admission inthe hospital and in the case of Policy No.181987198, the first premium was paid on31.03.1993. Late Shri Prakash Chandra Sharma was very much aware of the diseasehe was suffering from and has concealed the material fact. Therefore, LIC of India hasrightly repudiated the claimI uphold the decision taken by Life Insurance Corporation of India repudiating the claimof Smt. Kanaklata Sharma under the above policies.There is no further relief to be granted to the complainant.Complaint is disposed of finally.Delhi Ombudsman CentreCase No. : LI-JD/263/05-06Smt. Maya DeviVsLife Insurance Corporation of IndiaAward Dated : 23.11.06My office has received a complaint on 16.09.2005 from Smt. Maya Devi, against theLife Insurance Corporation of India, Divisional Office-Jodhpur, regarding non-paymentof Death Claim under policy No. 103036488The representative of Life Insurance Corporation of India, Jodhpur Division, during thehearing on 14.11.2006 informed vide their letter dated 18.10.2005 that the policy hasnot even acquired paid up value. The policy is in lapsed condition. Half yearly premiumdue on 14.3.2005 was not paid to Life Insurance Corporation of India. Life assuredexpired on 24.07.2005. No risk was covered under the terms and conditions of policycontract. Therefore, Death claim was not payable. I uphold the decision of LifeInsurance Corporation of India,There is no further relief to be granted to the complainant.The complaint is disposed of.Delhi Ombudsman CentreCase No. : LI-JP/275/05-06Smt. Kakayi DeviVsLife Insurance Corporation of IndiaAward Dated : 23.11.06My office has received a complaint on 02.03.2006 from Smt. Kakayi Devi that the LifeInsurance Corporation of India, Divisional Office-Jaipur, has not paid the Death Claim
on life of her husband Late Shri. Ram Charan Jatav under policy No.191482116. Smt.Kakayi Devi is the nominee under the policy.The representative of Life Insurance Corporation of India, Divisional Office-Jaipur,during the hearing on 14.11.2006, informed vide letter dated 05.07.2006 that the policywas in a lapsed condition. Yearly Renewal Premium due on 10.4.1998 was not paid toLife Insurance Corporation of India. Life Assured expired on 16.09.2003. Risk underthe policy was not covered as per terms and condition of policy contract. Policy has notacquired paid up value. Policy commenced with effect from 10.04.1997 and only firstyearly premium due on 10.04.1997 was paid . Death Claim is not payable under thePolicy and I uphold the decision of Life Insurance Corporation of India.There is no further relief to be granted to the complainant.Therefore, the complaint is disposed ofDelhi Ombudsman CentreCase No. : LI-JD/214/05-06Sh. Manohar LalVsLife Insurance Corporation of IndiaAward Dated : 27.11.06My office has received a complaint on 02.08.2005 from the complainant Sh. ManoharLal that the Life Insurance Corporation of India, Divisional Office-Jodhpur,, hasrepudiated the Death Claim on life of his mother Late Smt. Geeta Devi under policyNo.10056498, on basis of suppression of material facts.Hearing of the complaint was fixed for 14.11.2006, Shri Manohar Lal, complainantattended the hearing Shri. R.N. Meena, Manager (claims) Life Insurance Corporation ofIndia Division Office- Jodhpur attended the hearing on behalf of Life InsuranceCorporation of India.Policy commenced with effect from 26.11.1998 under Table Term 14-18 for SumAssured of Rs. 25000/-. The policy was revived on 28.12.1999 on the basis ofdeclaration of Good Health and premium due Half yearly May-99 and November-99were paid at the time of revival of Policy. Life Assured expired on 29.06.2000.Life Insurance Corporation of India vide their letter No claim /death/ 100564980 dated30.06.2001 has repudiated Death claim on ground that material facts regarding healthof Life Assured were not disclosed on form of declaration of Good Health at the time ofrevival of Policy.As per the prescription of Dr. Pratap Sancheti of Jodhpur, Life Assured Smt. GeetaDevi was suffering from the Rheumatic heart disease, Atrial Fibrallator, Mitral Stenosissince 26.09.1999.I uphold the decision of Life Insurance Corporation of India that the death claim is notpayable.Delhi Ombudsman CentreCase No. : LI-JD/21/05-06Smt. Uchhab KanwarVsLife Insurance Corporation of IndiaAward Dated : 27.11.06
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Repudiation of Claim for Payor’s
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Award Dated : 27-11-2006Repudiation
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The Complainant’s husband held a
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sniped at Utmost Good Faith that fo
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In view of the above, the decision
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concealment of material facts regar
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The complaint was registered and ne
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he had never suffered from any ailm
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from Chronic Hepatitis c Cirrhosis.
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same till death claim arises. The R
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adhikar ewam Rin pustika ” for Ag
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10 days from date of commencement a
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grounds of suppression of material
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the claim for the reason “Suppres
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It is observed from the Medical cer
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It has also not been verified by th
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disbursement of salary as reported
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There was no dispute that the DD fo
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proposal the contract remains uncon
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the claim stating that her son bein
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states that no common poison was fo
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the Insurer on the ground that the
Page 49 and 50: On perusing the documents it is obs
Page 51 and 52: application for insurance on 22.12.
Page 53 and 54: preferred a claim with the Insurer.
Page 55 and 56: the time of taking the policies. In
Page 57 and 58: in January 2000. The policy was rev
Page 59 and 60: Subsequently he was referred to Tir
Page 61 and 62: All the spells of medical leave hav
Page 63 and 64: In the hearing, the complainant sta
Page 65 and 66: KTVR Group Hospital due to “Hepat
Page 67 and 68: Chennai Ombudsman CentreCase No. :
Page 69 and 70: He was also on leave during 11.04.2
Page 71 and 72: Life Insurance Corporation of India
Page 73 and 74: Chennai Ombudsman CentreCase No. :
Page 75 and 76: found in the body. It was further r
Page 77 and 78: family doctor. He admitted that his
Page 79 and 80: Smt.S.Shanthi obtained a life insur
Page 81 and 82: act. She stated that as per the sta
Page 83 and 84: evival was almost like a fresh cont
Page 85 and 86: contended that the deceased life as
Page 87 and 88: Sri J. Hussain Mohammed submitted a
Page 89 and 90: and his wife was sitting after her
Page 91 and 92: In the hearing the complainant stat
Page 93 and 94: VsLife Insurance Corporation of Ind
Page 95 and 96: Jodhpur on 11.11.2002 and was disch
Page 97 and 98: He had concealed the material fact
Page 99: They further needed claim forms No.
Page 103 and 104: Delhi Ombudsman CentreCase No. : LI
Page 105 and 106: The representative from Life Insura
Page 107 and 108: 3 months and 14 days of taking poli
Page 109 and 110: 09.06.2003 and the proposal was sub
Page 111 and 112: Leukemia. Bone Marrow Report dated
Page 113 and 114: Thus, he withheld facts and was gui
Page 115 and 116: questions provided in item no.11 of
Page 117 and 118: the claims excepting the present on
Page 119 and 120: The submission of LIC is that the p
Page 121 and 122: LIC that other two policies of Sum
Page 123 and 124: Branch Office of LICI. It is stated
Page 125 and 126: We have considered the photocopies
Page 127 and 128: On the circumstances aforesaid, it
Page 129 and 130: Life Insurance Corporation of India
Page 131 and 132: nos.722662607 for Rs.50000/- and 72
Page 133 and 134: information. The insurer also suspe
Page 135 and 136: The claim was rejected by LIC stati
Page 137 and 138: Facts of the Case: (Late) G.Appa Ra
Page 139 and 140: Head Notes: Life assured availed a
Page 141 and 142: in English, which suggest that he i
Page 143 and 144: LIC about usage of herbal medicines
Page 145 and 146: age proof. She requested for settle
Page 147 and 148: the owner of the opposite vehicle i
Page 149 and 150: action was found to be based on pro
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certificate issued by one Dr.H.R.De
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suffering from disease prior to rev
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establish that the LA failed to dis
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The complaint under Rule 12(1)(b) r
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not be blamed entirely. But, the mi
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Life Insurance Corporation of India
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hypertensive before the inception o
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Ltd and expired on 30.09.04. Theref
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Kotak Mohindra Old Mutual Life Insu
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We may mention that the insurance c
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evidence to prove that the DLA was
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The insurance company in their self
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time of taking the policy and that
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the required papers and hence there
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their own guidelines can consider t
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the contract was not complete and e
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and, therefore, she interpreted tha
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cheque No.258433 dt.20.2.2007. Prob
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We were unable to modify the order
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certificates submitted by the claim
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Smt. Phoolpatti had lodged a compla
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dispute the will but contended that
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Jaiswal who in their report confirm
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treated the person but since the si
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31.03.05/11.04.05 issued under the
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Shri Sarvjit Gupta had lodged a com
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complainant awarded payment of full
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with him during the period 02.03.04
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Award dated 31.02.2007Smt. Shakunta
Page 209 and 210:
asis of which proposal was complete
Page 211 and 212:
Consultation/Treatment as proof of
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Smt Shantona Kanaiya Ghosh had take
Page 215 and 216:
ody with altered behavior for few m
Page 217 and 218:
Mumbai Ombudsman CentreCase No. : L
Page 219 and 220:
Diabetes Mellitus since 20 years an
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Jhatingrao Gaikwad to pursue the ca
Page 223 and 224:
into consideration, it would be rea
Page 225:
Mumbai Ombudsman CentreCase No. : L
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