Death Claim - Gbic.co.in

09.06.2003 and the proposal was submitted on 30.01.2003. The disease could not bedetected by the medical examiner of LIC of India since no clinical tests wereconducted. Therefore, the doctor was not able to detect the disease.Since Smt. Meera Devi has disclosed in her statement to Natural Health Care Centre,Jodhpur that she was suffering from cancer of ovaries for the last 2 years, that is,before submitting the proposal to LIC of India, there is concealment of material fact.I uphold the decision taken by LIC of India repudiating the claim of Shri Hapu RamVishnoi under the above said policy.There is no further relief to be granted to the complainant.Complaint is disposed of finally.Delhi Ombudsman CentreCase No. : LI-DL-III/04/06-07Shri Harish BansalVsLife Insurance Corporation of IndiaAward Dated : 07.03.2007Shri Harish Bansal has lodged a complaint with this Forum on 06.04.2006 that his wifeSmt. Kusum Bansal had taken a life insurance policy No.331370848 from LIC of Indiawhich was inforce at the time of her death. After filing a claim after her death, LIC ofIndia after 9 months has repudiated the same. He sees no logic for repudiating theclaim. He has requested the Forum that his case may be considered sympathetically.LIC of India, vide their letter, dated 10.05.2006, informed the Forum that PolicyNo.331370848 was issued on 31.01.2005 with date of commencement as 28.01.2005 infavour of Shri Harish Bansal and Smt. Kusum Bansal under table and term 89.20, thatis, Jeevan Sathi Plan. They have received the death intimation from Shri Harish Bansalthat Smt. Kusum Bansal had died on 20.06.2005 just after 4 months and 19 days oftaking policy due to heart attack.In the case history received from Orchid Hospital and Form No.5152 received from Dr.Arun Anand, it is stated that she was a known case of Rheumatic Arthritis andPulm.Koch’s and was taking treatment from him for the last two years for cough andcold and old arthritis. This non disclosure is material as the cause of death of lifeassured as per Orchid Hospital record is Pulm.Koch’s and Sepsis which has directnexus with the previous disease of the deceased. Therefore, they have rightlyrepudiated the claim.At the time of hearing, Shri Harish Bansal contested that his wife was medicallyexamined by Dr.S.Yadav and as per his medical report, she was not suffering from anydisease. Further, he contested that his wife died because of heart failure and notbecause of Rheumatic Arthritis. As such non disclosure of the same has no relevancewith the cause of death. His claim, therefore, should be paid.LIC of India contested that Smt. Kusum Bansal was first admitted in Orchid Hospitaland Heart Centre on 18.06.2005 at 2.10 p.m. and was discharged on 20.06.2005 andwas shifted to Kukreja Hospital and Heart Centre Private Limited and was diagnosed acase of Right sided Massive Pneumonic and Pulm.Koch. Since as per Form No.5152submitted by Dr.Arun Anand, Smt. Kusum Bansal was a patient of cough and cold andold Pulm.Coch for the last 2 years which was before the commencement of the policy,that is, 31.01.2005. The deceased life assured had not declared of her disease in theproposal form and the policy having only run for 4 months and 19 days, the claim is notpayable.