Death Claim - Gbic.co.in

of award/order under intimation to this Authority. However, if dis-satisfied, thecomplainant may approach here again.The LIC is further directed to consider payment of penal interest for any unusual delayin resolving the problem and making payment etc., as the case may be.Guwahati Ombudsman CentreCase No. : 24/01/005/L/06-07/GHYSmt. Rakhi PaulVsLife Insurance Corporation of IndiaAward Dated : 01.12.2006Facts (Statements and counter statements of the parties)The complainant Smt. Rakhi Paul states that the death-claim preferred by her inconnection with the policy in question has not been settled by the LIC.By letter dated 16/05/06 addressed to us the Manager (Claims) of LIC Divisional Office,Guwahati, stated that sum assured in this context was Rs.1,25,000/- under table andterm 103-20 on the life of Sujit Kr. Paul, D.L.A. (Deceased Life Assured) , mode ofpremium being ‘yly’. That at the death of the D.L.A. on 23/06/04, the policy was ofduration of 2 months 25 days. That as per the report of the I.O., the D.L.A. had beensuffering for 3 to 4 months prior to the death vis-à-vis the policy duration of 2 months25 days only. That the D.L.A. expired in the Dr. B. Borooah Cancer Institute, Guwahation 23/06/04 as per the statement of the claimant, but space for answers to questionscontained in claim form ‘B’ was left blank with a throughout remark ‘does not arise’ byauthority of Dr. B. Borooah Cancer Institute, Guwahati and accordingly, forclarification, it (LIC) wrote to the complainant/claimant for sending treatmentparticulars from 16/6/04 to 23/06/04 along with the case history. But the complainantdid not comply with the request till date of that letter dated 16/05/06.Decisions & ReasonsThe copy of claim form-‘A’ forwarded to us mentions that the duration of the last illnessof the D.L.A. was 7 days w.e.f. 15/06/2004 causing his death on 23/06/04 due to‘cardio respiratory failure’ and the D.L.A. complained of ill health (heart pain) on16/06/2004. It was rightly pointed by the concerned officer of the LIC that certificate ofhospital treatment, claim form ‘B’, issued by the Senior Resident of Dr. B. BorooahCancer Institute, Guwahati, has filled-up the form without any particulars simplymentioning ‘does not arise’. The medical attendants certificate, claim form ‘B’ alsomentions that the patient complained of heart pain and the duration of the same wasfor7 days w.e.f. 16/06/04. Interestingly, the certificate of identity and burial or cremation(claim form ‘C’) is signed by Residental Surgeon of Dr. B. Borooah Cancer Institute,Guwahati, mentioning that he saw the patient alive on 23/06/2004 and patient on deathwas cremated on 23/06/2004 at Lanka Muktighat (after his death at Dr. B. BorooahCancer Institute, Guwahati on 23/06/04 at 2.40 p.m). The photocopy of the certificatedated 19/03/05 from Dr. B. N. Mondal, Lanka forwarded here by the complainant showsthat said doctor treated D.L.A. Sujit Kr Paul on 29/05/04 for fever, headache andbodyache but treatment was not responding and he referred the D.L.A. to specialist on07/06/04 (there is no document to show that the D.L.A. was referred to the Dr. B.Borooah Cancer Institute, Guwahati by said Dr. Mondal).In her subsequent letter dated 10/07/06, the complainant Smt. Rakhi Paul has averredthat her husband (D.L.A.) was holder of seven number of policies and she received all