Death Claim - Gbic.co.in

The claim was rejected by LIC stating that the life assured was not having adequateincome to maintain the policies, furnished incorrect family history in the proposalforms, suppressed past history of alcoholism etc. LIC obtained a certificate from MROstating that the LA was having an annual income of Rs.6000 as per 1996 data. Theyobtained a letter from the father-in-law of the DLA, as per whom the LA was having anestranged wife with no children. However, in the proposal form it was mentioned thatthe LA had two living children. In the proposal forms, the LA’s mother was shown asdead but she survived the LA. The LA was in the hospital for less than one day for histerminal illness and the doctor suspected chronic renal failure with history ofalcoholism. The complainant refuted all the allegations of LIC and maintained that theLA was healthy at the time of issue of the policy.Considering the meager income of the LA as revealed from MRO certificate, noting inthe case sheet of the hospital about past history of alcoholism, incorrect family detailsin the proposal forms, it was decided to uphold the contention of the insurer. Thecomplaint was therefore dismissed.Hyderabad Ombudsman CentreCase No. : L-21-001-0334-2006-07Sri P. Ramachandra GoudVs.Life Insurance Corporation of IndiaAward dated 30-11-2006The complainant filed a case against the decision of LIC to repudiate a death claimunder Pol. No.600648044. The policy was taken on the life of late (Smt) P. Anjammafor a sum assured of Rs.50,000 from Nizamabad branch of LIC. The policy commencedon 8.11.2004 for a five year period under endowment plan (T-14). The life assured wasaged 57 years at time of commencement of the policy and she was engaged in tailoringprofession. She died on 11.4.2005 and her husband’s claim for payment of death claimwas rejected on the grounds of suppression of material facts.The enquiries of LIC revealed that the LA died in NIMS and case sheet details revealedthat the LA was hypertensive since 10 years prior to the issue of the policy and shewas on regular medication with ‘Amlog’ medicine. As the life assured did not discloseher past history of hypertension, LIC repudiated the claim for reasons of suppression ofmaterial facts. The complainant contended that his wife was medically examined by LICbefore issuing the policy and also that hypertension is not a disease. As per the casesheet obtained from NIMS hospital, the life assured was admitted into the hospital withcomplaints of fever for ten days, petechial rash, hematuria, ITP associated withbleeding etc. Based on the evidence produced and as Section 45 is not applicable, thecomplaint was not admitted.Hyderabad Ombudsman CentreCase No. : L-21-001-0234-2006-07Smt. M.VenkataratnaluVs.Life Insurance Corporation of IndiaAward dated : 11-12-2006(Late) Mudragadda Balaiah son of M. Subbaiah; Occ. Junior Asistant, CTO Office,Guntur obtained a policy no. 672870057 for Rs.50000 from City Branch-2 of LIC,Guntur. The policy was under Asha Deep plan (121-15) with a yearly premium ofRs.4281.00. The policy commenced on 15.1.2002 and the policy was issued under