Death Claim - Gbic.co.in

assured had suppressed two spells of medical history and hospitalisation forMyasthenia Gravis in 1999 and 2001. Even in such circumstances, considering the factthat the policy had run for nearly 2 ½ years, the insurer had paid the basic sumassured plus vested bonus on EX-GRATIA which the claimant had accepted in full andfinal settlement of all claims. The accident benefit was not payable as per the policyissued and, besides, the ex-gratia payment itself extinguished any further claim on thepolicy. In the circumstances, the complaint was found to be devoid of merits and thesame was dismissed.Kochi Ombudsman CentreCase No. : IO/KCH/LI/21-001-117/2006-07Smt.Dolly KuriakoseVsLife Insurance Corporation of IndiaAward Dated : 12.12.2006The complaint under Rule No.12(1)(b) read with Rule 13 of the RPG Rules, 1998relates to repudiation of a life insurance claim under Policy No. 773502618 held by thehusband of the complainant. The policy had commenced on 28.6.2000 and the samewas revived twice on 30.4.2003 and 26.7.2004 on the basis of declarations of goodhealth at the relevant points of time. All the same consequent on the death of the lifeassured on 28.3.2005, the investigations revealed that the life assured was sufferingfrom brain tumor right from April 2003 during which period of time, the first revival waseffected. From 27.4.2003 to 30.4.2003, the life assured was an inpatient at the JubileeMission Hospital, Trichur and the C.T.Scan done on 29.4.2003 had diagnosed theproblem as “low grade glioma in right frontal region”. In these circumstances, the claimwas repudiated for suppression of material facts at the time of revival. There was nopaid up value accrued on the policy as on the date of revival and therefore nothing waspayable to the complainant. In the circumstances of the case, the decision of theinsurer to repudiate the claim was found to be on solid grounds and hence the samewas upheld duly dismissing the complaint.Kochi Ombudsman CentreCase No. : IO/KCH/LI/21-001-180/2006-07Smt.Ramla BeeviVsLife Insurance Corporation of IndiaAward Dated : 12.12.2006The complaint under Rule 12(1)(b) read with Rule 13 of the RPG Rules, 1998 relates torepudiation of a life insurance claim under Pol.No.781485988 held by the husband ofthe complainant. The policy had commenced on 10.6.98 and it was revived on19.10.2005 by paying 7 quarterly premia cumulatively. The revival was supported by aMedical report and a personal statement of health. The life assured died on 30.10.2005and from the investigations and reports received from Medical College,Thiruvananthapuram, it was revealed that the life assured was suffering fromHypertension and Diabetes since 1 year and chronic kidney disease for 1 ½ months.Haemodialysis was also done on 15.10.2005. All these facts were not mentioned in thepersonal statement of health, which, as per the complainant was written out by theagent. The insurer had initiated action against the agent as well as the MedicalExaminer. However, although the life assured also should have been careful aboutwhatever was written out in the statement of health, as a lowly educated man, he could