Death Claim - Gbic.co.in

Award Dated : 06.03.07Facts & Submissions:The complainant was the wife and nominee under Jeevan Akshay policy no. 530073801of her husband Late Shyam Sundar Prasad. The life assured expired on 09.10.05. Shefurnished a copy of letter dated 03.05.06 issued by LICI, Eastern Zonal Office showingreturn of unutilized annuity cheques and confirming exit action taken by them. Thedeath claim was, however, kept pending by the servicing branch. The complainant didnot submit ‘P’ form.HEARING :A hearing was fixed. The complainant did not attend, while representatives of LICIattended. During the hearing, the representatives of LICI produced evidence that theyhave settled the death claim for Rs. 14,280/- vide cheque no. 133216 dated 28.12.06.This is also confirmed by the order issued by the District Consumer Forum, which hasstated that the above petitioner does not have any complaint against LICI as they havesettled the claim.Decision :Under these circumstances, the petition filed by the complainant is deemed to havebeen settled and no further action need be taken as the complainant is satisfied by theredressal of the complaint.Kolkata Ombudsman CentreCase No. : 349/24/001/L/08/06-07Smt. Sudhain MahaliVsLife Insurance Corporation of IndiaAward Dated : 07.03.07Facts & Submissions :This was a petition filed by Smt. Sudhain Mahali for non-settlement of death claimunder Salary Saving Scheme (SSS) Policy on the life of her husband by LICI.Smt. Sudhain Mahali, wife of Late Somra Mahali, deceased life assured (DLA), andnominee made this petition for non-payment of death claim under SSS policy issued byLICI. Against her representation, she was informed that the policy had lapsed w.e.f.August’99 and nothing was payable. Hence, this petition was filed for relief.According to the insurance company, the policy was under SSS with DOC 28.09.1998.They enquired from the employer Jogesh Chandra Tea Estate with regard to premiumsthat have been deducted from the DLA’s salaries and remittance particulars and it wasfound that the premiums were deducted up to April, 2000 (DLA was killed on15.05.2000), but remittance was made only up to July 1999. The employer failed toremit premium deducted from salary due to paucity of funds. According to theinsurance company, since the employer was at fault, they regretted the same. Theinsurance company further stated that they sent the claim forms to the claimant andstated that they requested their competent authority to consider the claim as ex-gratia.According to them, the complainant has not yet submitted the claim forms.Decision :Death of the life assured was established and it was presumed that the insurer havenot denied the claim. As per the details mentioned above, the premiums were deductedup to April 2000 and, therefore, the policy was in-force at the time of death of the DLA.Though the claim was lodged after more than 3 years, the insurance company under