Death Claim - Gbic.co.in

epresentative of the insurance company defended the decision of repudiation of claimon the lines mentioned above i.e., non-disclosure of material fact in the proposal form.Decision :The complainant was informed that the revived policy was only 5 ½ months old and thatthe DLA was suffering from chronic diseases which was within his knowledge whilesigning the personal statement form and, therefore, it could be easily inferred that hehad not disclosed the health condition in the personal statement even after having theknowledge of the same. It was, therefore, held that there was suppression of materialfacts at the time of reviving the policy. Under these circumstances, we did not have anyother alternative but to agree with the decision of the insurance company with regard torepudiation of the claim. The petition was dismissed without any relief to thecomplainant.Kolkata Ombudsman CentreCase No. : 172/24/001/L/06/06-07Shri Prabir Kumar BoseVsLife Insurance Corporation of IndiaAward Dated : 30.03.07Facts & Submissions :This petition was filed by the complainant Shri Prabir Kumar Bose for non-settlement ofclaim arising out of death of his father Late Jiban Krishna Bose, deceased life assured(DLA).The complainant was the nominee under policy no. 430937612 with DOC 07.02.1993.The life assured died on 27.02.1994, 1 year 20 days after the commencement of thepolicy. The complainant submitted the claim forms on 25.01.2005. As the claimremained pending, this petition has been filed before this forum for relief.LICI stated that the life assured died of Cirrhosis of Liver at home after 1 year 20 daysof taking the policy and the nominee sent the claim forms on 18.01.2005, nearly 11years after death, date of death being 27.02.1994. There was no possibility of anyinvestigation to be conducted to determine the allowability of the claim.HEARING :Originally a hearing was fixed for 06.02.2007. The Petitioner did not attend but sent arepresentative who was not permitted to attend. Therefore, another hearing was fixedfor 20.03.07 where both the Petitioner and the representatives of the insurancecompany attended. The Petitioner was asked why the claim was made after 11 yearswhen the life assured died on 27.02.1994. According to him, he sent a letter on03.09.1996 informing the death of his father. In response to this letter, the insuranceauthorities requested him to submit all the documents including the death certificate,etc. vide their letter dated 05.09.1996. He, however, stated that this letter was repliedonly on 27.09.2004 i.e., nearly 8 years later. He was asked why there was a delay insubmitting these forms for 8 years. He stated that obtaining the death certificate tooklot of time and the same was issued to him only on 11.09.2004. He could not give anyreason for such inordinate delay.The representatives of the insurance company defended their repudiation decision onthe ground that the claim was made after more than 10 years and that the medical