Death Claim - Gbic.co.in

Lucknow Ombudsman CentreCase No. : L-114/21/001/06-07Shri Rupesh Kumar GuptaVsLife Insurance Corporation of IndiaAward dated 19.01.2007Shri Rupesh Kumar Gupta had lodged a complaint with Insurance Ombudsman foralleged unjustified repudiation of claim by LIC of India under policy no.253185825 onthe life of his wife Smt. Anita Gupta on the ground that the fact regarding earliercaesarian delivery was not disclosed in the proposal form by the life assured and thisaffected the underwriting decision of the insurer. If this would have been disclosed shewould have been asked to complete addendum to proposal form as well as to submitreport from attending Gynecologist on form 3341 and also to submit haemogram report.Besides one of the causes of her death was Hepatic Encephalopathy and Hepatitis-Einfection developed during her pregnancy. Since the claim has been repudiated withintwo years from the date the policy was effected. The repudiation of the claim on theabove ground which was established by certificate of hospital treatment and theadmission of the complainant himself during personal hearing was, therefore, held tobe in order.Lucknow Ombudsman CentreCase No. : L-544/21/001/06-07Shri JitendraVsLife Insurance Corporation of IndiaAward dated 22.01.2007Shri Jitendra had lodged a complaint with Insurance Ombudsman for alleged unjustifiedrepudiation of claim by LIC of India under policy no.283695944 on the life of his motherSmt. Durga Devi on the ground that she was suffering from Anemia and Renal diseasesprior to the date of the proposal but she did not disclose the same in the proposal form.However, no cogent evidence to establish the fact of nondisclosure of the disease wasproduced by the insurer so as to establish that conditions of Section 45 of InsuranceAct 1938 were complied with. The letter of repudiation was, therefore, set aside andthe complainant nominee awarded full payment of claim alongwith accrued bonuses.Lucknow Ombudsman CentreCase No. : L-562/21/001/06-07Shri Nanhe Lal YadavVsLife Insurance Corporation of IndiaAward dated 22.01.2007Shri Nanhe Lal Yadav had lodged a complaint with Insurance Ombudsman for allegedunjustified repudiation of claim by LIC of India under policy no.283592436 on the life ofhis wife Smt. Phoolwati Yadav on the ground that in the personal statement regardinghealth dated 09.11.05 submitted for revival of the above policy the life assured hadsuppressed the ailments with which she was suffering prior to the date of the revival.The Insurer however did not submit any evidence in support of his repudiation actioneven although 15 days time as further sought by its representative on the date ofpersonal hearing for the purpose had elapsed by a sufficient margin. The repudiationletter dated 03.05.06 issued by the insurer was, therefore, set aside and nominee