Death Claim - Gbic.co.in

with him during the period 02.03.04 to 04.05.04. Pradhan, Gram Panchayat, Saal alsostated that he was not suffering from any disease. But on a careful consideration it washeld that these certificates on plain paper do not carry any evidentiary value. TheCertificates produced by Insurer were more reliable.Lucknow Ombudsman CentreCase No. : L-600/21/001/06-07Shri Pyare LalVsLife Insurance Corporation of IndiaAward dated 31.01.2007Shri Pyare Lal had lodged a complaint with Insurance Ombudsman for allegedunjustified repudiation of claim by LIC of India under policy no.222137073 on the life ofhis wife Smt. Usha Devi on the ground of nondisclosure of material facts relating to herhealth namely that she had suffered from TB and had taken treatment at TB hospitalHardoi prior to the date of proposal. In support of its contention the insurer submittedcopy of investigation report from its officer Shri A.K. Srivastava alongwith his affidavitconfirming the registration no. X00029/14.07.03 at TB Hospital Hardoi where she wastaking treatment alongwith statements from two residents of the locality. Thecomplainant contended that she was medically examined at the time of acceptance ofher proposal. However, since the medical examination does not absolve the proponentfrom disclosing all material fact relating to his / her health the repudiation of the claimunder the policy which was within 2 years from the date the policy was effected washeld to be in order.Lucknow Ombudsman CentreCase No. : L-506/21/001/06-07Smt. Sohan BiriVsLife Insurance Corporation of IndiaAward dated 31.01.2007Smt. Sohan Biri had lodged a complaint with Insurance Ombudsman for allegedunjustified repudiation of claim by LIC of India under policy no.271029649 on the life ofher husband Shri Ram Dass on the ground that there was nondisclosure of materialfacts regarding his illness of progressive weakness of all 4 limbs for last 2 years. Theinsurer in his support submitted copy of medical attendant certificate and certificate ofhospital treatment from St. Stephen’s Hospital, Delhi where the life assured wasadmitted on 23.06.05 and the history there was stated by the patient and his attendant.This was further corroborated by his consultation/ treatment undertaken earlierundertaken at Post Graduate Institute of Medical Sciences and Research, Chandigarh.The complainant on the other hand denied that the life assured was not in sound healthat the time of revival and submitted an affidavit and also contended that he hadundergone a medical examination before the revival was effected. However, since thecontract of Insurance is a contract of utmost good faith and the life assured is undersolemn obligation to disclose all material facts and the medical examination is not asubstitute for this obligation, it was held that the nondisclosure of the illness ofprogressive weakness of the limbs for last 2 years had been established by theevidence submitted by the insurer and as such all the ingredients of Section 45 ofInsurance Act 1938 were fulfilled and the repudiation of the claim was in order.Lucknow Ombudsman Centre