Death Claim - Gbic.co.in

adhikar ewam Rin pustika ” for Agriculture land Rakba- 0.433. Hence the contention ofthe Respondent that the DLA was not having any income is not acceptable.The Respondent could not submit any evidence to prove that the DLA was sick prior topolicy in question as well as it is also not acceptable that the DLA was not having sortof income. Further, no malafide intention of DLA is found in taking the policy inquestion.In view of the circumstances stated above, I am of the considered opinion that therepudiation of death claim by the Respondent on this ground stated above is unfair andunjustified.Hence, the Respondent is directed to pay the death claim amount under Policy No.344481789 within 15 days of receipt of this order failing which the Respondent shall beliable to pay further interest at the rate of 9% per annum from the date of this Order tillthe date of actual payment.Bhopal Ombudsman CentreCase No.: LI-1100-21/11-07/GWLShri Dhan Sunder JatavVsLife Insurance Corporation of IndiaAward Dated : 14.02.2007Shri Dhan Sunder Jatav, resident of Gram Bhageh, Tahsil Dabra District Gwalior M.P.(hereinafter called Complainant) is the son of late Smt. Beti Bai Deceased Life Assured(in short DLA). The DLA took a life insurance policy numbered 201247225 from LIC ofIndia, DO: Gwalior, BO- Dabra (hereinafter called Respondent) on 28.10.2004 for SumAssured of 50,000/- under Table/Term: 14-15. The DLA died on 18-03-2005 due toVomitting and loose motion. The complainant has complained that he had preferreddeath claim with the Respondent but the same was repudiated on the grounds ofunderstatement of age by DLA at the time of taking the policy in question. Further thecase was referred to the Claim Review Committee at LIC Zonal Office Bhopal. The ZOCRC in its meeting upheld the DO decision of repudiation on 01-11-2006. Aggrievedfrom the repudiation action of the Respondent, the Complainant has lodged a complaintwith this Office seeking directions to Respondent to settle the claim.The complaint was registered & necessary forms were issued to both the parties.Replies were received from both the parties.The Respondent vide its self-contained note dated 18.12.06 replied that the DLA wasof 63 years age instead of 50 years mentioned by her in the proposal form and she wasresponsible for understating her age by 13 years. Further she was suffering fromparalysis since last three years prior to the date of proposal for insurance. Had shedisclosed her actual age and status of her health in the proposal form, the presentpolicy would not have been issued to her at this age. It is, therefore, evident that shehad made deliberate and incorrect statements and withheld material informationregarding her age and status of her health at the time of affecting the assurance and ifshe had disclosed his correct age and status of her health in the proposal, the proposalwould not have been accepted. Hence in terms of policy conditions and thedeclarations contained in the form of proposal for assurance and personal statement,the claim was repudiated.Observations of Ombudsman : I have gone through the materials on records andsubmissions made during hearing and summaries my observations as follows: