Death Claim - Gbic.co.in

diabetes for past 3 to 4 years and one leg was amputed above knee some 3 years backand no other evidence was shown recommending repudiation of the claim. Even thesaid Dr. Hira Dalodriya’s had not mentioned the history of disease, treatment taken,admission in hospital etc. in reply to the question no- 7 (‚ã), (ºã), (Ôã), (ª) & (¾ã).Similarly nothing had been mentioned in reply to question no 10 (‚ã), (ºã), (Ôã) which isrelated with the previous treatments.It is apparent from the above that Respondent’s contention merely on the basis of Dr.Hira Dalodriya’s report that the DLA was diagnosed anemia c Dysentery and theRespondent’s Investigation report was just based on statements which were obtainedfrom the various person residing in the locality of the DLA where in it has been statedthat the DLA was suffering from diabetes for past 3 to 4 years is not acceptable as DLAwas a sick prior to date of revival.Had the DLA suffered from the disease since 3 or 4 years as contended by theRespondent, some Investigation reports viz., Blood report/X-ray report, doctor’sprescription with regard to treatment, etc. would have been made available to showthat DLA was actually suffering by any disease prior to revival.It is further observed from the claim form ‘B’ issued by the Dr. Hira Dalodriya dated21.02.2006 that the DLA was admitted in Civil Hospital, Ashta on 04.06.2003 for oneday and was discharged on the same day. Hence, it is not acceptable that the DLA wasactually suffering by diabetes prior to revival. The Respondent could not submit anyevidence to prove that the DLA was sick prior to date of revival. Further, no amplifiedintention of DLA is found in taking the policy in question.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.351491649 for basic sum assured within 15 days of receipt of this order failing whichthe Respondent shall be liable to pay further interest at the rate of 9% per annum fromthe date of this Order till the date of actual payment.Bhopal Ombudsman CentreCase No.: LI-1132-21/12-07/RPRSmt. Ratna VermaVsLife Insurance Corporation of India-Award Dated 21-02-2007Smt. Ratna Verma, resident of Village Funda, Post Dewda, Tahsil Patan and Distt.Durg (M.P.) [hereinafter called Complainant] is the wife of Late Shri Bhagwati RamVerma, Deceased Life Assured (in short DLA). The DLA had three life insurancepolicies under salary saving scheme of paying authority C.S.E.B. Durg bearing policynumber 382723326, 382725529 and 382283846 taken from LIC of India, DO: Raipur,BO-Durg [hereinafter called Respondent]. The details of policies are as under.Sr. Policy No. Date of Table/Term SumNo. Commencement Assured1 382723326 28-03-2004 14-10 750002 382725529 28-09-2004 14-12 500003 382283846 28-03-2003 106-15 (12) 50000The DLA expired on 21-09-2005 suddenly due to high B. P. etc. The death claim waspreferred by the Complainant with the Respondent but the same was repudiated on the