Death Claim - Gbic.co.in

Life Insurance Corporation of IndiaAward Dated : 22-11-2006Repudiation of Claim under Life Insurance Policy: While proposing for Insurance, theAssured had not disclosed the fact of having taken treatment for ‘Major DepressionDisorder and Agoraphobia’ from a month prior to the date of Proposal. The treatmentcontinued till his death. The assured died within a month of taking the InsurancePolicy. Claim on death of the deceased Life Assured was repudiated by theRespondent on the basis of ESIC Certificate and Certificate by Employer confirming hisabsence supported by Medical Certificate by ESIC. Non disclosure of this denied theopportunity to call for further Special Reports etc. The case could have been sent overto the Higher Offices of the Insurer for decision. As such, the facts being material forunderwriting, the decision of the Respondent to repudiate the Claim was upheld.Ahmedabad Ombudsman CentreCase No. : 21-007-0123Sri V B GhamandeVsMax New York Life Insurance Co. Ltd.Award Dated : 22-11-2006Repudiation of Claim under Life Insurance Policy: The Insurance Policy was lying in alapsed state on the death of the Life Assured. The Complainant argued that theRespondent did not guide him properly with regard to required deposit to be made andother compliances for Renewal of his Policy. The responsibility to know the premiuminstalments and to pay them in time rests on the Life Assured. Since, the same was notdone, to claim the proceeds on a lapsed Policy, just alleging lack of adequate guidanceby the Insurer, cannot succeed. As such, the decision of the Respondent to repudiatethe subject Claim was upheld without any further relief.Ahmedabad Ombudsman CentreCase No. : 21-002-0180Smt. A B RuchananiVsLife Insurance Corporation of IndiaAward Dated : 27-11-2006Repudiation of Claim under Life Insurance Policy: While proposing for Insurance, theAssured had not disclosed the fact of taking treatment for ‘HCV related Cirrhosis ofLiver’ from nearly 4 months prior to the date of Proposal. The treatment continued tillhis death. The assured died within 7 months of taking the Insurance Policy. Claim ondeath of the deceased Life Assured was repudiated by the Respondent on the basis ofCertificate of Hospital Treatment from the Treating Doctor. Non disclosure of this factdenied the opportunity to call for further Special Reports etc. The case could havebeen sent over to the Higher Offices of the Insurer for decision. As such, the factsbeing material for underwriting, the decision of the Respondent to repudiate the Claimwas upheld.Ahmedabad Ombudsman CentreCase No. : 21-001-0168Mrs. B A ParmarVsLife Insurance Corporation of India