Death Claim - Gbic.co.in

the Insurer on the ground that the insured had withheld material information regardinghis health is sustainable.The complaint is dismissed.Chennai Ombudsman CentreCase No. : IO (CHN)/21.04.2268Smt. S.BalamaniVsLife Insurance Corporation of IndiaAward Dated : 08.11.2006.Sri. P.Sakthivel took an Endowment policy bearing No.742683462 for Rs.100000/- fromLIC of India, Dindigul Branch (under Madurai Division). The date of commencementwas 20.03.2001 with the half-yearly premium being Rs.3969/-. On 20.11.2004 herevived the policy (which was lapsed due to non-payment of the premium due in March2004) on the strength of a “Personal Statement of Health” which was dated 10.11.2004.The life assured died on 16.01.2005 and Smt.S.Balamani, wife of the LA claimed thedeath benefit. The Insurer repudiated the claim on the ground that the LA had notdisclosed the fact, at the time of revival that he had suffered from Comminuted LateralCondyle Fracture, that he was a hypertensive and that he had taken treatment at CMC,Vellore for Inferior Wall Myocardial Infarction.In the hearing the complainant Smt. S.Balamani, said that her husband had died ofheart attack. She added that he was not well for 6 months before his death. She alsoinformed that he had met with an accident three years back for which he was operatedthrice. She replied that her husband had availed medical leave during 2003& 2004 ondoctor’s advice and to help during their daughter’s delivery. The Insurer informed thatthey had repudiated the claim as the life assured had not disclosed the treatment takenin various spells at different hospitals, during the pre-revival period, in his “PersonalStatement of Health” dated 10.11.2004. However they had offered to pay Rs. 37400/-which was the paid-up value and the bonus thereon.Keeping in mind the health background of the insured as evidenced from records, thefalse answers to question 2a),2b) and 2c) and question 4 of the “Personal Statement ofHealth” signed on 10.11.2004 was a clear case of suppression of “material facts” andthe repudiation was justified. There is also a nexus between the cause of death and theillness suppressed. Therefore the decision of LIC of India to pay Rs.37400/- as thepaid-up value with the accrued bonus is valid.Chennai Ombudsman CentreCase No. : IO (CHN)/21.04.2307.Sri.M.SelvarajVsLife Insurance Corporation of IndiaAward Dated : 14.11.2006Sri. S.Inbaraj, submitted a proposal to LIC of India, Periyakulam Branch under MaduraiDivision, to get life insurance cover.The policy numbered, 742820583, was for a sum assured of Rs.50000/-, under theEndowment Plan with a term of 16 years. Premiums were deducted from his salary andpaid to LIC by his employer. As he was not married he had nominated his father. Thelife assured died on 15.03.2005. Sri M.Selvaraj, father of the life assured claimed thebenefit under the above policy. The Insurer repudiated the claim stating that the life