Death Claim - Gbic.co.in

in January 2000. The policy was revived on 13.12.2003 on the strength of a“Declaration of Good Health” dated 13.12.2003 and with 3 quarterly premiums. Therevival was void since he was detected to be HIV positive in January 2001 itself. Theyhave obtained a letter from the Tambaram Hospital regarding the period of in-patienttreatment undergone by the life assured in the hospital.The Insurer had obtained clinching evidence to prove that the life assured was affectedby HIV and aware of the fact in the year 2001 itself. The declaration made by the lifeassured on 13.12.2003 regarding his health was incorrect. There was also a nexusbetween the cause of death and the illness suppressed.The complaint is dismissed.Chennai Ombudsman CentreCase No. : IO (CHN)/21.08.2366Smt. DhanamVsLife Insurance Corporation of IndiaAward Dated : 18.01.2007Sri. C.Settu submitted a proposal on 23.01.1999 to LIC of India, Tiruvanamalai Branchunder Vellore Division and obtained a policy bearing number 731118021 for a SumAssured of Rs.59000/- under Endowment Plan. The policy lapsed due to non-paymentof premiums after July 2000. Sri. C.Settu revived the policy on 20.05.2003 bysubmitting a “Personal Statement of Good Health” of even date and by paying therevival amount by cheque. The cheque was dishonored and the policy lapsed.Subsequently he revived the policy again by submitting a “Personal Statement of GoodHealth” on 18.07.2003. Sri. C.Settu died due to Myocardial Infarction on 05.09.2003.Smt. Dhanam, his wife and nominee preferred her claim for the death benefit with theInsurer. The Insurer, rejected her claim on the grounds that the life assured hadwithheld correct information regarding his health at the time of revival.In the hearing on 28.11.2006 the complainant stated that her husband was quitehealthy. Sometimes he used to complain of chest pain and used to take tablets. Oneday after he came back from work he complained of chest pain and died. Whenquestioned whether they knew Dr.Ramana Rao of Grace and Compassion Hospital atTiruvannamalai, she said that she knew the hospital but not the Doctor. The insurerstated that the policy lapsed and was revived on 18.07.2003 on the strength ofDeclaration of Good Health of even date. The cheque paid towards renewal washowever dishonoured for the reason “insufficient funds”. The premium was paid in cashthe second time along with DGH dated 18.07.2003. The life assured had takentreatment on 15.07.2003 at Grace and Compassion Hospital which he had notmentioned in the DGH dated 18.07.2003.Therefore the Insurer has established beyond doubt that on 18.07.2003 the life assuredhad furnished incorrect information in his “Personal Statement of Health”. The lifeassured was very well aware of the gravity of his health condition as the doctors inGrace & Compassion Hospital had advised him to avail treatment at JIPMER,Pondicherry as “his condition was not satisfactory”.The complaint is dismissed.Chennai Ombudsman CentreCase No. : IO (CHN)/21.07.2311Smt. R.Mariammal