Death Claim - Gbic.co.in

Smt. S.PappaVsLife Insurance Corporation of IndiaAward Dated 25.01.2007Sri. S. Sakkarai raja submitted a proposal for life Insurance on 06.10.2001 to SivakasiBranch of LIC of India. The Insurer issued him a policy bearing number 742831251under their Endowment Plan for a Sum Assured of Rs. 25000/-. He revived the lapsedpolicy on 19.05.2003 by submitting a “Personal Statement of Health” of even date. Sri.S. Sakkarai Raja died on 24.05.2003. Smt. S. Pappa his wife and nominee under thepolicy preferred her claim with the Insurer. The Insurer rejected her claim on theground that the life assured had revived the policy on 19.05.2003 by submitting falseanswers to the relevant questions in the “Personal Statement of Health”.In the hearing, the representative of the Insurer explained the policy details. The policywas an Endowment plan and resulted in Death claim on 24.05.2003.The policy had runfor 1 year 7 months and 16 days. He added that the policy was revived on 19.05.2003and the claim arose within 5 days from the date of revival. Even prior to revival, the lifeassured underwent chemotherapy at Government Rajaji Hospital, Madurai, for HodgkinLymphoma. He further added that the life assured was admitted in Hospital fortreatment on 15.04.2003 and was discharged on the next day i.e. 16.04.2003. Thepolicy was revived on 19.05.2003 and the assured was actually on treatment whilereviving the policy. The claimant came late and the Forum gave her an opportunity tobe heard. The claimant explained that her husband had a painful lump in the neck, aweek before death. He was going to work even at that time. The claimant confirmedthis fact that her husband took treatment at Madurai for 2 days. She said that theywere not aware that such details should have been mentioned in the form when thepolicy was revived.On perusing the above documents it is evident that the life assured was not keepinggood health at the time of reviving the policy. According to the case sheet ofGovernment Rajaji Hospital, Madurai where he had been admitted from 15.04.03 to16.04.03 the life assured had been described as “Patient is a known case of HodgkinLymphoma, now admitted for IV cycle of Chemotherapy”. Thus by suppressing the truestate of his health the life assured had misguided the Insurer in wrongly reviving thepolicy.The complaint is dismissed.Chennai Ombudsman CentreCase No. : IO (CHN)/21.01.2417Smt. VyjayanthimalaVsLife Insurance Corporation of IndiaAward Dated 29.01.2007Sri A.V.Mohan took a Endowment Policy from LIC of India, City Branch XIX, underChennai Division-I, by submitting a proposal for the insurance on 28.03.2004. SriA.V.Mohan died on 20.11.2004. Smt. Vyjayanthimala, his wife and the nominee,preferred her claim with the Insurer. The Insurer rejected the claim on the grounds thatthe life assured had suppressed that he was suffering from Diabetes and UmbilicalHernia.