Death Claim - Gbic.co.in

Shri Sriram Meena had not taken any sick leave except for 5 days and other leaveswere taken for domestic work. As such it can be presumed that he has been consumingAlcohol for the last 30 years and I do not consider it material for LIC of India torepudiate the claim since he has been performing his duties.I, therefore, pass the Award that Smt. Koshalya Devi be paid the sum assured alongwith other accrued benefits under the policy together with 8% interest from 01.02.2002till the time payment is made.The Award shall be implemented within 30 days of receipt of the same. The complianceof the Award shall be intimated to my office for information and record.Delhi Ombudsman CentreCase No. : LI/BK-419Smt.BismillaVsLife Insurance Corporation of IndiaAward Dated : 30.11.06Smt. Bismilla had lodged a complaint with this Forum 08.03.2005 that her son late ShriSamsuddin had taken a life insurance policy on 28.06.2001 for Rs.25000/- and the lifeassured has expired on 30.04.2004. She had completed all the formalities and wasadvised by LIC of India on 15.02.2005 that her claim has been repudiated. The reasonsfor repudiation were not valid. She has requested the Forum to settle the claim.LIC of India, vide their letter dated 17.01.2006 informed the Forum that during theirinvestigation, it was revealed that the life assured was handicapped at the time ofproposal. He was not in a position to move. The deceased life assured had applied forHandicap Pension from BDO, Panchayat Samittee, Nohar in the year 1999 which hasbeen confirmed by a letter from the Panchayat Samittee dated 09.11.2004. Thedeceased life assured had suppressed material information regarding his health andLIC of India had repudiated the claim on the grounds of concealment of material fact.This Forum has written a letter to LIC of India to get a confirmation from the StateGovernment whether the deceased life assured, Shri Samsuddin, was getting anypension from the State Government and any disability certificate was enclosed with theapplication with the State Government.At the time of hearing, the representative of Smt. Bismilla disclosed that late ShriSamsuddin was not getting any pension from the State Government. However, familypension was being given by the employer of his father.LIC of India, at the time of hearing, contested that the life assured had suppressedmaterial information regarding his health since he was a handicapped for the last 2years before the date of proposal and was not in a position to move. He had notdisclosed this material information in the proposal form submitted with the LIC of India.He had also applied for pension with the State Government. On enquiry by this Forumthat since LIC had received the Agent’s Confidential Report whether it was not the dutyof the agent to disclose that late Shri Samsuddin was handicapped which he has notdisclosed under Column III of his report . What action LIC of India had taken againstthe agent ? The representative of LIC of India informed the Forum that they had nottaken any action against the agent. Further, on enquiry from the representative of LICof India whether any disability certificate was obtained, the representative had noknowledge of the same.On examination of the papers submitted, it was observed that the life assured, ShriSamsuddin, was a handicap person as per the enquiry conducted by the LIC of India.