Death Claim - Gbic.co.in

they would only be approximate ages, since the recordings were not based on anyreliable documentary evidence. It was also observed that the insurers also collected anage extra for non-standard age proof which is intended to offset the inadequacies inpremium arising from inacuracies of age due to non-standard age proofs. Further theevidences they relied upon to arrive at the age of the assured as 56 were ration cardand voters list, which as per their rules were not considered even as non-standard ageproofs. Hence their contention that the assured was aged 56 years based on theinformation in certain documents, which they do not accept for age admission purposesat the time of underwriting, defies logic and cannot be a valid ground for repudiation.The fact that they have collected an extra premium for non-standard age proofs provesthat they are aware of the likely differences / inaccuracies in age involved in such nonstandardage proofs and the extra premium is only to offset the likely shortfall inpremium.As such, their contention that the age of the assured was understated in the proposalbased on the information available in ‘family card and votes’list’ and making it a groundfor repudiation could not be held sustainable and hence the repudiation was set aside.The complaint is, therefore, allowed.Chennai Ombudsman CentreCase No. IO (CHN) / 21.02.2587 / 2004 - 05Smt. L. SelvakumariVs.Life Insurance Corporation of IndiaAward Dated 23.06.2005Smt. L. Selvakumari, W/O late V. Logan, a Southern Railway employee, lodged acomplaint with this forum claiming that her claim with L.I.C. under the policies on thelife of her husband was denied to her and requested this forum to consider her appealfavourably and arrange for payment of claim by the insurers. Shri V. Logan took twoinsurance policies for Rs. 50,000/- and45,000/- in 07/99 and 08/2000 and nominated his wife Smt. Selvakumari under thesame. The claim under these policies was repudiated by the insurers on the plea thatthe pre-proposal health & habits of the assured were not disclosed in the proposal.All the relevant documents were called for and gone through. Hearing of both thecontending parties was arranged. The insurers’ main contention was that the assuredwas an alcoholic, he underwent treatment for alcohol withdrawal syndrome in RailwayHospital and that he was on sick leave during this period of treatment and also onmany occasions thereater, which facts were suppressed in the proposals for the abovepolicies, leading to their repudiation of claim. They brought before this forum acertificate from Southern Railway Hospital, Tambaram signed by their senior DivisionalMedical officer, which testified that the assured underwent treatment for ‘alcoholwithdrawal syndrome’ from 20.01.97 to 12.03.97. Even the leave records from SouthernRailway pointed out that the assured was on sick leave on many occasions, though forshort spells. The complainant contended that her husband was taking alcohol outsideher home with friends and that he stopped consuming alcohol after the treatment in1997. She informed that her husband fell down while crossing the front door of their hutand had an injury in the head. He fell unconscuious and could not be rushed to anyhospital and could not be revived.Judging from the entire documentary evidence, it was a fact that the assured wastaking alcohol, underwent treatment for withdrawal syndrome, during which period hewas also on sick leave. These facts were not mentioned in the proposal. To that extent