Death Claim - Gbic.co.in

08/2001 and the lapsed policy was revived on the basis of a personal statement ofhealth dated 30.06.2003, without disclosing the details of her illness andhospitalization and that she died of Brain cancer. They were able to produce before theForum all the hospital reports as documentary evidence. The Insurer offered to settlepaid-up value under the policy.The Ombudsman observed that the Insurer was able to prove fraudulent materialsuppression with clinching evidence and dismissed the complaint.The complaint was dismissed.Chennai Ombudsman CentreCase No. IO (CHN) / 21.04.2109 / 2005 - 06Smt. M. GanapathiammalVs.Life Insurance Corporation of IndiaAward Dated 19.08.2005Smt. M. Ganapathiammal came to this Forum with a complaint against the Insurer thatthe Insurer denied to settle the death claim under the policy held by her late husbandShri S. Murthy. The Insurer repudiated the claim for suppression of materialinformation by the assured in the personal statement of health furnished by him at thetime of revival on 06.08.2004.The complainant and the Insurer were present at the personal hearing held on29.07.2005. The complainant stated that her husband was generally healthy but for hisoccasional cold and wheezing and suffered chest pain only 4 days prior to his deathand did not have any heart problem. The Insurer contended that the assured did sufferfrom Ischaemic heart disease - Acute Coronary Syndrome, Lower Respiratory Infectionand wheezing and allergic bronchitis and produced hospital treatment particulars of2003 in support of their argument. The assured died on 07.09. 2004, a month after therevival of the policy.The Ombudsman observed that the Insurer was righrt in settling the paid -up valueunder the policy, setting aside the revival and dismissed the complaint.The complaint was dismissed.Chennai Ombudsman CentreCase No. IO (CHN) / 21.02.2157 / 2005 - 06Smt. E. RaniVs.Life Insurance Corporation of IndiaAward Dated 25.08.2005Smt. E. Ran, W/o D. Elumalai challenged the repudiation of the death claim under herhusband’s policy by the Insurer. Her husband had taken a policy for Rs. 50,000/- on25.11.1999. He died on 14.01.2004 due to Rheumatic Heart Disease and Mitral ValveStenosis. The Insurer denied the claim on the ground of the assured suppresssingmaterial information and making misstatements at the time of proposing for insurance.A personal hearing of both the parties to the dispute was held on 17.08.2005. Thecomplainant said that her husband had availed treatment in Chennai hospital in 1998and was on medication for a year and that he was managing the illness by practicingyoga till the terminal illness. She further added that the agent was none other than herhusband’s own brother who was instrumental in not disclosing all the relevant details inthe proposal form. The Insurer could produce before the Forum the evidence for pre-