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FINDINGS & CONCLUSIONS:-There is no doubt that the above Policy No. 352218677 under Plan & Term 174-20 for S.A.of Rs.40000/- was taken on 05.09.2005. The death has occurred on 14.08.2006 and the claimis paid on 19.11.2009 which reveals that there is in-ordinate delay on the part of respondentto settle the claim.The respondent is directed to pay panel interest to the complainant at the prevalent rate ofinterest for panel interest within 15 days from the date of receipt of this order, failing towhich further interest @ 9% will be payable.Dated at BHOPAL, on 30 th of NOVEMBER 2009.Order No.BPL/LI 09-10/ 72Case No. LIC-159-24/08-09/BPLSmt. Kaushalya Bai Lavvanshi….……………….……..ComplainantLife Insurance Corporation of India, BPL …………..…RespondentBrief Background - MiscellaneousSmt. Kaushalya Bai Lavvanshi w/o Late Shri Chandar Singh Lavvanshi, resident ofGagahoni, Tehsil Biaora Distt. Rajgarh (M.P.) lodged the complaint that her husband lateShri Chandar Singh Lavvanshi was insured under the Policy No. 353331218 under Plan &Term 180-20 for S.A. of Rs.50,000/- on 24.03.2007. He died on 07.10.2007 due to murder.Accident Benefit preferred by the complainant repudiated by the respondent on the ground ofmurder, which does not come under the purview of accident.Aggrieved from the action of the respondent the complainant lodged the complaint on20.08.2009 seeking the direction to pay double accident benefit.ex-The Complainant did not present herself despite our letter dated 06.11.2009. Hence,party hearing was conducted.The Respondent represented by Shri K. Ganga, Manager(Claims), Bhopal submitted that theBasic Sum Assured under the policy has already been paid to the complainant. Since themurder is not covered under the purview of accident benefit; double accident benefit has notbeen paid to the complainant.
FINDINGS & CONCLUSIONS:-There is no doubt that the above Policy No. 353331218 under Plan & Term 180-20 for S.A.of Rs.50,000/- on 24.03.2007. He died on 07.10.2007 due to murder.As per the copy of judgment Premnarayan and Dhurilal (culprit) were abusing to Gopal, forwhich he was forbidding. Annoying from that they attacked on him with knife and injuredhim; to save himself Gopal went in his house. Meanwhile Chandar Singh (younger brotherof Gopal) came out, they caught him and attacked on him with knife and he died. Since themurder has occurred without any provocation from the side of DLA . Hence it is proved thatit was an accident. I am therefore of the considered opinion that the decision taken by therespondent is not just & fair.Decision : -The respondent is directed to pay Rs. 50,000/- for double accident benefit to the complainant/ nominee within 15 days from the date of receipt of this order, failing to which furtherinterest @ 9% will be payable.Dated at BHOPAL, on 30 th of NOVEMBER 2009.Order No.BPL/LI 09-10/ 75Case No. LIC-331-24/03-09/JBPSmt. Tirtha Devi …………………………….….……..ComplainantLife Insurance Corporation of India, JBP …………..…RespondentBrief Background – MiscellaneousSmt. Tirtha Devi w/o Shri Rambhujarat (DLA) resident of Chandameta Tahsil Parasia Distt.Chhindwara (M.P.) lodged the complaint that her husband late Shri Rambhujarat was insuredunder the policy no. 371506217 for Rs. 1.00 lakh under plan no. 111-25 on 28.01.1995. Hedied on 24.02.2008 due to Electric Current. Claim preferred by complainant, the respondentpaid Rs. 13410.00 instead of Rs. 1.00 lakh.Aggrieved from the action of the respondent the complainant lodged the complaint on02.03.2009 seeking the direction to pay the full sum assured amount.The Complainant presents herself and submitted that premiums were deducted from thesalary of DLA by their employer. He has also some another policies for which she hasreceived the claim amount, but only under this policy she got only Rs. 13410.00, which isunjustified and requested for the payment of Rs. 1.00 lakh.
Page 1: AHMEDABADAhmedabad Ombudsman Centre
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Page 7 and 8: FINDINGS & CONCLUSIONS:-There is no
Page 9 and 10: Category - MISCELLENEOUSShri Kailas
Page 11 and 12: Category - MISCELLENEOUSShri OP Sri
Page 13: Order No.BPL/LI 09-10/ 57Case No. S
Page 16 and 17: Category - MISCELLANEOUSOrder no BP
Page 24 and 25: Order no BPL/LI/04-09/63CASE No. BA
Page 26 and 27: (19)Order no BPL/LI/04-09/64CASE No
Page 34 and 35: The Respondent represented by Shri
Page 36 and 37: The Respondent represented by Shri
Page 39 and 40: Order No.BPL/LI 09-10/ 84Case No. B
Page 41: Order No.BPL/LI 10-11/ 87Case No. K
Page 44 and 45: Order No.BPL/LI 10-11/ 94Case No. K
Page 47 and 48: Order No.BPL/LI 10-11/ 96Case No. R
Page 49 and 50: FINDINGS & CONCLUSIONS:-8. There is
Page 51 and 52: Brief Background - Non receipt of P
Page 53 and 54: Order No.BPL/LI 10-11/ 100Case No.
Page 55 and 56: information that the they have sent
Page 57 and 58: CHANDIGARHCHANDIGARH OMBUDSMAN CENT
Page 59 and 60: CHANDIGARH OMBUDSMAN CENTRECASE NO.
Page 63 and 64: FINDINGS: The insurer clarified the
Page 67 and 68: FINDINGS & DECISION: The insurer wa
Page 69 and 70: FACTS: The complainant Sh. Navdeep
Page 71 and 72: DELHICase No.LI-165/ICICIPru/09In t
Page 73: Case No.LI-JP/108/08In the matter o
Page 76 and 77: Case No.LI-185/Furture/09In the mat
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Case No.LI-135/HDFC/09In the matter
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Case No. LI-ICICI Pru/183/09In the
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from her profession she had intenti
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Case No. LI-ICICI Pru/123/09In the
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Case No.LI/HDFC/114/09In the matter
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1. This is a complaint filed by Shr
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5. Copies of the Order to both the
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2. Complainant had proposed for Kot
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5. Secondly, I find that at this st
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1. Shri Sachin Kumar has made a com
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2. The main complaint seems to be t
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Case No.LI-ICICI Pru/187/09In the m
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Case No.LI-DL-II/96/09In the matter
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2. The respondent company though ho
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policy as mentioned on the face of
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5. The question for consideration i
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After hearing the parties to the di
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Facts and Submissions:-This is a pe
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OFFICE OF THE INSURANCE OMBUDSMAN,
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INSURER:The insurer has not submitt
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Hence, the insurer is directed to s
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any loss or put to any disadvantage
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The Company was asked to provide th
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MUMBAI OMBUDSMAN CENTREComplaint No
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cash and the rest was to be convert
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coronary arteries and the branches
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MUMBAI OMBUDSMAN CENTREComplaint No
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MUMBAIMUMBAI OMBUDSMAN OFFICECompla
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y the company vide their letter dat
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The Company has also not denied the
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fair nor reasonable. It would be fa
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Jayshree Bipin Shah for the sum ass
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Respondent : Life Insurance Corpora
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2(B) The benefit of the policy sche
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