Page 29 - Life Insurance Today March 2016
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LEGAL
Legal Case Studies in Life Insurance
Death Claim
Case No. 21-001-0788-12 was repudiated by the Respondent on the basis of indis-
Smt. Amitaben Prajapapti putable evidence which proves that the DLA was suffer-
ing from Tuberculosis to the date of enrollment of policy.
Vs.
SBI Life Insurance Co. Ltd. The date of commencement of risk was 25-03-2011 and
Repudiation of Death Claim date of death was 27-05-2011. The Complainant was not
aware of her deceased husband's previous illness was not
Complainant's deceased husband was covered a Group In- acceptable by this Forum. Hence Complaint dismissed.
surance on 1-11-2011 for S.A Rs.1.00 and died on 11-5-
2012. Death claim lodged was repudiated by the Respon- Case No.21-001-0036-13
dent stating that the DLA was suffering from Heart disease
prior to inception of policy which was not disclosed in the Mr. Bharatbhai P. Humbal
proposal form. Duration of policy was only 6 months and
10 days. Vs.
Available documents of Hospital papers shows the DLA un- LIC of India
derwent Heart valve replacement in 2010 and related treat-
ment was taking regularly which was a pre-existing disease. Repudiation of Death Claim
Considering all, the Respondent's decision to repudiate the A Death claim lodged by the complainant for S. A.
Death Claim is upheld and complaint dismissed. Rs.10,00,000/-for death of his 22 years old wife was re-
pudiated by the Respondent stating that the deceased fe-
Case No.21-002-0039-13 male died an unnatural death and as the policy was issued
Smt. Jyotsanaben G. Patel with clause 4B, the policy has become null and void in
terms of the policy contract hence nothing is payable un-
Vs. der the subject claim. Refund of premium will be paid by
S.B.I Life Insurance Co. Ltd. branch office.
Repudiation of Death Claim under Group
As Police Report, death occurred due to Cardio respiratory
Master Policy arrest on account of electrocution. The DLA's occupation
was a Beauty Parlour in own house and allowed her to op-
The death claim of the complainant's deceased husband erate a Motor Pump installed in their Farm land without
safety measures. Duration of policy is 2 months and 1 day.
Looking to the entire Respondent's decision is upheld and
complaint dismissed.
"It is our choices, Harry, that show what we truly are, far more than our abilities."
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