Page 30 - Life Insurance Today March 2016
P. 30
Case No.21-001-0037-13 Case No. 21-014-014L
Smt. Mallika Kuppuswamy Shri Ganpathbhai S. Patel
Vs. V/s.
Life Insurance Corporation of India
Life Insurance Corporation of India
Repudiation of Death Claim
Partial settlement of Death Claim
A death claim lodged by the complainant for her deceased
husband was repudiated by the Respondent on the ground Complainant's son's death claim partially settled by the
of non disclosure of material facts of his health. Respondent for Rs.62,500/- . Insured was covered under
three polices out of which in one policy claim was paid. In
Death was due to cardiac arrest and the DLA was working rest of two policies claim was rejected by the insurer on
as Gangman in Railway since last 25 years, death occurred the grounds of non-disclosure of pre-proposal history of
on duty of service. Policy incepted in February 2009 and suffering from ulcer in left lower GBX, which was diag-
death occurred on 30-04-2011. nosed as symptom of cancer at later stage. DLA was hav-
ing habit of tobacco chewing for last 10 years. It has been
Respondent could not produce the documentary evidence observed from the claim papers, that the cause of death
to prove non disclosure of material facts of DLA's health. is direct complication of ulcer and tobacco chewing for
Looking to the entire Respondent's decision to repudiate long period. In the result complaint fails to succeed.
the death claim is set aside and directed to make payment
under intimation to this forum. Case No. 21-005-0020-13
Shri S K Shah V/s. HDFC Standard Life
Case No.21-001-0038-13
Shri Kaushikkumar K. Patel Ins.Co.Ltd.
Award dated: 24.09.2013
Vs.
Refund of Premium
Life Insurance Corporation of India
Complainant took policy for his daughter and paid pre-
Repudiation of Death Claim mium for Rs. 50,000/-, for Sum Assured of Rs. 3,26,146/-
. Unfortunately his daughter committed suicide immedi-
A death claim lodged by the complainant for his deceased ately after taking policy. Insured lodged claim only for re-
mother was repudiated by the Respondent on the ground fund of the premium and not for the entire sum assured.
of non disclosure of material facts of her health. The claim was rejected on the grounds of "within one year
refund of premium is not admissible. The complainant
Further at the time of inception of policy, the DLA'S hus- pleaded for refund of premium as special case in view of
band was alive then also the nomination given her major death of his daughter aged 22 years who was insured for
son which is creating doubts. She was insured Rs.1.00 Lac Rs.3,26,146/-. His plea for refund of premium cannot be
in addition to old policy whereas her husband was having accepted in view of the terms and conditions of the policy.
policy of Rs.50,000/- only. In the result complaint fails to succeed.
DLA's first policy incepted in 2005 which was settled by Corrigendum
the Respondent and second policy incepted in 21st Janu-
ary 2011 and date of death was 5th November 2011, du- The February, 2016, issue had an article titled 'Bancassurance
ration of policy was only 9 months and 11 days. in India and Digitalization' by Mrs. P. Srilatha.
Looking to all Respondents decision is upheld and com- In the article following corrections may be noted on Page
plaint dismissed. 23 last paragraph - '... a drive towards financial inclusion)
stood at Rs. 18.96 Crore as on October 21st 2015...' should
be '… a drive towards financial inclusion) stood at 18.96
Crore as on October 21st 2015…'
We regret for the error.
Chief Editor
30 March 2016 Life Insurance Today
