LIC told to pay Rs 8-lakh claim to deceased's kin

LIC told to pay Rs 8-lakh claim to deceased's kin

Avneet Kaur

Jalandhar, February 18

The District Consumer Disputes Redressal Forum has directed the Life Insurance Corporation (LIC) of India to pay Rs 8 lakh to legal heirs of a man who died due to ill health.

In a complaint filed by Resham Kaur and Charanjit Singh, the mother and father of the victim, Ravi Pal, it was stated that Ravi took a life insurance policy from the LIC for an assured amount of Rs 8 lakh for the period of 14 months on February 3, 2016. At the time of obtaining the policy, Ravi nominated Charanjit as his legal nominee, in case of any eventuality.

The complainants claimed that Ravi was hale and hearty and was found to be fit at the time of purchasing policy. However in March 2017, he was admitted to SGL Hospital following the complaint of seizures and headache and was diagnosed for left frontal tuberculoma brain tumour. Afterwards, he was taken to the PGI, Chandigarh, on March 4, 2017, for the treatment of diagnosed tuberculoma, but he died on March 16, 2017, at the hospital.

Charanjit said he intimated the insurance firm about the death and the claim was lodged in respect of the policy. He said he submitted relevant documents to the company but it declined the death claim, stating that the insured was not maintaining good health prior to submission of the proposal form and took the insurance after concealing the status of his health and as such, the claim was repudiated.

Meanwhile, the notice of the complaint was sent to the LIC, which in its reply to the forum said the claim was repudiated mainly on the grounds that at the time of making the proposal on February 3, 2016, the policy holder, Ravi Pal, was suffering from some physical problem and this fact was kept concealed from them.

"As per CT scan (head) reports of life insured from SGL Hospital, dated January 1, 2016 and February 20, 2016, there was a bone defect of surgical intervention seen in the left temporo-parietal region of insured. However, the same was never disclosed in the form,” the LIC said.

Meanwhile, advocate of the complainant, through valid certificates issued by SGL Hospital proved that the dates mentioned on the CT scan report — i.e. January 1, 2016, and February 20, 2016, were typing errors by the hospital, and the actual dates were January 1, 2017, and February, 20, 2017.

He said the same was also intimated to the LIC, but they were trying to manipulate the facts and denied the claim on baseless grounds.

The forum after verifying documents presented by both parties said: “Human being is a ‘putla’ of mistakes, and if any mistake is rectified that should be thoroughly verified and investigated. The dates January 1, 2016 and February 20, 2016, were typographical mistakes, whereas the year of the said reports was 2017 instead of 2016. Regarding this, a certificate was also obtained by the complainant from SGL Hospital and the same is signed by Dr Ajay Mahajan as well as by the Medical Superintendent."

"The LIC failed to consider the issued certificate. Thus, the complainants are entitled to get the insurance claim of their son — Rs 8,00,000," the forum said, further directing the LIC to pay the claim with 12 per cent Interest per annum from the date of filing the complaint, i.e. April 22, 2017, till realisation.

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