ABHIMANYU CHAUBEY Vs. INSURANCE OMBUDSMAN UTTAR PRADESH

JUDGEMENT

(1.) THE grant of partial relief by the Insurance Ombudsman under the award dated 13th April, 2005 has led to the filing of this petition by the nominee under the life insurance policy of the deceased Rajesh kumar Chaubey for a direction upon the Life Insurance Corporation of india (hereinafter referred to as the 'corporation') to pay the entire amount due under the policy as against the award of ex gratia amount of the basic sum assured.

(2.) THE deceased Rajesh Kumar Chaubey had submitted a proposal dated 14th May, 1999 to the Corporation for the assured sum of Rs. 1 lac along with a cheque of Rs. 10,507/-towards the first premium. In the said proposal form, apart from furnishing the required information, he also gave a declaration that if after the date of Submission of the proposal but before the issuance of the first Premium Receipt, there is any change in his general health, he shall forthwith intimate the Corporation about it in writing to enable it to reconsider the terms of the insurance and any omission on his part to do so shall render the insurance invalid and all the monies paid in respect thereof shall stand forfeited to the Corporation.

(3.) IT so happened that soon after the submission of the proposal form on 14th May, 1999, the proposer met with an accident on 23rd May, 1999 and ultimately succumbed to his injuries on 2nd June, 1999. In between, the Corporation had issued the First premium Receipt on 31st May, 1999. The petitioner, who is the nominee under the said policy, preferred a claim before the Corporation which was repudiated by the corporation by the communication dated 2nd march, 2000 on three grounds namely, that the policy holder had not disclosed his earlier policy with the Corporation; that the policy holder had not been medically examined by the Medical Officer and that the proposer did not inform the Corporation about his accident that had taken place on 23rd May, 1999.