Icici lombard property linked insurance policy --- not covered disease--reg
sigatapu naga seshu kiran kuma
(Querist) 26 August 2014
This query is : Resolved
Dear Sir,
Very respectfully bring the following facts of the case for your valuable and breathing suggestion for over coming the hurdle.
Sir,
My uncle purchased the Residential flat at Visakhapatnam on 30.10.2007 from Dharani Constructions by way of home loan from ICICI Bank, visahpatnam for an amount of Rs.6.00Lakhs and same was registered in mu uncles name.
I further humbly bring to you that, at the time of sanction of house loan by the ICICI banker insisted us for taking property linked term insurance policy ( in case of death of insured the debt amount of Rs.6.00Lakhs waived) from ICICI Lombard for an amount of Rs.30,000/- for a period of 5 years, at the instructions of the bank we bought the policy which was ended on 31.10.2012.
unfortunately on 02.12.2012 my uncle demised with leaver disease leaving behind my aunty and four daughters. later we filed claim form which was sent by ICICI bank and same was submitted along medical bills.
after prolonged time the Insurer returned the our claim with a letter that your disease not covered under policy, whereas the claim for consists of liver disease.
immediately we sent a letter to insurer about his indiscriminate action, but no replay and no action, finally we lodged a complaint before district consumer redressal forum same was numbered and sent notices to insurer.
NOW THEY RAISED THAT YOUR POLICY EXPIRED and we are not responsible.
so kindly help us for how to over com this.
your most respectfully
sasikiran
Kumar Doab
(Expert) 26 August 2014
If you have posted the dates correctly in your post then policy has indeed expired.
Now let the DCDRF decide the matter.
Devajyoti Barman
(Expert) 26 August 2014
The insurance policy needs to be seen.
In any case ask his legal heris to file case in consumer forum.
Rajendra K Goyal
(Expert) 26 August 2014
File consumer complaint, let it decide as the death occurred during the currency of the policy.
Kumar Doab
(Expert) 26 August 2014
The author has posted that:
"we bought the policy which was ended on 31.10.2012.
unfortunately on 02.12.2012 my uncle demised "
If this is correct the policy had expired before the uncle died.
This is term insurance policy and claim shall be admissible if deceased person was a holder of a policy 'IN Force' on the date of death.
You may obtain the the certified copies of brochure of loan, offer of loan, loan application, loan agreement, loan a/c statement, policy proposal form, policy schedule, and also check if there was an option of auto renewal and if policy premium was debited to deceased person/borrower.
The company provided wrong reason for declinature initially and is deficient to that extent.
ajay sethi
(Expert) 26 August 2014
insurance company wont be liable to make payment if term of policy has expired
Sudhir Kumar, Advocate
(Expert) 27 August 2014
given facts indicate that perhaps the stand of insurer is correct.
Rajendra K Goyal
(Expert) 27 August 2014
Sorry, for my mistake in noting the date of expiry of insurance policy.
Kumar Doab
(Expert) 27 August 2014
Don't withdraw the complaint.
The company provided wrong reason for declinature initially and is deficient to that extent.....................and DCDRF may award penalty/compensation.
Immediately demand the above mentioned documents from M/s ICICI, and also M/s ICICI Lambard by Redg. post only so as to reach you in next say 7 days and submit the copy of your demand to DCDRF and ask the company to substantiate its stand based on these documents alone and not verbally or by a letter.
Let President issue directions to company (ies) to place the documents before it.
