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Mahendra (Manager)     19 February 2014

Policy clause

Dear sir / madam

 

in one policy of mine has written following clause, i don't understand wht is exact meaning of the same.

If the life assured commits suicide within one year from the risk commencement date, whether sane or insane at that time, the nominee will be entitled to 80% of the premiums paid, the policy will be void and no claim will be payable.

If the life assured commits suicide within one year from the reinstatement date if reinstated, whether sane or insane at that time, the policy will be void and no claim will be payable 

My question is wht abt after insured person sucide after 1 year..

 

REgards

 

Mahendra



Learning

 1 Replies

Kumar Doab (FIN)     19 February 2014

We are not aware “Why are you asking this questions”

The questions asked by you can raise eye brows and all antennas shall be up in the o/o Insurer.

 

The propensity to commit suicide is a moral hazard and is not expected to continue beyond one year.

Your policy seems to be purchased after 1st Jan, 2014 is Non Linked and the clause is as per new rules announced by IRDA.

Within 2Y the death claim is rated as ‘Early Death Claim’.

After 2Y the death claim is rated as ‘Normal Death Claim’.

IRDA has issued guidelines on Matters to be stated in life insurance policy

 

You may go thru:

 

>>> Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002.

6. Matters to be stated in life insurance policy

 

(1) A life insurance policy shall clearly state:

 

(l)      any special clauses or conditions, such as, first pregnancy clause, suicide clause etc.; and

At;

https://www.irda.gov.in/ADMINCMS/cms/frmGeneral_Layout.aspx?page=PageNo50&flag=1&mid=Grievances%20%3E%3E%20Regulations

 

 

>>> Suicide Coverage

The desperate soul who rushes out to buy an insurance policy and then immediately commits suicide is misguided in two respects: first, he or she should have sought help from a mental health professional for assistance in dealing with such self-destructive thoughts; and, second, the life insurance policy won’t pay if the suicide is committed immediately after its purchase.

Most life insurance policies have a suicide clause. Either death resulting from suicide is not covered at all or a death resulting from suicide is covered only after two years have passed since the date of the policy’s purchase. Why the two-year period? It’s thought that a clause that excludes suicide as a valid cause of death in the first two years of the policy’s life will stop someone contemplating suicide from buying the policy on impulse. There’s no immediate benefit, so they won’t buy the policy. Even if a person intent on committing suicide does buy a policy, the chances that they will still want to end their life after waiting two years is slim. There are life insurance policies that do not exclude suicide at all, but most of these plans are prohibitively expensive.

Coverage for Suicide Attempts

The most relevant type of insurance coverage for someone who has survived a suicide attempt is health insurance. Obviously, someone who attempts suicide is in need of psychological help and many health insurance plans will pay for this. Some families might be hesitant to use this benefit because of the stigma attached to suicide and may be concerned that word of the family member’s mental health problems will become the subject of workplace gossip. Fortunately, those who handle and view insurance claims in an office are bound to strict rules of confidentiality and are prohibited from discussing any worker’s medical or psychological condition. The family can seek treatment and know that word of their situation will not be spread.

If someone survives a suicide attempt but sustains injuries that are permanent or that require long-term care, the situation can be pretty grim. Most health insurance companies will not cover injuries that are self-inflicted. So, things like hospital bills, rehabilitation costs, doctor’s bills, home care attendants and all other potential medical necessities would have to be paid for by the individual who attempted suicide.

https://www.solveyourproblem.com/insurance/suicide_life_insurance_policy_coverge.shtml

 

>>> Decided cases at;

https://www.policyholder.gov.in/Case_laws_or_Judgements.aspx

 

>>> Life Insurance  handbook at:

https://www.irda.gov.in/ADMINCMS/cms/frmGeneral_NoYearList.aspx?DF=HBKENG&mid=14.7.1

 

>>> Section 45 Of The Insurance Act, 1938.

https://indiankanoon.org/doc/1625886/

In policy handbook, proposal form usually the clause is mentioned on ‘Incontestability’:

 

 “No Policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the Policy Commencement Date of this Act and no Policy of life insurance shall after the expiry of two years from the date on which it was effected after the coming into force of this Act shall after the expiry of two years from the date on which it was effected, be called in question

by an insurer on the ground that a statement made in the proposal of insurance or any report of a medical officer, or a referee , or friend of the insured , or in any other document leading to the issue of the Policy,, was inaccurate or false, unless the insurer shows that such statements was on material matter or suppressed facts which it was material to disclose and that it was fraudulently made by the Policy holder and that the Policy holder knew at the time of making it that the statement was false or that it suppressed facts which it was material to disclose. Provided that nothing in the clause shall prevent the insurer from calling for proof of age at any time if he is entitled to do so and no Policy shall

be deemed to be called in question merely because the terms of the Policy are adjusted on subsequent proof that the age of the Life Insured was incorrectly stated in the proposal.” b. The Company would declare the Policy void in case of suppression or mis-statement or mis-representation of facts and this would lead to forfeiture of the premiums paid under the Policy.

 

>>> CLAIMS AND SETTLEMENT at:

https://www.nios.ac.in/media/documents/VocInsServices/m3-f7.pdf

 

 

>>> Chapter VI : LIFE INSURANCE  SECTOR AND CONSUMER PROTECTION

https://shodhganga.inflibnet.ac.in:8080/jspui/bitstream/10603/4464/15/15_chapter%206.pdf}}}

 

 

 


Attached File : 536828581 life insurance handbook.pdf, 536828581 15 chapter 6.pdf downloaded: 159 times

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