Complaint Details

Status	:	Closed
Complaint No	:	0002227/2012
Category	:	Insurance
Date	:	18-08-2012
Subject Line	:	Claim Dissatisfaction under the claim no. AH12002128 and policy no. U049627350
Complainant	:	Sunita Suresh Sheth
Address	:	2-Chinar Bungalow,Sandesh Press Road,Bodakdev, Vastrapur
Complainee	:	TATA AIA Life Insurance Co. Ltd.
Address	:	Delphi - B Wing, 2nd Floor,Orchard Avenue,Hiranandani Business Park,Powai,

Complaint Details
With reference to the above subject, My husband was holding TATA AIA LIFE INSURANCE CO. LTD. policy, whose policy no. is U049627350. Policy was taken on 19th March-2009. Sum Assured Rs.9,90,000/-. He died on dtd.12th March-2012.

We have received just Rs. 1,44,550.59( Rupees One lakh Forty Four Thousand Five Hundred Fifty and paisa Fifty Nine only) stating that insured was suffering from Diabetes and Hypertension since prior to the application for insurance.

But the fact was that, my husband had talked to servicing agent each & every fact regarding Diabetes and Hypertension at the time of taking policy. Servicing Agent assured him that he will write the fact in proposal form. Servicing Agent took signature of my husband in blank form and assured us the same.

As per the insurance Act 1938, Section45, its not a early claim. Death happened after 2 years & 11 month. The Act Says”. Policy not to be called in question on ground of mis- statement after two years. No policy of life insurance effected before the commencement of this Act shall after the expiry of two years from the date of commencement of this Act and no policy of life insurance 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 for insurance or in any report of a medical officer, or 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 statement 2[ was on a 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 3 [ or that it suppressed facts which it was material to disclose]:
1. Subs. by Act 62 of 1956, s. 2 and Sch., for" the States". 2. Subs. by Act 13 of 1941, s. 31, for" was on a material matter and fraudulently made". 3. Ins. by s. 31, ibid.
1[ Provided that nothing in this section 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.]


So on the basis of above facts and figures, we must get Rs.9,90,000/- as sum assured promised to my husband.

Requested to give us natural justice.

Thanking you,

Yours Faithfully



Sunita Suresh Sheth

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