my father had bought an insurence policy with bajaj allianz,when he passed away we claimed they refused?

it was a case of early claim and they said that we are refusing because the policy holder had diabetes which was the cause of his death and this was not notified to us while the policy was being bought . now what should I do ?

7 Replies to “my father had bought an insurence policy with bajaj allianz,when he passed away we claimed they refused?”

  1. Find someone close who is working in bajaj allianse insurance company and take his help to claim it. dont make that case get bigger and people come to know about it. claim it calmly.

  2. Not disclosing a serious medical condition that later leads to the death of the policy holder is usually pretty watertight grounds for refusing to pay up. To win your case you have to prove that you father either didn’t know he had diabetes when he signed up for the policy – ie from medical records or that he wasn’t asked whether he had any serious or life shortening illnesses when taking out the policy.

    I don’t hold out much for your chances but you should try anyway – good luck.

  3. I think
    this question is imaginary, because if your father took a policy and the claim is early that prima facia indicates, that he may be atleast 50 when he took the policy. as I understand that the insurance company does not know about the condition. It means they have issued the policy without any medical tests and the sum Insurance may not be more than 2 lacs,
    1) It is very difficult to prove that the person has died due to Diabeties.
    2) But if it is the main cause as per Death certificate, then its very very very difficult to prove that the diabeties is not more than 3 years old (before the policy period). Because medically its known Diebeties kills, but its known Diabeties kills SLOWLY. so its very very imaginary that your father may not be aware of his condition while taking up the policy.
    Practically if we see to it, at his age what triggered him to take up insurance for such a paltry sum, or was he insurance minded since long, which can be proved by his earlier taken policies.

    I am sure if he is covered for more than 10 lacs for more than 15 years, which is his last policy before this and for what sum. Bajaj Allianz will be any ways convinced that ur father was insurance minded, and may pay the claim of less than 2 lacs, even if it is an EARLY one.
    But if the case is IMAGINARY then there’s no perfect solution.

  4. Most of the policy holders do so as they are not aware of the underlying conditions for a claim pay out. There is always a disclaimer on every brochure or proposal form about Section 45 of Insurance Act 1938. According to this Section, if the insurance company gets to know that there has been a non-disclosure or misrepresentation of material facts in the application form, then the insurance company can call the policy null and void.

    It simply means that within 2 years of commencement of the policy, if the Insurance Company finds out that the policy holder has not stated the complete truth or has lied while filling up the proposal form for commencement or revival of the policy, then it can cancel the policy and decline the claim.

    Thus, if a smoker had mentioned that he is a non-smoker and he dies even a natural death within 2 years of the policy commencement, then also the Insurance Company may repudiate or decline the claim on grounds of “non-disclosure” or “misrepresentation” of “material facts”, i.e. for not stating the complete truth or misstating information which is relevant for underwriting and risk assessment.

    Thus, each and every question of the proposal form must be answered correctly and the form should be duly filled by the Proposer himself and not anyone else, as he is declaring that he is stating the truth when he undersigns the same. Any mistakes in the proposal form would be held against the policyholder in case of any dispute.

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