JUDGMENT

JUSTICE SHRI. K.R. UDAYABHANU:  PRESIDENT

The appellants are the 1^st opposite party/insurance company in CC.143/07 in the file of CDRF, Ernakulam.  The appellants are under orders to pay the assured sum of Rs.1,50,000/- to the complainant with interest at 12% from the date of the order till realization.

2. The case of the complainants’ who are the wife and children of the deceased Pavithran is that he met with an accident on 25/9/2005 while fishing as hit on the side of the country boat.  Since then he is an inpatient at first at the local hospital and thereafter as referred to the higher centre at Lissie Hospital, Ernakulam and during treatment he died on 13/10/2005 due to pulmonary embolism and consequent cardiac arrest.  The deceased was covered by the group insurance policy of the 1^st opposite party.  The claim was rejected contending that it is only a natural death.

3. The 1^st opposite party/appellant has contended that the deceased had a history of diabetes, hyper tension and renal problems when he died due to deep vein thrombosis.  There is no direct nexus between the accident and the cause of death.

4. The 2^nd opposite party, Matsyafed has admitted that the deceased was covered by the group insurance policy. 

5. Evidence adduced consisted of the testimony of  PWs 1 to 4, Exts.A1 to A10, Ext.B1 and X1.

6. Ext.X1 is the case sheet from Sarada Nursing Home, Nayarambalam, the hospital in which he was first admitted.  Ext.A3 is the FIR and A5 the final report in the matter.  It is evident from that the deceased sustained injuries while fishing in the sea, from the FIR and final report produced.  PW2 is the doctor of Sarada Nursing Home has proved Ext.X1 and has stated that the deceased was referred to a major hospital on 3/10/2005.   The date of admission at Sarada Nursing Home is on 25/9/2005.  It is the date of the accident also.  PW1 is the doctor of Lissie Hospital who was issued Ext.A2 discharge certificate. PW1 has deposed that he had abscess cellulites in the left leg and that he developed the condition on account of the accident.  He was treated by incision and drainage of abscess.  Subsequently he developed pulmonary embolism which is mainly the consequence of prolonged immobilization.   It is block in the pulmonary vessels due to long period of immobilization.  We find that the deceased had been under treatment continuously since the date of accident and it is as a consequence of the injury sustained in the accident that he developed pulmonary embolism and consequent cardiac arrest.  We find that no where it has been brought out that the deceased was suffering from diabetes, hyper tension and renal problems.  No evidence in this regard has been adduced or brought out in the examination of the witnesses.  PW3 is the 1^st complainant/wife of the deceased who has also denied that her husband was having any of the illness as alleged.  The opposite parties/appellants have not adduced any evidence except producing Ext.B1 copy of the insurance certificate.

In the circumstances we find that there is no scope for interfering in the order of the Forum at all.  Hence the order of the Forum is sustained and appeal is dismissed.  The opposite parties are directed to pay the amount of compensation to the complainant within 3 months from the date of receipt of this order failing which the complainants will be entitled for interest at 18% per annum from 5/1/2011, the date of this order.

Office will forward the LCR along with the copy of this order to the Forum.

VL.                               JUSTICE K.R. UDAYABHANU:  PRESIDENT