KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD, THIRUVANANTHAPURAM

APPEAL 72/2011

JUDGMENT DATED: 27..09..2011

PRESENT

JUSTICE SRI.K.R.UDAYABHANU  : PRESIDENT

SRI.S.CHANDRAMOHAN NAIR     : MEMBER

1. United India Insurance Co.Ltd.,      : APPELLANTS

    Divisional Office-I,

    Manjeri Division.

2. United India Insurance Co.Ltd.,

    Pathanamthitta Branch, rep.by its

    Sr.Divisional Manager, Divisional Office I,

    LMS Compound, Trivandrum,

    rep.by its Divisional Manager, Dr.Mohan Shanker.

(By Adv.R.Jagadishkumar)

          Vs.

1. Sreejaya.P.S.,                                           : RESPONDENTS

    W/o K.A.Jayadevan,  Kuriyilethu House,

    Melukara.P.O.,KozheNchery village.

(By Adv.Dinesh Sajan.K, counsel for R1)

2. Sreejesh.K.J., S/o Jayadevan.K.A.

                 -do-do-

3. Sreelekshmi, D/o Jayadevan.K.A.,

                  -do-do-

4. South Malabar Gramin Bank,

   Ayroor Branch,   Ayroor South.P.O.,

    Cherukolpuzha-689611,

    Rep.by its Manager.

(By Adv.K.N.Justin counsel for R4)

JUDGMENT

JUSTICE SRI.K.R.UDAYABHANU  : PRESIDENT

          The appellants are the 2^nd and 3^rd opposite parties in CC/15/09 in the file of CDRF, Pathanamthitta.  The appellants/insurers are under orders to clear outstanding dues in loan account of the deceased and also to pay Rs.5000/- as compensation and cost of Rs.1000/-.

          2. The case of the complainant/LRs of the deceased Jayadevan is that the deceased died consequent to a fall from bed on 20.6.07 and that he sustained serious head injury.  Thereafter he was treated at Poyyani hospital, Kozhenchery and thereafter Pushpagiri Medical College Hospital, Tiruvalla.  He died on 5.7.07.  He availed loan from the 1^st opposite party bank of Rs.1,50,000/-.  The loan outstanding dues were covered by the policy issued by the 2^nd and 3^rd opposite parties.   Insurance Company repudiated the claim denying the allegation that death was consequent to the accidental.

          3.  1^st opposite party/bank has filed version mentioning that  as per the postmortem report the cause of death was due to surgical injury caused to the liver and that death was due to medical negligence.   Hence the claim was repudiated by the insurers.  1^st opposite party/bank has denied any liability. 

          4. 2^nd and 3^rd opposite parties/insurers have contended that the allegation that the complainant had a fall from bed is to be strictly established.  It is also mentioned that in the postmortem report cause of death  is mentioned as surgical injury to the liver.  It is also mentioned that it has been found that the complainant has filed a complaint before the CDRF claiming compensation against hospital authorities alleging medical negligence.  In the circumstances the insurers have denied  liability.

          5. The evidence adduced consisted of the proof affidavit filed by respective sides; Exts.A1, B1 to B4.

          6. We find that the deceased died on 5.7.07 but the complaint has been filed only on 3..2..09.  No treatment records were produced.  There is no head injury as per Ext.B2 postmortem report.  It is not evident as to how surgical injury to the liver was sustained while undergoing treatment for head injury.  We find the above aspect has to be considered.  The complainant or the respective parties are directed to produce treatment records so that the above point can be clarified.  In the circumstances the order of the Forum is set aside.  The Forum is directed to examine the matter in detail and dispose of the matter afresh.

          7. The case stands posted before the Forum on 27..10.2011.

          Office will forward the LCR alongwith the copy of this order to the Forum urgently.

          JUSTICE.K.R.UDAYABHANU         : PRESIDENT

          S.CHANDRAMOHAN NAIR             : MEMBER

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