Date of filing : 22-11-2011
Date of order : 11-01-2013
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.319/2011
Dated this, the 11th day of January 2013
RESENT
SRI.K.T.SIDHIQ : PRESIDENT
SMT.P.RAMADEVI : MEMBER
SMT. K.G.BEENA : MEMBER
Bharathi, W/o.Soman, S/o.Kundaran, : Complainant
R/at Adkathbail Beach, Po.Kasaragod.671121
(Adv.K.Rajesh, Kasaragod)
1.The Commissioner, : Opposite parties
Kerala Fishermen’s Welfare Fund Board,
Head Office, Thrichur.2.
2. The Managing Director,
Matsyafed, Kuravankonam.Po.
Thiruvananthapuram.
(In Person)
3. The Director of Insurance,
Kerala State Insurance Department,
Thiruvananthapuram.
(Addl. Govt.Pleader)
4. The Divisional Manager,
United India Insurance Co.Ltd, Trissur.
(Adv.C.Damodaran, Kasaragod)
5. The Divisional Manager,
National Insurance Co. Ltd,
P.B.No.40, Bank Road Kannur.670001.
(Adv.C.Damodaran, Kasaragod)
6. The Divisional Manager,
M/s United India Insurance Co.Ltd,
Divisional Office, Round Circle,
Trichur.680541.
(Adv.C.Damodaran,Kasaragod)
O R D E R
SMT.K.G.BEENA,MEMBER
This complaint is filed by Bharathi for compensation for the death of her husband Soman while fishing in high seas. He was a member of Kasaba fisheries village affiliated to opposite party No.1 and Kasaba Fishermen Welfare Department Co-operative Society Ltd affiliated to opposite party No.2. After the death of Soman when the complainant approached opposite parties with claim, it was repudiated on the ground that as per the agreement and policy coverage under serial No.1&2, heart attack is not included and since the death of Soman does not come under the coverage clause 1&2. Hence the complaint for necessary redressal.
2. According to opposite party No.3, he is an unnecessary party in this case as he has not issued any policy against deceased Soman. Opposite party No.4 filed version praying opposite party No.1 may be directed to furnish insurance particulars. According to opposite partyNo.5, complainant is satisfied by a sum of 3 lakhs which is received by opposite party No.2. Opposite party No.6.filed a detailed version stating that as per agreement and policy coverage under serial No.1& 2 heart attack is not included. Since the death of Soman doesnot come under coverage clause 1&2. Repudiation is quite legal and as per terms of the agreement. Opposite party No.2 in their version stated that all the documents pertains to the death of Sri.K.Soman, S/o.Ambu were submitted to National Insurance Company on 31-01-2011 from Matsyafed and company in turn sanctioned the claim amount of Rs.3,00,000/- and there is no delay in rendering service by opposite party No.2. Complainant filed affidavit in lieu of chief-examination . Exts.A1 to A8 marked. On the side of opposite partyNo.6 Exts B1 & B2 marked. Both sides heard and documents perused. The questions raised for consideration are:-
1. Whether there is any deficiency in service on the side of opposite parties?
2. If so what is the relief?
3. Point No.1. The complainant’s husband died on 3-01-2011 at high seas. The deceased was a member of Kasaba Fisherman Village and Kasaba Fisherman Welfare Department Co-op. Society Ltd. The legal representatives of the complainant filed claim application before opposite parties. Opposite party No.1 repudiated the claim. On the ground that as per the agreement the policy coverage under serial Nos 1 & 2 heart attack is not included and since the death of Soman does not come under the coverage clause 1 & 2. But the claim of the complainant is satisfied by opposite party No.5 through cheque No.236635 dated 13-01-2012 for a sum of RRRs.3,00,000/- which is received by opposite party No.2. Complainant also admitted that an amount of Rs3,00,000/- is received opposite party No.6 produced Exts B1 & B2. As per Ext.B2 accidental death includes any type of accident, death due to dog/snake bite due to lightning, train accident and due to any unforeseen causes. Here the complainant’s husband is died due to heart attack, which is also an unforeseen cause. Moreover, opposite parties 2&5 admitted the claim and given the assured sum. So opposite parties 1 & 4 is also bound to admit the claim basing on Exts B1 &B2.
Relief& Cost : As per Ext.B1 Group Personal Accident Policy issued by opposite parties 1 & 4 in case of death of a fisherman his legal representatives are entitled for Rs2,00,000/- as the capital sum assured. Therefore the complaint is allowed and opposite parties 1 & 4 is directed to pay Rs2,00,000/- with interest @ 9% from the date of complaint till payment with a cost of Rs.3000/-. Time for compliance is limited to 30 days from the date of receipt of copy of this order. Failing which Rs.2,00,000/- will carry interest at the rate of 12% per annum.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exts.
A1. Copy of F.I.R.
A2.Copy of Post-mortem certificate of Soman
A3. Copy of Death certificate of Soman.
A4. 5-9-11 letter issued by Kerala Malsythozhilali Khsema Nidhi Board to Smt.Bharathi.
A5. 12-3-10 copy of receipt issued by Kasaba Malsyathozhilali Kshema Vikasana
Sahakarana Sangam, Kasaragod.
A6.15-9-11. Letter issued by FWDCS f OPNO.2 the pass book issued by the office of
OP No.1 to Soman with membership No.1491.
A7.Photocpy of pass book of A.Soman.
A8. copy of inquest report.
B1. True copy of policy
B2. True copy of Agreement executed between OP No.1 and OP No.6.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Pj/ Forwarded by Order
SENIOR SUPERINTENDENT
