Date of Filing : 25-05-2006 Date of Order : 23-07-2009 IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD C.C.No.67/06 Dated this, the 23rd day of July 2009. PRESENT SRI.K.T.SIDHIQ : PRESIDENT SMT.P.RAMADEVI : MEMBER SMT.P.P.SHYMALADEVI : MEMBER 1. G.Varghese, S/o.Paulose, Mission Colony, Pallikere, Po.Bekal, Kasaragod. 2. Biju, S/o. G.Varghese, Mission Colony, } Complainants Pallikere, Po. Bekal, Kasaragod.Dt. (Adv. K.Rajesh, Kasaragod) 1. The Commissioner, The Kerala Fishermen Welfare Fund Board, } Opposite parties Trichur. (G.P. Sri.K. Radhakrishnan, Kasaragod) 2. Managing Director, Matsyfed, Karuvamkonam, Thiruvananthapuram. 3. The Director of Insurance, Kerala State Insurance Department, Thiruvananthapuram. (By.Govt.Pleader, Kasaragod) O R D E R SRI.K.T.SIDHIQ, PRESIDENT Case of the complainants in brief is that Smt. Daicy the wife of Ist complainant and the mother of second complainant died on 14-08-2004 in a railway accident. She was a member of Ajanur Fisheries office that is affiliated to opposite party No.1 and was also a member of Pallikere Matsya Thozhilali Kshema Vikasana Sahakarana Sangam which is affiliated to opposite party No.2. 2. Since the death was due to an accident arising out of external violent and visible means opposite parties 1 & 2 have to compensate the complainants by paying Rs.1,50,000/- each. 3. The complainant claiming Janata Personal Accident befits submitted application to opposite party No.1. But the claim is not so far settled. Hence the complaint. 4. Opposite party No.1 Commissioner, Kerala Fisherman’s Welfare Fund Board admitted in their version that the death of deceased Daicy was due to accident that falls within the purview of accident policy and they already forwarded the claim papers and relevant documents with enquiry report to Insurance Company and necessary follow up is made to settle the claim. Hence there is no deficiency in service on their part. 5. According to opposite party No.2 the Matsyafed, the deceased Daicy has not remitted the premium towards the group personal Accident Insurance Scheme 2004-05 facilitated by them through United India Insurance Company. Hence the dependents of the deceased are not entitled for the insurance benefits. 6. Opposite party No.3 who later or impleaded as supplemental opposite party filed version totally denying the case of the complainant and their liability. According to opposite party No.3 they got a technical opinion that the applicants were not entitled for compensation and hence the claim was rejected in August 2005. Opposite party No.3 further contended since the death of the deceased was caused while she was crossing a railway track they are not liable to compensate the complainant since the policy is covering only the accidents occurring during the course of their employment. 7. Ist complainant the husband of deceased Daicy filed affidavit in support of the claim and Exts A1 to A6 marked. For opposite party No.2 K. Anitha the Commissioner of the Kerala Fishermen’s Welfare Fund Board filed affidavit and Ext.B1 the copy of the Group Insurance policy is marked. For opposite party No.2 no evidence either oral or documentary are adduced. For opposite party No.3 Sri Manivaranan the District Insurance Officer, Kasaragod filed affidavit reiterating that is stated in the version of opposite party No.3. 8. All the parties were heard and the documents and the argument notes filed by government pleader for opposite party No.3 were perused carefully. The contentions of opposite party No.3 that the fisherwoman Daicy was died in an accident while she was crossing the railway line and the policy issued by them to opposite party No.1 is covering only the accidents occurring during the course of their employment in sea is not at all acceptable. 9. Ext.A5, the pass book issued from the Fisheries Officer, Kerala Fishermen’s Welfare Fund Board, Ajanur and Ext.A6 the members Identity card issued from Pallikkere Matsya Thozilali Development Welfare Co-op. Society Ltd proves that the deceased Daicy was a Fisherwoman. As per Ext.A1, FIR lodged in respect of the death of Daicy, she was a fish vendor and at the relevant time of accident she was returning back after selling fish in the market. Therefore it can be safely concluded that the accident was occurred while the deceased fisher woman was during the course of her employment as a fish vendor. Ext.B1 is the copy of the policy issued by opposite party No.3 to opposite party No.1 in respect of Insurance coverage to 263338 fishermen and allied workers subject to list of beneficiaries submitted by insured to Kerala State Insurance Department who are active members of the Fund Board. 10. Therefore as stated in the affidavit filed on behalf of opposite party No.3 the policy is not only covering the accidents occurring during the course of their employment in sea but it covers the allied workers also. No doubt the allied workers includes the fish sellers also. 11. Therefore it is clear that the claim of the complainants are rejected without due application of mind by properly evaluating the documents and the circumstances. 12. The opposite party No.3 being in a dominant position acted in a very unreasonable manner and after having accepted a very huge amount towards the group insurance premium disown the genuine claim of the complainants on flimsy vague, and illogical grounds. This attitude is clearly unwarranted not only as being bad in-law but also ethically indefensible. 13. The rejection of the claim of the complainants are therefore amounts to deficiency in service and the opposite party No.3 is liable to settle the claim of the complainant. 14. As per the Ext.B1 policy in case of death the dependants of the deceased members are entitled for a sum of Rs.1,00,000/-. 15. Since complainants could not able prove that she was a member in the Insurance Scheme facilitated by opposite party No.2, no liability can be fastened on opposite party No.2. Therefore the complaint is partly allowed and opposite party No.3 is directed to pay a sum of Rs.1,00,000/- to the complainants 1 & 2 with interest @ 9% from the date of complainant from 25-05-06 till payment with a cost of Rs.3000/-. Time for compliance is 30 days from the date of receipt of copy of the order. Opposite parties 1 & 2 are exonerated from liabilities. Sd/- Sd/- Sd/- MEMBER MEMBER PRESIDENT Exts. A1. Copy of FIR A2. Photocopy of Post-mortem certificate A3. Photocopy of the death Certificate of Daicy A4. True copy of inquest report A5. Pass book of Smt. Saicy A6. Member’s Identity card B1. Group Insurance Policy. PW1. Varghees. Sd/- Sd/- Sd/- MEMBER MEMBER PRESIDENT Pj/ Forwarded by Order SENIOR SUPERINTENDENT
......................K.T.Sidhiq
......................P.P.Shymaladevi
......................P.Ramadevi | | 
