Date of Filing            : 02-04-2008

                                                               Date of Order            : 14-08-2009

IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD

                                                C.C.No.40/08

                                    Dated this, the 14th day of August 2009.

PRESENT

SRI.K.T.SIDHIQ                                            : PRESIDENT

SMT.P.RAMADEVI                                                : MEMBER

SMT.P.P.SHYMALADEVI                          : MEMBER

1. Radha

    W/o. Late Ravindran,

   R/at Kizhur Kadapuram,

   Fisherman Colony, Po.Chandragiri.                                } Complainants

2. Laxmi, D/o.Radha,

3. Gangad, D/o.Radha

4. Hari, S/o. Radha

(No.2 to 4 are minors rep.by legal guardian

  and mother)

(Adv. Rajesh.K, Kasaragod.)

1. The Commissioner,

     Kerala Fisherman Welfare Fund Board,                        } Opposite parties

     Karuvankonam,

     Thiruvananthapuram.

2. The Director of Insurance,

     Kerala State Insurance Department,

     Thiruvananthapuram.

(Dist.Govt.Pleader)

                                                                        O R D E R

SRI.K.T.SIDHIQ, PRESIDENT

            The complainants are the legal heirs of deceased Ravindran who was a fisherman registered under Kizhur Fisherman Village that is affiliated with Kerala Fisherman Welfare Fund Board.  He died in a railway accident on 23-06-06.  He being a beneficiary of the group insurance scheme facilitated by opposite party No.1, his legal heirs lodged the claim before Opposite party No.1.  Opposite party No.1 has forwarded the claim papers and related documents to opposite party No.2 in time and necessary follow up is made to settle the claim.  But opposite party No.2 has rejected the claim.  According to opposite party No.2 the death of Ravindran was not due to any accident but was a suicide. Further the liability as per the policy is only covering the accident occurring during the course of employment in the sea.

2.            Complainant filed affidavit and Exts A1 to A8 marked.   For opposite party No.2 Shri.C. Manivarnan, the District Insurance Officer filed affidavit and Ext.B1 marked.  Both sides heard and documents perused.

3.         The contention of opposite party No2 that the death of the fisherman was a suicide is not sustainable.  There is absolutely no evidence to show that the death of the fisherman was a suicide.

4.            Another contention of opposite party No.2 is that the policy covers only the accidents occurring during the course of employment in the sea.  This contention is also baseless.   Ext.B1 copy of policy shows that the policy covering 226160 fishermen and 50947 allied works.             The allied workers includes fish vendors and those who are doing ancillary and incidental works who never go to sea.  This itself shows that the policy covers not only fishermen employed in sea but allied workers also.  Moreover, as per the policy ‘accident’ is sustain bodily injury resulting solely and directly from accident caused by violent external and visible means which shall solely and independent of any other cause result in Death or Disablement as defined in the schedule.

6.            Therefore it is clear that policy nowhere provides that to get the benefits of the policy  the accident must have occurred during the employment in the sea where as any cause result in Death is covered by this policy.

7.         Hence the repudiation of claim is not justifiable and it amounts to deficiency in service on the part of opposite party No.2.

            Reliefs & Cost.

8.         As per the policy insurer opposite party No.2 is liable to pay the capital sum i.e. Rs.1,00,000/- in case of death of a fisherman. 

            Therefore the complaint is allowed and opposite party No.2 is directed to pay Rs.1,00,000/- (Rupees one lakh only) with interest @ 12% per annum from the date of complaint till payment along with a cost of Rs.2500/-. Time for complaint is limited to 30 days from the date of receipt of copy of order. Opposite party No.1 is exonerated from liabilities.

      Sd/-                                    Sd/-                                                             Sd/-

MEMBER                               MEMBER                                                       PRESIDENT

Exts.

A1.photocopy of Post-mortem certificate

A2. Photocopy of FIR.

A3.Inquest report.

A4.Photocopy of Death Certificate

A5.15-11-06 copy of lawyer notice

A6. Postal acknowledgement

A7. Pass of Ravindran

B1. Photocopy of Insurance policy.

PW1. Radha

    Sd/-                                       Sd/-                                                           Sd/-

MEMBER                             MEMBER                                                       PRESIDENT

Pj/                                                                    Forwarded by Order

                                                                SENIOR SUPERINTENDENT