<br /> By Smt. Saji Mathew, Member<br /> <br /> <br /> The gist of the case is as follows:<br /> The complainant has taken a policy in the name of his wife paying a premium of Rs.325/- The 1st opposite party instigated the complainant to take the policy from the 2nd opposite party. As per the policy, coverage is given to 4 members of the policy holder's family. The complainant's son Prakashan was downed in Karapuzha Dam on 8.4.2007. A claim was filed with the 2nd opposite party for the insurance amount of Rs,30,000/-. The claim was repudiated by the 2nd opposite party. This is deficiency in service on the part of the opposite parties. So, the complainant prays for an order directing the opposite parties to disburse the insurance amount of Rs.30,000/- and other expenses.<br /> <br /> 2. The 1st opposite party was set exparty. The 2nd opposite party filed version stating that the complaint is not maintainable before the forum as the complainant is not a consumer and the proper forum is arbitration. The 2nd opposite party admits the policy. A claim was submitted by the 1st opposite party in connection with the death of one Prakashan in an incident on 8.4.2007 at Karapuzha Dam. In the claim form, Smt. Balamani, Kallappara House, Narikuni Post, had submitted the application in the capacity as mother of the deceased. The claim after deep consideration was repudiated for the reason that it was an alcohol consumed case. The postmortum report of the deceased Prakashan clearly indicates about the consumption of alcohol which disqualifies the right of the claim as per the terms and conditions stipulated in the policy. The claim was therefore rightly refused. The complainant is to be put to strict proof regarding his membership in the group insurance policy. From the circumstances narrated about the incident, the possibility of committing suicide by Prakashan also could not be ruled out. The act of the deceased would amount to violation of law. So the claim was rightly repudiated by the 2nd opposite party. So, there is no deficiency in service on the part of the opposite parties and the complaint is to be dismissed.<br /> <br /> 3. The complainant was examined as PW1. Ext. A1 to A5 were marked on the side of the complainant. OP2 was examined as OPW1 and documents were marked as Ext. B1 and Ext. B2 on the side of the opposite parties. <br /> <br /> 4. The points to be considered are as follows:<br /> <br /> 1) Whether there is any deficiency in service on the part of the opposite parties?<br /> 2) Whether the complainant is entitled for any relief?<br /> <br /> 5. Point No.1: In this case, the claim was repudiated for the reason that it was an alcohol consumed case. The opposite party also assume the possibility of suicide by the deceased. In both these case, they are not liable to pay the insured amount. But on perusal of documents produced by the parties, there is no evidence to prove that the cause of death has any relation to the consumption of alcohol. There is no evidence for the consumption of alcohol. In the postmortem report ( marked as Ext. A4) cause of death is shown as 'Death from Asphyxie due to drowning' Ext. A4 has mentioned that the deceased's stomach contained food materials with a smell of alcohol. This is not sufficient to conclude that the deceased had consumed alcohol and the consumption of alcohol lead to drowning. F I R also does not show anything supporting the contention of opposite parties. So it is found that the 2nd opposite party has repudiated the claim without sufficient reason. So the point No.1 is found against the opposite party.<br /> <br /> 6. Point No.2: As the 2nd opposite party has repudiated the claim on flimsy grounds. The complainant is entitled to get the insurance amount of Rs.30,000/- and other costs.<br /> <br /> Hence, the Opposite party is directed to give the complainant the insured amount of Rs.30,000/- and the cost of petition Rs.1,000/- within 30 days of this order. The opposite party is directed to pay an interest at the rate of 10% on the ordered amount from the date of complaint till payment<br /> <br /> Pronounced in the open forum on this the day of 30th October, 2008.<br /> <br /> PRESIDENT: Sd/-<br /> MEMBER: I Sd/-<br /> MEMBER: II Sd/-<br /> A P P E N D I X:<br /> Witness examined for complainant:<br /> PW1 Vasudevan C Complainant<br /> Witness examined for opposite parties:<br /> OPW1 Pramod Raveendran Manager<br /> Exhibits marked for complainant<br /> A1 Copy of application form<br /> A2 Copy of notice Dt. 22.4.2008<br /> A3 Copy of death certificate<br /> A4 Copy of Post Mortum Certificate<br /> A5 Copy of health card<br /> Exhibits marked for opposite parties:<br /> B1 Copy of Group Personal accident Insurance policy<br /> B2 Copy of Power of Attorney<br /> Sd/-<br /> PRESIDENT, CDRF, WAYANAD.<br /> <br /> /By order/<br /> SENIOR SUPERINTENDENT, <br /> CDRF, WAYANAD.