IN THE CONSUMER DISPUTES REDRESSAL  FORUM, KOLLAM

Dated this the   9^th   Day of  December  2019

Present: -    Sri.E.M.Muhammed Ibrahim, B.A, LL.M. President

                   Smt.S.Sandhya Rani, BSc,LL.B, Member

                   Sri.Stanly Harold, B.A,LLB, Member

                                                            CC No.177/16

1. T.L.Mohan                              :         Complainants

        S/o Lorance

        Thekke Attathu Veedu

St.Thomas Nagar, Mangadu P.O

Kollam-691015.

2. Angel Marry

         W/o T.L.Mohan

        Thekke Attathu Veedu

       St.Thomas Nagar, Mangadu P.O

        Kollam-691015

       [By Adv.Ezhukone  A.R.Vijayasundaran]

V/s

1. The Director                                      :         Opposite parties

         Kerala State Insurance Department

       Transhouse, Vazhuthakkadu

        Thiruvananthapuram-695014

2. Managing Director

         Kerala forest Development Corporation

          Anakkayam

          Karappuzha, Kottayam-686003.

          [By Adv.C.R.Vijayakumaran Pillai]

FAIR  ORDER

Smt.S.Sandhya Rani, BSc,LL.B, Member

          This is a case based on a consumer complaint filed under section 12 of the Consumer Protection Act 1986.

          The averments in the complaint in short are as follows.

          Complainants are parents of deceased Sreekanth Mohan, who was employed in Kerala Forest Development Corporation, Gavi Division as Field Officer for a period from 18.02.2012 to 30.11.2012.  1^st opposite party is the Director of Kerala State Insurance Department and 2^nd opposite party is Kerala Forest Development Corporation Ltd.

          Prior to the date of joining  the service of 2^nd opposite party the deceased was employed with Kerala Police Department as police constable trainee since 17.02.2012.  After Joined in Kerala Forest Corporation Gavi Division as field officer on 18.02.2012 he was sent for 3 months training at Forest Training School, Arippa and thereafter posted to Akamalavaram Vettitil Estate, Malampuzha in Thrissur Division of KFDC.  However  during the course of his employment accidently he fell into the waterfalls at Kavarakundu and died due to drowning.  The death was an accidental one comes under the purview of the Group Personal Accident Insurance Scheme introduced by the Govt.of  Kerala. 

The first respondent is the insurer.  The deceased was a subscriber to the policy, he has remitted the premium for the relevant period, in the month of October 2012, by way of salary recovery by his employer/the second respondent.  There wasn’t any breakage of service in the case of deceased Sreekanth Mohan, that he resigned from the police department on 17.02.2012 and joined in Forest Development Corporation on very next day ie. on 18.02.2012 .  At the time of accidental death the deceased was unmarried.  In addition to the petitioners sister, Sreekala Mohan and brother Sandeep Mohan were also included as legal heirs of the deceased.  As the deceased has paid the GPAIS premium in the year 2012, the parents of the deceased have submitted an application for the claim to 2nd opposite party and he forwarded that application to 1^st opposite party for encashment as per letter dated 14.05.2013.  But unfortunately the 1^st opposite party returned the application by stating that, no recovery of premium was made for the year 2012 from the salary of deceased .  Even though the complainants have submitted petition regarding the rejection of claim amount before Finance Department of Kerala, no claim was preferred.  Thereafter when they have approached Hon’ble Insurance Ombudsman, they have directed to approach the proper forum for redressing the grievances.  Hence the complaint.

The complainants further allege  that the insurance premium amount Rs.200/-was collected by opposite parties in the month of October 2012 before issuing Govt. order dated 04.11.2012, that means the paid premium was not for the year of 2011 but for the year of  2012.  The insured died on 30.11.2012 by an accident after the recovery of the premium amount Rs.200/- from the salary of October 2012, hence the petitioners are entitled to get the insurance benefit as per  GPAIS.  Moreover it was the duty of 2^nd opposite party to collect and remit insurance premium without delay and    make    sure that  the subscriber is  covered under the scheme but here the opposite parties failed to do so hence they are liable to pay the assured sum    of  Rs.8 lakhs to the complainants .   370 days of delay in filing this complaint was not done willfully  but it was due to the denial attitude from the part of respondents along with difficulty occurred  in collecting records and waiting orders of authorities More over general Insurance Scheme is a beneficial legislation for wiping of the tears of the legal hires of the deceased who died untimely and an unexpectedly.  Hence opposite parties are liable to pay the insurance amount Rs.8 lakhs with interest and cost Rs.10,000/- and such other reliefs to the complainants.

In response to the notice opposite parties 1 and 2  appeared and filed version contending that it is not a consumer dispute because the relation between the complainant’s son and 2^nd opposite party is not as a consumer-service provider but as an employee-employer relationship, so such disputes shall be adjudicated by Commissioner for the Employees Compensation.  It is further contented that prior to join with the office of 2^nd opposite party the deceased was employed with Kerala Police department as Police Constable trainee and he was enrolled in GPAIS during the course of his service with that department but the complainants have failed to impleaded Kerala Police Department as necessary party in the complaint in that way the petition is not  be maintainable due to  non joinder of necessary parties.  Opposite parties would further admit that the deceased Sreekanth Mohan has not returned to the estate office quarters.   Later he was found dead at the water and the postmortem reveals that the death was due to drowning and  The Kerala Forest Development Corporation Ltd. released all due and compensation to the legal heirs of the deceased and the present  petition is filed only on flimsy grounds.  The deceased was joined in KFDC only on 18.02.2012 hence he was not entitled to get benefit of    the    GPAIS   of  Govt. for  the occurrence happened in the year  2012.  KFDC had already remitted the premium in 2011 itself to the insurance department for all existing staff for the year 2012.  Here the deceased was in service with Kerala Police Department as Police Constable till 17.02.2012 and as per Govt. rules he would have been covered under GPAIS of Government while he was employed in Kerala Police Department.  In the light of above reasons KFDC sent a letter No.E2-5997/10 dated 05.02.2013 directing the Police Department to avail the claim under GPAI scheme to the deceased.  By letter No.F5/1686/2013/KAP3 dated 25.02.2013 the Police Department informed KFDC that since Sri. Sreekanth Mohan was only a Recruit Trainee in their department who was paid only stipend during the training period without any deduction of premium  hence he was not covered under GPAIS during the period of  2012.

As per the terms and conditions of the Govt. Order No. G.O(P) No.504/2011/Fin dated 04.11.2011 one time collection of premium for the insurance had to collect from the salary of November and remit to the insurance department in December.  At the time when Sri.Sreekanth Mohan joined in KFDC on 18.02.2012, the KFDC had already remitted the premium to the insurance depart for all existing staff for the benefit of 2012.  So he had to wait till November 2012 to join in the scheme as per the said G.O.(P) No.504/511/Fin dated 04.11.2011.  That is why the claim for insurance coverage of the deceased was denied by the 1^st opposite party.  The premium deducted from the month of October 2012 of the deceased was to be remitted to the account of 1^st opposite party only in the month of December 2012, and only thereafter the deceased will qualify for the GPAIS as per the G.O.(P)No.504/2011/Fin in force.  So the deceased will get the benefit only from the year 2013 onwards.  Hence at the   time of his death he was not covered with the said insurance policy.  So the complaint may be dismissed with costs of the respondents.

In the light of above pleadings the points that arise for consideration are:-

1. Whether there is any deficiency in service on the part of opposite parties in returning the claim application filed by the complainant seeking insurance claim in respect of the deceased Sreekanth Mohan?
2. Whether the complaints are entitled to get the relief sought for ?
3. Relief and costs?

Evidence on the side of complainant consists of oral evidence of PW1 and P1 to P9 documents.  No oral evidence on  the side of opposite parties but got marked Exts.D1 and D2.  Both sides have filed notes of argument.  Heard both sides.

Points 1 & 2

For avoiding the repetition of discussion of materials these two points are considered together.    The specific case of the complainant is that  the deceased Sreekanth Mohan was an employer of  KFDC, Gavi division as  Field Officer for a period from 18.02.2012 to 30.11.2012   and during the course of employment the deceased Sreekanth Mohan fell down into waterfalls at Kouravakundu  and died due to drowning.  Since the death was an accidental one the same comes under the purview of the  Group Personal Accident Insurance Scheme introduced by the Government of  Kerala.  The deceased was a subscriber to the policy and he remitted  the premium for the relevant period in the month of October 2012 by way of salary recovery by his employer who is the 2^nd opposite party in this case.  According to him prior to the date of joining in the Forest Department he was a Police Constable Trainee since 17.02.2012 and after resigning from the Police Department   he   joined in the KFDC on the very next date ie, on 18.02.2012.  It is the further case  of the complainant that though the deceased has paid GPAIS premium in the year 2012   the 1^st opposite party has returned the claim application by stating that no recovery of premium was made for the year 2012 from the salary of the deceased.  According to the complainant the opposite parties have collected Rs.200/- by way of insurance premium from the salary of the decease Sreekanth Mohan.  But the opposite parties have denied having received the insurance premium  for the year 2012.  According to the 2^nd opposite party the deceased have joined in KFDC only on 18.02.2012.  Hence he was no entitled to get the benefit of GPAIS of the government as he died during that year itself.  It is further contented that KFDC had already remitted the premium relating to the year 2012 in the  year 2011 itself to the insurance department for all existing staffs.  Here in this case the deceased Sreekanth Mohan was not in service of  KFDC Ltd. during the year 2011.  Therefore there is no question of deducting premium during the year 2011 and remitting the same to the insurance company.  Admittedly he joined service at the KFDC Ltd. on 18.02.2012 and till that date he was a police constable trainee and there was no salary for a trainee.  A trainee used to get either stipend and will not get any salary.  Since there was no salary  no chance of making any recovery  from the salary towards insurance premium or provident fund or to any other scheme.  It is clear from GO(P) No.504/11 Fin dated 04.11.11 that one time collection of premium for the  insurance had to be collected from the salary of November and to remit to the insurance department in December.  However when the deceased Sreekanth Mohan joined in KFDC Ltd. on 18.02.2012 the  said Corporation had already remitted the premium to the Insurance Department for all existing staffs for the benefit of year  2012.  So  the deceased Sreekanth Mohan had to wait for 2012 to join in the scheme as per the said GO(P) No.504/11 Fin dated 04.11.11.  It is cristal clear that   the premium deducted on month of October 2012 from the salary of the deceased was to be remitted to the account of the 1^st opposite party only in the month of December 2012 and then only the deceased will qualify for the GPAIS as per the above  quoted GO.  In short as the deceased has joined in the KFDC Ltd. during the beginning of 2012 ie, on 18.02.2012 he will get the benefit only from the year 2013 onwards   as an employee has to pay insurance premium well in advance for the  coming year.  It is clear from the  available materials that at the time of his death he was not covered by  the said insurance policy as contented by the 2^nd opposite party.  On evaluating the entire materials available on record we come to the conclusion that there is no merit in the complaint and the same  is only to be dismissed. 

In the  result the complaint stands dismissed.

No costs.         

  Dictated to the  Confidential Assistant  Smt. Deepa.S transcribed and typed by her corrected by me and pronounced in the  Open Forum on this the     9^th     day of  December  2019.       

E.M.Muhammed Ibrahim:Sd/-

           S.Sandhya Rani:Sd/-

            Stanly Harold:Sd/-

                                                                                    Forwarded/by Order

                                                                                    Senior Superintendent

INDEX

Witnesses examined for the complainant:-

PW1:- T.L.Mohanan

Documents marked for the complainant:-

Ext.P1:-Copy of  FIR

Ext.P2 :- Copy of postmortem report

Ext.P3:- Copy of death certificate

Ext.P4:-Copy of the legal heir ship of the deceased Sreekanth Mohan

Ext.P5:-Copy of salary slip

Ext.P6:- Copy of letter from District Insurance Officer

Ext.P7:- Copy of the letters issued by the Deputy Director of Insurance

Ext.P8:- Order of the Hon’ble Ombudsman

Ext.P9:- Copy of government order

Witnesses examined for the opposite party:-Nil

Documents marked for the opposite party:-

Ext.D1:-Copy of  Employees Compensation order

Ext.D2:-Copy of Government order

E.M.Muhammed Ibrahim:Sd/-

S.Sandhya Rani:Sd/-

Stanly Harold:Sd/-

Forwarded/by Order

Senior Superintendent