IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Tuesday the 29th day of September, 2015
Filed on 20.11.2013
Present
- Smt. Elizabeth George (President)
- Sri. Antony Xavier (Member)
- Smt.Jasmine.D. (Member)
in
C.C.No.356/2013
between
Complainant:- Opposite Parties:-
1.. Sri. Bhasi, Kanichukadu House 1. The District Collector
Mannancherry P.O. Collectorate, Alappuzha –
Alappuzha 688 001
2. Smt.Sheeba, W/o Bhasi 2. The Revenue Divisional Officer
-do- Revenue Divisional Office
3. Chinchu.P., D/o Bhasi Opposite District Court -do- Alappuzha – 688 001
(By Adv. James Chacko) (By Adv. C.V. Lumumba – for
Opposite parties 1 and 2)
United India Insurance Co. Ltd.
Represented by its Divisional
Manager, Divisional Office
Sarada Shopping Complex
Mullackal, Alappuzha – 688 011
(By Adv. C. Muraleedharan)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
The case of the complainant is as follows:-
The son of the first and second complainants went to see Nehru Trophy Boat Race at Punnamada Lake with valid ticket to view the boat race. While watching the Boat Race at Punnamada finishing point at about 6 p.m. complainant’s son Varun.B., accidently fell on the lake due to heavy rush in the Gallery and died due to drowning in water at finishing point water spot itself. The Alappzuha North Police has registered a criminal case as Crime No.752/2012 and Postmortem was also conducted and final report also submitted to Court on 30.9.2012 in which accidental death of Varun.B. due to drowning in the water was confirmed. After the accidental death of first and second complainant’s son – Varun.B. complainants duly intimated the accidental death of their son to the opposite parties in time. More over on 22.9.2012, the second complainant made an application along with all relevant records for sanctioning the claim lodged before the second opposite party. On 22.9.2012 for getting legally entitled assured sum of Rs.2 lakhs which was forwarded by the second opposite party to the Village Officer, Mannancherry for report through Tahsildar, Ambalappuzha. On 24.9.2012 itself the Village Officer, Mannancherry reported the accidental death of Varun.B. due to drowning in water at Punnamada Lake while watching Nehru Trophy Boat Race, to the first and second opposite parties in time. But after that report, complainants personally visit first, second and third opposite parties’ Officers several times but no reply or proper explanation given to them. On 13.9.2013, the second complainant sent a Legal Notice to the first, second and third opposite parties for sanctioning legally entitled valid claim; but till now no reply given to the complainants’ by the opposite parties. In the above stated circumstances, the complainants are entitled to get an assured amount of Rs.2 lakhs as compensation amount from the third opposite party – the insurer – as per the terms and conditions of Group Insurance Policy Scheme, the first and second opposite parties are vicariously liable for sanctioning the legally entitled valid claim, from the third opposite party the insurer is liable to indemnity the first and second opposite parties against all risks and losses. Hence third opposite party is liable to pay the compensation to the complainants. The complainants are also entitled to get a compensation of Rs.30,000/- for mental agony and sufferings and also complainants are entitled for Rs.500/- as legal notice charge from the first, second and third opposite parties jointly or severally. The complainants are also entitled to get interest at the rate of 18% per annum from the date of accident for the award amount, till realization. Hence the complaint is filed claiming the following reliefs:-
- To pass an order directing the opposite parties to effect the payment of an amount assured for Rs.2 lakhs towards the legally entitled claim amount as per the terms and conditions of the valid policy to the complainants with interest @ 18% per annum from the date of accident till deposit.
- To pass an order of compensation of Rs.30,000/- for the mental agony and sufferings with Rs.500/- notice charges to the complainants from first, second and third opposite parties jointly or severally.
- To pass an order for realizing the cost of this complainants.
- To pass an order for such other reliefs which are fit and expedient in the interest of justice.
2. The version of the first and second opposite parties is as follows:-
It is true that the third opposite party had issued a policy in favour of the Secretary, Nehru Trophy Boat Race Society under the head of “special Contingency insurance policy” in connection with the Nehru Trophy Boat Race. As per the policy conditions the third opposite party was liable to pay Rs.2 lakhs per person in case of accidental death. It is admitted that the son of the second and third complainants fell on the lake and met with death due to drowning. The Sub Inspector of Police, North Police Station, Alappzuha registered a Crime as No.752/12 under section 174 of Criminal Procedure code under the caption of unnatural death. But on investigation, it was found that the unfortunate incident was happened accidently and not an act of suicide. These opposite parties had taken all the measures to sanction the amount to the dependents of the deceased. The third opposite party who is the insurer is liable to indemnify this opposite parties in the event of any loss or damages caused in connection with the Nehru Trophy Boat Race. The non-payment of the policy amount is without any valid reason. The third opposite party could not be justified in withholding the claim amount under a valid policy. There is no violation of any of the policy conditions. The facts and circumstances of the alleged incident clearly show that there was no negligence or intentional act on the part of the deceased.
3. The version of the third opposite party is as follows:-
All the averments in the complaint are not fully correct. The company issued a Special Contingency Insurance Policy to the Secretary & RDO Nehru Trophy Boat Race for the period from 9.8.2012 to 11.8.2012 with the conditions applicable to personal accident policy covering the officials, press, VIPs, Police and participants, spectators against death and permanent disability due to accident. The claim of the complainant was that their son Varun died due to accident by falling into the river and drowning. The police have registered a case for the same it was revealed from the police report that deceased voluntarily jumped into the river and drowned which is a self inflicted injury/suicide. As per the policy condition exceptions clause 5 the company is not liable to pay any amount in respect of death or injury from intentional self injury, suicide or attempted suicide etc. Hence the company is not liable to pay any amount as such the claim was repudiated. All other allegations against the above facts are absolutely false and devoid of any merit. Hence there is absolutely no deficiency in service on the part of this opposite party thus the complaint is liable to be dismissed with cost of this opposite party.
4. The second complainant was examined as PW1. The documents produced were marked as Exts.A1 to A12. Two witnesses were examined as PW2 and PW3. The third opposite party was examined as RW1. The documents produced were marked as Exts.B1 to B5.
5. The points for consideration are:-
- Whether there is any deficiency in service on the part of the opposite parties?
- If so the reliefs and costs?
6. According to the complainants, on 11.8.2012 their son went to see Nehru Trophy Boat Race at Punnamada Lake along with his friends and while watching the boat race their son accidently felt to the lake due to heavy rushing in the gallery and died due to drowning in water. The Alappuzha North Police has registered criminal case as Crime No.752/12 and postmortem was also conducted. Complainants produced the attested copy of the FIR and FIS which marked as Ext.A1. Final report which is marked as Ext.A2 and the postmortem report which is marked as Ext.A3. The opposite parties 1 and 2 filed version admitting that the son of the complainants 1 and 2 felt on the lake and met with death due to drowning. They also admitted that on investigation it was found that the incident was happened accidently and not an act of suicide. According to the third opposite party the deceased voluntarily jumped into the river and drowned which is a self inflicted injury or suicide. They also stated that as per the policy conditions they are not liable to pay any amount in respect of death or injury from intentional self injury, suicide or attempted suicide etc. The copy of the policy produced which is marked as Ext.B1(a). As per the clause 5 of personal accident policy, company shall not be liable for: “Payment of compensation in respect of Death, injury or disablement of the insured (a) from intentional self-injury, suicide or attempted suicide (b)whilst under the influence of intoxicating liquor or drugs, (c) whilst engaging in Aviation or Balooning whilst mounting into or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world, (d) directly or indirectly caused by venereal diseases or insanity (e) arising or resulting from the insured person committing any breach of law with criminal intent.” Therefore the only question which arises for consideration in this complaint is as to whether the death of the deceased Varun.B. took place on account of suicide. While cross examining he witnesses who went along with the deceased to watch the boat race categorically stated that, “
He again stated that, “
There was no independent evidence produced by the opposite party to prove that the deceased actually committed suicide by jumped into the water. From the evidence produced by the complainant we are of opinion that the death occurred when the deceased accidently felt into the water and got drowned. Therefore, his death was definitely covered by the policy under Special Contingency Insurance Policy. Therefore the opposite party was under a contractual obligation to pay sum of Rs.2 lakhs to the complainants. The reported decisions in 2014 CPJ Volume IV page No.46 and 126 also applicable in this case.
In the result, complaint is allowed. The third opposite party is directed to pay Rs.2,00,000/- (Rupees two lakhs only) with 9% interest to the complainant from the date of filing the complaint till realization. The third opposite party is further directed to pay Rs.3000/- (Rupees three thousand only) and Rs.2000/- (Rupees two thousand only) towards costs of this proceedings to the complainant.
Dictated to the Confidential Assistant transcribed by her corrected by me and pronounced in open Forum on this the 29th day of September, 2015.
Sd/- Smt. Elizabeth George (President) :
Sd/- Sri. Antony Xavier (Member) :
Sd/- Smt.Jasmine.D. (Member) :
Appendix:-
Evidence of the complainant:-
PW1 - Sheeba (Witness)
PW2 - Sreejith (Witness)
PW3 - Kishorkumar.C. (Witness)
Ext.A1 - Attested copy of FIR and FIS
Ext.A2 - Attested copy of Final Report
Ext.A3 - Attested copy of Postmortem report
Ext.A4 - Attested copy of Inquest report
Ext.A5 - Attested copy of Re-report of Alappuzha North Police Station
Ext.A6 - Attested copy of death certificate
Ext.A7 - True copy of Application for RDO dtd. 22.9.2012
Ext.A8 - True copy of Report of Mannancherry Village Officer dated 24.9.12
Ext.A9 - True copy of News Paper cuttings.
Ext.A10 - True copy of Legal Notice dated 13.9.13 with Acknowledgement
For the Hon’ble District Collector, Alappuzha
Ext.A11 - True copy of legal notice dated 13.9.13 with Acknowledgement for
the Hon’ble RDO., Alappuzha
Ext.A12 - True copy of the Legal notice dated 13.9.13 with acknowledgement for
The Divisional Manager, United India Insurance Co. Ltd., Alappuzha
Evidence of the opposite parties:-
RW1 - Bindhu (Witness)
Ext.B1 - Special Contingency Insurance Policy
Ext.B1(a),(b) & (c )- Personal Accident Policy
Ext.B2 - Copy of the letter dated 9.11.12
Ext.B3 - Copy of the First Information Report
Ext.B4 - Copy of the Postmortem Report
Ext.B5 - Copy of the reply notice dated 5.9.13
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite parties/S.F.
Typed by:- pr/-
Compared by:-
