IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA 

Thursday  the 30th   day of  November, 2017

Filed on .01.2015 

Present

1. Smt. Elizabeth George (President)

2. Sri. Antony Xavier (Member)

3. Smt. Jasmine D (Member) 

in

CC/No.206/2015

 Between

         Complainants:- Opposite party:-

 

Sri. A.V. Babu               The Manager

S/o A.K.Vasu                                     United India Insurance Co.ltd

Anjuthayyil House, Kommady Divisional Office

Thumpoly.P.O, Alappuzha Sarada Complex, Mullackal

Alappuzha- 688 011

(Adv. Hemalatha)

Saumini

W/o Late Manikkuttan

515(4/456) Chiratharachira

Kainakary Panchayath

Chennamkary, Kainakary

Alappuzha-688 501

(Adv. Suprabha Shenoy)

 

O R D E R

SMT. ELIZABETH GEORGE (PRESIDENT)

 

The case of the complainant is as follows:-

Complainant is the owner of the House Boat “Minar De Lake.”  The complainant insured the House Boat with the opposite party under the Policy No. 101500/46/14/37/00000418 from 31/10/2014 to 30/10/2015.  The complainant exclusively used the House boat for earning the lively hood for himself and his family members.  The service availed by the complainant from the opposite parties were only for purposes other than commercial activity.  The 2nd complainant Saumini, W/o Late Manikuttan, a beneficiary of the Opposite party’s Insurance Policy.  The spouse of the 2nd complainant during the course of the employment with 1st complainant succumbed to the injuries from downing, whose life was assured by the Opposite party.  The deceased was working as an employee with the 1st complainant for more than a year before his death.   The complainant lodged a death claim compensation for the accidental falling of 2nd complainant’s Husband Sri. Manikuttan in to the lake water, who was cook in the House Boat.   At the material time of the accident the deceased was proceeding to the kitchen of the House Boat & accidently slipped in to lake water.  The accident happened on 14/11/2014 at about 14.30.hrs during the voyage.  When the vessel/ House boat reached north of Rainbow Jetty there was violent natural disturbances- wing and its consequences the deceased accidentally slipped in to the lake water.  Immediately, all the occupants including other crews shouted loudly and the vessel stopped to save the life of the deceased. But all the attempts were in vain.  The accident was informed before the Police and Fire force without fault.  But lastly the deceased succumbed to drowning injuries.  The dead body of the deceased was subjected to post-mortem examination on 15/11/2014 at T.D.Medical College , Alleppy.  1st complainant submitted written intimation to the opposite party.  But there was no response from the opposite party to settle the claim so far.  The opposite party is liable to compensate the insured, insured  persons and Public.  Opposite party breached the insurance contract by not providing timely claim settlement.  Alleging deficiency in service on the part of the opposite party the complaint is filed.

2. Version of the opposite party is as follows:-

This opposite party issued a “Public Liability Non Industrial Risk” Policy to the 1st complainant for Rs. 10,00,000/- covering “public liability arising during the cruise of house boat, Minar de lake 1.”  Employee of the insured are not covered under the policy.  The deceased was an employee of the insured and so he is not covered under the policy.  So this opposite party is not liable to indemnify the insured to the death of the deceased.  There is no deficiency in service on the part of this opposite party.

 Complainant was examined as PW1, documents produced from the part of the complainant were marked as Ext.A1 to A14.  Were examined 3 witnesses from the part of the complainant as PW2 to PW4.

The points came up for considerations are:-  

Whether there is any deficiency in service on the part of the opposite party?

If so the reliefs and costs?

It is an admitted fact that the opposite party issued “Public Liability Non Industrial Risk” policy to the 1st complainant  for  rupees Ten lakh covering “Public Liability arising during the cruise of House Boat “MINAR DE LAKE 1”, .  In the complaint it is stated that the spouse of the  2nd complainant during the course of employment with the 1st complainant succumbed to the injuries from drowning.   The complaint is filed against the nonsettlement of the insurance benefit under the policy.  The opposite party filed version stating that the employee of the insured are not covered under the policy.  The 1st question to be answered is whether the employee of the insured was covered under the policy.  The policy copy produced by the opposite party marked as Ext.B1.  In page No. 2 of the policy it is seen that the sum insured rupees Ten lakh for the Public Liability of House Boat, MINAR DE LAKE 1.  According to the 1st complainant on 14/11/2014 while deceased was working as an employee under him at about 14.30 hrs. during the  voyage there was violent natural distarbances and he accidently slipped in the lake water and that caused the death.  The 1st complainant was examined as PW1. While cross examing him, he stated that Ext.A11 was issued by him.  Ext.A11 shows that deceased Manikkuttan was the employee since 15th July 2014 as a cook.  One witness was examined as PW2 also stated that he was working with deceased Manikuttan during the time of  the accident in the House Boat owned by the 1st complainant.  Ext. A8 is the FIR and Ext.A9 is the copy of Final report.  Ext.A8 and Ext.A9 also prove that  the deceased was an employee of the 1st complainant and he fell down from the House Boat due to the consequences of  heavy wind and  fury  climate  and he died due to drowning.   From the evidence of record, we are of opinion that the deceased was an employee of the boat owned by the 1st complainant and he fell down from the boat during voyage and the death was due to drowning.   The contention of the  opposite party that  as per the clause 8.14 of the policy, it does not cover  liability for claims arising out of injury to any person under  the contract of employment or apprenticeship  with the insured when such injury arising out of  the  execution of such contract.   As per the policy the injury means death, bodily injury illness or disease of or to any person.    In the instant case the employer deposed before the Forum that the deceased was an employee and he was working from July 2014 till the time of death.    In clause No. 4.1 of the policy it is stated that  “the indemnity granted extends to the officials of the insured in their business capacity arising out of the performance of their business or in their private capacity arising out of  their temporary  engagement of the insured’s employees”. The injured was one of the crew members of the house boat who was more or less an official of the insured in the business of running the house boat.  ”  In the decision “2004 CCC13(NS) Hon’ble Supreme Court lay down that  if there is any ambiguity  or a term is capable of two possible interpretations  one beneficial to the insured should be  accepted consistent with the purpose for which the policy  is taken, namely to cover the risk on the happening of certain event.”     So the clause 8.14 of the Ext.B1 policy is not applicable in this case.  Ext.A2 shows that the 1st complainant lodged a written intimation letter of accident to the opposite party.   PW4 the Sub Post master deposed before Forum that he delivered Ext.A2 letter to the opposite in time.   From the above discussion we are of opinion that the repudiation of the claim by the opposite party amounts to defect & deficiency in service.   The legal heirs of deceased are entitled to get the policy benefits from the opposite party. As per the policy the insurance amount limited to Rs. 10,00,000/-    

In the result the complaint is allowed, opposite party is directed to pay Rs. 10,00,000/- (Rupees Ten lakh only)  to the   legal heirs of  deceased manikuttan with 8%  interest from the date of  order till realization . Opposite party further directed to pay Rs. 2000/-(Rupees Two thousand only) cost of proceedings,  Since primary relief is granted no further amount granted as to compensation.

Dictated to the   Confidential   Assistant   transcribed   by   him   corrected by me and pronounced in open Forum on this the 30th    day of November, 2017.                                               Sd/- Smt. Elizabeth George (President):

Sd/-Sri. Antony Xavier (Member) :

                                                                           Sd/- Smt. Jasmine.D.  (Member) :

Appendix:-

Evidence of the complainant:-

 

PW1 - A.V. Babu (Witness)

PW2 - Soumini manikuttan(Witness)

PW3 - Stansil Rose  [Boss](Witness)

PW4 - Anumod kumar(Witness)

Ext.A1 - Copy of Insurance policy

Ext.A2 - Copy of claim intimation

Ext.A3 - Copy of documents submitted

Ext.A4  - Copy of letter issued by 2nd complainant

Ext.A5 - Post-mortem  Certificate

Ext.A6 - Copy of Death certificate

Ext.A7 - Family membership certificate

Ext.A8 - Copy of FIR

Ext.A9 - Copy of Admission Register

Ext.A10 - Employment certificate

Ext.A11 - Certificate of Registration

Ext.A12 - Certificate of Registration  

Ext.A13 - News paper cuttings

Ext.A14 - Delivery Slip

Evidence of the opposite parties:-  Nil

  Ext.B1 - Copy of Policy and Conditions  

 

 

// True Copy //                               

By Order                                                                                                  

 

 

 

                         Senior Superintendent

To

         Complainant/Opposite party/S.F.

 

Typed by:- br/-  

Compared by:-