IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Tuesday the 29th day of September, 2015
Filed on 19.11.2013
Present
- Smt. Elizabeth George (President)
- Sri. Antony Xavier (Member)
- Smt.Jasmine.D. (Member)
in
C.C.No.351/2013
between
Complainant:- Opposite Party:-
Smt. Sheeba, W/o Bhasi United India Insurance Co. Ltd.
Kanichukadu House Represented by its Divisional
Mannancherry P.O. Manager, Divisional Office
Alappuzha Sarada Shopping Complex
(By Adv. James Chacko) 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:-
On 11.8.2012, the complainant’s only son Varun. B. went to see Nehru Trophy Boat Race at Punnamada Lake with valid ticket to view 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 the Finishing Point Water Spot itself. The Alappzuha North Police has registered a case as Crime No.752/12 and Postmortem was also conducted and final report also submitted to the Hon’ble Court on 20.9.2012 in which accidental death due to drowning was confirmed. After the accidental death of complainant’s son, Varun.B. complainant duly intimated the accidental death of her son to the opposite party – the insurance company. On 10.9.2012, the complainant duly lodged claim form with all police documents needed for sanctioning the legally entitled amount of Rs.1 lakh as compensation as per terms and conditions of the said policy. But unfortunately on 9.11.2012 the opposite party repudiated valid claim of complainant by sending repudiation letter denying legally assured amount without any valid reasons. The act of the opposite party in repudiating the legally entitled claim amount as compensation to the complainant is quite illegal, unauthorized and against settled Principles of Law and hence the complaint is filed.
2. The version of the opposite party is as follows:-
The Special Contingency Insurance Policy to Varun.B. for the period from 25.7.2012 to 24.7.2013 with the conditions applicable to personal accident policy covering against death and permanent disability due to accident. The claim of the complainant was that her 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 hthis opposite party thus the complaint is liable to be dismissed
4. The complainant was examined as PW1. The documents produced were marked as Exts.A1 to A7. Two witnesses were examined as PW2 and PW3. The opposite party was examined in the connected case CC/No.356/2013 and produced 2 documents in this case which were marked as Exts.B1 and B2.
5. The points for consideration are:-
- Whether there is any deficiency in service on the part of the opposite party?
- If so the reliefs and costs?
6. It is an admitted fact that the opposite party had issued a Special Contingency Insurance Policy to Varun.B. for the period from 25.7.2012 to 24.7.2013. According to the complainant, her son Varun died due to accident by falling into the river and drowning. But opposite party repudiated the claim stating that the deceased voluntarily jumped into the river and drowned which is a self inflicted suicide and hence as per the policy condition exceptions clause 5 the company is not liable to pay any amount. Therefore the only question which arises for our considered issue in this complaint is as to whether the death of the deceased Varun took place accidental or not. Complainant has produced some documents which marked as Exts.A1 to A7. In Ext.A1 - FIR & FIS, police reported that the deceased voluntarily jumped into the river and drowned and that caused the death. Ext.A5 is the re-report submitted by Police Inspector, Alappuzha North Police Station. In Ext.A5, he specifically stated that Varun fell into water accidently. It was not challenged by the opposite party. Moreover PW2, PW3 the witnesses who were with the Varun for watching the Nehru Trophy Boat Race categorically stated before the Forum 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 fell 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.1,00,000/- to the complainant, she being the assignee under the policy without any deduction. 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 opposite party is directed to pay Rs.1,00,000/- (Rupees one lakh only) with 9% interest to the complainant from the date of filing the complaint till realization. The opposite party is further directed to pay Rs.3000/- (Rupees three thousand only) towards compensation 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 - True copy of FIR and FIS
Ext.A2 - True copy of Final Report
Ext.A3 - True copy of Postmortem report
Ext.A4 - True copy of Inquest report
Ext.A5 - True copy of Re-report of Alappuzha North Police Station
Ext.A6 - True copy of Special Contingency Policy
Ext.A7 - True copy of death certificate
Evidence of the opposite parties:-
RW1 - Bindhu (Witness)
Ext.B1 - Special contingency Insurance Policy
Ext.B2 - Personal Accident Policy (Individual)
// True Copy //
By Order
Senior Superintendent
Typed by:- pr/-
Compared by:-
