State Consumer Disputes Redressal Commission
National Insurance Co.Ltd., vs Ramani Tnankappan on 30 December, 2011
Daily Order
Kerala State Consumer Disputes Redressal Commission Vazhuthacaud,Thiruvananthapuram First Appeal No. A/11/309 (Arisen out of Order Dated 25/02/2011 in Case No. CC/02/151 of District Ernakulam) 1. NATIONAL INSURANCE CO. POST BOX NO.89.AMBIKA ASCADE,M.G.ROAD TRISSUR KERALA ...........Appellant(s) Versus 1. RAMANI THANKAPPAN M.N.THANKAPPAN,MEKKANDATHIL HOUSE,MANNARUVELIL,ARYANKAVU ERNAKULAM KERALA ...........Respondent(s) BEFORE: HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU PRESIDENT PRESENT: ORDER
KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD, THIURVANANTHAPURAM
FIRST APPEAL 309/2011
JUDGMENT DATED: 30..12..2011
PRESENT
JUSTICE SRI.K.R.UDAYABHANU : PRESIDENT
National Insurance Co.Ltd., :APPELLANT
Post Box.No.89 Ambika Ascade
M.G.Road Thrissur, 680001
Rep.by its Divisional Manager
National Insurance Co.Ltd.,
Divisional Office,
St.Joseph's Press Building,
Vazhuthacad, Thiruvananthapuram
(By Adv.M.Nizamudeen)
Vs.
1. Ramani Tnankappan, : RESPONDENTS
W/o late M.N.Thankappan
Mekkandathil House,
Mannaruvelil,
Keechery, Kulayttikkara.P.O.,
Aryankavu, Ernakulam district.
2. Sandhya, D/o late M.N.thankappan,
-do-do-
3. Savithamol D/o late M.N.thankappan,
-do-do-
4. Sanithamol D/o late M.N.thankappan,
-do-do-
(By Adv.C.S.Rajmohan - Amicuscuriae)
5. Regional Executive,
Fisherman Welfare Board
(Matsya Board) Ernakulam
6. The District Officer,
Matsyafed Thoppumpady, Cochin-15
(By Adv.Shyamkrishnan, counsel for 6th respt.)
JUDGMENT
JUSTICE SRI.K.R.UDAYABHANU : PRESIDENT The appellants are the 3rd opposite party/Insurance company in OP.151/02 in the file of CDRF, Ernakulam. The appellants are under orders to pay the assured sum of Rs.2,50,000/- with interest at 9% from the date of complaint. The 2nd opposite party/Matsyafed has been permitted to realize Rs.20000/- paid to the 1st complainant as and when the insurer pays the amount.
2. the case of the complainants who are the legal heirs/wife and children of the deceased, M.N.Thankappan a fisherman by profession is that his life was covered by 2 insurance policies with the 3rd opposite party/appellant. As per the personal accident insurance policy the coverage was Rs.1,00,000/- and as per Janatha Accident Insurance policy the coverage was Rs.1,50,000/-. The deceased died while fishing. The claim was rejected on the ground that the death was not accidental and that it was due to myocardial infraction which is not correct.
3. The 2nd opposite party/Matsyafed has filed version mentioning that the deceased was a member of Keecheri Inland fishermen Development co-operative Society Ltd. and that Matsyafed had availed an insurance scheme for fishermen who are members of the society. As per the scheme a member fishermen has to remit Rs.15/- as yearly premium and the sum assured is Rs.1.5 lakhs.
4. In the version filed by the 3rd opposite party insurer the repudiation is justified on the ground that the death was due to myocardial infraction and not due to accident. The existence of the janatha personal accident policy is denied.
5. The evidence adduced consisted of the testimony of PWs 1 and 2; Exts.A1 to A8 and Exts.B1 to B10.
6.We find that Ext.B8 and B9 produced by the opposite parties would show that the fishermen were covered by 2 policies - one for Rs.1,00,000/- and the other for Rs.1,50,000/-. Ext.B8 policy for 1,00,000/- is admitted, Ext.B9 is disputed on the ground there is nothing to show that the deceased had remitted premium at the rate of Rs.15/-. The 2nd opposite party/Matsyafed has supported the case of the complainants. It can be seen from the schedule attached to Ext.B9 that the coverage is for Fishermen who are various affiliated societies of the apex body of Matsyafed provided that such members are on the rolls of the society. As noted by the Forum Ext.B5 certificate issued by the Secretary of the society would show that the deceased was a member of the society. The premium in bulk has been remitted which is evident from Ext.B3,B6 and B10. Ext.B7 is the admission register of the society wherein the register number of the deceased as to his membership is 75/96. The appellants/insurer also could not produce anything to show that such and such persons alone had paid the premium. In the circumstances we find that the conclusion of the Forum that the complainant was covered by the Janatha Accident Insurance policy for Rs.1,50,000/- do not call for interference.
7. The contention that the deceased died due to myocardial infraction and not due to accident appears absurd in view of the fact that is evident from the documents produced and the testimony of PW2 an eye witness that while fishing he fell down from the boat and his legs got entangled in the fishing net and was brought dead at the hospital. We find that the Forum has elaborately discussed this part of the evidence as well as the decisions on the point and found that the deceased had an accidental death. The finding of the Forum we find is absolutely correct. In the circumstances we find that no interference in the order of the Forum is called for. The order of the Forum is sustained. The appeal is dismissed. The opposite parties/insurer/appellant will make the payment within three months from the date of receipt of this order failing which the complainants will be entitled for interest at 12% from 30.12.2011 the date of this order.
8. Hence the appeal is dismissed.
The office will forward the LCR to the Forum along with a copy of this order.
JUSTICE K.R.UDAYABHANU : PRESIDENT
ps
[HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU] PRESIDENT