State Consumer Disputes Redressal Commission
Oriental Insurance Co. Ltd., vs A. Rema W/O Late V.V. Sreenivasan, on 29 September, 2010
Daily Order
First Appeal No. A/09/29
(Arisen out of order dated in Case No. of District Kannur)
Oriental Insurance Company Ltd
Vs.
Rema & Others
BEFORE :
HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU
, PRESIDENT PRESENT:
None for the Appellant None for the Respondent Dated the 29 September 2010 ORDER Disposed as Dismissed KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM.APPEAL No. 29/2009
JUDGMENT DATED: 29-09-2010 PRESENT:
JUSTICE SHRI. K.R. UDAYABHANU : PRESIDENT APPELLANTS Oriental Insurance Co. Ltd., Represented by its Divisional Manager, Divisional Office No 2 St. Mary Villa, Ulloor, Thiruvananthapuram. (Rep. by Adv. Sri. Varkala B. Ravikumar) Vs RESPONDENTS 1. A. Rema W/o Late V.V. Sreenivasan, Vydyar Veettil, Thayyil, Kannur. 2. Reshma D/o Late V.V. Sreenivasan, aged 19 years -do- -do- (Represented by her mother the 1st respondent) 3. Rohith, S/o Late V.V. Sreenivasan, -do- -do- (Represented by his mother the 1st respondent) 4. Chairperson, Matsyafed, Matsyabhavan P.B. No. 821, Kowdiar P.O., Thiruvananthapuram. (R1 to R3 rep. by Adv. Sri. B.A. Krishnakumar) (R4 rep. by Adv. Sri. Vijayamohanan & others) JUDGMENT JUSTICE SHRI. K.R. UDAYABHANU: PRESIDENT
The appellants are the 3rd opposite party/Insurance Company in OP No. 131/2004 in the file of CDRF, Kannur. The appellants including the first opposite party are under orders to pay a sum of Rs. 1,50,000/- with interest at 8% per annum from the date of the order and also Rs. 500/- towards costs to the complainant.
2. The complainants and the legal representatives of the deceased Sreenivasan who was covered by the Master Policy with respect to accidents and issued by the 3rd opposite party through the first opposite party. The deceased was a fisherman who was a member of the organization represented by the first opposite party. The case is that on 08-07-20003 during fishing in the high seas he fell in the boat when trying to pull the fishing net and sustained internal injury. He was brought dead to the hospital. It is stated that at the time sea was very rough and it was due to the sudden rolling of the boat that he fell. The deceased had no preexisting ailments. The claim was repudiated alleging that the death was due to myocardial infraction and that the same has nothing to do with the alleged accident. The petitioners have claimed the assured sum of Rs. 1,50,000/- and compensation of Rs. 10,000/-.
3. The first opposite party has filed version disputing the claim. It is pointed out that the FIR and the postmortem report revealed that death was due to myocardial infraction and not due to accident. The existence of policy was admitted.
4. The 3rd opposite party/appellant has also filed version contending that only accidental death is covered by the policy.
5. Evidence adduced consisted of the testimony of PWs 1 to 3, Exts. A1 to A3 and B1 to B3.
6. The Forum has held that the case of the opposite parties that myocardial infraction is only a gradually developing disease as such cannot be accepted and that the same has not been established also. It is pointed out that PW2 the doctor who conducted the postmortem examination has mentioned that the death was due to the strenuous work and the prolonged stress and strain. The Forum has also relied on the version of PW3 another fisherman who was along with the deceased in the boat. The Forum directed the opposite parties to pay the amount covered by the policy.
7. It was submitted that the first opposite party has already paid Rs.75,000/- representing half of the amount ordered to be paid by the Forum.
8. It is the contention of the appellants that the evidence would clearly indicate that death was not on account of accident. According to the opposite party the policy covered only bodily injury resulting solely and directly from accident caused by, external, violent and visible means and consequent death. It is pointed out that the post mortem report clearly rules out the possibility of an accidental death. Shock due to myocardial infraction is the opinion as to cause of death. Only an abrasion 2x1cm over the right jaw is the injury noted. The deceased was aged 48. It was also pointed out that in Ext.B3 FIR that contained the first Information Statement by one Ashraf it is mentioned that during fishing the deceased developed chest pain at about 7 am and the boat was brought to the shore at 8 am and by the time they reached the hospital the person was dead.
9. It is PW3 one Nazar who was along with the deceased in the boat who has testified with respect to the incident. PW3 has stated that during fishing the deceased fell down from the boat on account of the rough sea. He has stated that the deceased had sustained injury on the back of the head. The only suggestion in the cross examination is that he is stating falsehood. The FIS allegedly lodged by another fisherman who was not brought to the notice of PW3. PW3 was not confronted with Ext B3 FIR that contained the FIS. It is pertinent to note that no oral evidence has been adduced by the opposite parties. Ext. B3 FIR/FIS was not sought to be proved. The fact that the fall of the deceased would have precipitated myocardial infraction stands not disproved. It has also to be noted that the deceased was aged at only 48. In the absence of any direct evidence adduced by the opposite parties, we find that the claim set up by the complainants cannot be rejected on the basis of inferences alone. In the circumstances, the order of the Forum is sustained and the appeal is dismissed.
JUSTICE K.R. UDAYABHANU: PRESIDENT Sr. [HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU] PRESIDENT