STATE CONSUMER DISPUTES REDRESSAL COMMISSION

BIHAR, PATNA

(Appeal No.339 of 2015)

National Insurance

Company, Kolkata & Patna.                                                                               Appellant.   

VERSUS

Amar Kumar,

S/O- Shri  Moti Lal Singh,

R/O- Vill- Bhangabha,

P.O.- Bariyarpur,

P.S.- Sakara,

District- Muzaffarpur & another.

                                                                                                     Respondents.            

BEFORE,

                                Hon’ble Mr. Justice S.K.Sinha, President,

                                Hon’ble Sri Upendra Jha, ADM(Rtd), Member and

                                 Hon’ble Smt. Renu Sinha, member (F)

ORDER

 02.02.2017

Upendra Jha Member.

                           This appeal is  against the order dated 08.04.2015 passed by the District Forum, Muzaffarpur in complaint case no. 42 of 2009 by which the appellant are directed to pay  Rs. 1,00,000/-  with 9% interest and Rs. 10,000/- by way of litigation cost within 30 days failing which 9% interest will be payable.

 2.                   Shortly, the case is that the complainant had obtained an Insurance Policy through  respondent G.T.F.S for Rs. 1,00,000/- from the appellant O.P. During  the insurance period life  assured injured on 24.05.2005 due to  an accident in toy factory in Delhi. F.I.R was lodged  in local  police . The  Insurance  company and G.T.F.S.  were informed claimed was find but the  claim was not settled. It was repudiated vide letter dated 17.02.2009. Then, this complainant filed a complaint before the District Forum. The appellant Insurance company could not contest the case there. After hearing parties the District Forum passed the impugned  order against which this appeal is preferred.    

3.        Despite notices, one could appear on behalf of the respondent - complainant. The appellant has filed written notes of arguments. Heard.  

4.        The District Forum holding deficiency in service on the part of the opposite party – appellant for non- payment of  Insurance  amount has allowed the  claim and passed the impugned order.

5.        The counsel for the appellant submits that the under benefit of insured. Column 2.8 specifically mentioned  that  50% compensation  of insured amount  is payable on physical  separation of one entire  hand but the District Forum has allowed 100% compensation  beyond the terms and condition  of the policy. Only 4 fingers of left hand was  separated. It cannot be considered  as amputation of entire  hand.  Hence, the District Forum order is not sustainable. It is fit to be set aside . The appeal be allowed.

6.                   Having considered the submission of opposite party  Insurance  company and on perusal of the order passed  by the District Forum it appears that the District Forum has not considered the terms and conditions printed  on the back  side of the policy Bond. Under column 2.8 of Head benefit, actual loss by physical separation of one entire hand 50% sum insured is payable.  But the District Forum has allowed 100% of the sum assured. It  is not sustainable. However, non-payment of payable of admissible amount to the complainant is deficiency in service on the part of the opposite party  - appellant and the complainant  respondent is entitled to set this benefits.  Hence,  we allowed Rs. 50,000/- as sum assured against Rs. 1,00,000/- (One lacs only)  awarded by the District Forum with 7% interest  from the date of filing  complaint. Compensation and litigation cost together Rs. 10,000/-. The  appellant is directed to pay the above amount within 60 days from the date of receipt of this order failing which 10% P.A.  interest will be payable.

           The District Forum order is modified and the appeal is partly allowed. Let a copy of this order be sent to parties free of cost.

S.K. Sinha                             Renu Sinha                                        Upendra Jha

President                              Member(F)                                         Member(M)

        Mukund