KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION

VAZHUTHACAD, THIRUVANANTHAPURAM

APPEAL 551/2009

JUDGMENT DATED: 1/11/2010

PRESENT

JUSTICE SRI.K.R.UDAYABHANU           : PRESIDENT

SRI.S.CHANDRAMOHAN NAIR              : MEMBER

1. The Manager,                                           : APPELLANTS

     M/s ICICI Lombard General Insurance Co.Ltd.,

     KVR Tower, Kannur-2.

2. The Manager,

    M/s ICICI Lombard General Insurance Co.Ltd.,

    Keshavarao Khadya Marg,

    Mahalaxmi, Mumbair 34.

(By Adv.Prassanna Kumar Nair)

                    Vs.

Babu Chacko,                                              : RESPONDENT

Karukappally House,

Peratta, Koottupuzha,

Kannur 670076.

(By Adv.Suja.R)

JUDGMENT

JUSTICE SRI.K.R.UDAYABHANU           : PRESIDENT

            The appellants are the opposite parties in CC.38/06 in the file of CDRF, Kannur.  The appellants are under orders to pay a sum of Rs.1,00,000/- as compensation and Rs.1000/- as cost to the complainant.

          2. It is the case of the complainant is that he was covered  with opposite parties Pravasi Bharathiya Bima Yojana policy and during the period he was employed abroad at Iraq. On 4.12.04 he sustained injuries in a bomb blast at Bagdad.  He was treated abroad and was discharged on 13.12.04 with  advice of bed rest up to 8.1.2005. On review at AI Amal Hospital, Bagdad it was detected that he sustained fracture of left tibia and fibula.  He was treated with external fixature.  He has sustained severe disability and was forced to return to India on 6.6.05.  He was admitted at Dhanalakshmi Hospital, Kannur  on 9.6.05 for removing the external fixatures and was discharged on 10.6.05 with an advice of 6 weeks rest.  He has claimed  a sum of Rs.95,000/- towards treatment expenses, Rs.80,000/- towards the loss of salary, Rs.23,000/- towards the price of the return ticket and also Rs.20,000/- towards compensation; altogether a sum of Rs.2,18,000/-.         

          3. The opposite parties/appellants have contended that only hospitalisation bills amounting to Rs.4211.65 which is with respect to the treatment in India has been produced.  It is alleged there is no permanent disability.  It was also contended that exclusion clauses with respect to the rebellion, mutiny/military occupation conditions applied.  It is also contended that the complainant has not produced any evidence to show that he was sustained permanent total disability.

          4. The evidence adduced consisted of the testimony of  PW1,DW1; Exts.A1 to A15 and Exts.B1 to B10.

          5. The complainant has testified as to the injury sustained and as to the treatment undergone.  He was retrenched from employment consequent on the injury.  He has lost employment and also incurred a sum of Rs.23000/- towards air fare.  It is seen from documents produced that he was sustained fracture to his left Tibia and Fibula at the ankle joint level.  The fracture is fixed correctly with an external   fixature.  After removal of fixature he was to start  weight bearing with the aid of two crèches for three months.  Exts.A3 and A4 the same would show that he had sustained very serious injuries. He has also produced Ext.A8 discharge card at Dhanalakshmi hospital which would show that he was an inpatient at Dhanalakshmi Hospital on 9.6.05 for removing external fixature  and he was discharged on 10.6.05.  He has also produced A14 medical bills.  Of course the complainant has not produced any permanent disability certificate as such.  Ext.A8 bill from Dhanalakshmi hospital will show that he had to pay Rs.4211.65/- for his treatment at the local hospital.  The Forum has rightly relied on the decision in Prabir Kumar Nath Vs. LIC of India 2004 ACJ 1582 wherein the High Court of Calcutta has held that the insurer should not insist for total permanent disability. Fracture of both bones at above ankle would have certainly resulted in certain amount of permanent disability.  Although the complainant has failed to produce a disability certificate as such we find no reason to disbelieve the version of PW1, complainant that he is having permanent disability.  The contention relying on the clause of exclusion with respect to the instance in a place under rebellion, mutiny/military occupation is not supported by any objective evidence.  In the circumstances we find that no interference  in the order of the Forum is called for.  The order of the Forum is sustained and the appeal is dismissed.

          The opposite party will pay the amount within 3 months from the date of receipt of this order failing which the complainant would be entitled for interest at 12% per annum from the date of the order of the Forum.

            JUSTICE SRI.K.R.UDAYABHANU           : PRESIDENT

            SRI.S.CHANDRAMOHAN NAIR              : MEMBER

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