IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Thursday the 30th day of July 2009
Filed on 04.07.06
Present
- Sri. Jimmy Korah (President)
- Sri. K. Anirudhan (Member)
- Smt. Shajitha Beevi (Member)
in
C.C.No.154/06
between
Complainant:- Opposite Party:-
Sri.Bineesh Kumar, 1. National Insurance Co.Ltd.,
S/o Sukumaran Nair, Alappuzha,
Chandrakantham Veedu, Represented by its Branch Manager.
Ward No.VII, (By Adv.T.S.Suresh)
Punnapra South Panchayat, Allappuzha.
(By Adv.PJaichandra Babu)
O R D E R
SRI.JIMMY KORAH (PRESIDENT)
The complainant is the registered owner of the Hero Honda Motor Cycle bearing No.KL-4/R 5896. On 20th June 2005 the complainant's vehicle knocked another vehicle. The complainant sustained very serious injuries. At the time of the accident, the complainant's vehicle was holding a valid insurance with the opposite party. The complainant underwent treatment in Medical College Hospital, Alappuzha and Medical Trust Hospital, Ernakulam. The complainant had to incur an amount of Rs.1,00,000/-(Rupees One Lac) for the said treatment. The complainant intimated the details of the accident to the opposite party. In line with the instruction of the Manager of the opposite party, the complainant lodged a claim for the amount incurred for the treatment with the opposite party. The complainant is entitled to an amount of Rs.1,00,000/-(Rupees One Lac) from the opposite party. The opposite party did not take any useful steps to deliver any amount to the complainant. Aggrieved on this the complainant approached this Forum seeking compensation and other relief.
1. Notice was sent. The opposite party turned up and filed version. Amongst other contentions, the prominent one put forth by the opposite party is that as per clause III of the terms and conditions of the policy, the opposite party is liable to pay compensation only for the four categories specified therein. According to the opposite party, the injuries allegedly sustained by the complainant do not come within the four categories specified in section III. In this context, the opposite party is not liable to pay any compensation, and hence the opposite party is to be exonerated from the alleged liability with cost to the opposite party, the opposite party asserts.
2. On the side of the complainant, the complainant himself was examined as PW1 and the documents Exbts Al to A10 were marked. Exbt Al is the copy of the policy, A2 is the copy of the FIR, A3 is the police charge, A4& A5 are discharge summaries, A6 is the investigation report from the Medical Trust, A 7 is the Medical bills, A8 is the estimate, A9 is the disability certificate and A10 is the 161 statement. On the side of the opposite party the document Exbt B1 was marked. Exbt B1 is the terms and conditions of the policy.
3. Bearing in mind the contentions of the opposite parties, the questions arise for consideration are:-
(1) Whether the complainant is entitled to any amount from the opposite party?
4. The existence of the policy or the involvement of the material vehicle is obviously not in dispute. The bone of the contentions raised by the opposite party is that the injuries sustained by the complainant do not come under anyone of the nature of injuries categorized in section III of the terms and conditions of the policy which would rightly render the opposite party not liable. In this context, the short question arises for immediate consideration is whether the terms and conditions of the policy stipulates so, and if so stipulates whether the complainant sustained such nature of injuries specified in section III as afore stated. For the said purpose we perused Exbt Bl terms and conditions of the policy. Section III therein categorically categorized four characters of injuries which would render the opposite party liable to pay compensation. On a closer scrutiny of Exbt A4/A5 discharge summaries and Exbt A6 investigation report from the Medical Trust, it is visible that the injuries sustained by the complainant on the very face of it will not come under the first three segments specified in section III. The fourth one specified therein referred to permanent total disablement. As to this, it appears that the complainant has produced Exbt A9 certificate which goes to show that the complainant is suffering from 20% disability. The doctor who has issued the certificate has not been examined to prove the said document. Even the affidavit of the said doctor has not been got filed. Regarding this, the contention of the complainant is that at the time of marking the said document the opposite party did not object to the marking of the said document. There fore Exbt A9 is an admitted document, the complainant asserts. We regret we cannot accept this contention. The complainant is expected to establish his case. The success or otherwise of the complainant case does not depend on the weakness of the case of the opposite party. We are of the definite view that the case of the complainant must have its own legs to stand. For this, the complainant ought to have examined the doctor responsible for the said certificate to get the same substantiated. In this context, we have no hesitation to hold that the complaint must fail.
For the forgoing facts and findings made herein above, we hold that the complaint is liable to be dismissed and the same is dismissed. The parties are left to bear their own cost.
Pronounced in open Forum on this the 30th day of July, 2009.
Sd/-Sri. Jimmy Korah
Sd/-Sri. K. Anirudhan
Sd/-Smt. N. Shajitha Beevi
Appendix:-
Evidence of the complainant:-
PW1 - Bineesh Kumar.S(Witness)
Ext. A1 - The copy of the policy
Ext. A2 - The copy of the FIR
Ext. A3 - The Police charge
Ext. A4 - The discharge summary
Ext. A5 - The discharge summary
Ext. A6 - The investigation report from the Medical Trust
Ext. A7 - The Medical Bills
Ext. A8 - The Estimate
Ext. A9 - The Disability Certificate
Ext. A10 - The 161 Statement
Evidence of the opposite party:-
Ext. B1 - The Terms and Conditions of the Policy
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite Parties/S.F.
Typed by:- k.x/-
Compared by:-
