The case of complainant is that the complainant was a worker in Kerala Chemicals and Proteins Limited, Kathikudam. He joined a policy with the respondent Company vide policy No.100602/42/07/01/00000686. The period of the policy was from 8.9.07 to 7.9.08. On 19.9.07 while the complainant was riding on his vehicle it was met with an accident and he has lost the vision of his right eye. The Koratty Police registered a crime No.347/07 against the accused under Sections 278 and 338 of I.P.C. Subsequently the complainant submitted application for claim before the respondent Company. As per the demand of the respondent the complainant was examined by the Medical Board constituted by District Hospital, Thrissur and certified that permanent disability of 30%. Dr. K.C. Joseph certified that he has no vision to right eye. So due to the accident the complainant has lost the sight of his right eye. So he is entitled for 50% of the capital sum insured. But the respondent Company allowed only Rs.42,000/- by stating that his disability belongs to the mild category. It is not so and the sight of right eye completely lost and the complainant is entitled for a claim of Rs.1,00,000/-. Hence this complaint.

 

            2. The respondent is called absent and set exparte.

 

            3. The complainant filed affidavit and Exts. P1 to P8 to substantiate his case. 

 

            4. According to the complainant, his vision of right eye completely lost. He produced Ext. P1 issued by one Dr. K.C. Joseph. He stated in the certificate that no vision to right eye (No PL). So the complainant stated that he is entitled for 50% of the capital sum assured. The capital sum is Rs.2,00,000/- and if he has permanent total disability he will be entitled for Rs.1,00,000/-. In Ext. P1 it is also stated that the complainant has a permanent visual disability of 40%. So as per Ext. P1 he has no permanent total disability. Ext. P5 is the copy of Standing Disability Assessment Board Certificate issued from District Hospital, Thrissur. It shows that the complainant has permanent disability of 30% and it belongs to mild category. In Ext. P5 it is also stated that if there is disability of more than 40%, it belongs to moderate category. There is no mentioning about this and the disability comes under 50%. In Ext. P5 it is also stated that in order to belong to total disability the percentage is 100. In the present case the complainant has disability of 30% as per Ext. P5 and 40% as per Ext. P1. So it cannot be said that he has total disability of 50%. So the complainant is not entitled for Rs.1,00,000/- as claimed by him. In the complaint it is stated that the company allowed Rs.42,000/-. But there is no document to show that the amount is accepted by the complainant. From the records it can be seen that he has permanent disability of 30%. So he is entitled for an amount of Rs.42,000/- which is offered by the Company and is seen genuine. If the amount is accepted by the complainant, he is not entitled for any further amount.

 

            5. In the result, the complaint is partly allowed and the respondent Company is directed to pay an amount of Rs.42,000/- (Rupees forty two thousand only) within one month. If this amount is already paid, there is no need to further payment. No order as to costs and compensation.