KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM.

  APPEAL NO. 344/2011

JUDGMENT DATED:30-11-2011

PRESENT:

JUSTICE SHRI. K.R. UDAYABHANU              :  PRESIDENT

SHRI.S. CHANDRAMOHAN NAIR                             : MEMBER

Sujith Babu, S/o Sekharan,

124A, Pulikkunnummal House,

Valavayal Post, Poothadi,                                  : APPELLANT

Sulthan Bathery Taluk,

Wayanad District.

(By Adv:Sri.Celine Joseph)

          Vs.

The Branch Manager,

The Oriental Insurance Co. Ltd.,

Pramod Building, Terootty Road,                      : RESPONDENT

Calicut-673 001.

(By Adv:Sri.M.Manikantan Nair)

                                       JUDGMENT

JUSTICE SHRI.K.R. UDAYABHANU : PRESIDENT

The appellant is the complainant in CC.56/2010 in the file of CDRF, Wayanad.  The complaint stands dismissed.

2.      It is the case of the complainant that he had availed a two wheeler package policy along with personal accident coverage to the owner cum driver for Rs.1.lakh.  He sustained an accident on 2.11.09 which resulted in amputation of the right big toe.   He has spent Rs.40, 000/- towards treatment, for repair of the vehicle he had spent another sum of Rs.4000/-.  The accident was intimated to the opposite party but they have not responded.  Lawyer notice was issued seeking a claim form for which the opposite parties have replied raising false contentions.  The contention therein, that the opposite parties have already processed the own damage claim submitted by the complainant is incorrect.  The complainant is unaware of the appointment of the surveyor or assessment of damages.  It is not proper to insist that only on sustaining the injuries mentioned in the reply notice that the complainant will be entitled for compensation.  The complainant has sustained permanent total disablement as he has lost his right big toe. The opposite party has not sought for further details as to the bodily injury sustained.  He has sought for Rs.50,000/- towards the disability sustained and Rs.35,000/- towards treatment expenses and Rs.4000/- the amount spent for repairing the vehicle.

3.      In the version filed the opposite parties/insurance company has pointed out that as per the policy conditions the compensation with respect to the personal accident is confined to death, loss of limbs and total permanent disablement.  The accident was intimated only on 17.11.2009.  The vehicle garaged in the workshop was inspected by the surveyor, Mr.K.V.Jeevan who recommended a sum of Rs.1,088.70.  The claim was settled for a sum of Rs.1,150/- vide cheque dated:21.1.2010.  The complainant had not given any information regarding the injury to the person driving as required in column No.8 of the claim form.  It is not correct that the complainant has not submitted any claim form.

4.      The evidence adduced consisted of the testimony of PW1, Exts.A1 to A7 series, C1 and B1 to B6.

5.      The Forum has noted that Ext.B2 claim form contained the name and signature of the complainant.  The name and signatures contained in the complaint and Ext.B2 claim form on verification appeared alike.  Hence the case of the complainant that he has not submitted the claim form was disbelieved.  As per Ext.D1 policy the risk is confined to (1) death (2) loss of limbs or sight of two eyes or one limb and sight of one eye (3) Loss of one limb or sight of one eye (4) Permanent total disablement from injuries other than named above.  As per Ext.C1 disability certificate he had traumatic amputation of right big toe and the permanent disability is 6%.  Hence evidently he is not entitled for compensation as per Ext.B1 policy conditions.

6.      We find that the finding of the Forum that the signatures in Ext.B2 claim form and in the complaint appeared alike, do not call for interference.  There is no reason for the opposite parties/insurance company to forge Ext.B2, as contented by the counsel for the company.

7.      It was contended that the policy conditions were not intimated to the complainant.  There is no such pleading in the complaint.  The counsel for the appellant/complainant has relied on the decision in New India Assurance Company Limited Vs. Santhosh K.A. 2011 (II) KHC 457 (DB) wherein the High Court was held that the vision of one eye of the driver of a transport vehicle can be reckoned as permanent total disablement as contemplated in part (1) schedule (1) of Workmen’s Compensation Act, 1923. There is no scope for application of the above ratio in the instant case as the complainant has no case of permanent total disablement.   Hence the appeal is dismissed.

Office will forward the LCR along with a copy of this order to the Forum.

JUSTICE K.R. UDAYABHANU:  PRESIDENT

S. CHANDRAMOHAN NAIR : MEMBER

VL.