Orissa

StateCommission

A/346/2017

Anup Kumar Patro - Complainant(s)

Versus

Divisional Manager, United India Insurance Co. Ltd. - Opp.Party(s)

M/s. R.K. Pattnaik & Assoc.

25 Jan 2023

ORDER

IN THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION
ODISHA, CUTTACK
 
First Appeal No. A/346/2017
( Date of Filing : 07 Jul 2017 )
(Arisen out of Order Dated 21/06/2017 in Case No. Complaint Case No. CC/17/2016 of District Koraput)
 
1. Anup Kumar Patro
S/o- Late Bala Krushna Patro, Sriram Nagar, Last Line Parabeda, Jeypore
Koraput.
...........Appellant(s)
Versus
1. Divisional Manager, United India Insurance Co. Ltd.
Divisional Office 4, 2nd Floor, Posneti Bhavan, Hyderabad-500001, Telengana.
2. The Branch Manager, Andhra Bank
Govt. Polttechnic Ext, Kancharapalem, Visakhpatnam-530007, Andhra Pradesh.
3. The Chairman,
District Medical Board, Care of Office of the CDMO, Koraput-764020
Koraput
Odisha
...........Respondent(s)
 
BEFORE: 
 HON'BLE MR. JUSTICE Dr. D.P. Choudhury PRESIDENT
 HON'BLE MR. Pramode Kumar Prusty. MEMBER
 HON'BLE MS. Sudhiralaxmi Pattnaik MEMBER
 
PRESENT:M/s. R.K. Pattnaik & Assoc., Advocate for the Appellant 1
 M/s. A.K. Mishra & Assoc., Advocate for the Respondent 1
Dated : 25 Jan 2023
Final Order / Judgement

   Heard learned counsel for the appellant. None appears for the respondent.

2.              This appeal is  filed  U/S-15 of erstwhile  Consumer Protection Act,1986(herein-after called the Act). Hereinafter, the parties to this appeal shall be referred to  with reference to their respective status before the learned District Forum.

3.                   The case     of the complainant, in nutshell  is that  complainant   had opened an account under AGOGP Scheme with OP No.2. Complainant has also purchased  a  policy from OP No.1 on payment of Rs.45/- per person per annum. It is alleged inter-alia that on 18.08.2014 the complainant met accident  for which there was  multiple fracture. He has undergone complicated surgery in a private  hospital  at Visakhapatnam   and same fact was reported to Sadar PS,Koraput. It is alleged that  complainant has  furnished all documents  to OP No.2 who forwarded same to OP No.1. The  OP No.1 insisted disablement certificate  issued  by District Medical Board  and the complainant applied for said certificate  with District Medical Board but  OP No.3 did not intimate anything. It is further  submitted that the complainant  on 17.11.2015 submitted another application before the CDMO and basing on that  the OP No.3 issued a letter mentioning 25 % disability. The complainant submitted the said letter with OP No.1  but no action has been taken by it. Hence, the complaint  was filed.

4.            The  OP  No.1    filed written version denying all the allegations  and contended that the present case is  falling under the jurisdiction of MACT and hence the case is not maintainable under this Act. It is stated by the OP No.1  that after survey they have repudiated the case of the complainant on 13.01.2016. Therefore, they have no deficiency in service on their part.  

5.                     OP No.2 filed  written version denying the allegations  and  submitted that  the duty of OP No.2   is to forward insurance claim  with related documents to OP No.1, who is to scrutinize same to settle the claim  but for OP No.2 he has no deficiency in service on their part.

6.              OP No.3  filed written version denying all the allegations. According to him the complainant  was brought   to  the DHH,Koraput as an outdoor patient  and he was admitted in special cabin as an indoor patient. After necessary treatment, the complainant was referred to MKCG  Medical  College & Hospital,Berhampur for further treatment. Thereafter the complainant  was shifted   to Visakhapatnam  for treatment. It is further averred that the complainant registered his name  through online and appeared  in person before the District Medical Board,Koraput  who found complainant disabled  to the extent  of 25 % only. The complainant requested the medical board  to give  the certificate of disability for 40 %  but  the medical board did not agree. Thus, there is no deficiency in service on the part of the OP No.3.

7.                       After hearing both the parties, learned District Forum   dismissed the complaint.

8.               Learned counsel for the appellant submitted that learned District Forum has committed error in law by not considering the written version filed by the Ops with proper perspectives. According to him   the complainant has got 25 % disability but further contended that  due to accident his foot has been reduced to 2 inches and as such the complainant getting  pain for such disability  and they have only considered the case to the extent  it is required.  Learned counsel  for appellant submitted that learned District Forum ought to have considered  that the medical certificate   of 25 % disability should be treated as permanent disability to 100 % because the complainant being   a lawyer  to the best of his ability is not discharging duty. Accordingly he is entitled  to the compensation available under the scheme. Therefore, he submitted to set-aside the impugned order by allowing the appeal.

9.                      Considered the submission  of learned counsel for the appellant, perused the DFR and impugned order.       

10.                It is admitted fact that during currency of the policy the complainant met accident and sustained loss. The medical report is clear to show that  complainant  has 25 % disability lucomoto which is partial. The scheme does not allow such type of disability for awarding any compensation.  The doctor can not be saddled with liability to enhance percentage  of the disability unless there is such  disability. Therefore, we find no error in the judgment and accordingly it is confirmed  and the appeal stands dismissed. No cost.                     

                   Free copy of the order be supplied to the respective parties or they may download same from the confonet  or website of this  Commission to treat same as copy of order received from this Commission.  

                     DFR be sent back forthwith.                                     

 
 
[HON'BLE MR. JUSTICE Dr. D.P. Choudhury]
PRESIDENT
 
 
[HON'BLE MR. Pramode Kumar Prusty.]
MEMBER
 
 
[HON'BLE MS. Sudhiralaxmi Pattnaik]
MEMBER
 

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