KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD, THIRUVANANTHPAURAM

APPEAL 826/04

JUDGMENT DATED: 21.4.2010

PRESENT

SMT.VALSALA SARANGADHARAN       : MEMBER

SRI.M.V.VISWANATHAN                         : JUDICIAL MEMBER

SRI.S.CHANDRAMOHAN NAIR               : MEMBER

National Insurance Co.Ltd.,                          : APPELLANT

Branch Office,

PB.No.89,

2^nd Floor,

Ambika Arcade,

M.G.Road,

Thrissur.

(By Adv.Saji.Isaac.K.J)

        Vs.

1. K.G.Gopalakrishnan Pillai,                        : RESPONDENTS

    Irumbanath House,

    Elampally.P.O.,

   Anicadu,

   Kottayam.

(By Adv.B.Asok)

2. The Managing Director,

    Placement Sales & Services Ltd.,

    Regd. & Admn. Office

    Regancy Centre,

    Calvary Road,

    Thrissur-4.

(By Adv.A.Y.Khalid)

3. Aravind.A,

    Manimalayil,  

    Panamattom.P.O.,

    Ponkunnam,

    Kottayam – 686 522

JUDGMENT

SRI.M.V.VISWANATHAN      : JUDICIAL MEMBER

          The appellant was the 1^st opposite party and respondents 1 to 3 were complainant and opposite parties 2 and 3 respectively in OP.262/03.  The aforesaid complaint was preferred against the opposite parties 1 to 3 alleging deficiency of service in repudiating insurance claim preferred by the complainant under the Janaseva insurance policy.  The 1^st opposite party (appellant ) filed written version justifying their action in repudiating the insurance claim preferred by the complainant.  It was contended that the left lower limb of the complainant/insured was amputated because of the pre existing disease of diabetes.  1^st opposite party had also taken the contention that the Forum below had no jurisdiction to entertain the complaint.  The other opposite parties also filed version denying the alleged deficiency of service on their part.

          2. Before  Forum below A1 to A14 documents were marked on the side of the complainant and B1 to B7 documents on the side of the 1^st opposite party.  On an appreciation of the evidence on record, the Forum below passed the impugned order directing  the 1^st opposite party insurance company to pay an amount of Rs.79000/-  with interest at the rate 9% per annum from the date of the claim application till payment.  The 1^st opposite party was also directed to pay cost of Rs.1000- to the complainant.  Aggrieved by the said order the present appeal is preferred by the 1^st opposite party therein.

          3. We heard the learned counsel for the appellant/1^st opposite party.  There was no representation for respondents 1 to 3(complainant and opposite parties 2 and 3).  The learned counsel for the appellant/1^st opposite party  vehemently argued for the position that the complainant  in OP.262/03 was not entitled to  get the insurance claim because of the fact that he was  chronic diabetic patient and that the injury to the left lower limb resulted in amputation   only because of the pre existing disease of diabetes.  He also argued for the position that the Forum below had no jurisdiction to entertain the complaint as the 1^st opposite party/Insurance Company was functioning at Thrissur and the 2^nd opposite party who canvassed for the 1^st opposite party/Insurance company was also situated at Thrissur.  The appellants denied the case of the complainant that the 3^rd opposite party was an agent of the 1^st opposite party.  Thus, the appellants prayed for setting aside the impugned order dated 19.7.04 passed by CDRF, Kottayam in OP.262/3.

          4. The points that arise for consideration are:-

1)     Whether there was any deficiency of service on the part of he appellant/1^st opposite party in repudiating the insurance claim putforward by the complainant in Op.262/03?

2)     Is there any sustainable ground to interfere with the impugned order passed by the Forum below?

5. Points 1 and 2:-

There is no dispute that the complainant(1^st respondent)   was insured under the  Janaseva insurance policy and B1 insurance policy was issued by the 1^st opposite party insuring the complainant under the said scheme.  Admittedly during the existence of B1 policy the complainant/insured sustained an injury to his left lower limb while working  in the agricultural field.  It is also an admitted fact that the said injury ultimately resulted in amputation  of the left lower limb.  The medical records available on record would make it abundantly clear that the complainant was treated for the said injury which was infected and later on  amputated from the hospital.  It would also show that the complainant was inpatient in the hospital for a period of 2 months.  The mere fact that the complainant was a diabetic patient  cannot be taken as a ground of  hold that the amputation of the left lower limb was resulted only due to that diabetes.  It is further to be noted that the opposite party has not adduced any medical evidence to substantiate their contention that the amputation was resulted due to the diabetes.  There can be no doubt that the injury  to the lower limb was caused due to the external violent   and visible means and that the said injury was infected which resulted in amputation of the left lower limb.  The materials on record would make it crystal clear that the complainant was entitled to get the benefit under the B1 insurance policy namely Janaseva Insurance policy.

6. There is no dispute that on loss of one limb, the insured is entitled  to get insurance benefit of Rs.75000/-.  He was also entitled to get weekly compensation of Rs.500/- per week.  So, the complainant can be awarded a sum of Rs.4000/-  by way of weekly compensation.  Thus, the Forum below is perfectly justified in awarding compensation of Rs.79000/- to the complainant with interest at the rate of 9% per annum from the date of claim application till payment.  The cost of Rs.1000/- ordered by Forum below can also be treated as just and reasonable.

7.Admittedly the complainant was a resident of Kottayam district and he was covered under the Janaseva insurance policy.  He met with the aforesaid  accident while he was engaged in his work at Ponkunnam within the territorial jurisdiction of CDRF, Kottayam.  So, the present claim is based on the said injury sustained by the complainant while he was working within the territorial jurisdiction, CDRF, Kottayam. Thus, part of the cause of action has arisen with in the territorial jurisdiction of CDRF, Kottayam.  The impugned order passed by the Forum below can be upheld.  These points are answered accordingly.

In the result the appeal is dismissed.  The impugned order dated 19.7.04 passed by CDRF, Kottayam in OP262/03 is confirmed.  As far as the present appeal is concerned there will be no order as to costs.

          SRI.M.V.VISWANATHAN                         : JUDICIAL MEMBER

          SMT.VALSALA SARANGADHARAN       : MEMBER

          SRI.S.CHANDRAMOHAN NAIR               : MEMBER

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