Per Mr B A Shaikh, Hon’ble Presiding Member

1.      This appeal is filed by original opposite party against the order dtd.27.06.2014, passed by District Consumer Forum, Washim in consumer complaint bearing No.46/2012, by which the complaint has been partly allowed and direction has been given to the opposite party to pay the complainant assured sum of Rs.2.00 Lacs with interest @ 6% p.a. from 13.12.2012 till its realization by him and also to pay him compensation of Rs.5,000/- for physical & mental harassment & economic loss and cost of Rs.2,000/-.

2.      We have heard Advocate Mr W G Paunikar appearing for the original opposite party / appellant herein and Mr M A Haque for original complainant / respondent herein. We have also perused the record of the appeal.

3.      The learned advocate of the appellant argued that in the complaint the complainant has mentioned 22% injuries sustained by him, but the Forum held that the complainant sustained 40% injuries. He also argued that the terms & conditions of the policy show that the disability should be at least 40% for making claim and the expenses incurred cannot be more than 80% and the insured sum for personal accident.  Thus, according to him, the Forum has not considered the terms & conditions of the policy in right perspective and erred in partly allowing the complaint.

4.      On the other hand, the learned advocate of the respondent supported impugned order and submitted that the bills of  expenditure incurred by the complainant / respondent for hospitalization were produced before the Forum and they were of more than Rs.40,000/-.  He further submitted that as per policy Rs.1,60,000/- are assured for personal accident and Rs.40,000/- are assured for hospitalization charges and that the Forum has rightly granted that amount.

5.      We find that in the complaint the percentage of burn injuries sustained by the complainant is shown as 22%. However, during pendency of the complaint, the complainant obtained permanent disability certificate showing permanent disability to the extent of 40% and it was produced before the Forum below.  There is no reason to disbelieve the same.  Hence, we are inclined to accept that the complaint sustained 40% permanent disability in the incident that took place during the period of policy.

6.      Moreover, the bills produced by the complainant / respondent herein prove that they are of Rs.40,841/-. No doubt, in the original complaint the complainant mentioned the expenses that he incurred for hospitalization are of Rs.30,515/-, medicine expenses of Rs.10,000/-, conveyance expenses of Rs.10,000/-, diet expenses of Rs.20,000/-. In prayer clause, the complainant claimed Rs.2.00 Lacs towards entire sum assured under the policy. He also claimed compensation of Rs.10,000/- for physical & mental harassment and Rs.5,000/- for litigation expenses.

7.      We find that the complainant has rightly made claim under the complaint showing properly the expenses incurred by him for hospitalization.

8.      The claim of the complainant is duly supported by the terms & conditions of the policy and the documents filed on record by him. We, therefore, find no substance in the appeal.  The impugned order deserves to be confirmed.

ORDER

i.        The appeal is dismissed.

ii.       No order as to costs in this appeal.

iii.      Copy of the order be supplied to the parties free of cost.