F.A.No.565 OF 2008 AGAINST C.C.NO.484 OF 2007 DISTRICT FORUM-I HYDERABAD

Between:

Mr.Gautham Ganeriwal S/o Sri Vinodji Ganeriwal

Aged about 20 yrs, R/o Rama Towers, 2^nd Floor

5-4-83, M.G.Road, Secunderabad-003                                            

                                                                                Appellant/complainant

                A N D

The Manager
ICICI Lombard General Insurance Co.Ltd.,
6-3-352/1, Osman Plaza, 3^rd Floor, Road No.1,
Banjara Hills, Hyderabad

                                                                                Respondent/opposite party

Counsel for the Appellant                     Sri G.Venkatswamy Goud

Counsel for the Respondent                  Sri Ravishankar Jandhyala

        QUORUM:   SRI R.LAKSHMINARASIMHA RAO, HON’BLE MEMBER
               

                                                AND

SRI THOTA ASHOK KUMAR, HON’BLE MEMBER

THURSDAY THE THIRD DAY OF NOVEMBER

                                TWO THOUSAND ELEVEN

Oral Order (As per Sri R.Lakshminarasimha Rao, Hon’ble Member)

                                                ***

1.     The complainant has filed the appeal seeking enhancement of `27,800/- awarded by the District Forum.

2.     The appellant had obtained motor accident insurance policy on 21.8.2005 in respect of his truck bearing registration No.AP 10U for the sum assured of `5,57,142/-.  The vehicle met with an accident on 1.6.2006.  The appellant had lodged claim for `45,800/- towards the damage caused to the truck and towards the medical bill of a person who was injured in the accident.  The appellant had addressed letter and got issued notice demanding for settlement of his claim besides lay off damages Rs.1,50,000/- etc. 

3.     The respondent insurance company had resisted the claim on the premise that the loss caused to the third party injured in the accident is not amenable to the jurisdiction of the consumer forum.  The appellant had not informed the respondent company within 48 hours after occurrence of the accident and he had made his own estimate of damages and the medical expenditure etc.

4.     The appellant has filed his affidavit and got marked Exs.A1 to A26.  On behalf of the respondent insurance company reply sent by it to the appellant had been marked Ex.B1. 

5.     Feeling aggrieved by the order of the District Forum, the appellant had come in appeal contending that the District Forum had not awarded compensation for mental agony and it had awarded costs of `2,000/-. 

6.     The points for consideration are

1)                Whether there was any deficiency in service on the part of the respondent company in settlement of claim?

2)                To what relief?

7.     POINT NO.1:     The ownership of the appellant over the vehicle, truck No. AP 10U and its insurance coverage by virtue of the insurance policy issued by the respondent company have not been at dispute between the parties.  The appellant had claimed `27,800/- towards the damages of the truck and `18,745/- towards the medical charges stated to have been incurred for the treatment of a third party. 

8.     The District Forum has dealt with the distinction between third party claim and own property damage claim.  The District Forum held that the third party claims are not within the ambit of the provisions of the Consumer Protection Act and as such the medical expenses of a third party injured in the accident cannot be sought for in the complaint filed before the consumer forum.  In regard to the damages to the tune of `27,800/-, the District Forum has allowed the amount of `27,800/- as was sought for by the appellant and it had not considered the documents as to whether they would support the appellant’s claim to such sum.  In the absence of any challenge thereto by the respondent insurance company, we do not intend to disturb the findings and the award to that extent passed by the District forum. 

9.     The appellant has not substantiated how his claim to the tune of `45,800/- can be allowed which involves medical charges for the treatment of a third parties who was injured in the accident.  

10.    The appellant has addressed letter dated 12.7.2006 to the respondent company stating that he had incurred an amount of `28,800/- which include the expenses incurred in lifting and repairing of the vehicle.  The general repairs estimated at `8,000/- mentioned in the letter do not find any support in the shape of bills.  The appellant had submitted bills issued by Surya Medical Hall, Secunderabad, Smt Bhagavan Devi Hospital, Hyderabad for `292/- and `18,000/- respectively.  The medical expenses pertaining to the treatment of the third party are not covered by the terms of the insurance policy.  The appellant through his letter dated 20.10.2006 addressed to the IRDA Hyderabad stated that he had incurred an amount of `45,800/- towards damage of the vehicle and injury to the cleaner/supervisor.  As already held hereinabove, the medical expenses are not covered by the terms of the insurance policy. 

11.    The appellant had claimed on behalf of the third party.  The insurance ombudsman in his letter dated 26.2.2007 had observed that the appellant had claimed the amount in regard to the salary and medical bills of third party and the policy was issued relating to personal accident benefit which does not include expenses for a third party.  The insurance ombudsman in his letter dated 24.1.2007 had observed that “the nature and extent of monetary loss suffered is purely in the nature of third party injury”.  Viewed from any point or angle of the matter, it becomes clear that the appellant had been focusing on the expenses stated to have been incurred by a third party who was injured in the accident.  The appellant failed to establish his entitlement to the amount claimed.  The District Forum had liberally awarded interest @ 12% per annum from the date of claim. 

12.    The appellant had not placed any evidence on record as to the claim of `45,800/- and lay off damages etc.  The lay off charges which is not covered by the terms of the policy is too remote to be considered in a complaint filed alleging deficiency in service on the part of the insurance company.  We do not see any factual or legal infirmity in the award passed by the District Forum.  The appeal is devoid of any substance and liable to be dismissed.

13.    In the result the appeal is dismissed.  The order of the District Forum is confirmed.  There shall be no order as to costs.

                                                                                    Sd/-

                                                                                                        MEMBER

                                                                           Sd/-

                                                                        MEMBER

                                                                   Dt.03.11.2011

KMK*