BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri. T.Sundara Ramaiah, B.Com B.L., President
And
Sri. M.Krishna Reddy, M.Sc., M.Phil., Male Member
And
Smt. S.Nazeerunnisa, B.A., B.L., Lady Member
Friday the 12th day of August, 2011
C.C.No.7/2010
Between:
B.Pavan Kumar, S/o B.Krishnamurthy,
Resident of 5-1-33, Allagadda, Kurnool District.
…Complainant
-Vs-
1. M/s. Unite India Insurance Company Limited,Represented by tis Branch Manager,
Door No.22/144,Gandhi Road, Proddutur, Kadapa District.
2. M/s. United India Insurance Company Limited,Rep.by its Divisional Manager,
Mourya Inn complex, Bhagyanagar, Kurnool District.
...Opposite ParTies
This complaint is coming on this day for orders in the presence of Sri M.Sivaji Rao, Advocate for complainant and Sri D.Yella Reddy, Advocate for opposite parties 1 and 2 for upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. T.Sundara Ramaiah, President)
C.C. No.7/2010
1. This complaint is filed under section 11 and 12 of C. P. Act, 1986 praying to direct the opposite parties:-
- To pay the assured amount of one laksh rupees with interest from the date of death;
- To pay a sum of Rs.1,50,000/- towards the medical expenses;
- To pay a sum of Rs.25,000/- towards the compensation for causing mental agony and hardship;
- To pay a sum of Rs.20,000/- towards the costs of the complaint;
- To any other order or orders which are deems to be fit and proper in the circumstances of the case.
2. The case of the complainant in brief is as under:- The complainant is the owner cum driver of the TATA SUMO vehicle bearing No.AP28 J 6336. On 15-12-2007 the complainant insured his vehicle with opposite party No.1. Opposite party No.1 issued the policy bearing No.050901/31/07/01/00001301. The policy covered the owner cum driver from personal accident benefits for a sum of Rs.2,00,000/-. For loss of one limb or sight of one eye the compensation is restricted to 50%. A separate premium was paid towards the compulsory personal accident to owner cum driver. On 31-07-2008 at about 3.40 A.M. while the complainant was driving his vehicle he found a lorry stopped on middle of the road near Gunakitarna Bridge on Pune Bangalore High Way Road No.4. The complainant vehicle dashed the said lorry from the back side. In the said accident the complainant received grievous injuries to his left eye. Wadgaon police registered a case in Crime No.98/2008 under Section 304 A, 337 and 338 of I.P.C. The complainant was shifted to Lokneta Rajarambabu Patil Hospital, Urun Islampur. He was given treatment as inpatient from 31-07-2008 to 08-08-2008. Thereafter the complainant was shifted to Gowri Gopal Hospital, Kurnool on 09-08-2009. Again on 11-08-2008 the complainant joined in Viswabharathi Hospital, Kurnool for treatment of his left eye. On 15-08-2008 the Doctors have operated his left eye. The complainant lost his eye sight. The complainant suffered permanent disability. The complainant is entitled for Rs.1,00,000/-. The opposite party failed to pay the assured amount to the complainant. Hence the complaint.
3. Opposite party No.1 filed written version and the same is adopted by opposite party No.2. It is stated in the written version that the complaint is not maintainable. The complainant insured his TATA SUMO vehicle bearing No.AP28 J 6336. The policy was in force from 15-12-2007 to 14-12-2008. The said policy covers personal accident to owner cum driver to an extent of Rs.2,00,000/-. /-. For loss of one limb or sight of one eye the compensation payable is 50% of the assured amount. The complainant claimed damages to his TATA SUMO vehicle. The claim was settled by opposite party No.1 for Rs.55,000/-. No claim was submitted by the complainant in respect of the injuries sustained by him. The complainant has not received injury to the eye. He has not taken any treatment for the eye injury as no injury is received by the complainant to his eye. The complainant is not entitled to claim any amount. The complaint is liable to be dismissed.
4. On behalf of the complainant Ex.A1 to A11 are marked and sworn affidavit of the complainant is filed. PW1 to PW5 are examined and Ex.X1 to X5 are also marked on behalf of the complainant. On behalf of the opposite parties 1 and 2 Ex.B1 is marked and sworn affidavit of the opposite party No.1 is filed.
5. Both sides filed written arguments.
6. Now the points that arise for consideration are:
- Whether there is deficiency of service on the part of Opposite Parties?
- Whether the complainant is entitled to the reliefs as prayed for?
- To what relief?
7. POINT No.1:- Admittedly the complainant is the owner cum driver of TATA SUNO vehicle bearing No.AP28 J 6336. The said vehicle was insured with opposite party No.1 under Ex.B1 (Ex.A1) policy bearing No.050901/31/07/01/00001301. The policy was in force from 15-12-2007 o 14-12-2008. The said policy covers personal accident to owner cum driver to an extent of Rs.2,00,000/-. It is also admitted that the compensation payable under the policy is 50% of the assured amount for loss of one limb or sight of one eye.
8. It is the case of the complainant that his vehicle met with an accident on 31-07-2008 near Gunakitarna Bridge on Pune Bangalore High Way Road No.4 and that wadgaon police registered a case in Crime No.98/2008. The complainant filed Ex.A2 copy of F.I.R., in Crime No.98/2008 of Wadgaon police of Kolhapur District of Maharastra State. It is mentioned in Ex.A2 that on 31-07-2008 the complainant was driving his vehicle and that the vehicle of the complainant dashed against the stationed truck on back side. It is also mentioned that the persons in the vehicle of the complainant received injuries including the driver who is he complainant here in. It is also admitted by the opposite party No.1 that the claim of the complainant for damages to his vehicle in the accident was settled by paying Rs.55,000/-. The opposite parties are not disputing about the accident occurred on 31-07-2008.
9. It is the case of the complainant that he sustained injuries to his left eye in the said accident resulting loss of eye sight. The opposite parties denied the contention of the complainant that he received injury to his left eye in the accident. The complainant to prove his case that he received injuries including the injury to his left eye relied on evidence of PW 1 to PW 5. PW 1 in his evidence stated that on 31-07-2008 the complainant was admitted in their hospital and that the complainant sustained Lacerated Wounds on his fore head and sustained fracture of mandible. He produced Ex.X1 to X3. They go to show the complainant took treatment in L.R.P. Hospital from 31-07-2008 to 08-08-2008. PW 3 Medical Officer attached to Gowri Gopal Hospital, Kurnool stated that the complainant was admitted in the Hospital on 09-08-2008 and he was discharged on 11-08-2008 and that Ex.X5 is the case sheet. PW 2 eye specialist in Viswa Bharathi Hospital, Kurnool in her evidence stated that the complainant took treatment in the hospital from11-08-2008 to 21-08-2008 that on 12-08-2008 she gave treatment to the complainant for his left eye and that she found perforated corneal tear with iris prolapse and as a result the complainant lost vision of his left eye. Ex.X4 is the case sheet maintained by Viswa Bharathi Hospital, Kurnool where in it is mentioned that the complainant was given treatment for injury in his left eye. PW 5 Opthomologist attached to Regional Officer Kurnool deposed that he gave Ex.A9 visual disability certificate and that the complainant got 30% disability. He also confirmed the injury to eye of the complainant. In the light of oral and documentary evidence available on record it is very clear that the complainant also received injury to his left eye in the accident that took place on 31-07-2008.
10. The complainant claims compensation of Rs.1,00,000/- for loss of eye sight. Admittedly policy covers personal accident to owner cum driver to an extent of Rs.2,00,000/-. The compensation payable for loss of one limb or sight of one eye is 50% of the assured sum of Rs.2,00,000/-. According to PW 5 the complainant suffered 30% disability. Therefore we are of the view that the complainant is entitled to Rs.30,000/- being 30% of Rs.1,00,000/-. It is also the case of the complainant that he also purchased medicines and incurred an amount of Rs.1,50,000/-. As per the terms and conditions of the policy insurer is not liable to pay any amount towards medical expenses spent by the insured. The complainant is entitled to only Rs.30,000/-. In spite of the demand notice Ex.A10 dated 08-07-2009, the opposite parties did not settle the claim of the complainant. There is deficiency of service on the part of the opposite parties.
11. In the result, the complaint is partly allowed directing the opposite parties jointly and severally to pay Rs.30,000/- to the complainant with interest at 9% from the date of the complaint i.e., 06-01-2010 till the date of payment along with cost of Rs.500/-.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 12th day of August, 2011.
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : PW1 to 5 For the opposite parties : Nill
List of exhibits marked for the complainant:-
Ex.A1 Photo copy of Certificate of Insurance policy No.050901/31/07/01/00001301.
Ex.A2. Photo copy of F.I.R.in Crime No.98/2008
dated 01-08-2008 along with English Translation letter.
Ex.A3 Photo copy of Driving Licence of the complainant
dated 02-09-2008.
Ex.A4 Medical Bills dated 21-08-2008 issued by Viswa Bharathi
Super Speciality Hospital, Kurnool.
Ex.A5 Certificate of illness dated 07-10-2008.
Ex.A6 Photo copy of Injury Certificate dated 31-07-2008.
Ex.A7 Discharge card of Gowri Gopal Hospital Private Limited,
Kurnool.
Ex.A8 Discharge card of Viswa Bharathi Super Speciality Hospital,
Kurnool dated 21-08-2008.
Ex.A9 Disability Certificate issued by Chairman Medical
Superintendent regional Eye Hospital Kurnool
dated 05-12-2008.
Ex.A10 Photo copy of legal notice dated 08-07-2009 along with
postal receipts and acknowledgements.
Ex.A11 Particulars of Loknete Rajarambapu Patil Hospital &
Research Islampur dated 08-08-2008.
PW1 Deposition of Dr.Abdur Rahman Shahnawaz Latif
dated 31-08-2010.
PW2 Deposition of Dr.A.Geetha dated 07-10-2010.
PW3 Deposition of Dr.A.H.Praveen dated 29-10-2010.
PW4 Deposition of B.Sudarshan dated 04-01-2011.
PW5 Deposition of Dr. K.Bharani Kumar Reddy
dated 17-05-2011.
Ex.X1 Photo copy of Injury Certificate dated 31-07-2008.
Ex.X2 Office copy of Particulars of Loknete Rajarambapu Patil
Hospital & Research Islampur dated 08-08-2008.
Ex.X3 Letter dated 29-08-2010 issued by Medical Superintendent
Urun -Islampur
Ex.X4 Case Sheet of complainant issued by Viswa Bharathi Super
Speciality Hospital Kurnool dated 27-08-2010.
Ex.X5 Case Sheet of complainant issued by Gowri Gopal Hospital
Private Limited, Kurnool dated 11-08-2008.
List of exhibits marked for the opposite parties:-
Ex.B1 Photo copy of Certificate of Insurance policy No.050901/31/07/01/00001301 vehicle No.AP-28 J-6336.
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
// Certified free copy communicated under Rule 4 (10) of the
A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties :
Copy was made ready on :
Copy was dispatched on :
