Present: Sh. V.K. Monga counsel for the complainant. <br /> Sh. Y.P. Bansal counsel for opposite party No. 1 and 2.<br /> Opposite party No. 3 exparte.<br /> <br /> ORDER<br /> DHARAM SINGH PRESIDENT<br /> Bindu Singh complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 requiring the opposite party No. 1 and 2 to pay the claim to the tune of Rs. 2.5 Lac alongwith interest @ 9% per annum from the date of accident till final payment alongwith damages and litigation expenses in respect of claim No. 401702/41/05/86/90000002 dated 12.10.2005.<br /> 2. The complainant averred in his complaint that the opposite party No. 3 is the employer of complainant and the complainant has been employed with opposite party No. 3 is worker in the card board mill of opposite party No. 3 at Chahal Road, Faridkot. The opposite party No. 3 being employer of complainant on 11.1.2005 purchased Workmen Compensation (Gen.) policy of insurance from opposite party No. 1 and 2 valid up to 10.1.2006 vide policy No. 401702/41/04/8600002 in the sum of Rs. 3 Lac covering the risk of employees of opposite party No. 3. On 12.10.2005 at about 8.30 A.M. the complainant was working in the factory of opposite party No. 3 as worker of opposite party No. 3. The complainant was unloading trolley of Calendar rolls in the mill alongwith other worker Dharminder Kumar, Dinesh Kumar etc. Per chance roll calendar slipped from the trolley and hit on the left foot of complainant causing serious injury to the left foot. The complainant was rushed to Preet Hospital, Faridkot where amputation of left foot was advised and done by Dr. A.P.S. Kalhar, M.S. Ortho. The complainant remained admitted in hospital and was discharged on 20.10.2005 and thereafter the complainant remained under treatment in Preet Hospital as OPD patient. With the amputation of left foot the complainant become disable and disability of the complainant is 50%. The complainant is unable to do labour work, as he was working before the accident. At the time of accident the complainant was getting salary to the tune of Rs.2500/- per month from the opposite party No. 3. After the accident the information was given to opposite party No. 1 and 2 and subsequently each and every formality was completed by the complainant through opposite party No. 3. The information of the accident was also given to the Deputy Director of Factories, Moga (Commissioner Workmen) vide letter dated 13.10.2005 by the opposite party no. 3. After that the complainant through opposite party No. 3 has been providing each and every document available to the complainant with regard to accident to opposite party No. 1 to 2 but the opposite party No. 1 and 2 vide their letter dated 4.4.2007 illegally, arbitrarily and on flimsy grounds closed the file of complainant as 'No Claim'. The objections raised by the opposite party No. 1 and 2 in the above letter are quite wrong and illegal as clarification of the treatment and amputation of foot from the hospital run by Dr. Manpreet Kaur a Gynecologist was made by furnishing a letter dated 21.3.2007 issued by Manpreet Hospital that amputation was done by Dr. A.P.S. Kalhar, M.S. Ortho and such clarification was furnished to the opposite party No. 1 and 2 in their office of Kotkapura. As regards providing copy of FIR such demand on the part of opposite party No. 1 and 2 is illegal as the accident took place per chance and the same was not for cognizance of the police, so no information was given to the police. Rests of the objections were also cleared by furnishing documents to the opposite party No. 1 and 2 from time to time. So there is deficiency of service by not paying the claim to the complainant under the policy of insurance. As per Workmen Compensation Act, Section 4 and schedule appended to it the complainant was aged about 45 years at the time of accident and has suffered disability due to the accident to the extent of 50%. So keeping in view the salary of complainant as per provisions of Workmen's Compensation Act the complainant is entitled to the tune of Rs.2,50,000/- from opposite party No. 1 and 2 alongwith damages for the harassment caused by the opposite party No. 1 and 2 in repudiating the claim on false grounds and the complainant is also entitled for litigation expenses. The complainant is entitled to interest @ 9% per annum from the date of accident. Hence the present complaint. <br /> 3. The counsel for complainant was heard with regard to admission of the complaint and vide order dated 4.5.2007 complaint was admitted and notice was ordered to be issued to the opposite parties. <br /> 4. On receipt of the notice the opposite party No. 1 and 2 appeared through Sh. Y.P. Bansal Advocate and filed written statement taking preliminary objections that the present complaint is not maintainable under the Consumer Protection Act as the complainant is not the consumer and moreover this Hon'ble Forum has got no jurisdiction to hear and try the present complaint as the proper remedy available to the complainant if any is under the Workman Compensation Act. There is no deficiency of service on the part of the opposite party No. 1 and 2. The insured is estopped from his own act and conduct as the complainant never cooperated with the opposite party No. 1 and 2 and never furnished the required documents, therefore, the insured is not entitled to any relief and further as per law of equity a person who wants equity must come with clean hands but in the present complaint. The complainant has not come before the Hon'ble Forum with clean hands and has concealed the material facts therefore, the complainant is not entitled for even the relief of equity. There is no privity of contract of the answering respondents with the complainant, therefore, the present complaint is not maintainable. The maximum liability of the opposite parties if any is limited up to Rs. 1,01,664/- under Workmen Compensation Policy but this liability of the insurance company is also categorically denied. The lengthy evidence is required in the present complaint only after thrashing of the evidence which is to be led by all the parties only after that the Hon'ble Forum can reach at a right conclusion but as the scope of Consumer Protection Act is limited and the procedure is in summary nature, therefore, this Hon'ble Forum has got no jurisdiction to hear and try the present complaint, so the complainant be directed to approach the other appropriate Court. On merits the opposite party No. 1 and 2 submitted that the complainant is not the employee of the opposite party No. 3 as till today no complete record has been furnished by the opposite party No. 3 to prove that the complainant is employee of the opposite party No. 3. It is admitted that the opposite party No. 3 purchased a policy which was effective from 11.1.2005 to 10.1.2006. No accident occurred on 12.10.2005 and the complainant did not receive any injury. No treatment was given by Dr. A.P.S. Kochhar M.S. Ortho and no amputation was done by the said doctor as till today nor a single letter or certificate has been produced by the complainant that the complainant ever got treatment from Dr. A.P.S Kochhar. The certificate produced by the complainant of Preet Hospital, Faridkot which is being run by Dr. Manpreet Kaur who is D.G.O Gyno. and she is not competent to do operation regarding ortho surgery. No complete record of the treatment has been furnished by the complainant. There is no disability of 50% to the complainant rather a certificate produced by the complainant showing the disability to the extent of 40%. It is wrong that the complainant was getting the salary to the tune of Rs.2,500/- per month from the opposite parties. It is correct that the intimation was given by the complainant by opposite party No. 3 on 13.10.2005 but it is not in the knowledge of the answering opposite parties whether any information is given to the Deputy Director of Factories Moga but no copy of the letter regarding intimation to Deputy Director factories was produced by the complainant to the answering opposite parties. It is further submitted that the after giving intimation by the opposite party No. 3 the answering opposite parties vide letter dated 20.12.2005 requested the opposite party No. 3 to produce the documents mentioned in the letter but the complainant never furnished any documents. The opposite party No. 1 and 2 sent a reminder dated 12.1.2006 and 20.1.2006 vide which the opposite party no. 3 was requested to furnish the documents mentioned in the letter dated 20.12.2005 but the opposite party No. 3 did not even take notice of the reminders of the opposite party No. 1 and 2. Finally on 31.1.2006 the claim was declared as 'No Claim' on the ground that required documents/information was not produced nor any communication from the opposite party No. 3 despite of the letters dated 20.12.2005, 12.1.2006 and 20.1.2006 was received. The opposite party No. 3 requested the answering opposite parties to reopen the file and furnished some documents i.e. fitness certificate, treatment papers, X-ray, discharge slip, age proof and photo of injured worker. On processing of these papers the company found that the treatment fitness certificate and discharge certificate issued by lady Dr. Manpreet Kochhar M.B.B.S and DGO Preet Hospital who is Gynecologist and not a surgeon of ortho qualified to do amputation. Further it is submitted that X-ray submitted by the opposite party No. 3 of the complainant was totally black without any supporting report. No wages register muster roll or employment record of the factory has been submitted. No FIR was submitted, no notice has been given to the Commissioner under Workman Compensation Act in the area regarding the injury of the worker. So vide letter dated 4.4.2007 it was informed to the opposite party No. 3 that the company cannot accept the request to reopen the case which is not maintainable under Workman Compensation Insurance Policy and the company repudiated the claim. The intimation of this letter was given to the opposite party No. 3. Till today no certificate is produced by the complainant or opposite party No. 3 to ascertain that the amputation was done by Dr. A.P.S Kochhar or any treatment was given by Dr. A.P.S. Kochhar. The demand of FIR by the opposite party No. 1 and 2 is as per law. The FIR always reveal the factum of accident and the injury to the complainant during the course of his employment. Even no intimation was given by the opposite party No. 3 or by the complainant to the police regarding the accident. It was the duty of the opposite party No. 3 or by the complainant to given intimation to the police regarding the alleged accident in question. It is wrong that all the objections raised were cleared and all the required documents were furnished by the complainant or by the opposite party No. 3. So there is no deficiency of service on the part of the opposite party No. 1 and 2. So the complainant is not entitled for the amount of Rs.2,50,000/- and further he is not entitled for any interest and there is no disability of 50% and he is not entitled for any litigation expenses. Hence the complaint be dismissed with costs. <br /> 5. On notice of the Forum the opposite party No. 3 appeared through Sh. Satpal Prop. of opposite party No. 3 on 29.5.2007, but after that he is failed to appear in the Forum and vide order dated 13.6.2007 the opposite party No. 3 was proceeded against exparte. <br /> 6. Both the parties wanted to lead evidence to prove their respective pleadings and proper opportunity was given to them. The complainant tendered in evidence his affidavit Ex.C-1, affidavit of Dhurinder Singh Ex.C-2, copy of letter dated 13.10.2005 Ex.C-3, copy of claim form Ex.C-4, copy of wage register Ex.C-5, copy of letter of Preet Hospital Ex.C-6, copy of letter dated 22.12.2005 Ex.C-7, copy of letter dated 20.12.2005 Ex.C-8, copy of disability certificate Ex.C-9, copy of investigation report of Preet Hospital Ex.C-10 to Ex.C-12, copy of letter dated 6.12.2006 Ex.C-13, copy of identity card Ex.C-14, copy of affidavit of Bindu Singh Ex.C-15, copy of character certificate Ex.C-16, copy of resident certificate Ex.C-17, copy of report of Dinesh Kumar Gupta C.A. Ex.C-18, copy of Insurance Policy Ex.C-19, copy of letter dated 9.5.2006 Ex.C-20, copy of letter dated 15.3.2007 Ex.C-21, copy of letter of Preet Hospital dated 21.3.2007 Ex.C-22, copy of letter dated 13.10.2005 Ex.C-23, copy of wage register Ex.C-24 to Ex.C-25, copy of attendance register Ex.C-26 and Ex.C-27, affidavit of Satpal Bansal Partner Bharat Card Board and General Mill, Faridkot Ex.C-28, UPC receipt Ex.C-29, affidavit of Dr. Manpreet Kaur Prop. M/s Preet Hospital, Talwandi Road, Faridkot Ex.C-30, copy of admission record of complainant Bindu Singh Ex.C-31, affidavit of Dr. A.P.S Kochhar M.S. Ortho Ex.C-32 and closed his evidence. <br /> 7. In order to rebut the evidence of the complainant the opposite party No. 1 to 2 tendered in their evidence affidavit of Sunil Gupta Divisional Manager, NIC, Moga Ex.R-1, letter dated 4.4.2007 Ex.R-2, terms and conditions of the policy Ex.R-3, letter dated 31.1.2006, 20.1.2006, 12.1.2006, 20.12.2005 Ex.R-4 to Ex.R-7, X-ray film which was produced by the insured Ex.R-8 and evidence of the opposite party No. 1 and 2 was closed by order of this Forum vide order dated 4.12.2007. <br /> 8. We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file. Our observations and findings are as under.<br /> 9. Learned counsel for the complainant has submitted that the opposite party No. 1 and 2 have illegally repudiated the claim of the complainant who sustained injuries while working in the mill of the opposite party No. 3 as worker. The employer of the complainant have purchased Workmen Compensation (Gen.) policy of insurance from the opposite party No. 1 and 2 which was valid policy on 12.10.2005 when the complainant met with an accident.<br /> 10. Learned counsel for the opposite party No. 1 and 2 have submitted that the complainant is not entitled to recover any amount from the opposite parties. The opposite parties have rightly repudiated the claim of the complainant. Even complainant have not got himself treated from the proper hospital. <br /> 11. As per affidavit Ex.C-1 of Bindu Singh he was working in the Card Board Mill of opposite party No. 3. The opposite party No. 3 purchased policy worth Rs.3,00,000/- covering risk of employees of the opposite party No. 3 which was valid from 11.1.2005 to 10.1.2006. At about 8.30 A.M. on 12.10.2005 when the complainant was unloading trolley of calendar rolls in the mill alongwith other worker Dharminder Kumar and Dinesh Kumar etc. per chance roll calendar slipped from the trolley and hit on the left foot of the complainant causing serious injury to the left foot. Complainant got treatment from Preet Hospital where amputation of left foot was advised and done by Dr. A.P.S. Kochhar, M.S. Ortho who was working as Ortho specialist at Preet Hospital Faridkot and is husband of proprietor of Preet Hospital, Faridkot. Complainant have discharged from the hospital on 20.10.2005. He became 50% disable due to the injury. He was receiving salary of Rs.2500/- per month from the opposite party No. 3. Information was given to the opposite party No. 1 and 2. Formalities were completed through Deputy Director of Factories, Moga (Commercial Workmen) vide letter dated 13.10.2005 by the opposite party No. 3. Each and every information was provided to the opposite party No. 1 and 2. Queries were replied but the opposite party No. 1 and 2 did not pay any claim of the complainant. <br /> 12. The above noted evidence of the complainant is supported from letter Ex.C-3 written by the employer of the complainant to the Deputy Director of Factories on 13.10.2005. Claim form Ex.C-4 also was filled up by the complainant. The salary slip is Ex.C-5. The report of Preet Hospital with regard to injuries received by the complainant during his employment as laborer is Ex.C-6. The opposite party No. 3 employer of the complainant wrote letter Ex.C-7 dated 23.12.2005 to the Branch Manager, National Insurance Company Limited, Kotkapura with regard to payment of the insurance amount. The insurance company vide letter Ex.C-8 dated 20.12.2005 have put questions to the employer of the complainant. The reply to this queries were given by the Bharat Card Board and General Mill on 6.12.2006 vide letter Ex.C-13. The opposite party No. 1 and 2 have refused to reopen the claim of the complainant as per their letter Ex.C-23 dated 23.10.2005 with regard to closing of the claim case vide letter No. 1498 dated 31.1.2006. <br /> 13. From the perusal of the file it is made out that complainant and his employer had rendered best quality of informations required by the opposite party No. 1 and 2 but opposite parties have repudiated claim to the complainant illegally. It is definite that complainant received injuries while working in the mill of the opposite party No. 3. He is having disability of 40% as per certificate Ex.C-9 dated 3.8.2006 issued by Civil Surgeon, Faridkot. Preet Diagnostic Hospital is being run by Dr. Manpreet Kochhar and her husband A.P.S. Kochhar is M.S. Ortho who have given treatment to the complainant. If A.P.S. Kochhar was working in Civil Hospital then there can be no bar for him to give treatment to the complainant as emergency case. The opposite party No. 1 and 2 cannot find fault with the doctors or their ability to give treatment. The X-ray report is already on the file. Other documents also had been provided by the complainant and his employer to the opposite party No. 1 and 2. They have illegally withheld amount of the compensation payable to the complainant. <br /> 14. The complainant if have not proceeded against the opposite parties as per Workmen Compensation Act they are not debarred from putting their case in the District Consumer Disputes Redressal Forum due to deficiency of services to be provided by the opposite parties to the complainant. So the complaint in the District Consumer Disputes Redressal Forum is maintainable. So this Forum have jurisdiction to try and decide this complaint. The opposite parties have been proved deficient in providing services to the complainant with regard to insurance claim. <br /> 15. In view of the aforesaid facts and circumstances the complaint filed by the complainant is accepted. With regard to compensation on account of insurance claim the complainant is having disability of of 40% and he was having income of Rs.2500/- per month and his age is about 45 years. So by calculating annual income with 40% disability and apply multiplier of 12, the complainant is entitled to recover Rs.1,44,000/- from the opposite party No. 1 and 2 alongwith interest at the rate of 12% per annum from the date of accident i.e. 12.10.2005 till the decision of this complaint. So the opposite party No. 1 and 2 are directed to pay the amount of Rs.1,44,000/- alongwith interest at the rate of 12% per annum from the date of accident i.e. 12.10.2005 till the decision of this complaint to the complainant within the period of one month from the date of the receipt of the copy of this order, failing which the opposite party No. 1 and 2 shall pay the above mentioned amount with interest at the rate of 12% per annum from the date of the decision of this complaint till realization of the amount. The above noted amount includes expenses on the treatment of the complainant in Preet Hospital, Faridkot which were borne by the poor factory worker. No order as to costs due to peculiar circumstances of the case. Copies of the order be sent to the parties free of costs. File be consigned to the record room. <br /> Announced in open Forum:<br /> Dated: 15.2.2008<br />