Kerala

StateCommission

A/08/289

United India Insurance Co. - Complainant(s)

Versus

Praveen Mathew - Opp.Party(s)

Lakshman.T.J

20 Jul 2010

ORDER

First Appeal No. A/08/289
(Arisen out of Order Dated 16/06/2008 in Case No. CC 242/06 of District Idukki)
1. United India Insurance Co.Kerala ...........Appellant(s)

Versus
1. Praveen MathewKerala ...........Respondent(s)

BEFORE :
HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU PRESIDENT
PRESENT :

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ORDER

KERALA STATE CONSUMER DISPUTES REDRESSAL

COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM.

 

APPEAL No: 289/08

 

JUDGMENT DATED:20-07-2010

 

 

PRESENT:

 

JUSTICE SHRI. K.R. UDAYABHANU              :PRESIDENT

 

SHRI.S. CHANDRAMOHAN NAIR                             : MEMBER

 

The Branch Manager,

United India Insurance Co. Ltd.,                         : APPELLANT

Thodupuzha.

 

(By Adv:Sri.Lakshmanan.T.J)

 

            Vs.

 

Praveen Mathew,

Marattil house,                                                                    : RESPONDENT

Kumaramangalam.P.O,

Vazhakkala, Thodupuzha.

 

    

JUDGMENT

 

JUSTICE SHRI. K.R. UDAYABHANU:PRESIDENT

 

 

The appellant is the opposite party/Insurance Company in CC.242/06 in the file of CDRF, Idukki.  The appellant is under orders to pay a sum of Rs.5000/- towards medical expenses with interest at 12% from the date of the petition and Rs.500/- towards cost.

2. The case of the complainant is that he had availed medi claim policy from the opposite party and that he met with an accident on  27-03-2004 and sustained fracture on the right tibia.  Surgery was done and implants were applied.  Subsequently after 2 years he developed pain and was again admitted and underwent another surgery for removal of the screws.  The medical expenses amounted to Rs.15,000/- but the claim was repudiated.  The contention of the opposite parties that as per the provisions of the policy in cases of re-admission into the hospital only if it is within 6 months from the date of accident the opposite parties are liable to re-imburse the medical expenses.

3. The evidence adduced consisted of the testimony of PW1, DW1 and Exts.P1 to P5.

4. We find that the policy is renewed on an yearly basis.  Removal of the steel screws after 2 years of the accident cannot be treated as re-admission with respect to the same injury.  We find that there is no patent illegality in the order of the Forum.  There is no scope for admitting the appeal.

In the result the appeal is dismissed in-limine.

The office will forward the LCR along with the copy of this order to the Forum.

 

 

JUSTICE K.R. UDAYABHANU:PRESIDENT

 

 

 

S. CHANDRAMOHAN NAIR : MEMBER

 

 

 

VL.

 

PRONOUNCED :
Dated : 20 July 2010

[HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU]PRESIDENT