Tripura

StateCommission

A/14/2015

United India Insurance - Complainant(s)

Versus

Sri Sanjoy Datta - Opp.Party(s)

Mr. S.Datta Chowdhury

27 Jul 2015

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

TRIPURA

 

 

APPEAL CASE No.A/14/2015.

 

United India Insurance Co.Ltd.,

R.M.S. Chowmuhani,

West Tripura, Agartala.

                  ….    ….    ….    ….    Appellant.

                   Vs

Sri Sanjoy Datta,

S/O Sri Dipak Datta,

Vivekananda Palli, Mohanpur,

P.S-Sidhai, P.O-Mohanpur,

Dost.-West Tripura.

             ….    ….    ….    ….    Respondent.

 

 

PRESENT :

       

             HON’BLE MR.JUSTICE S.BAIDYA,

             PRESIDENT,

             STATE COMMISSION

                          

                  MRS. SOBHANA DATTA,

             MEMBER,

               STATE COMMISSION.

 

               MR.NARAYAN CH. SHARMA,

               MEMBER,

                 STATE COMMISSION.

               

 

For the Appellant    :      Mr.S.Datta Choudhury,Adv.

          For the respondent   :      Mr.A.Sengupta,Adv.

                                         

Date of Hearing         :     27.07.2015.

Date of delivery of Judgment  :

             

 

 

 

J U D G M E N T

 

S.Baidya,J,

            This appeal filed on 06.05.2015 by the appellant-United India Insurance Co.Ltd. under Section 15 of the Consumer Protection Act., 1986 is directed against the judgment dated 03.02.2015 passed by the Ld. District Consumer Disputes Redressal Forum, (in short District Forum), West Tripura, Agartala in case No.C.C-106 of 2013 whereby the Ld. District Forum allowed the complaint filed under Section 12 of the C.P.Act, 1986 and directed the O.P.-Insurance Company, the appellant herein to pay Rs.1,00,339/- (Rs.54,397/- as cost of medical treatment plus Rs.45,935/- as travelling expenses) to the complainant as compensation with a further direction to pay Rs.5,000/- to the complainant for causing mental agony and harassment together with Rs.2,000/- as cost of litigation. The Ld. District Forum by the said judgment further directed the O.P.-Insurance Company to pay the said amount within six weeks from the date of judgment, failing which the payable amount will carry interest @ 9% p.a. from the date of judgment till the payment is made.      

2. The case of the appellant as narrated in the memo of appeal, in brief, is that the respondent Sanjoy Datta who is the complainant in the complaint case is the owner-cum-rider of the motor cycle bearing registration No. TR-01-J-6963 which was duly insured with the appellant-Insurance Company with the coverage of Personal Accident benefit. It has also been alleged that on 04.10.2011 at about 3.00 p.m. the respondent was coming from Hezamara to Mohanpur and when he reached near Rangacherra road culvert, suddenly he fell down from the motor cycle for improper erection of hump on the road near the culvert. It has also been alleged that soon after the accident he was brought to Mohanpur Hospital wherefrom he was shifted to G.B.P.Hospital for better treatment. It has also been alleged that as the respondent sustained head injury, he was referred to SSKM/AMRI Hospital, Kolkata for specialized treatment by the Standing Medical Board,G.B.P.Hospital, Agartala on 05.10.2011. It has also been alleged that the respondent received treatment in Medica Superspecialty Hospital, Kolkata from 05.10.2011 to 11.10.2011 as an in-patient and on being discharged therefrom, he attended the out-patient department of the said hospital for medical check up and as he was busy with his treatment, he lodged a complaint with the Officer-In-Charge of Sidhai P.S. vide G.D.Entry No.1153 dated 26.11.2011.                                                  
3. It has also been alleged in the memo of appeal that on 06.02.2012 the complainant-respondent preferred his claim with the appellant-Insurance Company for reimbursement of the expenses incurred by him in connection with his medical treatment in Kolkata as he was under the coverage of package Personal Accident Insurance Policy. But the appellant neither paid the expenses incurred by him towards his medical treatment in Kolkata nor responded to his claim which gave rise to the cause of action of the complaint case for the negligence act and deficiency in service on the part of the appellant.
4. It has also been alleged that the appellant contested the complaint case by filing written objection and thereafter, the Ld. District Forum considering the pleadings of the parties and the evidences on record passed the impugned judgment and thereby being aggrieved and dissatisfied, the appellant has preferred the instant appeal on the grounds that the Ld. Forum failed to appreciate the terms and conditions of the personal accident coverage policy as the respondent does not fall within any of the four categories mentioned in the policy, that the Ld. Forum passed the impugned judgment without any application of mind as the Ld. Forum in para-11 of the judgment admitted that injury sustained by the respondent does not fall within any of the four categories as mentioned in para-10 of the impugned judgment, that the Ld. Forum did not consider the decision of the Hon’ble Apex Court as reported in 2004 (8) Supreme Court Cases 644 and in 2007 (3) Supreme Court Cases 700, that the Ld. Forum relying on a Civil Miscellaneous Appeal passed the impugned judgment awarding compensation which is totally perverse and therefore, cannot be sustained in the eye of law and hence, the appellant has preferred the instant appeal praying for setting aside the impugned judgment.           

Points for consideration.

5.       The points for consideration are (1) whether the Ld. District Forum was proper, legal and justified in awarding compensation by the impugned judgment and (2) whether the judgment under challenge in this appeal should be set aside as prayed for.      

                         Decision with Reasons.

6.  Both the points are taken up together for the sake of convenience and brevity.
7. At the very outset, the learned counsel for the appellant referring to the two decisions of the Hon’ble Apex Court reported in 2004 (8) Supreme Court Cases 644 and 2007 (3) Supreme Court Cases 700 submitted that the terms and conditions of the insurance policy are binding upon the insured and the insurer and there is no scope on either side to deviate from the strict terms and conditions incorporated in the insurance policy. He also submitted that there are some contingencies in the insurance policy for getting compensation on the fulfilment of either of the four contingencies. He also submitted that admittedly, the injury of the respondent-complainant does not fall within the ambit of any of the four categories. He also submitted that barring these four categories mentioned in the insurance policy, there is no other provision in the said  policy for awarding compensation to the claimant, even if that claimant sustained bodily injury, but not falling within any of the four categories.
8. The learned counsel for the appellant also submitted that the Ld. District Forum categorically admitted in the impugned judgment that the nature of the injury sustained by the complainant does not fall within any of the four categories as mentioned in the policy, but in spite of that, the Ld. Forum relying on the decision of a Civil Miscellaneous Appeal being C.M.A. 3006 of 2012 between National Insurance Co.Ltd. Vs. Krishnan passed the impugned judgment awarding compensation without giving any value to the terms and conditions mentioned in the insurance policy. He also submitted that the provision of law in this regard has been well settled by the decisions of the Hon’ble Apex Court mentioned above and as such, the impugned judgment, being contrary to the principles of law laid down by the Hon’ble Apex Court mentioned above, cannot be sustained in the eye of law and deserves to be set aside.
9. On the other hand, the learned counsel for the respondent submitted that the Consumer Protection Act, 1986 is a consumer friendly legislation and the Section 3 of the said Act provides for additional remedy, barring statutory remedy available under other provisions of law. He also submitted that the Hon’ble Madras High Court while deciding an appeal being C.M.A. No.3006 of 2012 relying on the decision of the Hon’ble Apex Court reported in AIR 2000 Supreme Court 1930 between Rita Devi and others Vs. New India Assurance Co.Ltd. awarded compensation holding that the Motor vehicles Act is a beneficial legislation and also on the ground that there is no negative covenant in the insurance policy. He also submitted that the Ld. District Forum awarded medical expenses and the travailing expenses as compensation by the impugned judgment following the principles of law laid down by the Hon’ble Madras High Court on the ground that the insurance policy in question does not contain any negative covenant.   
10. The learned counsel for the respondent also submitted that it is a fact that the insurance policy in question contains only four categories within which an insured or the legal representative of an insured can get compensation. He also submitted that the insurance policy in question does not contain any exclusion clause specifically. He also submitted that a person purchases an insurance policy for his benefit on the happening of any accident by motor vehicles. He also submitted that the complainant incurred a total expenditure more than rupees one lakh towards the cost of medical treatment in Kolkata and also the cost incurred as travelling expenses for going there and coming back therefrom after medical treatment. He also submitted that the complainant genuinely incurred these expenses for sustaining such injury in the motor vehicle accident. He also submitted that the policy in question covers the owner-cum-driver of the vehicle i.e. the motor cycle, but the insurance company repudiated the claim of the complainant on the ground that the case of the complainant does not fall within any of the four categories mentioned in the policy. He also submitted that the law of equity demands that the complainant who incurred such expenditure due to the accident of his motor cycle, at least should get reimbursement of the expenses incurred by him for his medical treatment. He also submitted that the Ld. District Forum rightly relied on the decision of the Hon’ble Madras High Court and the Hon’ble Apex Court and accordingly, awarded the compensation only for medical expenses and travailing expenses incurred by him. He also submitted that when the written terms and conditions of the policy cannot provide any just compensation to the sufferer, the purposive construction and the interpretation of the insurance policy should be made from the stand point of law of equity and from that stand point the Ld. District Forum rightly passed the impugned judgment and as such, it should be affirmed and the appeal should be dismissed.
11. The learned counsel for the respondent also submitted that the principles of law laid down by the Hon’ble Apex Court in the decision reported in (2007) 3 Supreme Court Cases 700 and (2004) 8 Supreme Court Cases 644 referred by the learned counsel for the appellant in connection with the interpretation of the provision of law under insurance policy are nothing, but a general proposition of law concerning the Act Policy, but in the instant case, the complainant-respondent is covered under Package Policy of motor cycle. He also submitted that the Act Policy is different from Package Policy which is comprehensive in nature. He also submitted that the complainant-respondent paid a premium of Rs.50/- covering the insurance of the owner-cum-driver. He also submitted that as the Package Policy is the subject-matter of consideration in the instant claim case, the principles of law laid down by the Hon’ble Apex Court mentioned above as referred by the learned counsel for the appellant in connection with the Act Policy, have got no application in the instant case.   
12. The learned counsel for the respondent also submitted referring to a decision reported in (2014) 2 Tripura Law Reports 996 between Subhash Ranjan Debbarma (appellant) Vs. Birendra Chandra Ghosh and others (respondents) submitted that in the above referred case, the Hon’ble Chief Justice of Tripura High Court relying on the decision of the Hon’ble Apex Court in New India Assurance Co.Ltd. Vs Harshadbhai Amrutbhai Modhiya reported in (2006) 5 SCC 192 has been pleased to hold that as the insurance policy does not contain any exclusion clause concerning payment of any interest, the Insurance Company is liable to pay the interest. It has also been held in the said decision that if the Insurance Company wants to escape its liability to pay the interest, it must produce and prove the insurance policy and show that there is a clause therein that the Insurance Company is not liable to pay interest. Referring to the above decision of the Hon’ble Tripura High Court, the learned counsel for the respondent submitted that as the policy in question of the instant case is a Package Policy and as it contains no exclusion clause, the respondent-Insurance Company is legally bound to make compensation to the respondent-complainant on the basis of his claim application submitted before the Insurance Company.    
13. The learned counsel for the respondent then submitted before us that following the principles of law enunciated in the decision of the Hon’ble Tripura High Court and the Hon’ble Supreme Court mentioned above, the complainant-respondent was legally entitled to get the compensation for incurring by him the medical expenses and also the travelling expenses for going to Kolkata for such medical treatment, but the appellant-Insurance Company made no response to satisfy the claim of the respondent and thereby the complainant has been compelled to lodge the complaint under Section 12 of the C.P.Act before the Ld. District Forum. He also submitted that the Ld. District Forum considering all, rightly passed the impugned judgment awarding compensation and as such, the judgment under appeal should be affirmed and the appeal should be dismissed.
14. We have gone through the two decisions of the Hon’ble Apex Court referred by the learned counsel for the appellant, the decision of the Hon’ble Tripura High Court, the decision of the Hon’ble Apex Court and also the decision of the Hon’ble Madras High Court passed in connection with the Civil Miscellaneous Appeal No. 3006 of 2012 pronounced on 15.03.2013 referred by the learned counsel for the respondent. We have also gone through the evidences, the pleadings of the parties, the impugned judgment and also the memo of appeal. From the insurance policy in question (Ext. 6), it is found that it is a Package Policy of motor cycle/scooter concerning the vehicle No.TR-01-J-6963 belonging to the respondent-complainant.
15. From the decision of the Hon’ble Apex Court reported in (2004) 8 Supreme Court Cases 644, it transpires that there involved the question of definition of ‘Burglary’ as defined in the insurance policy as theft covered by the policy, but the facts and circumstances of the instant case is altogether different from the referred case. Furthermore, the principles of law laid down by the Hon’ble Apex Court in the above reported case is relating to an Act Policy, but not in connection with any comprehensive or Package Policy. That being the position, we are of the view, that the principles of law laid down in the above reported case referred by the learned counsel for the appellant are not applicable in the instant case.
16. Going through the decision of the Hon’ble Apex Court reported in (2007) 3 Supreme Court Cases 700, it transpires that there involved the question of third-party risk’s. It further transpires that the insurance policy involved in the referred case being under an Act Policy was governed by the provision of the Statute. It further appears that being the said policy under Act Policy, it was not contractual, whereas the policy involved in the instant case, being comprehensive/Package Policy, is contractual. It also appears that there involved the question of terms of an insurance policy, but in the instant case, we find nothing regarding the interpretation and terms of the Package Policy (Ext. 6) and as such, there arises no question of adding or subtracting anything to the terms of the Package Policy involved in this case. For the reasons mentioned above, we are of the view that the principles of law laid down by the Hon’ble Apex Court in the above cited case referred by the learned counsel for the appellant also have no application in the instant case.        
17. It is also found admitted position that an amount of Rs.50/- has been realized by the Insurance Company towards compulsory P.A. to owner-cum-driver with a coverage of an amount of Rs.1,00,000/-. It is also admitted fact that the accident in question took place on 04.10.2011 within the insurance coverage period from 16.09.2011 to 15.09.2012. It transpires from the Ext. 6 (Package Policy) that the insurance policy provides for allowing compensation in four categories for the Personal Accident Cover for owner-cum-driver which is as follows :-

          Details of Injury                                Scale of compensation

1. Death                                                            100%
2. Loss of two limbs or sight

Of two eyes or one limb and

sight of one eye                                           100%

3. Loss of one limb or sight of one eye             50%
4. Permanent total Disablement from

injuries other than named above               100%

18. From the above, it transpires that there are four types of injuries for which separate scale of compensation is provided in the Personal Accident Cover Policy for the owner-cum-driver. It also appears that as per Terms and Conditions of the policy (Ext.6), the compensation shall be payable under only one of the items 1 to 4 and the total liability of the insurer shall not in aggregate exceed the sum of Rs.1,00,000/- during any one period of insurance. It also appears that no compensation shall be payable in respect of death or bodily injury directly or indirectly wholly or in part arising or resulting from or traceable to (a) intentional self-injury, suicide or attempted suicide, physical defect or infirmity or (b) an accident happening whilst such person is under influence of intoxicating liquor or drugs. Such compensation shall be payable only with the approval of the insured name in the policy and directly to the injured or his/her other legal representative whose receipt shall be a full discharge in respect of the injury of such person. It further appears that the cover is subject to, (a) owner-cum-driver is the registered owner of the vehicle insured herein; (b) the owner-cum-driver is the insured named in the policy; (c) the owner-cum-driver holds an effective driving licence, in accordance with the provision of Rule 3 of the Central Motor Vehicles Rules, 1989 at the time of accident.
19. It has been held by the Hon’ble Madras High Court mentioned earlier in para-104 therein that the maximum scale of compensation for bodily injuries/death for the owner-cum-driver of the vehicle, @ 50% or 100%, depending upon the nature of the four specific injuries, does not mean that the injured owner-cum-driver, is not at all entitled to any compensation, if he sustains injury, incurred expenses for treatment, medicines and any other incidental expenditure or when he suffers a permanent disablement, without the loss of two limbs or sight of two eyes or one limb or sight of one eye.
20. It has also been held by the Hon’ble Madras High Court in para-105 and 106 of the judgment passed in CMA No.3006 of 2012 between the National Insurance Co.Ltd. (appellant) Vs. Krishnan (respondents) which is as follows :-  

          105.Scales of compensation is quantified and fixed, in respect of the four mentioned categories and in respect of other bodily injuries, directly or indirectly, wholly or in part, arising or resulting in an accident, involving the use of vehicle, the damages can always be measured, depending upon the nature of injuries, period of treatment, expenditure incurred, extent of disablement assessed by the Doctor and such other factors, which are taken into consideration for awarding compensation, on the principles of just compensation, but at the same time, the aggregate shall not exceed a sum of Rs. 1 Lakh, during anyone period of insurance, In cases other than the specified injuries, Courts/Tribunals cannot shut down the legitimate claims of the insured or the legal representatives of the deceased, when the beneficial legislation is founded on the principles of just compensation.

          106.The contention that the Insurance Company need not pay any compensation to any grievous injury or permanent disablement, arising out of the injuries, except for Items 1 to 4, specified in the Personal Accident Cover Policy, cannot be accepted, as the contract of insurance, viz., Personal Accident Cover Policy for the owner-cum-driver, is also a Motor Transport Policy, under IMT 15, recognized by the Motor Tariff Committee. As stated supra, when the policies issued under the Insurance Act, are recognized by the Committee, subject to the regulations and instructions, issued by the Committee, it is not open to the Insurance Companies to disown, their liability to pay compensation, in respect of other bodily injuries, wherein, scales of compensation are not specifically provided. There is no negative covenant in the policy, that no compensation would be paid, in respect of other bodily injuries. It is well settled that the Motor vehicles Act is a beneficial legislation. Reference can be made to a decision of the Apex Court in Smt. Rita Devi and others v. New India Assurance Co.Ltd., reported in AIR 2000 SC 1930, wherein, in construing the provisions of the Act, the Supreme Court held that it is to advance the beneficial purpose underlying the enactment in preference to a construction, which tends to deviate the purpose. 

21.     It has also been held in para-109 of the said judgment passed by the Hon’ble Madras High Court “Such a narrow construction of the terms of the policy, proposed by the Insurance Company, would run contrary to the purpose of the beneficial legislation. For the abovesaid reasons, this Court is not inclined to deny the benefit of Personal Accident Cover to the respondent/claimant, who is the owner-cum-driver of the vehicle involved in the accident……”   

22.     From the case reported in (2014) 2 Tripura Law Reports 996, it transpires that there was no provision in the connected insurance policy to the effect that the Insurance Company will not be bound to pay any interest on the compensation amount. It further appears that as there was no exclusion clause to the effect that the Insurance Company is not bound to pay the interest on the compensation amount, it has been held by the Hon’ble Tripura High Court that by virtue of non-exclusion clause in the insurance policy, the Insurance Company is legally bound to pay the interest holding that had the Insurance Company any intention not to pay interest on the compensation amount, the same would have been incorporated in the insurance policy.

23.     It transpires from the decision of the case of the Hon’ble Apex Court reported in 2006 (5&6) SBR 281 that in the connected insurance policy there was a clause excluding the liability of the insurer towards interest and penalty, but the Hon’ble Gujrat High Court allowed the interest. The Hon’ble Apex Court has been pleased to hold that a contract of insurance is governed by the provisions of the Insurance Act and unless the said contract is governed by the provision of a statute, the parties are free to enter into a contract as per their own volition. The Hon’ble Apex Court also has been pleased to hold in the said judgment that the Insurance Act does not contain a provision like Section 147 of the Motor vehicles Act and where a statute does not provide for a compulsory insurance or extent thereof, the parties are free to choose their own terms and contract and in that view of the matter, contracting out, so far as reimbursement of amount of interest is concerned, is not prohibited by a statute and as such, the Hon’ble Apex Court has been pleased to set aside the judgment of the Hon’ble Gujrat High Court holding that the appellant is not liable for the interest, but the employer shall be liable to pay interest to the claimant. In the case in hand, the insurance policy (Ext.6) does not exclude the liability of the Insurance Company to make good by way of granting any compensation for the loss suffered by the respondent-complainant for sustaining injuries not covered by any of the four categories mentioned in Section III of the Package Policy.

24.     Admittedly, the respondent-complainant is a owner-cum-driver of Motor Cycle bearing No. TR-01-J-6963. It is evident that the respondent-Insurance Company realized premium Rs.50/- towards compulsory P.A. to owner-cum-driver covering personal accident benefit for owner-cum-driver up to an amount of Rs.1,00,000/-. It has also been mentioned that the accident took place within the insurance coverage period. It further appears that on 04.10.2011 at about 3.00 p.m. when the complainant while coming from Hezamara side to Mohanpur by riding his motor cycle fell down from his motor cycle due to erection of defective hump on the road near Rangacherra road culvert and sustained severe injuries in various parts of his body and immediately after the accident he was taken to Mohanpur hospital wherefrom he was shifted to G.B.P. hospital, Agartala and as he was suffering from severe head injury, he was referred to Kolkata for better treatment by the Medical Board of G.B.P.Hospital on 05.10.2011 and thereafter, the respondent-complainant was treated in MEDICA Superspcialty Hospital, Kolkata w.e.f. 05.10.2011 to 11.10.2011 as indoor patient, although he was referred to SSKM hospital, Kolkata / AMRI hospital, Kolkata and thereafter, he was also compelled to go to Kolkata once again on 12.12.2012 for further treatment. It further appears from the document that the complainant had to incur an expenditure of Rs.54,397/- as cost of medical treatment and Rs.45,935/- as travelling expenses for going to Kolkata and returning therefrom in connection with his medical treatment in Kolkata totalling an amount of Rs.1,00,339/-. It appears that the respondent was treated in Kolkata in MEDICA Superspecialty Hospital, but not in SSKM/AMRI Hospital referred by the Medical Board of G.B.P.Hospital, but the fact remains that the complainant-respondent had to go to Kolkata in connection with his medical treatment for sustaining such injuries and incurred such expenditure. To our mind, MEDICA Superspecialty Hospital, Kolkata is also a renowned hospital and as such, it does not make any difference even if, the respondent-complainant was treated in MEDICA Superspecialty Hospital instead of SSKM/AMRI hospital, Kolkata because the primary object was the recovery of the patient-complainant. It is nobody’s case that the complainant-respondent was not properly medically treated in Kolkata.

25.     Going through the evidences, we find nothing to hold that the complainant negligently caused the said Motor vehicle Accident or the said accident was caused voluntarily by the complainant. There is also nothing to prove that the complainant violated any terms and conditions of the Package Policy. The appellant-O.P. also has no case that the complainant ever violated any terms and conditions of the Package Policy (Ext.6).  The oral and documentary evidences have proved the fact of the case having no rebuttable evidence from the side of the Insurance Company.

26.     It has been mentioned that the injury sustained by the respondent-complainant does not fall in any of the four categories of injuries mentioned in Section III of the Package Policy (Ext.6). It is an admitted position that in the Package Policy there is no exclusion clause that the Insurance Company will not be liable to pay any compensation for any other injuries sustained by the owner-cum-driver, the respondent herein in the motor vehicle accident, if the said injury does not fall in any of the four categories. It has been held by the Hon’ble Apex Court in the case reported in 2006 (5&6) SBR 281 that where a statute does not provide for a compulsory insurance or the extent thereof, the parties are free to choose their own terms and conditions. In that view of the matter, it can be said that had the appellant-Insurance Company any intention to exclude any liability for the owner-cum-driver sustaining injury not falling within any of the four categories mentioned in Section III of the Package Policy, the Insurance Company could easily incorporate such an exclusion clause to avoid its liability to make good by way of compensation not falling within any of the four categories. But the appellant-Insurance Company having such opportunity to include such an exclusion clause in the Package Policy, did not do so and in that case, the principles of law laid down by the Hon’ble Tripura High Court, the Hon’ble Madras High Court and the Hon’ble Apex Court mentioned earlier referred by the learned counsel for the respondent are found applicable in the instant case. Following the principles of law laid down in the above reported cases, we are also of the view that having no exclusion clause in the Package Policy which is known as comprehensive insurance policy, the respondent-complainant is legally entitled to be compensated by way of reimbursement of the medical expenses and the travailing expenses incurred due to the said motor vehicle accident occured within the insurance coverage period, but such compensation amount in any way shall not exceed Rs.1,00,000/- as mentioned in the Package Policy.

27.     It transpires from the impugned judgment that the Ld. District Forum awarded an amount of Rs.1,00,339/- to the complainant as compensation, but according to us, it should not exceed Rs.1,00,000/- as per terms and conditions of the agreement of insurance arrived at by and between the parties, the respondent and the appellant herein vide Package Policy (Ext.6). Be that as it may, it is palpable that the respondent-complainant under the Package Policy is legally entitled to get medical expenses and the travelling expenses limiting it to an amount of Rs.1,00,000/- mentioned above as compensation, but the appellant-O.P. failed to settle the said claim of the complainant rendering it negligent and deficient act in providing service to the complainant compelling him to knock  the door of the Ld. District Forum by lodging a complaint under Section 12 of the C.P.Act, 1986. Considering the facts and circumstances, we find that the awarding of an amount of Rs.5,000/- to the complainant for causing mental agony and harassment together with Rs.2,000/- as cost of litigation cannot be said to be an exorbitant and unreasonable one. In view of the above, we are of the view that the amount of compensation shall be an amount of Rs.1,00,000/- in lieu of Rs.1,00,339/-. The impugned judgment of the Ld. District Forum is liable to be modified only to that extent. Barring this direction in the impugned judgment, we find nothing to interfere concerning any other matter directed in the impugned judgment and as such, it is liable to be affirmed, barring the said modification and therefore, the appeal is liable to be allowed in part.                

28. In the result, the appeal is partly allowed.
29. The impugned judgment dated 03.02.2015 passed by the Ld. District Forum concerning the amount of 1,00,339/- is modified and instead of it, an amount of Rs.1,00,000/- is liable to be paid to the complainant by the appellant-O.P.-Insurance Company as compensation. The remaining portion of the impugned judgment remains unaltered. Accordingly, the impugned judgment of the Ld. District Forum is modified. There is no order as to costs.

 

          

       MEMBER                          MEMBER                                PRESIDENT

               State Commission             State Commission                     State Commission

                     Tripura                               Tripura                                       Tripura