This case is coming on for final hearing before us in the presence of Sri Akella Ramamurthy, Advocate for the Complainant and D.Narasimha Raju Advocate for the OP having stood over for consideration the Forum made the following:-

O R D E R

AS PER SRI T.SRIRAMA MURTHY,PRESIDENT

This is a complaint filed U/s-12 of C.P.Act seeking  the relief to direct the O.P. to pay a sum of Rs.1,20,000/- towards compensation and damages sustained in the motor vehicle accident on the following averments:-

     The complainant is the owner of car bearing No.AP 30H 9186 and the same was insured with the O.P. and was in force from 07.05.2013 to 06.05.2014.  On 03.07.2013 at about 11.00 PM while the complainant and his family members were coming in the car being driven by the complainant and reached near Raghu Engineering College, Vizianagaram it suddenly turned turtle as a result of which the right leg of the complainant was factured and he sustained  some more injuries all over his body.  After the accident the complainant was taken to Venkateswara Nursing home and from there he was shifted to Tirumala Nursing Home, Vizianagaram for better treatment and he incurred a sum of Rs.80,000/- towards operations, medicines, and extra nourishment.  The complainant has sustained loss of salary during the period of treatment for the injury sustained in the accident.  After the complainant was discharged from the hospital he made a claim to the O.P. by submitting the claim petition along with material documents but the O.P. did not settle the claim.  The complainant went to the office of the O.P. many a time and made a request to settle the claim but no effect.  Since there is deficiency in service on the part of O.P. for not settling the claim the complainant suffered mental agony and discomfort.  Hence the complaint.

     The O.P. filed counter traversing the material allegations made in the complaint and has averred  that the O.P. is not aware of the complainant coming on his car from Visakhapatnam to Vizianagaram or about the treatment taken by the complainant in Venkateswara Nursing Home and Tirumala Nursing Home at Vizianagaram.  It is averred that the complainant has intentionally and willfully suppressed the material information and mischievously filed present complaint without disclosing the real facts which led to filing of the complaint.  The complainant did not pay additional premium to cover the risk of complainant under the head personal accident.  It is averred that the complainant did not make any claim and did not submit material documents to the O.P. in this regard.  It is averred that the complainant has claimed compensation to a tune of Rs.1,20,000/- on all heads without disclosing anything about the basis for such estimation and without filing medical bills into the Forum and as such the assessment of loss is invalid and is not tenable.  It is averred that there is no deficiency in service or dereliction of duty on the part of O.P. and as the complainant filed the complaint with an ulterior motive the same merits no consideration and is liable to be dismissed.

     In support of complainants case he filed his evidence affidavit and got marked exhibits A1 to A4 and on behalf of OP affidavit evidence of RW1 is filed and exhibit B1 is marked.

     Perused the material placed on record and heard the counsel for respective parties.

     Now the point for consideration is whether the claim of complainant is sustainable and whether the O.P. is in dereliction of duty and whether the complainant is entitled to get the reliefs prayed for.

     As seen from the contents of written argument filed on behalf of complainant the car of complainant was insured with the O.P. and the same was in force from 07.05.2013 to 06.05.2014 and as the complainant being the owner of the car while coming from Visakhapatnam to Vizianagaram and reached near Raghu Engineering College the same turned turtle and he sustained injuries and was taken to Venkateswara Nursing Home and Tirumala Nursing Home for treatment and he incurred a sum of Rs.80,000/- towards medical expenses and during the time of treatment he was not paid salary and though he made a claim to the O.P. to pay Rs.1,20,000/-.  The latter did not respond to his request and as there is deficiency in service on the part of O.P. the complainant is entitled to get the reliefs prayed for.

     As against the above said contention the learned advocate for O.P. has contended that the complainant did not disclose the true facts and did not make any claim for payment of any amount to the O.P. and as the O.P. is not in dereliction of duty and as there is no deficiency in service the complaint petition is liable to be dismissed.

     It is the specific contention of complainant that he being the owner of car bearing AP 30H 9186 was driving the same and reached near Raghu Engineering college at about 11.00 PM on 03.07.2013 the same turned turtle and in the said accident he received both simple and grievious injuries and his right leg was factured.  In normal circumstances in a case of this nature the victim lodges a complaint with the police as it is a medico legal case but for the reasons best known the complainant did not report the matter to the police concerned.  As per complainant after the accident he was admitted in Venkateswara Nursing Home and later he was shifted to Tirumala Nursing Home for better treatment.  In normal circumstances the doctor attending on the injured would report the matter to the police for due investigation to know as to how the accident took place.  When the injured is taken to a private hospital the doctor would normally enquire the injured or his men as to how the injured sustained injuries and in case it comes to his knowledge that the injured sustained injuries in a motor vehicle accident he has to report the matter to the police for due investigation to know as to how the accident took place.  For the reasons best known the doctors who attended on the complainant for treatment of injuries did not report the matter to the police.  In a case of this nature the complainant ought to have examined the doctors who have given treatment to him, to speak that on a particular date the injured was admitted in their hospital and has taken treatment for the injury sustained in the motor accident.  The complainant did not file any medical record to show that he was treated for a considerable length of time in Venkateswara Nursing Home and Tirumala Nursing Home, Vizianagaram.  In the complaint it is averred that medical bills and all other papers were submitted to the OP for settlement of claim. In the counter filed by the O.P. they have clearly stated that no claim was made by the complainant and no documents were submitted for settlement of any claim.  Under the above circumstances a duty is cast upon the complainant to file copies of medical bills as well as medical record maintained by the hospital to show that he sustained injuries and spent Rs.80,000/- towards his treatment.  But for the reasons best known the complainant did not file any medical records to substantiate his case.  The complainant filed a copy of letter alleged to have addressed to the Branch Manager of the O.P. company and got the same marked as exhibits A1.  As seen from its contents he has submitted the zerox copies of medical bills and other necessary papers and made a request to them to send necessary claim form for claiming the insurance amount.  If the above said contentions are considered to be true the original medical bills and other papers must be with the complainant. But for the reasons best known the complainant did not file those documents in this Forum.  When the complainant has made a request to the O.P. to send necessary claim forms for claiming the insurance amount it cannot be said that he made a claim to the O.P’s for payment of claim amount.  The said letter did not disclose as to when he made a claim to the O.P. for payment of claim amount.  The complainant filed a disability certificate and got the same marked as exhibit A3.

     As seen from its  contents an old facture of right leg was found and the disability was assessed at 25%.  The complainant did not examine the doctors who issued the disability certificate to prove its contents.  It does not disclose as to how the complainant sustained facture and whether the disability due to facture of right leg was happened prior to the date of accident or subsequent to the same.  On assumptions and presumptions it cannot be said that the old facture noticed by the doctors was caused in the motor accident held on 03.07.2013.  Exhibit A4 is the leave certificate issued by the principal Vivekvardhan Junior college and as seen from its contents the complainant was on leave from 03.07.2013 to 03.01.2014,  and he was on loss of pay due to the injuries sustained in the motor vehicle accident.  The complainant did not choose to examine the principal to speak to the contents of exhibit A4.  Marking of a document will never dispense with proof of the same.  In a decision in 11 (2001) CPJ 391 in between Rangannagari Yadev Reddy Vs Vijaya kumari wherein it is held: In the absence of proof by way of some evidence the averments of the complaint by themselves cannot be accepted and when the complainant has failed to substantiate the allegations leveled in his complaint the same fails for want of evidence and is therefore liable to be dismissed.  Coming to case on hand there is no explanation as to why the complainant and the doctors treated him did not give a complaint about the accident to the police when the case is a medico legal case.  Though the complainant has averred in exhibit A1 letter that he has submitted zerox copies of the medical bills and other necessary papers he did not choose to file the originals in this Forum to prove that on 03.07.2013 he sustained injuries in a motor accident.  Though he filed the disability certificate to prove that he has sustained facture to his right leg the said document is no way helpful to him to believe that the said facture was caused in the above said motor accident.  As We have already stated supra in exhibit A1 letter the complainant only asked the O.P. to send necessary claim form to make a claim of insurance amount. When the above said contention is taken to be true it cannot be said that the O.P. did not settle his claim so that he had a cause of action to come to this Forum.  There is no cogent evidence to believe that a motor accident took place on 03.07.2013 and in the said accident the complainant sustained facture to his right leg and other injuries all over his body.  In the above said facts and circumstances we are of the considered opinion that the complainant has failed to prove that there is deficiency in service on the part of O.P.

     In the result, the complaint is dismissed but under the circumstances without costs.            

Dictated to the Steno, transcribed by him, corrected by me and pronounced by us in the open Forum, this the 30th day of April, 2015.

MEMBER                                  PRESIDENT

C.C.No.70 / 2014

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

For complainant:-                   For opposite parties:-

PW 1                                   RW1  &  RW2

DOCUMENTS MARKED

For Compainant:-

Ex.A-1 Letter dated 31.01.2014 to the opposite parties

   along with original Medical bills.       

Ex.A-2 Policy Copy of the car bearing No.AP 30H 9486 of the

   opposite parties.

Ex.A-3 Original Disability certificate issued by the

   treatment doctor.

Ex.A-4 Leave Certificate.

For OP’s:-

Ex.B1 Policy schedule cum certificate of insurance copy.  

                                              President