SRI.LAIJU RAMAKRISHNAN(PRESIDENT)<br /> <br /> The petitioner is the owner-cum-driver of a Bajaj autorikshaw bearing Reg.No.KL-06B-7592 and it was insured in the opposite party's company as Policy No.570B02/31/04/6311323. The policy period was from 20/03/2005 to 19/03/2006. The said autorikshaw while plying through Nachivayal - Kovilkadavu road on 11/03/2006 met with an accident. At about 7.30 p.m. a wild animal crossed the road and the petitioner turned the autorikshaw to the left side of the road, so the vehicle was truned down to the left. Due to the accident the petitioner sustained serious injuries and a fracture was on the right tibia of the complainant, also there was injury on upper radicle area. He was taken to Primary Health Centre at Marayoor on the same day and after that he was admitted in District Hospital, Idukki for better treatment. He was treated as inpatient for 25 days under Dr.Koshy Idikkula. After discharge he was under bed rest for 5 months. The treatment expenses cost about Rs.80,000/-. He was not able to drive the autorikshaw for 5 months, after the accident. The petitioner went to the office of the opposite party and an application was given for claim form, but the opposite party repudiated the claim and harassed the petitioner. Due to deficiency in the service of the opposite party, the petition is filed for compensation under various heads.<br /> <br /> 2. The opposite party filed a written version and it was admitted in that version that the vehicle No.KL-06B/7592 was insured with the respondent in the name of Mr.Gregorious V.V, 100, Vattavayalil, Ward No.3, Marayoor, Devikulam for the period from 20/03/2005 to 19/03/2006. But as per the contract of insurance personal accident cover of Rs.2,00,000/- for owner-cum-driver is given for the following injuries as shown below :<br /> <br /> Nature of injury Scale of compensation<br /> <br /> 1. Death 100%<br /> 2. Loss of two limbs or one sight of two eyes <br /> or one limb and sight of one eye 100%<br /> 3. Loss of one limb or sight of one eye 50%<br /> 4. Permanent total disablement from other<br /> injuries other than named above 100%<br /> <br /> As per the contract of insurance no other injuries are covered by insurance. It is true that the petitioner once came to the opposite party's office at Kolencherry and discussed the claim with the Branch Manager. The Branch Manager shown the relevant conditions of the policy to the petitioner and informed him that he is not entitled to get any amont as compensation. Hence the petitioner returned from the office. Avernment in the complaint that petitioner visited the opposite party's office many times and the Branch Manager misbehaved to the complainant are baseless and false. The petitioner is not entitled to get a compensation of Rs.80,000/- as per the petition. The petition is not maintainable.<br /> <br /> <br /> 3. The point for consideration is whether there was any deficiency in service on the part of the opposite party, and if so, for what relief the complainant is entitled to ?<br /> <br /> 4. The evidence consists of the oral testimony of PW1 and Exts.P1 to P5 marked on the side of the complainant and the testimony of DW1 and Ext.R1 was marked on the side of opposite party.<br /> <br /> 5. The POINT :- The opposite party in the written version, it is admitted that the vehicle was insured with the respondent for the period from 20/03/2005 to 19/03/2006. So there is no dispute regarding whether the complainant is a consumer of the opposite party. Ext.P1 is the copy of the FIR produced by the complainant, in which it is clearly stated that the vehicle No.KL-06B/7592 was met with an accident on 11/03/2006 at about 7.30 P.M. because of a wild animal crossed the road and the autorikshaw turned down. The petitioner happened serious injuries as described in the complaint. A mahazar was prepared by the S.I of Police, Marayoor. Ext.P4 is the treatment certificate from Dr.P.Koshy Idicula, Ortho Paediatric Surgeon, District Hospital, Idukki. These documents clarifies the same injuries and accident as per the petition. Ext.P3 is the medical bill produced by the petitioner which is not at all challenged by the opposite party. The policy certificate produced by PW1 which is Ext.P2 give evidence to the proof of the policy. Ext.P5 is the copy of letter given by the complainant on 10/04/2007 for the policy claim form. So there is no dispute regarding the accident and the injuries sustained to the complainant. The only dispute is whether the complainant is entitled for a claim as per the conditions of opposite party. Ext.R1 is the policy and the terms and conditions of the policy produced by the opposite party. In the written version the opposite party states that as per Section IV - Personal Accident cover for owner-cum-driver of the policy conditions, the petitioner is not entitled for the claim. The petitioner never received the policy from a registered agent. The petitioiner is an illetrate auto driver who was taken the policy directly and he was not given instructions about the terms and conditions of the policy at the time of paying the premium. As per the evidence of PW1, the terms and conditions of the policy was not given to the petitioner at the time of paying the premium. The opposite party only supplied the certificate of policy which is Ext.P2. The terms and conditions of the policy are shown by the opposite party only before the Forum at the evidence stage. So the petitioner was not aware of the same. Anyway as per Ext.R1, the IV condition never says that the claim is barred or rejected if the injuries other than prescribed in Section IV is happened to the owner or driver of the vehicle. Section IV describes about the scale of compensation. So Section IV is not at all barred to the petitioner. So the repudiation of the claim from the opposite party was a gross deficiency in service. The injury caused or the bill is not at all challenged by the opposite party. So Rs.12,320/- may be a genuine medical bill paid by the petitioner. He was admitted at District Hospital, Idukki for 25 days as inpatient and after that he was bed rest for 5 months. So Rs.10,000/- will be awarded as medical expenses. Rs.5,000/- for the mental agony and pain suffered by the petitioner due to the accident and Rs.5,000/- can be given for the loss of earning and cost of the petition to the petitioner.<br /> <br /> In the result, the petition is allowed. The opposite party is directed to pay Rs.32,320/- to the petitioner with 12% interest from the date of this petition within one month of receipt of a copy of this order, failing which the outstanding amount shall carry another 12% interest from the date of default. <br /> <br /> Pronounced in the Open Forum on this the 10th day of June, 2008 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />