Karnataka

Chitradurga

CC/15/2021

S.Rajappa S/o Sharanappa - Complainant(s)

Versus

The Branch Manager,BAJAJ Allianz General Insurance co ltd., - Opp.Party(s)

Sri.P.S.Sathyanarayanarao

20 Aug 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHITRADURGA.

CC.NO:15/2021

DATED: 20^th AUGUST 2022

PRESENT: -    Sri. M.I.SHIGLI. B.A., LL.M.,       PRESIDENT

                    

                        Smt. B.H. YASHODA.    B.A., LL.B., LADY MEMBER

 

                    

……COMPLAINANT/S	.Sri.S.Rajappa S/o Sharanappa, Class 1 Contractor, Owner of Car bearing Regn No.KA-16-N-0507, Near Railway Station, Now residing at Chowdeshwari Nagara, Davalagiri Badavane, Chitradurga (Rep by Advocate Sri P.S. Sathyanarayana)
V/S
.….OPPOSITE PARTY/S	1 . The Branch Manager, BAJAJ Allianz General Insurance co ltd., Golden Heights,4th Floor,No:1/2,59th  Cross,4th Block, Rajaji Nagara, Bangalore 560010     2 . The Authorised Signatory, BAJAJ Allianz General Insurance company Ltd., Regd and Head office GE Plaza, Airport road, Yerawada, Pune - 411006   (Rep by Advocate Sri. B.M. Ravi chandra)

 

:ORDER:

 

Sri. M.I.SHIGLI. B.A., LL.M., PRESIDENT

 

       The Complainant has filed this compliant against the OPs, and has sought for an award of compensation of Rs.6,50,000/- together with interest with incidental reliefs of claim for loss of earnings and mental agony.

The Complainant has not mentioned the provision under which he is invoking the jurisdiction of this commission. However from the date mentioned in the complaint, on filing complaint this commission assumes the jurisdiction vested under U/s 35 of C.P. Act 2019.

BRIEF FACTS OF THE CASE:

 

1. The complainant claims to be the owner of Maruthi Ertiga Car bearing its Reg. No. KA-16-N-0507 which is insured by OP No.1 and 2.

 

2. That on 08/11/2019 while the owner with his relatives, on NH-50 near Kudligi met with an accident, due to which he sustained body injuries, and was shifted to Bengaluru, where he took treatment between 14/11/2019 and 04/12/2019 as inpatient. He is stated to have underwent surgery for fracture of shaft of light tibia, and was admitted there for about 21 days. Even after his discharge he is suffering and unable to pursue his daily routines.

 

3. The treating doctor is said to have opined that, he is 9% disability with respect to left lower limb and 24% disability with respect to whole body. He is said to have incurred heavy medical expenses, during and after surgical operations.

 

4. He asserts that, on the date of accident, he was the owner of the vehicle in question, and the OPs were the insurer for which he has sought for Personal Accident benefits as per policy schedule. The OPs are stated to have not settled his claim despite requests; hence this complaint.

 

5. This commission after registering this complaint, ordered for issuance of notice to OPs, who in turn, have appeared through their counsel, and filed their detailed version, traversing the contentions of the complaint.

 

6. The OPs interalia have basically challenged, the jurisdiction of this commission, as it is only summary proceedings adopted under CP Act. It is contended, that, this complaint involves intricate questions of facts and law, and require voluminous evidence for proper adjudication.

7. However at para 7 (a) of its version the OPs have admitted the subsistence of the policy in the name of the complainant and have contended that, the policy covers P.A. (Personal Accident) to owner cum driver for an amount of Rs.15,00,000/- only in confirmation of 64 VB and also term and conditions of M.V. Act, and accordingly have sought for dismissal of complaint.

8. On case being set for evidence of parties, the complainant, got himself examined as PW-1 and got marked documents at Ex.A-1 to A-13 and closed his side. The OPs on the other hand examined their representative as DW-1 and got marked documents at Ex.B-1 and B-2 only.

9. The counsels for respective parties submitted their written as well as oral arguments.

Based on the rival contentions of either parties, the following points for consideration arise for our findings, viz…

 

1. Whether the complainants prove that he is the consumer of the OPs.
2. Whether the complainant further prove deficiency of service on the part of OPs.
3. What order?

10. Our findings on the above points are as under.

Point (a): In the affirmative

Point (b): In the Negative

Point (c): As per the final order for the following.

:REASONS:  

        11. As stated above, the complainant has failed, to mention the provision of relevant Law under which he seeks, the relief as against the OPs. Having heard the respective counsels and perusal of the documents, our attention is diverted towards the consideration of Point (a). The perusal of the version of OPs, discloses that the OPs nowhere questioned, the locus of the complainant as consumer and there is no specific denial in the entire version. And on the contrary as stated above, para 7 (a) of the version depicts, that, the OPs are admitting the fact that the, the complainant is the insured under its P.A. (Personal Accident) policy. This leads us to answer Point (a) in the affirmative.

As far as Point (b) is concerned this commission is confronted with the question as to whether there is any deficiency of service on the part of OPs.

        12. A glance at the exhibited documents discloses that, Ex.A-1 is the copy of the insurance policy and Ex.A-2 is the FIR in respect of the accident and Ex.A-3 is the Final Report i.e. charge sheet. This Ex.A-3 discloses the fact that, it is the complainant who has been charge sheeted for the offences U/s 279,337 and 338 of I.P.C who has driven his vehicle in the wrong direction. Ex.A-4 is the M.V. Report, and Ex.A-5 is the wound certificate Ex.A-6 is the spot Mahazar whereas Ex.A-7 is the accident report transmitted to OPs on 27/10/2020 and it appears to be claim for compensation from the OPs. Ex.A-9 to Ex.A-13 are the medical bills and documents of treatment.

        It is revealed from the evidence of OP that, the OPs have settled the claim for damage to the vehicle to the tune of Rs.3,20,747/-, which is not being disputed by the complainant.

        13. The only contentions of the OPs is that, the policy in question is personal accident policy, which covers only the injuries resulting into death or permanent and total disablement, as contended in para 7 (e) of its versions and para  6 (e) of chief examination of DW-1. These assertions of the OPs has not been rebutted  by the counsel for complainant Ex.B-2 evidences to the fact that, the policy in question is package policy/Act policy, and the parties are governed under the contractual stipulations.

 

        14. This commission is conscious of the ratio laid down by the Apex Court of Land in the matter of M/s Suraj Mal Ram Niwas Oil Mills V/s United India Insurance Co. Ltd. in Civil Appeal No.1375/2003,  where it is held at para 22 of the Judgement that...

 “…It is trite that in a contract of insurance the rights and obligations are governed by the terms of the said contract…” 

“…It is also well settled that since upon issuance of an insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risks covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavour of the court should always be to interpret the words in which the contract is expressed by the parties…”

The counsel for the OPs has relied upon an authority, reported in 2003 CCJ 516 of Tamil Nadu State Commission Where it is observed, that…

“…We are able to perceive, that unless there is a total and irrevocable loss of sight of one eye or total and irrevocable loss of use of one hand or a fact, the claim is not tenable under the policy… Such repudiation can by no stretch of imagination be stated to be is an act which could be described as deficiency of service on the part of OPs insurance company…”

        It is pertinent to observe, that, the complainant in the present case has not claimed that there was permanent total disablement or injuries, either in pleading or evidence to that effect, in the nature of section III of the policy enumerated in Ex.B-2.

Under the circumstance, this commission is of the view that, the complainant has failed to prove Point (b) in his favour. Accordingly the same is answer in the Negative.

        Based on the analogy of facts and relevant law, we answer Point (c) and Proceed to pass the following.

 

::ORDER::

       

The complaint filed by the complainant is dismissed.

          There is no order as to costs. Communicate the order to the parties and supply the free copy

 (Typed directly on the computer to the dictation given to stenographer, the transcript corrected, revised and then pronounced by us on 20^th August 2022.)

 

 

 

         LADY MEMBER                                      PRESIDENT

 

-:ANNEXURES:-

 

Witnesses examined on behalf of Complainant:

1. Sri.S.Rajappa S/o Sharanappa

 

Witnesses examined on behalf of Opponents:

DW-1: Prabhakar Naik S/o Manjunath Naik

 

 

Documents marked on behalf of Complainant:

01	Ex-A-1:-	copy of the insurance policy
02	Ex-A-2:-	FIR copy
03	Ex-A-3:-	Final Report i.e. charge sheet
04	Ex-A-4:-	M.V. Report
05	Ex-A-5:-	wound certificate
06	Ex-A-6:-	Mahazar Copy
07	Ex-A-7:-	Accident report transmitted to OPs dated 27/10/2020
08	Ex-A-8:-	Postal Window receipt with acknowledgment card
09	Ex-A-9:-	Discharge summary
10	Ex-A-10:-	Vidyadhar Orthopaedic Centre instruction letter.
11	Ex-A-11:-	Medical bills
12	Ex-A-12:-	Doctor prescription slips
13	Ex-A-13:-	Lab reports

 

Documents marked on behalf of opponents:

 

01	Ex-A-1:-	copy of the insurance policy
02	Ex-A-2:-	Policy Wordings

 

 

         LADY MEMBER                                      PRESIDENT

 

 

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