Tripura

West Tripura

CC/2/2015

Sri Babul Das - Complainant(s)

Versus

The Divisional Manager National Insurance Company Ltd - Opp.Party(s)

Mr.S.C.Majumder, Mr.J.P.Saha

04 Jan 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSSAL FORUM
WEST TRIPURA : AGARTALA

 

    CASE NO:  CC-  02 of 2015

 

Sri Babul Das,
S/O- Lt. Banamali Das,
Ghaniamara, Bisalgarh,
District- Sipahijala.            .............Complainant.
    

         ______VERSUS______

The Divisional Manager,
National Insurance Co. Ltd.
42, Akhaura Road, Agartala,
P.S. West Agartala,, 
District- West Tripura.           .........Opposite Party.
            

                    __________PRESENT__________

 

 SRI A. PAL,
PRESIDENT,
  DISTRICT CONSUMER  DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. Dr. G. DEBNATH
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SHR. B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

 

C O U N S E L

For the Complainant    : Sri Sujit Chandra Majumdar,
                  Sri J. P. Saha and
                  Advocates.
                                                         
For the Opposite Party    : Sri Joy Deep Paul,
                  Sri Amrit Lal Saha,
                  Sri Sumi Datta,
                  Advocates.

JUDGMENT  DELIVERED  ON:  04.01.16

J U D G M E N T

        This  case arises on the complaint filed by Babul Das on the fact that on 18.11.13  while he was driving the Maruti Vehicle Registration No. TR 01-AD-0252 the vehicle met accident due to dashing with a motor bike. The vehicle dashed with bel Tree. As a result petitioner suffered injury and lost his sense. He was taken to Bisalgarh Hospital then to G.B. Hospital, treated there up to 03.12.2013. Thereafter complainant was referred to SSKM Hospital. As seat was not available he was treated in the AMRI Hospital from 04.12.13 to 10.12.13. Thereafter he was treated again in another hospital and total cost was Rs.3 lakhs. So, the petitioner prayed for compensation of Rs.3 lakhs.

2.        Respondent side on the other hand appeared and filed written statement denying the claim. It is stated that as per terms and conditions of the policy petitioner is not entitled to get any compensation as because insurance coverage extends to only death, permanent disablement not for any injury. 

3.        The claim petitioner produced the Advocate Legal Notice, FIR, National Insurance Certificate, discharge summary of the hospital, Impatient bill and other papers relating to treatment.

4.        On the other hand O.P. Insurance Company produced standard form of Private Car Package  Policy and one witness. 

5.        On the basis of the contention raised by both the parties we shall now decide whether the petitioner is entitled to get the compensation as claimed.  

        FINDINGS:
6.        On careful scrutiny  of written argument it is apparent that petitioner suffered accidental injury and underwent treatment. This fact is also admitted by the respondent. So, on factual aspect there is no dispute. It is also admitted that petitioner was the driver cum owner of the vehicle who is covered by insurance policy and insurer was the O.P. Petitioner paid premium covering personal accident as owner cum driver amounting to Rs.2 lakhs as per policy certificate. His claim can not go beyond 2 lakhs. It is admitted that petitioner had driving license. The main contention of the O.P. is that insurance coverage is for death, loss of limb, loss of sight, permanent disablement not for any injury. This matter is clearly reflected in the Private Car Package Policy. 

7.        On this point we have to rely upon the decision of the Madras High Court in the CMA No. 306 of 2012 National Insurance Co. Ltd. Vrs. Krishnan wherein it has be held that ''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, recognised by the Motor Tariff Committee.  As stated supra, when the policies issued under the Insurance Act, are recognised 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.''
        It has been further held that'' such a narrow construction of the terms of the policy proposed by the Insurance company, would run to the purpose of the beneficial legislation. For the above said 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.'' 
   
8.        In our considered opinion the ratio of the law laid down by the Madras High Court is applicable in the present case. So, we hold that the complainant is entitled to compensation under Personal Accident Coverage Policy though the injury sustained by the claimant does not fall within the category of death or permanent disablement. The treatment papers as produced shows that the petitioner was admitted in the GBP Hospital thereafter he was referred to SSKM Hospital. The Original certificate for referral outside the state is produced. From the certificate it is clear that Babul Das was referred to SSKM Hospital or Rabindranath Tagore Hospital. The air ticket for Kolkata journey also produced. From the impatient bill cum receipt of the AMRI Hospital it is found that Rs.129690/- was paid for treatment in the hospital of AMRI. Details of bills vouchers of the period of treatment from 04.12.2013 to 10.12.13 produced. Some vouchers is produced in respect of treatment of petitioner in Subodh Mitra Cancer Hospital and Research Centre. This Cancer treatment is not relevant to the accident. So petitioner is not entitled to get any amount for the cancer treatment he underwent in the Subodh Mitra Cancer Hospital and Research Centre. From the  careful scrutiny of the vouchers, prescriptions and bills it is found that for accidental injury petitioner was treated in the GBP Hospital. There he spent about Rs. 4,000/-(Rupees four thousand) for cost of medicines. Thereafter he spent an amount of Rs. 1,29,690/-(Rupees One lakh twenty nine thousand six hundred ninety) in the AMRI Hospital which is related to accidental injury. In addition he spent an amount of Rs.10,000/- (Rupees ten thousand) i.e., for air journey with one escort. For pain and suffering he is entitled to get Rs.15,000/-(Rupees fifteen thousand). Thus in total he is entitled to get Rs.1,58,690/-(Rupees One lakh fifty eight thousand six hundred ninety)  The coverage is extended to Rs.2 lakhs. The award is below 2 lakhs. Though it is not permanent disablement but the petitioner suffered grievous injury  and had to go outside for treatment. Considering all aspects we are of the opinion that this amount the complainant is entitled to get as compensation.

9.        Therefore, direct the O.P. Insurance Company to pay the aforesaid amount to the petitioner within 2 months. If not paid within the period it will carry interest @ 9% P.A.
        
10.                  A N N O U N C E D

 

SRI A. PAL
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

 
SMT. DR. G. DEBNATH
MEMBER,
 DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
  AGARTALA, WEST TRIPURA.    SHRI. B. BHATTACHARYA,
MEMBER,
 DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
  AGARTALA, WEST TRIPURA.