Tripura

West Tripura

CC/28/2016

Sri Arun Ch. Deb. - Complainant(s)

Versus

The Divisional Manager, New India Assurance Company Ltd. - Opp.Party(s)

Mr.A.K.Sarkar, Mr.B.C.Deb, Mr. K.K. Pal.

26 Sep 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
WEST TRIPURA :  AGARTALA

CASE   NO:   CC- 28 of 2016

Sri Arun Chandra  Deb,
S/O-  Lt. Surendra Ch. Deb,
Madhya Pratapgarh,
P.S. East Agartala,
West Tripura.                    ..…..…...Complainant.

       VERSUS

The Divisional Manager,
New India Assurance Company Ltd.,
4 Mantribari Road,
Agartala, 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.

SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

C O U N S E L

    For the Complainant        : Sri Kishore Kr. Pal,
                          Sri Arun Kr. Sarkar,
                          Sri Bimal Kanti Nath,
                            Sri Bikash Ch. Deb,
                          Advocate.

For the O.P.                 : Sri G.S Das,
                      Sri Kushal Deb,
                      Advocate.

 

    JUDGMENT  DELIVERED  ON:  26.09.2016

J U D G M E N T
    
        This case arise on the petition filed by one Arun Ch. Deb U/S 12 of the Consumer Protection Act. Petitioner's case in short is that on 08.04.14 he was going to Reshambagan with the scooter TR 01 36622. At that time another vehicle TR 01 A 1359 came from opposite direction in rash and negligent manner and dashed the complainant.  As a result he suffered injury and treated in the GB hospital, AGMC. He suffered 50% disablement and prayed for sum assured from the New India Assurance Company. Advocate notice sent to New India Assurance Company but they refused to pay the  amount. Complainant prayed before the court for present accident claim by policy which is valid from 10.10.13 to 09.10.14. Policy covered up to Rs.1 lakh. 

        O.P. appeared, filed W.S denying the claim. It is stated that policy condition cover is applicable in case of death, loss of 2 limbs or loss one limb or one eye, Permanent total disablement. Petitioner suffered no permanent disablement therefore his is not entitled to get any compensation.
        
        On the basis of contention raised by both the parties following points cropped up for determination;
        (I) Whether the petitioner is covered by the policy certificate and entitled to get compensation as per terms of the policy?

        Petitioner side produced the photocopy of legal notice, registration receipt slip, registration certificate, tax token, policy certificate, insurance policy, driving license. Petitioner also produced the statement on affidavit of Arun Ch. Deb. Petitioner also produced personal Accident Insurance Policy, disablement certificate at the later on stage.

        O.P. on the other hand produced letter dated 30.09.14 issued by the Insurance Company.
        On the basis of all these evidence we shall now determine the above points.

    Findings & Decision:

        In this case Insurance Policy certificate was firstly submitted for policy certificate  No- 53100031130200011668. In the later stage another personal accident Insurance Policy copy was submitted, its number is 53100042130100001136. In the petition nothing written about this Personal Accident Insurance Policy. Whether this policy was related to 2 wheeler not mentioned in the policy itself. The policy submitted earlier is 2 wheeler liability policy. But the policy filed later on is not related to 2 wheeler. Only Personal Accident Insurance of individual. The case is filed in respect of Accident of 2 wheeler which is covered by the policy first produced not the policy produced second time at the later stage. Nothing written in the petition also about the 2nd policy. As per first policy certificate for 2 wheeler P.A. coverage is covered for Rs.1 lakh but for the second policy P.A. Coverage is for 2 lakhs. From the petition and evidence it is clear that first policy is to be taken into consideration while deciding the case not the second policy. The P.A. coverage is given for owner cum driver in the 1st policy. Petitioner was the owner-driver of the scooter 2 wheeler dashed to another vehicle and as a result he suffered injury. He was the 3rd party  in respect of the vehicle which dashed his scooter. So, he is entitled to get compensation for his loss and other aspects in a MACT Tribunal as a 3rd party. Petitioner claimed compensation in respect of his P.A. Coverage before this Forum. 

        Petitioner as given evidence established that he suffered accidental injury but injury nature and prescription, details of treatment papers not produced. In the petition nothing also stated to support that there was huge expenditure for treatment. 2 petitions filed in this case, 1st petition is in respect of 1st Policy. We will consider the 1st policy as it is relevant to two wheeler accident. Policy period is between 08.10.13 to 09.10.14.  It is admitted fact  that within the policy period accident occurred. 
        Main contention of the O.P. is that petitioner suffered no permanent disablement and as per terms of policy he is not entitled to get any compensation. 
        On this point we have relied upon the decision of the Madras High Court C.M.A. No- 3006 of 2012(National Insurance Co. Ltd. Vrs. Krishnan) wherein it was held that party is entitled to get compensation for other bodily injuries where in scales of compensation are not specifically provided. There is no covenant in the policy in respect of other bodily injuries. 

        In this instant case, disablement certificate was produced in the later stage of the case. In this Consumer Court Evidence Act is not to be followed in toto. From the permanent disablement  certificate  it appears that petitioner suffered 50% disablement in both legs. As per terms of the policy in case of loss of one limb petitioner is entitled to get 50% of sum assured. In case of permanent total disablement 100%. In this instant case petitioner suffered 50% disablement of 2 limbs. So he is entitled to get 50% of the insured amount as per terms of the policy. From the Insurance policy certificate it is found that sum assured was Rs.1 lakh for PA coverage. So, petitioner is entitled to get 50% of Rs.1 lakh  i.e., Rs.50,000/- in this case for other expenditure for treatment as other no papers submitted before us. It may be a fact that on the same cause MACT claim petition was filed as a 3rd party in respect of involvement of bus TR 01 A 1359. The amount might have been realized from the insurer of the bus. So, in our considered view petitioner is entitled to get Rs.50,000/- from the Insurance company as the Insurance company failed to pay the same for PA coverage. Petitioner  is also entitled to get Rs.10,000/- for cost of litigation in total Rs.60,000/-. 

        In our considered view O.P., New India Assurance company failed to give proper service to the petitioner but petitioner also failed to submit papers in regard to disablement certificate in time. So deficiency of service not clearly proved. However, petitioner is entitled to get Rs.60,000/-(Rupees sixty thousand) from the O.P. as per terms of the policy and cost of litigation.

        We therefore, direct the Insurance company to pay the amount within 2 months, if the amount is not paid it will carry interest @ 9% P.A. till the amount is paid.

     
                   Announced.

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

 

SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.