Date of Filing : 17-01-2009 Date of Order : 20-07-2009 IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD C.C.No.10/09 Dated this, the 20th day of July 2009. PRESENT SRI.K.T.SIDHIQ : PRESIDENT SMT.P.RAMADEVI : MEMBER SMT.P.P.SHYMALADEVI : MEMBER Manorama, W/o.Babu, R/at Badibagilu, Nullipady, Amey, Kasaragod. Po. } Complainant (Adv. A.Balakrishnan Nair, Kasaragod) 1. The Divisional Manager, New India Assurance Co-Ltd, Shafeer Complex, Opp: Y.M.C.A, Kannur Road, Calicut.1. (Adv. C.Damodaran, Kasaragod) } Opposite parties 2. Bar Counsil of India, Welfare Committee for the State of Kerala, High Court Complex, Kochi. (Adv. P.V.Jayarajan, Kasaragod) 3. The Secretary, Bar Association, Po.Vidyanagar, Kasaragod. (Adv. Rajesh.K. Kasaragod) O R D E R SMT.P.RAMADEVI, MEMBER This complaint is filed by Smt. Manorama against opposite parties seeking a relief against opposite party No.1 the New India Assurance Company Ltd. 2. The facts of the case in brief are as follows. 3. That the complainant Smt. Manorama was a Sweeper of Bar Association, Kasaragod from February 1989 onwards. The complainant sustained grievIous injuries due to Motor Vehicle Accident and now became permanently disabled, she sustained lacerated wound over frontal area, closed head injury, fracture of lower radius fracture of tibia, and pelvic bone. The accident was occurred on 16-06-03 she was an inpatient at Indira Hopsital, Mangalore from 16-06-2003 to18-6-2003 and therafter at Kasturba Medical College, Mangalore from 6-8-2003 to 22-9-2003 and again on 22-9-2003 to 19-9-2003. There was no coverage of insurance for the Motor Cycle involved in the accident. The Medical Board assessed the disability as 20%. 4. There is an insurance policy with opposite party No.1 and 2 and as per the condition of the policy opposite party No.1 is liable to pay compensation of Rs.1,00,000/- to the complainant. But the opposite party No.1 has not paid the amount inspite of repeated reminders by the opposite party No.2. According to the complainant there is no jurisdiction for non-payment of the agreed amount as per policy. According to the complainant it amounts to deficiency in service on the part of opposite party No.1. Hence the complaint is filed for necessary relief. Opposite party No.2 and 3 are arrayed as party since the policy stands in the name of 2nd opposite party. 5. The Opposite parties were served noticed and filed their version. According to opposite party No.1 as per policy conditions the complainant is not entitled to get the compensation. As per the conditions of the policy the insured is eligible to get Rs.1,00,000/- only on accidental death, accidental loss of both limbs or any two limbs or one eye and one limb and Rs.50,000/- for accidental loss of one eye or one limb. The complainant has not suffered any loss of limb or loss of eye. The disability suffered by the complainant is 20% which will not come under the purview of the policy conditions and the repudiation of claim is legal and based on policy condition. Hence there is no deficiency in service on the side of the opposite party No.1. Hence the complainant is liable to be dismissed. 6. Opposite party No.2 and 3 were also filed their written version admitting the claim of the complainant. 7. After considering the facts of the complaint and written version filed by the opposite parties the issues raised for consideration are: 1. Whether the repudiation of claim on the part of the complainant is legal or not? 2. Whether there is any deficiency in service on the part of opposite party No.1? What is the relief? 8. The evidence in this case consists of Exts A1 and A2 on the side of the Complainant and Exts.B1 and B2 on the side of the opposite party No.1. 9. The specific case of the complainant is that she sustained grievous injuries due to Motor Vehicle Accident and became permanently disabled and the Medical Board assessed her disability as 20%. She submitted the claim before opposite party No.1, the New India Assurance Company ltd and the same was repudiated by opposite party No.1. According to the complainant she is entitled to get Rs.1,00,000/- as compensation and the rejection of her claim amounts to deficiency in service on the side of the New India Assurance Company Ltd. The contentions raised by opposite party No.1 is that as per Ext.B2 the conditions of the Janata Personal Accident Group policy, the policy coverage of Rs.1,00,000/- for accidental death, accidental loss of both limbs or any two limbs or any two limbs or one eye and one limb and Rs.50,000/- is for accidental loss of one eye or one limb. Here the complainant has suffered only 20% of disability. Ext.B1 clearly shows the injuries sustained by the complainant and the percentage of disability is 20%. The injuries stated in Ext.B1 will not come under the perview of the policy condition. Hence the complainant is not entitled to get the compensation as per the Janata Personal Group Policy. The repudiation of claim on the part of the New India Assurance Company is legal. There is no deficiency in service on the part of the opposite party No.1, the New India Assurance Company. Hence the complaint is dismissed. No order as to costs. MEMBER MEMBER PRESIDENT Exts. A1.31-01-08 served copy of the letter issued by OP NO.2. A2.12-12-05 letter issued by Bar Council of India Welfare Committee for the sate of Kerala to all the President/Secretary of all Bar Associations in the State. B1. Photocopy of Medical Certificate. B2. Photocopy of Janatha Personal Accident(Group) Policy. MEMBER MEMBER PRESIDENT Pj/
......................K.T.Sidhiq
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