::BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT BIDAR::
C.C. No.61/2016.
Date of filing: 22.08.2016.
Date of disposal: 24.05.2018.
P R E S E N T:-
(1) Shri. Jagannath Prasad Udgata, B.A., LL.B.,
President
(2) Shri. Shankrappa (Halipurgi),
B.A.LL.B.,
Member.
COMPLAINANT/S: 1. Sri.Shivraj S/o Hanumantappa Patil,
Age: Major, Occ: Business,
R/o H.No.17-4-86/15 Gouramma Nilaya
Gouramma Layout beside sindlo Kalyan
Mantap Amlapur Road Mailore Bidar
Dist: Bidar-585403.
(By Sri.Mahesh Patil., Adv.)
VERSUS
OPPONENT/S: 1) The Manager reliance General Insurance
company Ltd. No.1-89/3/b/40 to 42/ks/301 3rd
floor krishe block krishe sapphire, Madhapur,
Hyderabad 500081 policy bearing
No.1407542311002064 veiled
from 24.06.2014 to 23.06.2015.
(By. Smt.Padma Maharaj., Adv.)
:: J UD G M E N T ::
By Shri. Jagannath Prasad Udgata, President.
The present complaint is u/s 12 of the Consumer Protection Act,1986 by an injured victim (complainant) alleging deficiency of service in the part of the opponent, consequent upon the repudiation of claim. The gist of the compliant is as underneath:-
2. That, the complainant was an entrepreneur running a business enterprise named as Jeera Mineral Water, was 58 years old and further was hale and healthy. He was owner of an Innova 2.5 V7 STR car assigned registration No.KA-38 M 8136 and was covered under policy bearing No.1407542311002064 of the Opponent. The validity of the policy was from 24.06.2014 to 23.06.2015 and extra premium was collected to cover risk of owner driver under personal Accident benefits.
3. It is avered by the complainant that, on 22.04.2015 he had gone to Chalkapur for opening ceremony of Sidharoodha Math at about 5.30 A.M. to deliver some articles and while was coming back to Bidar on Humnabad Andoor Road, at about 6.00 A.M., of the same day they reached a small bridge and the Driver negligently and rashly driving the above said car dashed against the bridge resulting injuries of fracture of left hip and femur and loss of consciousness. He was initially admitted in Prayavi Hospital, Bidar, where is the initial treatment was given and he was refered to Kamineni Hospital, Hyderabad. He was admitted on the same day vide UHID No.2015411963- I.P.No.201509159, underwent surgery with fixation of implants and Knails on left hip and femur and was discharged on 28.04.215. Next, he was readmitted in Vikram Hospital, Bangaluru on 16.03.2016 vide No.140037 for treatment of pain full movements, wherein broken implants were removed, fresh implants, compression screw were fixed and bone graft was done. He was discharged with un going treatment procedure prescribed on 21.03.2016.
4. The complainant raised insurance claim with the opponent which was repudiated vide letter date: 04.05.2016 (copy as annexure-Y), aggrieved by which, he has filed the present claim seeking a compensation of Rs.19,90,000/- with costs.
5. The opponent entering appearance through counsel has filed written versions in which the quantum of claimed monthly income has been denied so also the fact of accident. The opponent Insurance company further claims that, the complainant himself was responsible for the accident and the Insurer would not be liable to compensate. It is further alleged that, the Police case has been registered using the complainants political influence. The Paras 6,7 and 8 of versions the O.P.claims that, the liability of the Insurer is limited to Rs.2,00,000/- subject to proof and the arousal of cause action has been denied in the subsequent paragraphs.
6. Both sides have submitted evidence affidavits, repeating their assertions and written arguments. In the written arguments of the O.P., though the fact of accident and issuance of policy has been admitted, a baseless assertion is being made that, the accident took place 26.04.2016, beyond the coverage of the policy. Only, the complainant has filed documents listed at the end of this order.
7. Basing on the contentions of the parties, the following points arise for our consideration.
- Does the complainant proves the allegation of deficiency of service?
- Does the O.P. prove that, its’ repudiation was justified?
- What orders?
8. Our answers to points are as following:-
- In the affirmative.
- In the negative.
- As per the final orders owing to the following:
:: REASONS ::
9. Point 1&2: Both points being inter webbed are being answered together. The complainant has submitted overwhelming documents proving the facts of obtainment of policy with P.A. cover for owner-driver, accident cased to the vehicle, injuries sustained by him and elaborate, costly surgical procedures undergone by him. He has also submitted ample proofs proving his status as Income Tax Assesee and disability certificate at Annexure-Z. None of these profs were ever seriously challenged by the opponent but only a bland denial has been thrusted upon. The documents at Annexures-A toG while speak volumes of the fact of accident and injuries sustained, Annexure-H is the copy of the Insurance policy. Annexures-J to L are copies of his I.T. records and Annexure-M is the copy of the Driving Licence of the driver of the vehicle. Anneures N to X are treatment records for the injuries sustained by him, Annexure-Y is the repudiation letter (copy). The most clinching evidence produced by the complainant is at Annexure-Z, in which one Dr.Vijaykumar, M.B.B.S. Dortho following the guidelines of Government of India, Ministry of social Justice and Empowerment date: 28.08.1998- Ref No.16-18/97 N1.1 has certified the percent age of permanent disability of left lower limb at 50%. Can an elderly person like the complainant would ever be able to overcome the disability aforesaid? Would he be able to be normally mobile? Therefore, we construe that, the disability is total and permanent and answer the points accordingly, not justifying the rebuttal of the opponents, since this proof was never challenged.
10. Point 3: The complainant has claimed a fanciful compensation of Rs.19.90,000/- with costs. We are not here trying the claim of a third party herein in a M.A.C.T. case, wherein the claims of such claimant can be entertained. Both sides are privy to a contract entered in the shape of an Insurance policy, where in the limit of liability of the Insurer is recorded at a sum of Rs.2,00,000/-. Therefore, we conclude that, the complainant is only entitled for that much with other conventional benefits and proceed to pass the following:-
ORDER.
- The complaint is allowed in part.
- The opponent is hereby directed to pay a sum of Rs.2,00,000/- as P.A. Cover to the complainant along with an interest @ 12% p.a. calculated from the date of accident i.e. 22.04.2015 till realisation;
- The opponent would further be liable to pay a sum of Rs.5,000/- towards litigation expenses;
- Four weeks time granted to comply this order.
(Typed to our dictation then corrected, signed by us and then pronounced in the open Forum on this 24th day of May 2018).
Sri. Shankrappa H. Sri. Jagannath Prasad
Member. President.
Documents produced by the complainant
- Annexure. A- C.C. of F.I.R and complaint.
- Annexure. B– C.C. of charge sheet.
- Annexure. C– C.C. of spot Panchanama.
- Annexure.D—C.C. of Statement of witness Sri. Akash.
- Annexure. E– C.C. of statement of witness Sri. Shrimanth.
- Annexure.F- C.C. of wound certificate of Prayavi Hospital, Bidar.
- Annexure.G- C.C. of I.M.V. report.
- Annexure.H- Copy of Insurance certificate.
- Annexures.JtoL-Copy of Income Tax Calculations and Tax
payments of Complainant. - Annexure.M- Copy of Driving Licence of Driver Nirhankar.
- Annexure.N- Estimate of Kamineni Hospital, Hyderabad.
- Annexure.P- Discharge receipt of Kamineni Hospital, Hyderabad.
- AnnexureQ- Discharge bill of the above hospital.
- Annexure.R- Pharmacy report derail of the above hospital.
- Annexure.S- discharge summary of Kamineni Hospital Hyderabad.
- Annexure.T- Receipt voucher of Prayavi Hospital, Bidar.
- Annexure.U- Prescription of Prayavi Hospital, Bidar.
- Annexure.V- Referal letter of Prayavi Hospital, Bidar date: 22.04.2015.
- Annexure-W- Discharge Summary of Vikram Hospital, Bengaluru.
- Annexure.X- bill of the above hospital.
- Annexure.Y- repudiation letter of O.P. date: 04.05.2016.
- Annexure.Z- Disability Certificate issued by Dr. Vijayakumar.
Document produced by the Opponents.
-Nil-
Witness examined.
Complainant.
- P.W.1- Sri.Shivraj S/o Hanumanthappa Patil (complainant).
Opponent No.1
- R.W.1- Sri Vijayakumar Kotin S/o Kashinath (Legal claims
Manager of O.P.).
Sri. Shankrappa H. Sri. Jagannath Prasad
Member. President.
