Tripura

West Tripura

CC/35/2015

Goutam Ghosh. - Complainant(s)

Versus

The Manager, The United India Insurance Company Ltd. - Opp.Party(s)

Mr. B.Bhattacharjee,Miss. S.Dhar, Mr.P.R.Barman, Mr.R.Banik.

04 Apr 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSSAL FORUM
WEST TRIPURA : AGARTALA

CASE NO:  CC-   35   of   2015

Sri Goutam Ghosh,
S/O- Sri Rajkumar Ghosh,
Ananganagar, Bimanghar, 
P.S.- Airport, Agartala,
Dsitrict- West Tripura.            ...........Complainant.
    
             ___VERSUS___
             
The United Insurance Company Ltd.,
Represented by the Manager, Divisional Office,
United India Insurance Company Ltd.,
RMS Chowmuhani, Agartala,
District- West Triupura.            .........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 Purushuttam Roybarma, 
                      Sri Bikramjit Bhattacharjee,
                      Smt. Suchismita Dhar,
                      Sri Rahul Banik,
                      Advocates.

For the Opposite Parties        :  Sri Sandip Dutta Choudhury,
                       Advocate.                                       

              
        JUDGMENT  DELIVERED  ON:  04.04.2016

J U D G M E N T

        One Goutam Ghosh filed this complainant against the United India Insurance Company Ltd. alleging about the deficiency of service. It is stated that the complainant while driving his two wheeler TR-01- T- 4779 met an accident suffered grievous injury, admitted to hospital. He claim the expenditure for treatment before the United India Insurance company. He purchased policy covering the accident risk from the O.P. The P.A. Coverage was for Rs.1 lac. But the O.P. Insurance company refused to pay the amount. So, he filed this petitioner claiming Rs.1 lac. against the O.P. United Insurance company.
    
2.        O.P. United Insurance Company appeared, filed w/S denying the claim. It is stated that the injury are not covered by the policy purchased by the petitioner. It was not the case of death, permanent disablement. Therefore, he is not entitled to get any amount as per terms of the policy.

3.        Petitioner produced G.D. Entry, Legal notice, Insurance Policy, discharge summary, medical treatment papers of ILS hospital, G.B. Hospital, FIR, which are marked Exhibit-1 Series. Petitioner also examined one witness i.e., the petitioner himself.

4.        O.P. on the other hand examined one witness, Animesh Dey. He also produced the policy certificate, Exhibit-A. 

5.        On the basis of all these evidence on record we shall now determine the following points.
        (I) Whether the accused person sustained injury when policy was alive?
         (II) Whether the petitioner is entitled to get compensation for deficiency of service?

Findings and Decision:

6.        We have gone through the documents, Exhibit-1 Series, medical treatment papers. The fact of accident and injury is not specifically denied by the opposite party. The contention of the O.P. Insurance company is that such injury is not covered by the policy certificate. We have gone through the policy certificate. It is found that the compulsory P.A. coverage for owner-driver was there. Premium of Rs.50/- was paid. Limits of P.A. coverage liability was Rs.1 lac. Learned advocate for the O.P. argued that as per standard form for commercial vehicle two wheeler the P.A. Coverage is given to owner-driver. It coverage is up to 100% in case of death, loss of 2 limbs, loss of eye sight, permanent disablement. Here in this case petitioner, Goutam Ghosh is the owner-driver of the two wheeler. He has driving license, registration etc. which are produced. But he did not suffer any permanent disablement or death was not caused by the accident. So, contention of the O.P. is that as per terms and conditions he is not entitled to get any compensation. Admittedly, injury sustained by the complainant does not fall within one of the categories as prescribed in the standard form for commercial vehicle. 
7.        In this connection it is advantageous here to refer to the decision rendered by the Madras High Court in CMA No. 2012, 2006 (National Insurance Co. Ltd. Vrs. Krishnan), wherein it is held that ''Insurance need not pay any compensation to any grievous injury or permanent disablement, arising out of the injuries except item No.1 to 4, specified in  Personal Accident Cover Policy, can not be accepted, as contract to Insurance, viz., Personal Accident Cover Policy for the owner-cum-driver, is also a Motor Transport Policy under IMT 15, recognized by the Motor Tariff Committee. As stated Supra, when this policies issued under the Insurance Act, are recognized by the Committee, subject to regulation 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.
        In our considered opinion compensation are not specifically provided. There is no negative provision in the policy to support that no compensation will be paid in respect of bodily injuries. It is well settled that Motor Vehicle Act is a beneficial legislation. In Rita Devi case AIR 2000 SC 1930 our Supreme Court held that ''motor vehicle is to advance the beneficial purpose under lying the enactment in preference to the construction, which stands to deviate the purpose.''    
        
8.        In such a case petitioner is entitled to get cost of treatment for injuries. But there is no clear evidence to support the total cost of treatment. It is found that the petitioner, Goutam Ghosh was referred from AGMC, GB hospital. Referral certificate  by 3 doctors is produced. Thereafter Goutam Ghosh was treated in the ILS hospital. CT scan was done earlier. In the discharge summary of ILS Hospital it is found that he was admitted on 29.09.2014. Surgery was done on 1st October, 2014 and discharged on 05.10.2014. Injury in the left knee which was 5 days old. One Vouchers supports the expenditure of Rs.1908/-. Another Rs.891/-, another voucher for Rs.919/-. The vouchers of the ILS Hospital also produced. Total hospital in the ILS hospital along with operation is shown Rs.83,911/-. The amount was paid by the petitioner. So, it appears to us that total expenditure was about Rs.90,000/-. P.A. Coverage was for Rs.1 lac. So, we are of the considered view that the petitioner is entitled to get Rs.90,000/-. Thus two points are decided accordingly.        
9.            In view of our above findings the petition is allowed. In our considered view the petitioner is entitled to get Rs.90,000/- from the O.P. along with litigation cost. We therefore, direct the O.P. Insurance company to pay the amount of Rs.90,000/- to the petitioner within a period of 2(two) months, if not paid it will carry interest @ 9% P.A. Supply copy of the judgment.   
                          Announced.

 

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

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