IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Monday the 30th day of January, 2012
Filed on 16.06.2011
Present
- Sri. Jimmy Korah (President)
- Sri. K. Anirudhan (Member)
- Smt. N. Shajitha Beevi (Member)
in
C.C.No.205/2011
between
Complainant :- | Opposite party:- |
Sri. Appachan, Mankalathu veli House, Muttathi parambu. P.O, Cherthala, Alappuzha (D) (Adv. James Chacko, Alappuzha) | The National Insurance Co.Ltd, Reptd. By its Branch Manager, Branch Office, Near Iron Bridge, Alappuzha (Package policy; Policy issued from Alappuzha Branch- (Adv. C. Muraleedharan, Alappuzha) |
O R D E R
SRI.JIMMY KORAH (PRESIDENT)
The complainant case in a nutshell is as follows: - The complainant on 12th April 2011 met with an accident while riding on his motorcycle bearing Reg. No.KL4-Q2285. The complainant sustained serious injuries and permanent disability. At the time of the accident, the material vehicle was holding a valid insurance from the opposite party. The complainant was also covered by the personal risk policy for an amount of Rs.I00000/-( Rupees One lack only) at the time of the accident. Subsequent to the accident, the complainant along with all material documents approached the opposite party for personal policy amount. Notwithstanding the complainant’s recurrent attempts for the policy amount the opposite party without any valid reason, repudiated the legitimate claim of the complainant. Feeling aggrieved the complainant approached this Forum for compensation and other relief.
2. Notice was served. The opposite party turned up and filed version. The opposite party contends that the injuries alleged to have been sustained by the complainant will not come under the coverage of the policy held by the complainant. According to the opposite party, the complainant has never sustained any permanent total disablement. . The complainant is not entitled to any of the relief sought for from this Forum. The complaint is only liable to be dismissed with cost to the opposite party, the opposite party fervently contends.
3. The complainant evidence consists of the testimony, the counter affidavit of the complainant, and the documents Exbts. A1 to 10 marked. On the side of the opposite party, the affidavit and counter affidavit were filed, and Exbt B1 & B2 were marked.
4. Keeping in view, the contentions of the parties the questions that come up before
us for consideration are:-
a) Whether the injury sustained by the complainant comes under the policy coverage?
5. We meticulously perused the entire materials put on record by the parties. It is revealed that the complainant is the owner of the vehicle involved in the accident. Concededly, he was driving the vehicle at the time of the accident. Indisputably, the complainant sustained injury in the said accident. What has been disputed by the opposite party is the nature and manner of injury. According to the opposite party, going by the terms and condition of the material policy, the injury sustained by the complainant would not entitle him to the benefit of the policy. Now the immediate short question arises before us for consideration is whether the complainant sustained disability as contemplated in the conditions of the policy. Bearing in mind the said contention, we anxiously went through the Exbts Al to A10 and Exts.B1 and B2 documents placed on record by the parties. On an anxious perusal of the said document Exbt.A5, it is very clearly unfolded that the injury sustained by the complainant caused him disabled permanently. Needless to say, Exbt A5 document issued by the medical practitioner discloses that the complainant sustained permanent disability. It is also crucial to notice that the opposite party has not made it a point to discredit or to challenge the Exbt.A5 document. In the given facts and materials of the instant case, the contention canvassed by the opposite party to the effect that the sort of injury sustained by the complainant does not cause any inhibition in the mind of the Forum to accept the case of the complainant that the complainant has permanent disability. In essence, the complainant/driver is permanently disabled. In the terms and conditions of the policy Ext.B2, there is no elaboration as to what 'permanent total disablement' referred to. In this context, we are of the unyielding view that the same is to be construed as permanent disability without presuming any particular consequence to the term 'total' occurs in the particular policy condition.
6. As per the terms of the policy, it is an intended contract between the insurer and the insured viz. the complainant and the opposite party. Strangely yet, without any appropriate reason, the opposite party repudiated the complainant's claim. Repudiation of a legitimate claim is apparently a service deficiency. Thus viewing form any perspective, the contentions set up by the opposite party to deny the complainant the policy amount do not merit acceptance. It goes without saying that the complainant is entitled to relief.
7. For the forging facts and findings emerged herein above, we hold that the complainant is entitled to the policy amount of Rs.I00000/-(Rupees One lakh only ) to be obtained from the opposite party. As such, the opposite party is directed to pay to the complainant the aforesaid amount of Rs.1,00,000/- ( Rupees One lakh only ) with 9% interest from the date of the instant complaint till its recovery. The opposite party shall comply with the order of this Forum within 30 days of receipt of the same.
The complaint is allowed accordingly. No order as to compensation or cost.
Pronounced in open Forum on this the 30th day of January 2012.
Sd/- Sri.Jimmy Korah (President)
Appendix:-
Evidence of the complainant:-
Ext. A1 - Police Report dated 24.04.2011
Ext.A2 - Wound Certificate dated 12/04/2011
Ext.A3 - Letter given to opposite party by complainant dated
12/05/2011
Ext.A4 Series - Discharge Card of complainant dated 22/04/2011
Ext.A5 - Disability certificate dated 26/10/2011
Ext.A6 Series - Bill of amount dated 22/04/2011
Ext.A7 - Tourist Taxi Receipt dated 12.04.2011 (1-5 Numbers)
Ext. A8 - Certificate of Insurance of Motorcycle
Ext.A9 - Certificate of R.C Book (04 Nos)
Ext.A10 - Driving License
Evidence of the Opposite party:-
Ext.B1 - Certificate of lnsurance of Motorcycle dated 1/11/2010
Ext.B2 - Two Wheeler Package Policy
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite party/S.F.
Typed by:- sh/-
Compared by:-
IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Monday the 30th day of January, 2012
Filed on 16-06-2011
Present
- Sri. Jimmy Korah (President)
- Sri. K. Anirudhan (Member)
- Smt. N. Shajitha Beevi (Member)
in
C.C.No.205/2011
between
Complainant :- | Opposite parties:- |
Sri. Appachan Mankalathu Veli House Muttathi parambu P.O. Cherthala, Alappuzha Dt. (By Adv.James Chacko) | The National Insurance Co. Ltd. Represented by its Branch Manager Branch Office, Near Iron Bridge Alappuzha (Package Policy, Policy issued from Alappuzha Branch) (By Adv. C. Muraleedharan) |
| |
O R D E R
SRI. JIMMY KORAH (PRESIDENT)
The matter has been heard in detail and Judgment was drawn up. The other two members of the Forum dissented with the conclusion arrived on by the President. The members so prepared a common order and the President drew up a separate one. As per Section 14-2A of the Consumer Protection Act, the view of the majority of the District Forum will prevail and that shall be the Forum’s final order.
In view of the above, the complaint stands dismissed.
Pronounced in open Forum on this the 30th day of January, 2012.
Sd/- Sri. Jimmy Korah
// True Copy //
By Order
Senior Superintendent
Typed by:-pr/- Compared by:-
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