Haryana

Yamunanagar

CC/531/2010

Babu Ram S/o Kura Ram - Complainant(s)

Versus

The Oriental Insurance Company Ltd. - Opp.Party(s)

Manoj Saini

27 Jul 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                    Complaint No.  531  of  2010.

                                                                                    Date of institution: 31.5.2010

                                                                                    Date of decision: 27.7.2015.

Babu Ram son of Sh. Kura Ram resident of Village Mansoorpur, Sub Tehsil Radaur, Tehsil Jagadhri, District Yamuna Nagar.  

 

                                                                                                                                                               …Complainant.

                                                Versus

 

The Oriental Insurance Company, Ltd. through Branch Manager, Branch Opposite Madhu Hotel, Jagtadhri Road, Yamuna Nagar, District Yamuna Nagar.                                                                                                                                                

                                                                                                                                                              …Opposite party.   

           

CORAM:          SH. ASHOK KUMAR GARG, PRESIDENT,

                        SH. S.C.SHARMA, MEMBER.

 

Present: Sh. Naresh Khurana, Advocate, counsel for complainant.    

              Sh. Amit Bansal, Advocate, counsel for OP. 

ORDER

 

1.                     Complainant has filed the present complaint under section 12 of the consumer Protection Act 1986.  

2.                     Brief facts, as alleged in the complaint, are that the complainant is registered owner of Motor Cycle bearing registration No. HR-02K-3226 Make Hero Honda Splendor which was insured vide Act Liability Insurance Policy alongwith covering  the risk of personal accident for Rs. 1,00,000/- and paid Rs. 50/- on this account, bearing No. 261700 valid from 12.9.2007 to 11.9.2008. At the time of issuance of this policy, the OP assured to the complainant that complainant is entitled to get Rs. 1,00,000/- on account of accidental death or injury. It has been further mentioned that when on 13.1.2008 the complainant was driving the said motorcycle and was going from village Kheri Lakha Singh towards his village Mansoorpur he met with an accident and fell down on the road and suffered multiple injuries. Due to the injuries suffered by him in road side accident, he remained admitted in Gaba Hospital, Yamuna Nagar from 13.1.2008 to 29.1.2008 and thereafter complainant also remained under treatment of Gaba Hospital as our-door patient and also got the treatment from Dr. Nageshwar Iyer C/o Smile Hospital, Yamuna Nagar and spent a total sum of Rs. 80,000/- on his treatment. It has been further alleged that complainant has become permanent disabled. It has been further alleged that OP was requested to pay the compensation on account of injuries sustained in the accident and completed all the formalities but despite completing of all the formalities, the opposite party is putting off the matter with one pretext or the other and ultimately has refused to pay any compensation without disclosing any reason. Hence, there is a great deficiency on the part of OP and prayed for directing the OP to pay the compensation of Rs. 80,000/- on account of injuries and further to pay Rs. 50,000/- on account of cost of proceedings, mental agony, harassment and financial loss etc.   

3.                     Upon notice, OP appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable, has suppressed the material facts from the Hon’ble Forum, no cause of action and on merit, it has been mentioned that the Act Liability policy bearing No. 261700 valid from 12.9.2007 to 11.9.2008 alongwith covering the risk of personal accident for Rs. 1,00,000/- after charging Rs. 50/- on this account was issued in respect of Motor Cycle bearing registration No. HR-02K-3226 subject to the terms and conditions of the insurance policy.  It has been further mentioned that complainant had not lodged any claim with the OP till date, hence this complaint is liable to be dismissed on this ground alone. It has been further mentioned that otherwise also the said policy is only Act Liability Policy and Rs. 50/- has been charged for covering the personal accident converge of Rs. 1,00,000/- on account of death of owner-cum-driver while driving the vehicle. The personal accident coverage of Rs. 1,00,000/- was available to the owner-cum-driver, if the ownership driver dies or suffers injuries to a certain scale i.e. 100% compensation if he suffers loss of two limbs or sight of two eyes or one limb and sight of one eye and 50% compensation if he suffers loss of one limb and sight of one eye. In the same way 100% compensation if owner-cum-driver becomes permanent disabled from the injuries other than noted above. Except above noted injuries, no other injury or expenses of treatment comes under the purview of the policy in question. Hence, the case of the complainant does not fall within the purview of policy in question and he is not entitled to get any compensation and the other allegations are frivolous, alluring and are baseless. The complainant has tried to manipulate the facts for extorting money from the insurance company. It has also been further mentioned that the present complaint is without any cause of action and complaint is liable to be rejected as per provision contained under order VII Rule 11(a) of the Code of Civil Procedure, 1908, which states that the plaint shall be rejected where it does not disclose a cause of action. Hence, there is no deficiency in service on the part of OP and prayed for dismissal of complaint.  

4.                     As the complainant failed to lead any evidence, hence his evidence was closed by court order on 7.4.2015. However at the time of filing of complaint, complainant filed his affidavit as CX  and documents such as Photo copy of driving license Annexure-C-1 and  Photo copy of registration certificate as Annexure-C-2 with the complaint.

5.                     On the other hand, counsel for the OP tendered into evidence Copy of Insurance policy as Annexure R-1 and closed the evidence on behalf of OP. 

6.                     We have heard the learned counsels for both the parties and have gone through the pleadings as well as documents placed on file very minutely & carefully.  

7.                     Learned counsel for the complainant argued that complainant met with an accident while driving the motorcycle on 13.1.2008 and received injuries and remained admitted in Gaba Hospital, Yamuna Nagar from 13.1.2008 to 29.1.2008 and after that remained under the treatment of Dr. Nageshwar Iyer C/o Smile Hospital, Yamuna Nagar and spent a sum of Rs. 80,000/- on his treatment etc. and has become permanent disabled. It has been further alleged that formalities were completed and opposite party was requested to pay the compensation on account of injuries suffered by him, as the complainant was insured with the opposite party for Rs. 1,00,000/- and paid Rs. 50/- as a premium on this account but the opposite party has been putting off the matter on one pretext or the other. In support of his contention complainant filed his affidavit alongwith copy of driving license C-1 and Copy of registration certificate of motorcycle bearing No. HR-02K-3226 as C-2.

8.                     On the other hand, counsel for opposite party argued that in fact neither any intimation about the occurrence of accident as well as injuries/treatment has been given to the opposite party nor any claim has been lodged by the complainant. Further, it has been stated that as no claim has ever been lodged with the opposite party, hence no question arose to complete the formalities as alleged by the complainant. Learned counsel for the opposite party further argued that on merit also, claim of the complainant is not maintainable since the case of the complainant does not fall within the sphere and purview of the insurance policy in question. As per insurance policy in question, Rs. 50/- was charged for covering the personal accident converge of Rs. 1,00,000/- on account of death of owner-cum-driver while driving the vehicle. The personal accident coverage of Rs. 1,00,000/- was available to the owner-cum-driver, if the owner-cum driver dies or suffers injuries to a certain scale i.e. 100% compensation if he suffers loss of two limbs or sight of two eyes or one limb and sight of one eye and 50% compensation if he suffers loss of one limb and sight of one eye. In the same way, 100% compensation if owner-cum-driver becomes permanent disablement from the injuries other than mentioned above. Except above noted injuries, no other injury or expenses of treatment comes under the purview of the policy in question. The policy in question is only Act liability policy covering the requirements of Motor Vehicle Act.. As the complainant has not lodged any claim with the opposite party and also has not filed any disability certificate or any treatment record as well as bill of expenses with the opposite party, hence, there is no deficiency in service on the part of opposite party and the complaint is liable to be dismissed.

9.                     From the perusal of the insurance policy Annexure R-1 and after hearing the arguments advanced by counsel for both the parties,  it is not disputed that the motorcycle bearing registration No. HR-02K-3226 was insured vide Act Liability Insurance Policy bearing No. 261700 valid from 12.9.2007 to 11.9.2008 alongwith covering  the risk of personal accident for Rs. 1,00,000/- and premium of Rs. 50/- was paid on this account. The plea of the counsel for the complainant that complainant is entitled to get Rs. 80,000/- on account of medical expenses from the opposite party is not tenable firstly on the ground that complainant has totally failed to submit any medical treatment record as well as bill of expenses and lodged the claim with the opposite party. Even the complainant has not disclosed any date and month on which the claim was lodged with the opposite party and has also not filed any documentary evidence regarding expenses of medical treatment, disability certificate before this Forum. Further, the complainant has also not filed any documentary evidence that he had lodged any claim with the opposite party. The complainant has filed only his affidavit and copy of driving license C-1 and copy of RC C-2. Secondly, insurance policy in question covers owner-cum-driver for the risk of death or loss of two limbs or sight of two eyes or one limb and sight of one eye but in this case no such disability  certificate has been filed by the complainant. In the absence of any documentary evidence regarding medical expenses, treatment and disability certificate, no deficiency in service is proved on the part of the opposite party. Even otherwise also, the complaint of the complainant is time barred as the complaint has been filed on 31.5.2010 whereas the complainant was discharged from hospital on 29.1.2008. Hence, we are of the considered view that the present complaint of the complainant is devoid of merit and the same is hereby dismissed with no order as to costs. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court. 27.7.2015.

                                   

                                                                                          ( ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER