SRI. JIMMY KORAH (PRESIDENT)<br /> The case of the complainant is that the complainant is an owner cum driver of the vehicle No. KL 2Q 9641 vide policy No. 101501/31/05/00006817 for the period 06-11-2005 to 05-11-2006. He met with an accident on 28-02-2006. The nature of accident is that his scooter hit to a bicycle and in consequences of the accident he sustained injuries. The policy taken by the complainant is a package policy. The complainant preferred a claim before the opposite party on the strength of personal accident coverage from the opposite party. But the opposite party not turned up for answering the claim of the 2. Opposite party filed version stating that the complainant has not preferred any claim be only in case of death, loss of limb, loss of eyesight and permanent total disablement from injuries other than named above. The complainant has not given any letter on 13-03-2006 as stated in the complaint.<br /> 3. Considering the rival contention of the complainant and the opposite party this Forum framed following issues:-<br /> “Whether there is any deficiency of service on the part of the opposite party?”<br /> 4. The complainant given evidence and produced 9 documents. They are marked as Exts. A1 to A9. Opposite party filed proof affidavit and produced 3 documents. The documents produced by the opposite party are marked as Exts. B1 to B3.<br /> 5. The case of the complainant is that he met with an accident on 28-02-2006. The vehicle involved in the accident is owned by the complainant and he himself was riding the said vehicle at the time of accident. For substantiating his contention he produced copy of the R.C. Book which was marked as Exts. A6 and the copy of the Police charge which was marked as Exts. A4. As per Ext. A1 policy it can be seen that complainant is the insured. Ext. A4 is the police charge in crime No. 139/2006 of Punnapra Police station which shows that complainant was the rider of the said vehicle at the time of accident. Ext. A5 shows that complainant is holding valid driving license for driving two wheeler at the time of accident. The main dispute in this case is that whether complainant suffered any injury for getting compensation as per the terms and conditions of the policy. As per Ext. A2 and A2 (a) it can be seen that complainant sustained medical malleolus fracture. Ext. A8 shows that complainant sustained permanent physical disability of 6%. In cross examination of PW2 the doctor who was issued the certificate has stated that he has not assessed permanent total disability. Further he adds permanent total disability cannot assess on a live patient.<br /> 6. In the terms and conditions of the policy there is no definition regarding the word permanent total disablement. This term has defined in Sec. 2(15-B) of Employees State Insurance Act. The Section stated as follows:-<br /> “Permanent total disablement means such disablement of a permanent nature as incapacitates an employee for all work which he was capable of performing at the time of accidents resulting in such disablement”.<br /> 7. Here the complainant has suffered only 6% of disability as certified by the doctor. He is working at Popular Mega Motors. In the disability certificate it is stated that “he is an automobile Mechanic by profession and needs prolonged squatting while on work. This indicates that he is still working in Popular Mega Motors. The complainant has no case that he was incapacitated for all work which he was capable of performing at the time of accident resulting in such disablement. Hence 6% of disability of the complainant cannot be considered as permanent total disablement. Hence he is not entitled to get any benefit under the coverage of package policy. There is no merit in the contention of the complainant and the complaint stands dismissed. There is no order on cost. <br /> Complaint dismissed.<br /> Pronounced in Open Forum on this the 28th day of May, 2008.<br /> Sd/- Sri. Jimmy Korah <br /> Sd/- Sri. K.Anirudhan<br /> Sd/- Smt. N.Shajitha Beevi<br /> <br /> <br /> <br /> APPENDIX<br /> Evidence of the Complainant:-<br /> PW1 - T.I.Sandeep<br /> PW2 - Dr. E.C. Babukutty<br /> Ext. A1 - Photocopy of Certificate of Insurance<br /> Ext. A2 - Photocopy of Medical report<br /> Ext. A2 (a) - Photocopy of Discharge Card<br /> Ext. A3 - Photocopy of FIR<br /> Ext. A4 - Charge Sheet<br /> Ext. A5 - Photocopy of Driving License<br /> Ext. A6 - Photocopy of Registration Book of the Vehicle KL 02 Q 9641<br /> Ext. A7 - Photocopy of Medical Report<br /> Ext. A8 19-04-2007 Certificate issued by Dr. E.C. Babukutty<br /> Ext. A9 13-03-2006 Intimation letter to The Manager, United India Insurance Co. Ltd, Kayamkulam<br /> <br /> Evidence of the Opposite party:-<br /> RW1 - Asokan K.P.<br /> Ext. B1 - Photocopy of Certificate of Insurance<br /> Ext. B2 - Two Wheeler package policy of United India Insurance Co. Ltd.<br /> Ext. B3 - Package policy motorcycle/scooter of –do- -do- <br /> <br /> <br /> // True Copy //<br /> <br /> By Order<br /> <br /> <br /> <br /> Senior Superintendent<br /> To<br /> Complainant/Opposite party/SF<br /> Typed by: Sh/-<br /> Compd by:<br />