KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACADU THIRUVANANTHAPURAM APPEAL NO: 486/2009 JUDGMENT DATED:11..05..2010 PRESENT JUSTICE SHRI.K.R.UDAYABHANU : PRESIDENT National Insurance Company Ltd., Branch Office, PB No:89, Ambika Arcade, MG Road, : APPELLANT Thrissur R/by its Manager. (By Adv:Sri.Sreejith.S.Nair) Vs. Velayudhan.N.A, S/o Adima, Neendiyil House, Anakkad, Kanjany, : RESPONDENT Manaloor, Thrissur. (By Adv:Sri.N.G.Mahesh) JUDGMENT JUSTICE SHRI.K.R.UDAYABHANU: PRESIDENT The appellants are the opposite parties/National Insurance Company Ltd. in CC:911/03 in the file of CDRF, Thrissur. The appellant is under orders to pay a sum of Rs.50,000/- as insurance benefit and Rs.1000/- as cost. 2. It is the case of the complainant that he was covered by the accident benefit policy of the opposite party and during the period of policy coverage he fell down from a coconut tree and sustained serious injuries. He has sought for the entire sum assured. 3. The opposite party has contended that the complainant has not sustained permanent total disability and other disabilities specified in the policy. The doctors have prescribed only six months rest. 4. The evidence adduced consisting of Exts.P1 to P3, Exts.R1 R2 series and R3. 5. The Forum has relied on Ext.P1 report of the medical board. It has been stated that he has sustained a disability of 24% and that he sustained fracture of both bones of right leg - lower 1/3 with intra articular extension, fracture L2 vertebra and facture pelvis. It is stated that the fracture of the lower end of tibia and fibula of the right leg as malunited. We find that Ext.R1 policy conditions produced is with respect to the Janatha Personal Accident policy having a coverage of Rs.25,000/-. In the instant case admittedly the coverage is Rs.1,00,000/-. It appears that the conditions differs in the appeal memorandum as conditions (c) mentioned includes actual loss of use of one entire hand or one entire foot where as the conditions in Ext.R1 restricts the benefits to the actual loss of the limb. Evidently the complainant has sustained serious injury. The fracture to the right leg is malunited. The counsel for the respondent has relied on the decision in LIC of India Vs. Ram Singh Tanwar I (2007) CPJ 48 (NC) wherein the National Commission has held that ambiguity in terms of policy, if any should be interpreted in favour of the insured. In the circumstances we find that no interference in the order of the Forum is called for. In the result the appeal is dismissed. Office is directed to forward the LCR to the Forum along with the copy of this judgment urgently. JUSTICE K.R.UDAYABHANU: PRESIDENT VL. | 
