KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION

                     VAZHUTHACAUDTHIRUVANANTHAPURAM      

                                        APPEAL NO.200/09

                             JUDGMENT DATED 27.9.2010

PRESENT

JUSTICE SHRI.K.R.UDAYABHANU            --  PRESIDENT

SRI.S.CHANDRAMOHAN NAIR                     --  MEMBER                                                                                           

New India Assurance Company Ltd,

Divisional Office, Thrissur

Reptd. by the Divisional Manager,

New India Assurance Co.Ltd.                           --  APPELLANT

Divisional Office,

Thiruvananthapuram.                                

          (By Adv.Sreevaraham G.Satheesh)

                    Vs.

Xavier, O.J

S/o Joseph, Olakkenkil Lane,                              --  RESPONDENT

Eyyal-PO, Kachery,

Thrissur.

(By Adv.S.Reghukumar)

                                                JUDGMENT

JUSTICE SHRI.K.R.UDAYABHANU,PRESIDENT

          The appellants are the opposite parties/Insurance Company in CC.1033/06 in the file of CDRF, Thrissur.  The appellants are under orders to pay Rs.50,000/- the assured   sum to the complainant.  

          2. The case of the complainant is that he met with an accident while riding   his motorcycle.   He sustained serious injuries.  He was admitted at the Amala Hospital, Thrissur from  20.1.04 to 18.2.04.    At present he lost his memory and is unable to speak and unable to do any work.  It was a package policy that included personal accident coverage up to 1lakh.

          3. The opposite parties have contended that the personal  accident coverage  is restricted to the injuries stated in the policy.   The complainant has not sustained any  permanent total disability and hence he is not entitled for any  amount   the policy coverage is admitted.

          4. The evidence adduced consisted of the testimony of PW1, Exts. P1 to P7, R1 and R2.

          5. PW1 is the Neuro Surgeon, who had treated the complainant and issue Exts. P2 and P3 medical certificates.  It is seen from the discharge certificate ie; Ext.P5, that he is aged 44 years  and sustained head injury with left  posterior temporal contusion.  Repeated scans after 24 hours showed similar contusion with increased oedema.   He developed continuous seizure.   He was intubated and electively ventilated for 72 hours.  Tracheostomy was done and continuous physiotherapy was administered.   The doctor has certified vide Ext.P3 proved by PW1 dated 8.1.08 ie; after 3 years of the incident that the petitioner is still having memory  loss, speech abnormality  and the same cannot be improved from the present status.       

          6. The counsel for the appellant has relied on the decision of the National Commission  in   Ajaykumar V. Life Insurance Corporation of India I (2007) CPJ 230 (NC).  Therein the National Commission has held that the disability, in the case therein was partial and not permanent.  In the instant case, we find that  the Forum  has  only  ordered to pay Rs.50% of the amount assured.   In  Ext.R1 policy 100% of the policy amount is to be paid for permanent total disablement.  It is not evident in the decision cited as to exactly what were the conditions of the policy involved therein.  In view of the  fact that Forum has only ordered to pay 50% of the insured amount and   in view of the fact that    very serious injuries have been sustained and even after 3 years of treatment the complainant is still having very serious disabilities which would show that  is unable to maintain himself.        We find that no interference of the order  of the Forum is called for.   The appeal is dismissed.

          The office will forward the LCR along with the copy of this order to the Forum urgently.

JUSTICE  K.R.UDAYABHANU --  PRESIDENT

       S.CHANDRAMOHAN NAIR --  MEMBER

s/L