State Consumer Disputes Redressal Commission
The Divisional Manager vs Fazila Bibi on 25 May, 2012
State Consumer Disputes Redressal Commission State Consumer Disputes Redressal Commission West Bengal BHABANI BHAVAN (GROUND FLOOR) 31, BELVEDERE ROAD, ALIPORE KOLKATA 700 027 S.C. CASE NO- FA/467/2011 (Arising out of Case no CC/2011/13 of District Forum, Nadia) DATE OF FILING: 04.11.2011 DATE OF FINAL ORDER: 25.05.2012 APPELLANT : The Divisional Manager, The National Insurance Company Limited, Division-III, 8, India Exchange Place, Ruby House, Kolkata-700 001. RESPONDENTS : 1. Fazila Bibi, W/o Abdul Ohab Sk., Vill-Tegharipara, P.O. & P.S.-Nabadwip, Dist-Nadia. 2. The Manager, Golden Trust Financial Service (GTFS), Poramatala, ( Nadia Plaza), P.O. & P.S.- Nabadwip, Dist-Nadia. BEFORE HONBLE MEMBER : Smt. Silpi Majumder. HONBLE MEMBER : Sri Debasis Bhattacharya. FOR THE APPELLANT : Mr. Sujit Moitra, Advocate. FOR THE RESPONDENTS: 1. Mrs. Nabanita Kar, Advocate. 2. Mr. Avik Kumar Dutt, Advocate. Silpi Majumder, Member
This the complaint is directed against the judgment passed by the Ld. District Forum, Nadia, on 30.06.2011, in its case no-CC/11/13, whereby the Ld. Forum allowing the complaint has directed the OP-1 and OP-3 to pay sum of Rs.2,50,000/- either jointly or severally to the Complainant within a period of one month from the date of passing the judgment, in default the decreetal amount would carry interest @10% p.a. from the date of passing the judgment till realization of the entire amount.
The brief fact of the case of the Complainant is that she purchased one JPA policy through the GTFS from the OP-3 on 23.03.2003, which was valid up to 22.02.2018. The sum assured was of Rs.5,00,000/-. On 26.10.2008 she received fracture injury on her right leg caused by a bus accident. She was admitted to Montessor Hospital, Burdwan from where she was referred to Kolkata and was admitted to Labbaik Medical centre for her treatment. She was treated there and spent Rs.1,50,000/- but her injury on the leg was not cured by the treatment. The Complainant thereafter claimed accidental benefit before the OP-3 through the GTFS, but to no effect. So she filed a case before the District Forum being no-CC/09/45 which was decreed in her favour, but in appeal preferred by the Insurance Company the Honble State Commission was pleased to set aside the said judgment passed by the Ld. District Forum on the ground that no paper was submitted in support of amputation of the right leg of the Complainant. At the same time, the Honble State Commission has mentioned it its judgment that if any amputation had already been completed the Complainant would be at liberty to file another fresh case before the Ld. District Forum claiming the insurance amount from the Insurance Company. It is submitted by the Complainant that amputation was completed on her leg on 19.01.2010 and the earlier judgment was passed by the Ld. Forum below in case no-CC/2009/45 was passed on 26.02.2010. Accordingly the Complainant filed the complaint before the Ld. Forum below praying for reliefs as stated in the petition of complaint.
Being aggrieved by the abovementioned judgment the OPs-Appellants have preferred the present appeal before this Commission contending that the Ld. Forum below has failed to appreciate that the Complainant did not adduce any evidence as to in which hospital and on what date amputation of her leg was done and in this respect no medical documents confirming the amputation was filed by the Complainant. The Appellants have further stated that the certificate of Dr.S. A. Samad as to the amputation of right leg has not been taken into confidence by the Honble State Commission in its judgment in the case no-FA/212/2010. According to the Appellants the judgment passed by the Ld. District Forum being erroneous is liable to be set aside and prayer has been made for allowing the present appeal.
We have carefully perused the record and documents as available and for proper adjudication of this appeal the LCR has been called for. We have also gone through the LCR and heard arguments from the Ld. Counsel for the parties. It is seen by us that in the instant case there are some admitted facts i.e. The Complainant obtained one Janata Personnel accident Insurance Policy from the Insurance Company through the GTFS on 23.03.2003 and the insured amount is of Rs.5,00,000/-, the Complainant got injury due to bus accident on her right leg during the validity of the said insurance policy, she was admitted at Montessor Hospital from where she was transferred to Kolkata and in Kolkata she was admitted at Labbaik Medical Centre where she was treated and due to her treatment along with other expenses she had to spend sum of Rs.1,50,000/-. Further admitted fact is that on earlier occasion the Complainant filed a complaint before the Ld. Forum below, where the Complainant got decree in her favour, but in appeal of the said case the order and judgment of the Ld. Forum below was set aside as this Commission did not find out any paper or document toward the amputation of the right leg of the Complainant. So liberty was given to the Complainant for filing fresh case if in the meantime amputation of the right leg of the Complainant is done. We have noticed that admitted in the earlier case being no-CC/2009/45 as the document showing amputation was not available; this Commission was pleased to set aside the Forums order. In the said case as after filing of the complaint amputation was done the Complainant has failed to submit the said document in the said case. Admittedly the Forum has passed the judgment in the said case on 26.02.2010 and the amputation was done on 19.01.2010. As due to amputation fresh cause of action arose, the Complainant did not file the said document in the earlier case record before the Ld. Forum below. As this Commission provided liberty to the Complainant for filing a fresh complaint, the Complainant filed fresh complaint before the Ld. Forum below on 21.10.2011. In the said case in support of the amputation the Complainant filed the certificate issued by Dr. S.A. Samad dated 19.01.2010, from where it is evident that the said Doctor has stated that she underwent amputation through the right leg above knee after which patient will be able to wear artificial limb. Therefore from the said statement it can safely be said that amputation above knee on the right leg of the Complainant was done on 19.01.2010. We have also noticed that the amputation has not been challenged by the Insurance Company before the Ld. Forum below. Therefore, we are also at one with the Ld. Forum below that as per category no-2.9 the Complainant is very much entitled to get 50% of the insured amount due to actual loss by physical separation of one entire foot.
Going by the foregoing discussion hence, it is ordered, that as the ld. Forum below has passed a well-reasoned order and judgment, we are not inclined to interfere in it and the same will be unaltered. The appeal is dismissed on contest without any cost and the judgment passed by the Ld. Forum below is hereby affirmed. The office is directed to send down the LCR to the Ld. Forum below along with a copy of this judgment forthwith.
Sri Debasis Bhattacharya Silpi Majumder Member Member