State Consumer Disputes Redressal Commission
1.The Oriental Insurance Company Ltd., ... vs 1.Baljit Kumar Son Of Sh. Gaja Nand R/O ... on 14 January, 2014
STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA First Appeal No.717 of 2013 Date of Institution: 09.10.2013 Date of Decision: 14.01.2014 1. The Oriental Insurance Company Ltd., Branch Office, D.A.B., A-55, Pagaria Chambers, Ground Floor, Sardar Patel Marg, C-Scheme, Jaipur. 2. Branch Office, Opposite Mini Secretariat, Mohindergarh Road, Narnaul, Both through its authorized signatory B.S. Negi, Regional Manager, LIC Building, Jagadhri Road, Ambala Cantt. Appellants (Opposite Parties No.2 & 3) Versus 1. Baljit Kumar son of Sh. Gaja Nand r/o Mohalla Silkhana, Town Narnaul, Tehsil and District Narnaul. Respondent (Complainant) 2. Tulip Company, 212, 2nd Floor, Jaipur Tower, opposite All India Radio, M.I. Road, Jaipur through Manager/Director. Respondent (Opposite Party No.1) CORAM: Honble Mr. Justice Nawab Singh, President. Mr. B.M. Bedi, Judicial Member. Mrs. Urvashi Agnihotri, Member. For the Parties: Shri J.P. Nahar, Advocate for appellant. Shri Munish Gupta, Advocate for respondent No.1. Shri R.S. Bhatia, Advocate for respondent No.2. O R D E R
B.M. Bedi, Judicial Member (Oral):
The Oriental Insurance Company Ltd-opposite parties No.2 and 3 (appellants herein) appeal against the order dated July 26th, 2013 passed by District Consumer Disputes Redressal Forum, Narnaul (for short District Forum), whereby direction was issued to appellants and Tulip Company-opposite party No.1 (respondent No.3 herein) to pay a sum of Rs.70,000/- to Baljit Kumar-complainant (respondent No.1 herein) on account of disability suffered by him.
2. Respondent No.1 being distributor of respondent No.2, was insured with the appellants under INDIVIDUAL NAGRIK SURAKSHA Insurance Policy (for short Insurance Policy) vide Annexure C-87 and Annexure C-88. On the intervening night of 12/13.06.2009, the respondent while traveling in vehicle bearing Registration No.HR-35D-8489 suffered multiple and grievous injuries in an accident. F.I.R. No.109 (Annexure C-20) under Section 279/337 I.P.C. was recorded with Police Station Renwal on dated June 13, 2009. The respondent was treated in LOTUS HOSPITAL & RESARCH CENTRE, Narnaul, SAWAI MAN SINGH HOSPITAL Jaipur (Rajasthan) and VIJAY VERGIYA HOSPITAL, Jaipur. According to the respondent No.1, he spent Rs.1,50,000/- on his treatment. Respondent No.1 submitted claim (Annexure C-80) with the appellants but the same was denied on one pretext or the other. Forced by the circumstances, the respondent No.1 filed complaint under Section 12 of the Consumer Protection Act, before the District Forum seeking compensation.
3. Appellants as well as the respondent No.3 contested complaint by filing their respective written statements denying the averments of the respondent No.1. The complaint was accepted by the District Forum vide impugned order.
4. Aggrieved of the said order, appellants have filed the instant appeal.
5. The contention raised by the learned counsel for the appellants is that the policy had covered the total sum of Rs.1.00 lac, that is, Rs.80,000/-
towards personal accident and Rs.20,000/- towards hospitalization. To get compensation under personal accident head, there should be minimum 40% disability. In support of his contention, learned counsel for the appellants referred to Section-1 of the Insurance Policy Annexure A-5, the relevant part of which is reproduced as under:-
Permanent Partial Disablement (PPD) The bodily injury which is the sole and direct cause of total and irrecoverable loss of use of or the actual loss by physical separation permanently incapacitating the Insured person to the extent of 40% or more in aggregate.
5. Appellants do not challenge the finding of the District Forum that the complainant had suffered 7% permanent disability.
Clause of Section-1 of the Insurance Policy, mentioned above, is of no help to the appellants, which does not restrict that insured having disability less than 40% is not entitled at all to any compensation under the head of Personal Accident.
6. No other point was argued by the counsel for the parties.
7. As a sequel to the aforesaid discussion, this Commission is of the view that the District Forum has rightly issued direction to the appellants to pay the insurable benefits to the complainant. No case for interference in the impugned order is made out.
7. Hence, the appeal is dismissed being devoid of any merit.
8. The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the respondent No.1 (complainant) against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.
Announced:
14.01.2014 (Urvashi Agnihotri) Member (B.M. Bedi) Judicial Member (Nawab Singh) President CL