State Consumer Disputes Redressal Commission
The Oriental Insurance Co. Ltd vs Abibulla Khan on 8 September, 2023
Cause Title/Judgement-Entry KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION BASAVA BHAVAN, BANGALORE. First Appeal No. A/2046/2017 ( Date of Filing : 11 Oct 2017 ) (Arisen out of Order Dated 05/08/2017 in Case No. Complaint Case No. CC/4/2017 of District Chikmagalur) 1. The Oriental Insurance Co. Ltd Nagnirmala Complex, 1st floor, Opp. Ranganna choultry, Basavanahalli Main road, Chikkamagalur. Rep. by Regional Office, No.44/45, Leo Shopping complex, Residency road, Bangalore-560025 By its Duly Con ...........Appellant(s) Versus 1. Abibulla Khan Ayaz, S/o Late Anwar Khan, R/a Hoovadigara Beedhi, Ramanahalli, Chikkamagalur ...........Respondent(s) BEFORE: HON'BLE MR. JUSTICE Huluvadi G. Ramesh PRESIDENT HON'BLE MR. Krishnamurthy B.Sangannavar JUDICIAL MEMBER HON'BLE MRS. Smt. Divyashree.M MEMBER PRESENT: Dated : 08 Sep 2023 Final Order / Judgement Dated:08.09.2023 O R D E R
BY HON'BLE Mr. JUSTICE HULUVADI G RAMESH : PRESIDENT This Appeal filed by OP under Section 15 of Consumer Protection Act, 1986, aggrieved by an order dated 05.08.2017, passed in CC/4/2017 by District Consumer Disputes Redressal Forum, Chickmagalur (herein after referred as District Forum and the parties arrayed as in the consumer complaint) The Commission examined impugned order, grounds of appeal and heard learned counsel for appellant.
It is undisputed fact that complainant/respondent is owner of Bajaj Discover Motor Cycle bearing registration no.KA-18/Y-8077. It is also not in dispute that he had obtained two wheelers package policy from OP/appellant bearing No.472602/31/2015/7612 for the period commencing from 10.02.2015 to 09.02.2016. Complainant/respondent met with an accident on 23.12.2015 i.e., well within the policy period is also not in dispute at all. The only dispute is related to repudiation of claim of the complainant/respondent on the ground that complainant/respondent had not suffered any permanent disability due to accident and also the Disability Certificate is created, fabricated and not obtained by Wenlock Hospital, Mangalore where he underwent surgery for implantation of rod, instead had obtained such certificate from M.G.Hospital, Chickmagalur. It is to be noted herein that OP/appellant had not disputed the fact of accident occurred on 23.12.2015. Further OP/appellant had also not disputed that due to the said accident complainant/respondent underwent surgery for implantation of rod in Wenlock Hospital, Mangalore. It is found that OP/appellant had only disagreement with the Disability Certificate issued by M.G.Hospital, Chickmagalur. Except disagreement, nothing is placed on record either before the Forum below or before this Commission to prove that the said document is created or fabricated. In other words, OP/appellant had not argufied the injury or fracture of femur and implantation of rod caused due to accident. But argufying the Disability Certificate obtained from M.G.Hospital, Chickmagalur. In our view, when the RTA occurred well within the policy period and when the injury and taking of treatment is undisputed and also when there is no breach on the part of the insured concerning a policy condition, it is the duty of insurer to indemnify the insured. In other words, the insurer is not allowed to avoid its liability towards the insured unless there is a sufficient cause to do so. Further to look into the genuineness of the Disability Certificate the Forum below while passing the impugned order made notice of the fact that the said certificate which is issued by M.G.Hospital, Chickmagalur is based on the wound certificate and treatment given at Wenlock Hospital, Mangalore. Furthermore, the Forum below based on the Disability Certificate which constitute that the complainant/respondent having permanent disability upto 50%, had awarded 50% of the PA benefit, which in our view does not calls for an interference of this Commission, for the grounds set out in the appeal. Hence Commission proceed to dismiss the appeal with no order as to cost.
The Amount in deposit is directed to be transferred to Commission below for needful.
Send a copy of this Order to the District Commission and parties to the appeal.
Lady MemberJudicial MemberPresident *GGH* [HON'BLE MR. JUSTICE Huluvadi G. Ramesh] PRESIDENT [HON'BLE MR. Krishnamurthy B.Sangannavar] JUDICIAL MEMBER [HON'BLE MRS. Smt. Divyashree.M] MEMBER