THE KARNATAKA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)
DATED THIS THE 26th DAY OF AUGUST, 2024
APPEAL NO.213/2012
PRESENT
SRI RAVI SHANKAR, JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI, MEMBER
1. The Divisional Manager
National Insurance Co. Ltd., … Appellant/s
Sujata Complex, PB Road, Hubli,
2. The Branch Manager,
National Insurance Co. Ltd,
PB Road, Haveri
Now represented by its
Regional Manager,
National Insurance Co. Ltd.
Regional office, Subharam Complex,
144, MG Road, Bengaluru-560 001
(By Sri.A.N.Krishna Swamy, Advocate)
V/s
Swamy Paramahamsa
Prasad Murthy … Respondent/s
Now aged about 75 years,
R/o Huvinakatti (Hunasikatti),
Tq: Ranebennur
(By Sri.Shivayogi Math, Advocate)
O R D E R
BY SRI.RAVISHANKAR, JUDICIAL MEMBER
Perused the certified copy of the order passed by the District Consumer Commission and memorandum of appeal, crux of the appeal is that, the complainant had approached the District Commission alleging deficiency of service in not paying the personal accident benefits as mentioned in the policy. The District Commission after trial allowed the complaint and directed this appellant to pay compensation of Rs.60,000/- with interest @9% per annum. In fact as per the terms and conditions of the policy, this appellant is only liable to pay when there is permanent disability or death are as here under;
Sl. No. | Nature of injury | Scale of compensation |
1 | Death | 100% |
2 | Loss of two limbs or sigh of two eyes or one limb and sight of one eye | 100% |
3 | Loss of one limb or sight of one eye | 50% |
4 | Permanent total disablement from the injuries other than named above | 100% |
2. The learned advocate for appellant submits that, the complainant had not suffered any the above said injuries or disablement, but the District Commission failed to appreciate the same terms and conditions of the policy and allowed the complaint. The order passed by the District Commission is not in accordance with law, hence prays to set aside the order passed by the District Commission.
3. Of course, the terms and conditions of the policy are binding on both parties, when the terms and conditions of the policy discloses that they liable to pay personal accident benefits when there is a death 100%, loss of limbs or sight of two eyes 100%, loss of limbs or sight of one eye 50% and permanent total disability 100%.
4. The complainant failed to establish before the District Commission or before this Commission that he suffered such a disablement as mentioned above. The District Commission failed to appreciate the terms and conditions of the policy, the personal accidental benefits are payable only when the above said disablement was proved, in the absence of such the complainant is not entitled to get benefits. The District Commission failed to appreciate the said clause. The order passed by the District Commission is not in accordance with law. Hence there is no deficiency of service on the part of appellant. As such the order passed by the District Commission hereby set aside. Accordingly the appeal is allowed and the complaint is dismissed. Hence, we proceed to pass the following:-
O R D E R
The appeal filed by the appellant is hereby allowed.
The impugned order 14.12.2011 passed by the District Consumer Disputes Redressal Commission, Haveri in CC.No.288/2011 is set-aside. Consequently, the complaint filed by the complainant is dismissed.
The amount in deposit shall be transmitted to the concerned District Consumer Commission to pay the same to the appellant/Opposite Party.
Send a copy of this order to both parties as well as concerned District Consumer Commission.
Member Judicial Member
