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WEST BENGAL STATE CONSUMER DISPUTES REDRESSAL COMMISSION
S. Coari and D. Bhattacharya, Members
NATIONAL INSURANCE CO. LTD. - Appellant
Versus
NIRMAL KUMAR DAS AND ANR. - Respondents
S.C. Case No. FA/923 of 2012
Decided on : 26-09-2013
Mr. Swarajit Dey, Advocate, for the Appellant; Ms. Keya Banerjee and Mr. Avik K. Dutt, Advocates, for the Respondent
The main legal point established in the judgment is the interpretation and application of Rule 20 of the Workmen's Compensation Act, 1923 in determining the entitlement of the insured to benefit and the court's authority to modify the relief granted based on the law.
Headnote:
Insurance Claim - Road Accident - Workmen's Compensation Act, 1923 - Rule 20 - [Rule 20 of Workmen's Compensation Act, 1923] - The court discussed the entitlement of the insured to benefit under Rule 20 of the Workmen's Compensation Act, 1923 and the decision of the Medical Board in granting relief to the extent of 60%. The court found that the relief should have been reduced to 50% as permitted by the law, thereby modifying the judgment to reduce the amount granted to the complainant.
Fact of the Case:
The complainant, with a valid insurance coverage, met with a road accident causing severe injuries and resulting in the amputation of his right leg below the knee. The complainant filed an insurance claim, which was not allowed by the Insurance Company, leading to the petition of complaint.
Finding of the Court:
The court found that the relief granted to the complainant to the extent of 60% should have been reduced to 50% as permitted by the law, thereby modifying the judgment to reduce the amount granted to the complainant.
Issues: The main issue was whether the relief granted to the complainant by the learned District Forum was justified in granting relief to the extent of 60% based on the Medical Board's decision.
Ratio Decidendi: The court held that the relief granted to the complainant to the extent of 60% should have been reduced to 50% as permitted by the law, thereby modifying the judgment to reduce the amount granted to the complainant.
Final Decision: The Appeal stands allowed in part on contest, without any order as to costs. The amount of Rs. 3,00,000 granted by the learned District Forum in favor of the complainant is reduced to Rs. 2,50,000, while keeping the other portion of the impugned judgment unaltered.
ORDER
S. Coari, Member - The present Appeal has been directed against the judgment and order No. 15 dated 5.10.2012 passed by learned District Consumer Disputes Redressal Forum, Uttar Dinajpur in Consumer Complaint No. 15/2012, wherein the learned District Forum allowed the petition of complaint on contest with cost against the OP/Insurance Co. and dismissed without cost against the OP No. 3, Golden Trust Financial Services, along with a direction that the complainant will get a sum of Rs. 3,00,000 as compensation from the OP/Insurance Company and Rs. 500 as litigation cost.
2. The case of the Complainant/Respondent before the learned District Forum, in brief, was that during the subsistence of a valid insurance coverage obtained from the Insurance Company through GTFS the complainant met with a road accident causing severe injuries on his person. Ultimately, the complainant was admitted at North Bengal Medical College and Hospital where his right leg had to be amputated below the knee. Subsequently, a Medical Board has adjudged the complainant to be a handicapped to the extent of 60%. The complainant preferred an insurance claim after observing all the formalities, but the Insurance Company did not pay any heed to the request and hence, the petition of complaint.
3. The Insurance Company contested the case by filing a written version thereby denying and disputing all the material averments mentioned in the petition of complaint contending, inter alia, that there was no negligence at the instance of the Insurance Company and the same is liable to be dismissed.
4. The OP/GTFS contested the case by filing a separate written version thereby more or less supporting the case of the complainant and has prayed for dismissal of the complaint case.
5. Learned District Forum while disposing of the petition of complaint has observed that since admittedly the accident has rendered the complaint to be handicapped to the extent of 60% and in the absence of any bona fide challenge from the side of the Insurance Company in this regard, the complainant was very much entitled to the reliefs to the extent of 60% and accordingly, disposed of the petition of complaint in the manner discussed above.
6. The only moot question that revolves round the present Appeal is as to whether the learned District Forum was justified enough in disposing of the petition of complaint in the manner as mentioned above.
Decisions relied upon by the Appellant/Insurance Company:
1.(2012) 4 CPJ 148 (NC) Ind Swift Limited v. New India Assurance Co. Ltd. and Others.
2.(2012) 4 CPJ 151 (NC) National Insurance Co. Ltd. v. Giriraj Proteins.
3. (2012) 2 CPJ 91 (NC) Sehdev Singh v. New India Assurance Co. Ltd.
4. (2012) 2 CPJ 94 (NC) Bankim Mandal v. Haryana Urban Development Authority and Anr.
5. (2007) 1 CPJ 380 (NC) Tayal Enterprises v. United India Insurance Co. Ltd.
Decision with reasons:
7. At the time of hearing it has been submitted by the learned Advocate for the complainant/respondent to the effect that the learned District Forum has really appreciated the case of the respective party and in arriving at a just and proper decision has left no stone unturned. It has been submitted by the learned Advocate for the respondent that since there is no denial and/or dispute as regards factual aspect of the case, namely, the complainant sustained injury due to a road accident and that subsequently his right leg had to be amputated below the knee and that a Medical Board has adjudged him to be disabled to the extent of 60%, question of denying relief to the complainant to the extent of 60% cannot be avoided by the Insurance Company learned District Forum having rightly adjudged the case of the respective party has arrived at a just and proper decision, which should be confirmed.
8. We have duly considered the submissions so put forward on behalf of the complainant/respondent and have also gone through the materials on record including the impugned judgment and find that in this case the compl
