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2021 Supreme(Online)(Kar) 328

KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BENGALURU (PRINCIPAL BENCH)
*K. B. Sangannanavar (Judicial Member), M. Divyashree (Member)
Oriental Insurance Co. Ltd. v. H. S. Mullappa
Appeal No. 785 of 2014



1. This is an Appeal filed under S.15 of Consumer Protection Act, 1986 by the Opposite Party / Appellant herein, aggrieved by the impugned order dated 1.4.2014 passed by Chickmagaluru District Consumer Disputes Redressal Forum in CC.No.70/2013 (for short District Forum / Commission and the parties as arrayed in the consumer complaint).

2. The brief facts of the consumer complaint raised before District Forum would be stated that, the Complainant is the owner of TVS star DLX Motor Bike bearing registration No. KA18 L4913 and he insured this bike with OP for the period from 13.12.2011 to 12.2.2012. He met with an accident on 14.6.2012 near Chikkadevanoor Railway gate. As a result of accident, he suffered grievous injuries. He was shifted to General Hospital, Kadur and after first aid shifted to Nanjappa Hospital, Shivamogga as an inpatient treated from 14.6.2012 to 16.6.2012. He has spent more than Rs.1 lakh towards medical expenses, medicines, transportation expenses, food and other incidental charges. Due to the accident his vehicle was also damaged. He had submitted the claim papers to OP along with necessary documents and claimed for own damage claim along with personal accident benefits. However OP had not settled the claim of personnel accident benefits. He raised consumer complaint before District Forum which was contested by the OP contending that as per terms and conditions of the policy insured is not entitled for personal accident benefits and therefore no deficiency in service on his part.

3. In view of such rival contentions, District Forum held an enquiry by receiving affidavit evidence of the Complainant and OP along with the documents Ex - P1 to P8 and Ex.R1 respectively, thereby allowed the complaint directing OP to pay eligible medical expenses under the head of personal accident risk by receiving the entire medical bills and do pay Rs.10,000 for deficiency in service and Rs.1,000 for litigation expenses within one month from the date of receipt of the order, failing which award amount carry interest at 9% p.a. till realization, which is now impugned in this appeal under S.15 of the CPA 1986 contending that, the Forum below failed to follow the ratio laid down by the Hon'ble Apex Court and Hon'ble NCDRC in catena of decisions and failed to appreciate the liability of the insurer in consideration of the agreed terms and conditions of the policy and in gross violation, directed Op to settle the claim, is contrary to the facts and law, is liable to be set aside.

4. The Commission heard and gone through the impugned order passed by District Forum. We examined the documents submitted along with appeal memo. Now, we have to examine, whether the Complainant is entitled for personal accident benefits covered for owner - driver as per policy obtained by him from OP?

5. No doubt, contract of insurance is one of species of commercial transaction between the insurer and insured. In other words, the insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. On facts, admittedly, the Complainant is owner of TVS star DLX Motor Bike bearing registration No. KA18 L4913 and he insured this bike with OP company vide policy No. 472602/31/2012/10499 for the period from 13.12.2011 to 12.2.2012. He met with an accident on 14.6.2012 near Chikkadevanoor Railway gate. As a result of accident, he suffered grievous injuries. He was shifted to General Hospital, Kadur and after first aid shifted to Nanjappa Hospital, Shivamogga as an inpatient taken treatment from 14.6.2012 to 16.6.2012. All these facts are not at all disputed by OP / insurer. The Complainant has placed some materials consisting of police papers / FIR marked as Ex - P1, MVA report, Charge sheet marked a
























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