UNITED INDIA INSURANCE CO LTD Vs. BALWANT SINGH

JUDGEMENT

(1.) THIS appeal arises out of order dated 16.9.2006 passed by the District Consumer Forum (DCF), Sri Ganganagar whereby while allowing the complaint, the Appellant Insurance Co. was directed to pay to the Complainant a sum of Rs. 75,000 within a period of two months failing which the Appellant was directed to pay interest @ 9% per annum from 13.3.2006. The Appellant was further directed to pay Rs. 5,000 combined for compensation and cost of litigation.

(2.) THE Complainant Balwant Singh had obtained a Personal Accident Policy valid from 10.5.2005 to 9.5.2006. It is stated in the complaint that on 29.12.2005, the Complainant was doing some work in his Workshop as a Mechanic and during that period he sustained eye injury. This injury led to complete loss of vision. It was further stated by the Complainant that he got treatment from 29.12.2005 to 21.1.2006 and since he lost the vision of right eye, he claimed a sum of Rs. 75,000 as per the policy condition. The Appellant filed a reply wherein it mentioned that the insured had deliberately not given any information to the Insurance Co. about the accident and had not submitted any document. As per the policy condition, the Complainant should have immediately informed the Insurance Co. about the accident. It was also stated that no claim was lodged with the Insurance Co. as per the established practice and procedure and the claim was not decided, therefore, the complaint is premature. It was further stated that there should be evidence that the incident took place on account of some external violent and visible means and in absence of these ingredients, the claim is not maintainable.

(3.) THE learned DCF found that the Complainant sustained injury which amounts to injury by accident and since the Medical Board had declared total loss of vision, the aforesaid amount of compensation was awarded in favour of the Complainant.