NEW INDIA ASSURANCE CO LTD Vs. MUTHAIYAN

JUDGEMENT

(1.) The 1st opposite party in O. P. No.59/2002 on the file of the District Consumer Disputes Redressal Forum, Nagercoil, is the appellant herein. The case of the complainant was as follows: (a) The complainant a member of Poothurai Fishermen Co-operative Society, in Kanyakumari District took a group personal Accident Insurance Policy From opposite party No.1 along with other fishermen registered with various co-operative societies and as per the records available at the office of the Assistant Registrar of the Fisheries at various places. The policy for the period from 25.3.2000 to 24.3.2001 covering all the members as per the records of the Fisheries Department came to be issued. The sum insured under the policy in respect of each member was Rs.15,000. On 15.6.2000 at 6 a. m. , when he had gone to the sea in catamaran for fishing, a tidal wave of the sea dashed against him and his catamaran resulting in grievous injury over his right upper limb. He was brought to the sea shore and he was taken to hospital for treatment. He got permanent disability and the percentage was 70%. Investigations by the police also confirmed causation of the injury sustained by him. A claim was made to the 1st opposite party. The 1st opposite party took the stand that as per the doctor's certificate, the complainant had sustained dislocation of right upper arm and he was given treatment by open reduction with place and screws and the doctor had opined that the injury was a grievous one. The injury had caused only a partial loss. The 1st deposit party had issued a policy for Rs.15,000 to the complainant. After the occurrence, the complainant had forwarded the claim papers through the 2nd opposite party. The policy covered only permanent total disability and the complainant having suffered only partial disability nothing was payable. In any event, if the complainant was aggrieved, he could approach the Civil Court for appropriate remedies.

(2.) The 2nd opposite party took a stand that the complainant had not paid any amount for insurance policy through their society and the complaint was liable to be dismissed.

(3.) The District Forum found that the 1st opposite party was liable that there was total permanent disability of right upper limb i. e. , 70% as a result of catamaran injury. The doctor had issued a certificate stating that the complainant could not swim using his right arm and, therefore, he would not be able to perform his fishing job for his livelihood. The District Forum by order dated 30.1.2003 directed the opposite party to pay Rs.1,82,500 together with sum of Rs.5,000 as compensation. It is as against that the present appeal has been filed.