NATIONAL INSURANCE CO LTD Vs. MAHAPRASAD PANDEY

JUDGEMENT

(1.) -THIS appeal is directed against the order dated 1. 3. 2007 passed by the District Consumer Forum, Dehradun, allowing the Consumer Complaint No. 98 of 2003, Sh. Mahaprasad Pandey v. National Insurance Co. Ltd. and directing the insurer - appellant to pay a sum of Rs. 1,00,000 together with interest @ 8% p. a. from the date of repudiation of the claim till the date of actual payment.

(2.) THE facts of the case in brief are that the respondent-complainant had taken a Janta Personal Accident Insurance Policy No. 451000/9601174/98 for a risk of Rs. 1,00,000. The policy was effective for the period from 30. 10. 1998 to 29. 10. 2003. Under the scheme, the Insurance Company had undertaken to indemnify the insured if he sustains any bodily injury resulting solely and directly from the accident caused by outward violent and visible means and undertakes to pay the insured the sum stated as hereunder:

(3.) THE respondent - insured, when he was going to his home by a three-wheeler on 12. 1. 2000 for taking his lunch, the vehicle got over turned due to its high speed and the insured sustained severe injuries. Due to these injuries, the respondent's left hand became permanently and totally disabled. The respondent runs a shop of clothes. Before the aforesaid accident, he used to do all the work of his business himself, such as showing the clothes to the prospective buyers; to lift and keep the heavy bales of the clothes from one place to another and measuring the cloth and packing it in a proper manner for the buyer. As the respondent had become totally disabled to do all these works related to his business, he lodged a claim with the appellant-insurer to the effect that he be indemnified as per terms of the policy for the permanent and total disability in running his business. The appellant-insurer repudiated the claim on the ground that the complainant -respondent's hand had lost the working efficiency upto 59% as certified by the Chief Medical Officer, Haridwar. Upon this, the respondent filed a consumer complaint before the District Consumer Forum, Dehradun, which was allowed by the District Forum with the directions to the insurer as stated above. Aggrieved by the said order, this appeal has been filed by the insurer.