Page 53 - Insurance Times December 2023

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Man who lost leg in strange accident Lt., the insurer. The corporation is required to pay the com-
pensation.
gets Rs. 2 crore
The events of October 18, 2016, occurred. After that, the
A 53-year-old Bhandup man was hit by a tanker on the na- victim was traveling from Gwalior to MP. His colleague rec-
tional highway in 2016 while peeing, resulting in a bizarre
accident that cost him his right leg. The Motor Accident ommended Datiya Hospital in Madhya Pradesh, and he was
Claims Tribunal has now awarded him Rs 2 crore (plus in- then taken to the city to receive treatment for a fractured
terest). right hip, following which his right knee was amputated be-
low the knee. The tribunal determined that the tanker driver
The man was traveling to Datiya in Madhya Pradesh with was responsible for the accident in question based on the
a friend when they pulled over to answer nature's call be- evidence, which included the police files. The panel declared,
side a dhaba on the highway. At that moment, the tanker "Petitioner had no role to play in contributing the same."
approached from the incorrect direction. The man was a
deputy general manager with an FMCG at the time.
Insurance company ordered to reim-
"...although the petitioner did not experience a substan-
tial loss of earnings, it is important to acknowledge that burse patient damages of Rs. 3 Lakh
their earning potential has been clearly limited. It cannot A district consumer commission has ordered an insurance
be concluded that the petitioner did not lose his ability to company to reimburse Rs 2.65 lakh plus compensation of
make money given the nature of his profession and the Rs 2.70 lakh to a 55-year-old Colaba woman who had un-
problems he was facing. Conversely, it has been severely dergone a pacemaker replacement surgery at a prestigious
curtailed, if not completely eliminated," the panel declared. South Mumbai hospital in 2019. The commission chastised
The tribunal went on to state that even if his freedom of the insurance company for its excessively technical ap-
proach and adherence to a "pick and choose" theory.
movement had been restricted while carrying out his tasks,
it was fortunate for him that his employer had kept him on The claim was denied by the firm due to the discharge re-
staff. "His performance has an impact on his earnings. Stated port mentioning that the issue was merely a "pacemaker
differently, he is unable to perform to the level he did prior battery replacement." The commission highlighted, how-
to the injury, the tribunal declared, bestowing the medal. ever, that further documentation confirming the pace-
As part of his settlement, the man additionally received Rs maker replacement and another discharge statement veri-
1 lakh for unpaid services provided by his relatives. fied by the attending surgeon corrected the erroneous line.
The tribunal stated that the guy had a 50% permanent, in- "Therefore, the discharge summary contains the arbitrary
curable handicap and awarded more than a crore for the order of claim repudiation based on incorrect phrase inter-
disability he had endured. Therefore, he needs the help of pretation. Therefore, the committee concluded that the
at least one person every day, preferably with a stick. His order of repudiation was unsustainable under the law.
right leg was amputated, making it difficult for him to drive, On August 28, 2019, Shauheen and Muneera Daya filed a
climb, or carry out daily tasks. Furthermore, the tribunal complaint with the commission against Genins India Insur-
stated that he must undergo routine follow-ups about his ance TPA Ltd. and The United India Insurance Co Ltd. Ac-
prosthetic. cording to Shauheen's submission, he bought the policy in
In 2017, the victim filed a tribunal motion against Rakesh September 1998 for himself, his wife, and their daughter.
Sharma, the owner of the vehicle, and The Oriental Ins Co The policy was periodically extended.

48 December 2023 The Insurance Times