Kochin Ombudsman Centre
Case No. IO / KCH / GI / 11-005-045 / 2004-05
Sri P. G. Unnikrishnan
Vs.
Oriental Insurance Co. Ltd.
The complaint under Rule No. 12(1)(b) read with Rule 13 the RPG Rules, 1998 arose from repudiation of a GPA claim preferred by the complainant before the Insurer. The Complainant was employed in the GTN Textiles and reportedly while on duty in the factory on 12.09.2003, he had sustained a pain on his back and was hospitalized. Subsequently he had also availed of treatment from the ESI hospital.
The Insurer had rejected the claim stating that it was not a case of accident. It was, on the other hand, a simple sprain on the back, due to a particular posture in which he was positioned at his work place. The contention of the Insurer was also borne out of the records in the file and the complainant was not able to prove that it was an accidental injury.
Since there was nothing wrong in the interpretation of the Insurer, it was found that there was no force or merit in the complaint and the same was dismissed.
