O R D E R

(By Sri D.Shankar Rao, Member)

1. The brief-facts set out in the complaint are that the complainant No.1 is the son and complainant No.2 is the wife of late Dharma Reddy who died on 26-04-2012 in a road accident.  The deceased Dharma Reddy owned motor cycle bearing No.AP-25-AG-1695 insured with the opposite party vide policy No.OG-12-1809-180200003333 valid form 04-08-2011 to 03-08-2012.  The said policy also coverage of personal accident to owner-cum-driver for a sum of Rs.1,00,000/-.  The traffic police Nizamabad issued FIR No.51 of 2012 against the driver of crime vehicle for causing the accident and death of Dharma Reddy.  The complainant No.1 has claimed the vehicle damages and death claim of Dharma Reddy under P.A. coverage of the policy but the opposite party has repudiated the claim on a ground that the deceased Dharma Reddy not having driving license at the time of accident.  The deceased has not contributed to the accident, as such he having license or not having license makes no difference, hence the act of repudiation the claim on 18-07-2012 is illegal and un warranted.  The deceased Dharma Reddy was holding a license to ride motor cycle since 1985 and the said license lapsed on 20-07-2005 but he was not disqualified from holding or obtaining a license and it was due for renewal.  Therefore the opposite party is liable to pay the own damages of the vehicle of Rs.6,650/- and to pay Rs.1,00,000/- towards P.A. policy with damages of Rs.1,00,000/- towards mental agony and hardship with costs.

1. The opposite party filed its counter and briefly stated that they admitted to an extent of issuing of policy No.OG-12-1809-1802-00003333 for the vehicle No.AP-25-AG-1693 covering the period from 04-08-2011 to 03-08-2012 is subject to terms, conditions, exceptions and limitations of the policy.  The opposite party has not received any intimation from the complainant with regarding to the claim of personal accident coverage of the insured.  Hence the claim is liable to be dismissed.  It is admitted to an extent that the opposite party has repudiated the claim of the own damages of the vehicle on the ground of non-holding of driving license by the driver at the time of accident.  No person shall drive a motor vehicle in any public place unless he holds and effective driving license.  Hence non-holding of driving license is violated the policy terms & conditions.  The personal accident cover for owner-driver states that owner-driver holds an effective driving license in accordance with the law.  The opposite party is also not liable to pay P.A. sum assured as the deceased was not holding driving license at the time of accident.  All other allegations have been denied.  Therefore the complaint is liable to be dismissed.

3.       During enquiry, the complainant No.1 filed his evidence affidavit on his be-half and on be-half of complainant No.2 as PW1 and got marked exhibits A1 to A7 documents.

          The opposite party filed the evidence affidavit of their Senior Executive Jetla Mahesh as RW1 and got marked exhibits B1 & B2 documents.

4.       Heard Arguments.

5.       The points for consideration are:-

          1)  Whether there is any deficiency of Service on the part of opposite party                         in repudiating the claim under policy ?

          2)  To what relief?

6.       Point No. 1 &2: It is not disputed that the Gobburu Dharma Reddy was the owner of motor cycle bearing No.AP-25-AG-1695 and insured vide policy No.OG-12-1809-1802-00003333at the time of accident on 26-04-2012.  It is also not disputed that the said policy is also covering with the personal accident insurance to owner-driver.

          The dispute is that the deceased Dharma Reddy not holding driving license at the time of accident.

          In order to prove the case the complainant No.1 filed his evidence affidavit as PW1 and relied upon exhibits A1 to A7 documents.

          The opposite party also field the evidence affidavit of their Senior Executive Jetla Mahesh as RW1 and relied upon Ex.B1 & B2 documents supporting to their contention.

          Ex.A1 is the FIR 51 of 2012 dated 26-04-2012 issued by traffic police Nizamabad. Ex.A2 is the inquest report.  Ex.A3 is the post mortem examination report.  Ex.A4 is the charge sheet.  Ex.A5 is the insurance policy.  Ex.A6 is the repudiation letter dated 18-07-2012.  Ex.A7 is the driving license of deceased Dharma Reddy. 

          Ex.B1 is the insurance policy.  Ex.B2 is the repudiation letter dated 18-07-2012. 

          We have heard the arguments of counsel for the parties and also verified the written arguments field by opposite party.  We have also verified the entire case record and perused the exhibits on both sides.

          Ex.A7 is the attested copy of driving license issued on 22-2-1985 in the name of deceased Dharma Reddy and renewed it upto 21-02-1995.  Thereafter no renewal was made in Ex.A7 driving license.  Hence we are of the considered view that the said Dharma Reddy had no driving license to drive the vehicle at the time of accident but he can drove the vehicle.  Therefore we are inclined to accept the version of opposite party that the deceased Dharma Reddy drove his vehicle without having driving license at the time of accident which is a violation of policy condition in respect of own vehicle damages as well as P.A. coverage under the policy.  However, non-holding of driving license was not nexus with the cause of accident as per Ex.A1 & A7 documents.  At the same time we are not inclined to accept the act of opposite party in repudiation of claim in toto under the policy.  Even that there was a breach of condition of the insurance policy the opposite party ought to have settled the claim on non-standard basis as held by the Hon’ble Apex Court in its judgment between “AMALENDU SAHOO V/s ORIENTAL INSURANCE COMPANY LIMITED” reported in 2010 4 SCC 536 following the guidelines issued by the insurance company about settling all such non-standard claims.

          The said guidelines are set out below:-

          The guideline No. (iii) is applicable to the instant case, the opposite party is liable to pay 75% of the admissible claim of the complainant under the policy, in respect of own damages as well as P.A. coverage.

          The complainants 1 & 2 are claiming Rs.6,650/- as own damages to the vehicle bearing No.AP-25-AG-1695 as well as personal accident coverage of Rs.1,00,000/- under the policy.  The opposite party has not denied the value of damages.  Hence we are in opinion that the damages of Rs.6,650/- plus Rs.1,00,000/- under personal accident coverage are an admissible claim.

          The complainants 1 & 2 have not adduced any other evidence for other reliefs.  Hence complainants 1 & 2 are only entitled Rs.75,000/- in respect of P.A. coverage and Rs.4,987-50 p.s. in respect of own damages i.e. 75% of admissible claim of Rs.1,00,000/- in respect of P.A. coverage and Rs.6,650/- in respect of own damages under the policy with interest and costs. 

          In view of discussions and findings, we are of the considered view that the opposite party is liable to pay Rs.75,000/- as P.A. coverage and Rs.4,987-50 ps. as own damages of the vehicle under the policy to the complainants 1 & 2 with interest and costs equally.

7.       IN THE RESULT, the complaint is allowed in part as under:-

1. The opposite party is directed to pay total Rs.79,987-50 p.s. (Rs.75,000/- P.A. plus Rs.4,987-50 p.s. own damages) with 9% interest per annum from the date of repudiation i.e. 18-07-2012 till realisation to the complainants 1 & 2 equally.

1. The opposite party is further directed to pay Rs.2,000/- to the complainants 1 & 2 equally towards costs of the complaint.

Typed to dictation, corrected and pronounced by the President in Open Forum on this the 1^st day of December 2014.