SRI.K. VIJAYAKUMARAN, PRESIDENT. Complaint seeking insurance claim with interest. The averments in the complaint can be briefly summarized as follows: The first complainant is the wife , 2nd and 3rd complainants are the children and 4th and 5th complainants are the father and mother respectively of deceased Vasudevan Pillai who died on 15.10.2006 at 7.30 p.m. in a motor cycle accident at Byepass Junction, Jaipur Sirsi Road, Vaisali Nagar, Jaipur. The deceased was traveling as a Pillion rider in motor cycle bearing Reg.No.14/SP-3787. When he reached the scene of accident a tata lorry bearing Reg.No.RJ-2/G-4391 hit behind the motor cycle and the deceased was thrown down on the road and fatally injured. The motor cycle was insured with the opp.parties on 27.8.2006 as per cover note JRO No.53884 on payment of premium of Rs.969/- which included the premium for Personal Accident Coverage to the owner of the vehicle. The policy was valid till 26.8.2007. The Vaisali Nagar Police registered as crime No.631/06 under Section 279, 338 and 304 IPC The complainant preferred the claim on 12.11.2007 along with all records. The application was received by the 2nd opp.party on 18.11.2007. But no further action was taken to give the compensation amount as per the policy. It is deficiency in service on the part of the opp.parties. Hence the complaint. The opp.parties filed a joint version contending, interalia, that the complaint is not maintainable either in law or on facts. The definition complaint, complainant, Consumer Dispute, service as defined in section 2 [1] of the Consumer Protection Act do not cover the claim made out in the complaint. The complainant has no cause of action . It is admitted that the opp.party have issued a two wheeler package ‘B’ policy in favour of the deceased Vasudev Pillai for his motor cycle bearing Reg. No.RJ/14 SP – 3787 for a period from 27.8.2006 to 26.8.2007. As perhe above policy, Personal Accident Coverage for a sum of Rs.1,00,000/- is payable to the owner cum driver in case of his death due to an accident occurred while he was riding the motor cycle. As per the terms and condition of the policy the above Personal Accident risk of the insured is covered only when he was riding the vehicle in his capacity as the owner cum driver. It is specifically shown in the schedule of property itself that the above personal accident coverage is granted to owner cum driver alone. In this case the owner of the vehicle Sri. Vasudevan Pillai was riding as pillion rider in the insured vehicle at the relevant time of the occurrence. Since the insured is not the driver of the vehicle he is not eligible to claim any benefits available under the Personal Accident cover for the owner cum driver. The risk of the pillion rider is not covered under the Personal Accident coverage. The premium collected by the opp.party is only for covering the risk of the owner cum driver alone and not for the pillion rider. Therefore the complainant is not eligible to claim compensation. The complainant has not preferred any claim with this opp.party as alleged in the complaint. Even in the case of a genuine claim notice shall be given to the opp.party in writing immediately upon the accident by the insured. The complainant herein has not informed the accident immediately . The allegation that they have preferred claim on 12.11.2007 are absolutely baseless and false. The complainants have willfully violated the condition No.1 of the policy and as such they have no manner of right to allege any deficiency in service against the opp.party. Hence the opp.party prays to dismiss the complaint. Points that would arise for consideration are: 1. Whether there is any deficiency in service on the part of the opp.party 2. Reliefs and costs. For the complainant PW.1 is examined. Ext. P1 to P10 are marked. For the opp.party Ext. D1 is marked. POINTS : As a matter of fact the policy is admitted. The accident is also admitted. The case of the complainant is that at the time of accident the deceased Vasudevan Pillai was traveling as a Pillion rider in his motor cycle bearing Reg.No.RJ/14 SP/3787 which was being driven by a friend of his one Kuttanpillai and the deceased succumbed to his injuries. The contention of the opp.parties is that the insurance coverage under Ext. D1 policy is available only to the owner cum driver and not to even if he is the owner of the vehicle. It is an admitted case that the deceased was traveling as pillion rider in his motor cycle driven by one Kuttanpillai. It is argued by the learned counsel for the opp.parties that as per the terms and conditions of the Ext. D1 policy the personal accident of the insured is covered only when he was riding in the vehicle in the capacity as owner cum driver. In the scheduled of premium of Ext. D1 the wording used is ‘compulsory PA to owner cum driver’. From the wording in the schedule it is obvious that only the owner who is driving the vehicle alone is eligible to get insurance coverage under Ext. D1. As argued by the learned counsel for the opp.party the risk of the pillion rider is not covered under the personal accident covered given under the policy. The learned counsel for the complainant would argue that there is no condition in Ext. D1 that owner has to drive the vehicle so as to get coverage. That argument cannot be accepted in the light of the specific wording in Ext. D1 “Compulsory PA to owner cum driver”. It does not contemplate a pillion rider. Since the deceased who admittedly is the owner was traveling as pillion rider at the time of the accident, in the light of the stipulation in Ext. D1 we are of the view that the deceased is not entitled to get policy coverage offered to owner cum driver. In these circumstances it cannot be said that there is deficiency in service on the part on the opp.parties. Point found accordingly. In the result the complaint fails and the same is hereby dismissed. No cots. Dated this the 21st day of July, 2010. . I N D E X List of witnesses for the complainant PW.1. Sudhakumary List of documents for the complainant P1. – FIR P2. – Final report P3. – Postmortem certificate P4. – Insurance covernot P5. – Reg. Certificate P6. – earner’s license P7. – Notice issued to the 2nd opp.party P8. – Postal receipt P9. – Acknowledgement card. P10. – Form of Driving License List of witnesses for the opp.part : NIL List of documents for the opp.party D1. - Policy schedule |