By Sri. MOHANDASAN.K, PRESIDENT
1. The complainants are the legal heirs of deceased Abdulla S/o Muhammed, who is the registered owner of the vehicle No. KL P 765 Scooter. He was a pillion rider on the scooter KL 55 P 765 and the scooter hit against a lorry bearing registration No.TN 47 AF 3352, which was stationery at Malappuram Kizhakkethala on 22/05/2016 at about 9.00 hours. The scooter was riding by one Mr. Nazimudheen, who is son of elder brother of deceased Abdulla. The vehicle was insured with the opposite party vide policy No.76020431150200012926 which is valid from 11/04/2016 to 16/10/2016. The registered owner Mr. Abdulla died from the medical college hospital, Calicut on 02/06/2016.
2. The complainants filed this complaint claiming compensation of rupees 4,90,000/- on various heads.
3. On admission of the complaint notice was issued to the opposite party and the opposite party entered appearance and filed version.
4. The opposite party submitted that the motor cycle KL- 55P/ 0765 was insured vide policy No.76020431150200012926 from 17/10/2015 to 16/10/2016. The policy is a two-wheeler liability policy with compulsory personal accident coverage to the owner- driver.
5. The opposite party denied the allegation that the opposite party did not reply to the registered notice dated 16/07/2019. The opposite party further denied the allegation that the act of non-payment of compensation amounts deficiency in service, the opposite party willfully denied the compensation, thereby causing hardships to the petitioners, the opposite party is liable to pay compensation of 4,90,000/- etc. The submission of the opposite party is that the policy issued is only an act liability policy in respect of third party liability with compulsory personal accident coverage to the owner-driver.
6. The policy condition stated in section 3 are as follows: -
- The compensation shall be payable under only of the items (i) to (iv) above in respect of the owner – driver arising out of any one occurrence and the total liability of the insurer shall not in the aggregate exceed the sum of Rs. 1 lakh during any one period of insurance.
- No compensation shall be payable in respect of the death or bodily injury directly or indirectly wholly or in partly arising or resulting from or traceable to ( a) intentional self – injury or suicide or attempted suicide physical defect or infirmity or (b) an accident happening whilst such person is under the influence of intoxication liquor or drugs.
- Such Compensation shall be payable directly to the insured or to his /her legal representatives whose receipt shall be the full discharge in respect of the injury to the insured.
This cover is subject to
- The owner – driver is the registered owner of the vehicle insured herein:
- The owner – driver is the insured named in his policy.
- The owner – driver holds an effective driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicles Rule, 1989, at the time of the accident.
7. Since the insured did not possess valid driving license at the time of accident, compensation as per the policy cannot be paid by virtue of the policy. Moreover,such
claims should have been filed within 12 months from the date of accident. The opposite party contended that if the company shall disclaim liability to the insured or any claim here under and such claim shall not, within 12 calendar months from the date of such disclaimer have been made the subject to matters of a suit in a court of law, then the claim shall for all purpose we deemed to have been abundant and shall not there after we recoverable here under. The opposite party submitted that the insurance policy is a contract which is regulated by terms stipulated therein and the respective parties have their obligation if there and specific clauses / provisions enlisted that regard. The insured has purchased a two-wheeler liability policy on 16/10/2015 for the period 17/10/2015 to 16/10/2016 vide No.76020431150200012926 with a compulsory personal accident coverage for owner-driver paying Rs.671/-. As per the premium regulation by IRDA the insured is eligible for Rs.1,00,000/- only by virtue of that policy. As per the policy condition the insured should have a valid driving license at the time of accident.
8. The submission of the opposite party is that the legal heirs did not file a claim petition in respect of personal accident claim or owner-driver within the prescribed time and the insured did not possess a valid driving license at the time of the accident. Hence the opposite party cannot allow the claim under law and the complaint is liable to be dismissed with the compensatory cost of the opposite parries.
9. The complainant and opposite parties filed affidavit and documents. The documents on the side of the complainant marked as Ext. A1 to A13 and the opposite parties filed documents and it is marked as Ext. B1 series. Ext. A1 is power of attorney executed on 12/08/2021. Ext. A2 is copy of notice issued by the complainants to the opposite party. Ext. A3 is copy of personal accident insurance claim form submitted before the opposite party on 10/12/2019. Ext. A4 is copy of FIR, in crime No.409/2016 dated 24/05/2016, Malappuram Police station. Ext. A5 copy of seen mahasar dated 24/05/2016. Ext. A6 is copy of charge sheet. Ext. A7 is copy of legal heir ship certificate dated 30/01/2017, Taluk office Ernad, Manjeri. Ext. A8 is copy of postmortem report dated 03/06/2016. Ext. A9 is copy of death certificate issued by Calicut Corporation dated 07/06/2016. Ext. A10 is copy of death certificate issued by Thrikkanmgode gramapanchayath 07/06/2018. Ext. A11 is copy of policy schedule cum certificate of insurance in respect of policy No.76020431150200012926. Ext. A12 is copy of written statement submitted by opposite party in OP (MV) No.1022/2017, MACT, Manjeri dated 18/09/2019. Ext. A13 is copy of postal receipt. Ext. B1 series is policy copy along with transferred copy and policy clause in respect of insurance policy No.76020431150200012926.
10. Heard complainant and opposite party, perused affidavit and documents. The following points arise for consideration-
- Whether the complainants are entitled for insurance benefit.
- Whether there is deficiency in service on the part of opposite parties
- Relief and cost.
11. Pont No.1 and 2
It is admitted case that the deceased Abdulla was the registered owner of the vehicle No. KL 55 P 765 scooter and he was the holder of insurance policy No.76020431150200012926. The case of the complainant is that as per the policy they are entitled insurance benefit of Rs.4,90,000/- which stands denied by the opposite party. On the other hand, the opposite party contended that the policy is only an act liability policy in respect of third-party liability with a compulsory personal accident coverage to the owner-driver. It is contended that as per the policy condition the owner-driver holds an effective and valid driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicle Rules 1989 at the time of the accident and then only the opposite party is liable to pay the insured amount. In this case the opposite party has got a case the insured owner of the vehicle was not holding valid driving license at the time of accident. Moreover, the claim for the insurance benefit must be preferred within 12 months from the date of incident.
12. In this complaint the complainants preferred a claim petition as OP(MV) 1022/2017 before the motor accident claims tribunal Manjeri, which shows that the opposite party was aware of claim of the complainants regarding the insurance coverage. The opposite party could have settled the matter if the complainants are entitled for the insurance benefit. So, there is no merit in the contention of the opposite party regarding the delay in preferring the claim before the opposite party.
13. The documents produced by the complainant that Ext. A4 shows the accident took place on 22/05/2016 at about 9 am while the registered owner of the vehicle was riding as pillion rider on his scooter. The document Ext. A6 shows that the RC owner was not the rider of the scooter at the time of accident. There is no case for the opposite party either before this Commission or before the Motor Accident Claims Tribunal that the rider of the scooter was not having valid driving license as per rule 3 of the central motor vehicles rule 1989. The opposite party admitted the issuance of compulsory personal accident coverage for owner-driver paying Rs.671/-. As per the premium regulation by IRDA the insured is eligible for Rs.1,00,000/- only by virtue of that policy.
14. Now it is admitted fact that the opposite party collected premium for the personal accident insurance coverage from the policy holder, the owner of the vehicle. The object of the insurance coverage of a personal accident for owner-driver of the vehicle is relevant to consider at this juncture. The object of personal accident cover was to benefit the owner for any losses and injuries that could occur due to an accident. The intent behind personal accident cover for owner-driver is to ensure that the insured vehicle owner does not have to burden medical expenses in case of any major injuries of permanent disabilities. Moreover, vehicle owner can rest assured that in case of that amenities due to major accident, their families will receive a death benefit. The Motor Vehicle act or any statute does not necessitate to hold an effective driving license for being the owner of a vehicle. A person who is not holding a driving license can also be an owner of the vehicle. The driving license is provided as per motor vehicles act to drive a motor vehicle and not as the qualification to own a vehicle. Physical disabled person is not deprived from holding a motor vehicle. At the same time, he may not be qualified to hold a valid driving license.
15. In this complaint it is relevant to not the fact that the policy holder, the owner of the vehicle was only pillion rider and not rider of the scooter. There is no case for the opposite party that the scooter was ridden by a person who is not holding a valid driving license. So, there is no merit in the contention of opposite parties that the policy holder – the owner of the vehicle was not holding valid driving license and not entitled to insurance coverage. The insurance company is liable to pay the insurance coverage as per the driver-cum owner personal accident insurance coverage policy. The denial of insurance coverage without sufficient reason amounts deficiency in service.
16. Point No.3
The complainant claimed compensation of Rs.4,90,000/- under the insurance policy. The amount include compensation on account of deficiency in service and also on account of medical expenses met by the complainant. But the insurance coverage available to the complainants under the present policy is not as vicarious liability. The insurance available to complainants is under the driver cum owner policy. The opposite party produced Ext. B1 series to show the conditions of the policy issued in favor of the deceased registered owner of the vehicle. As per the terms of the policy the maximum liability under the policy is limited up to 1,00,000/- rupees. So, the complainants are entitled only for rupees 1,00,000/- as per the policy condition. The Commission finds that the complainants entitled Rs.1,00,000/- as per the policy. The complainants also entitled cost of Rs. 5,000/-. The complaint stands filed through the holder of power of attorney and he produced the same as exhibit A1.
In the light of above fact and circumstances we allow this complaint as follows: -
1) The opposite party is directed to pay Rs.1,00,000/- (Rupees one lakh only) to the complainant as compensation along with interest at the rate of 9% per annum from the date of complaint to till date of payment.
- The opposite party is directed to pay Rs.5,000/- (Rupees five thousand only) as cost of the proceedings to the complainant.
The opposite party shall comply this order within one month from the date of receipt of copy of this order, failing which the opposite party is liable to pay interest at the rate of 12% per annum from the date of order to till date of payment.
Dated this 26th day of April , 2023.
APPENDIX
Witness examined on the side of the complainant: Nil
Documents marked on the side of the complainant: Ext.A1 to A13
Ext.A1: power of attorney executed on 12/08/2021.
Ext.A2: Copy of notice issued by the complainants to the opposite party.
Ext A3 : Copy of personal accident insurance claim form submitted before the opposite
party 10/12/2019.
Ext A4 : Copy of FIR, in crime No.409/2016 dated 24/05/2016, Malappuram Police
station.
Ext A5: copy of seen mahasar dated 24/05/2016.
Ext.A6: copy of charge sheet
Ext.A7: Copy of legal heir ship certificate dated 30/01/2017, Taluk office Ernad
Manjeri.
Ext A8: Copy of postmortem report dated 03/06/2016.
Ext A9: Copy of death certificate issued by Calicut Corporation dated 07/06/2016
Ext A10: copy of death certificate issued by Thrikkanmgode gramapanchcayath
07/06/2018.
Ext.A11: Copy of policy schedule cum certificate of insurance in respect of policy
No.76020431150200012926.
Ext.A12: Copy of written statement submitted by opposite party in OP (MB)
No.1022/2017, MACT, Manjeri dated 18/09/2019.
Ext.A13: Copy of postal receipt
Witness examined on the side of the opposite party: Nil
Documents marked on the side of the opposite party: Ext. B1
Ext.B1: Policy copy along with transferred copy and policy clause in respect of
insurance policy No.76020431150200012926.
