V.M Mathew, filed a consumer case on 30 Sep 2008 against Divisional Manager, in the Kottayam Consumer Court. The case no is CC/06/257 and the judgment uploaded on 30 Nov -0001.
1. Bindhu M Thomas 2. K.N Radhakrishnan 3. Santhosh Kesava Nath P
Complainant(s)/Appellant(s):
OppositeParty/Respondent(s):
OppositeParty/Respondent(s):
OppositeParty/Respondent(s):
ORDER
O R D E R Sri. Santhosh Kesavanath P., President. Case of the petitioner's is as follows: The petitioners are the only legal heirs of deceased Mercy Mathew, who was the wife of the 1st petitioner and mother of other petitioners. The petitioner narrate the accident as follows: On 25..12..2004 at about 2.30 P.M while the vehicle driven by the 1st petitioner reached near a bridge at Kurianad, it hit on a barricade. As a result of the -2- accident the wife of the petitioner succumbed to injuries and she was immediately taken to Matha hospital and later she died. At the time of accident the petitioner has a valid driving license. The petitioner states that at the time of accident the petitioner was insured to the opposite party. As per the personal accident cover of the policy the petitioner is entitled for an amount of Rs. 2,00,000/- as compensation. The petitioner preferred a claim to opposite party but the opposite party has not cared to process the claim so, the petitioner on 27..12..2005 issued registered lawyers notice to the opposite party to settle the matter by making payment of Rs. 2,00,000/-. But the opposite party sent a reply stating that petitioners are not entitled for the claim because as per conditions of policy the driver cum owner is only entitled for the benefits of the policy According to the petitioner the act of repudiation of the claim of the petitioner is a clear deficiency of service. So, he prays for a direction of the Forum to the opposite party to pay the petitioner an amount of Rs. 2,00,000/- as additional personal accident cover with 18% interest from 27..12..2005, petitioner also claims an amount of Rs. 15,000/- as compensation and cost of the proceedings. The opposite parties filed version contenting that the petition is not maintainable. Opposite party contented that at the time of accident the car was driven by another person and not the registered owner of the vehicle bearing No. KL -10 S- 6838. The personal accident cover under the policy issued for the vehicle will cover only if the insured is the driver of the vehicle at the time of accident The opposite party contented that as per general regulation No. 36 of the Tariff Advisory Committee, personal accident cover will be applicable in cases where the insured holds effective and valid driving -3- license at the time of accident. In this case the insured owner, deceased, has no driving license for driving the type of the vehicle involved in the accident.Generally insurance companies are issuing policy as per regulation of Tariff Advisory Committee. Tariff Advisory Committee is a statutory body created as per Section 64 of the Insurance act. According to the opposite party it have statutory binding on insurers. Hence this opposite party is liable to follow the general regulation No. 36 of the Tariff Advisory Committee. So, the opposite party contented that as per the policy condition they are not liable for the claim preferred by the petitioner. So, they pray for a dismissal of the petition with their costs. Points for determination are: i) Whether there is deficiency in service on the part of the opposite party? ii) Reliefs and costs. Evidence in this case consists of the affidavit filed by both parties. Ext. A1 to A5 documents on the side of the petitioner and Ext. B1 document on the side of the opposite party. Point No. 1 Petitioner produced claim repudiation letter issued by the opposite party and said document is marked as Ext. A5. From Ext. A5 it can be seen that claim of the petitioner is is repudiated on the ground that the owner - driver is not holding an effective driving license at the time of accident. Opposite party produced the policy with conditions of policy and said document is marked as Ext. B1. In Ext. B1 the conditions of section 3 personal accident cover for owner-driver is stated. In GR 36 of the Indian -4- Motor Tariff it is stated that the owner of the insured vehicle holding an effective driving license is termed as owner-driver for the purpose definition owner-driver. The counsel for the petitioner argued that the argument of the opposite party that the owner can claim the amount only if the owner had a valid driving license is not sustainable because if that benefit was available only to a owner who holds valid driving license , certainly, the wording in the policy ought to have been owner-cum-driver. Since the wording in the disputed policy is owner-driver it means that either of them is entitled to claim compensation as per personal accident policy. The verbatim reproduction of the conditions of policy in Ext. B1 is as follows: i) the personal accident cover is subject to: (a) the owner-driver is the registered owner of the vehicle insured here in (b) the owner-driver is the insured named in the policy (c) the owner -driver holds an effective driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicle Rules at the time of accident etc. We are of the opinion that since it is mentioned in the condition of policy that the owner-driver name is the insured named in the policy. Defenitely the policy coverage of owner-driver is owner -cum- driver . As per GR 36 of the personal accident cover of the Indian Motor Tariff the owner -driver is defined. In GR 36 it is mentioned that the owner of the insured vehicle holding effective driving license is termed as owner-driver for the purpose of the section. Since Indian Motor Tariff is the conditions made by the tariff advisory committee for transaction of motor insurance business in India constituted as per provisions of the insurance act it is binding on all insurance companies. So, defenitely -5- the conditions mentioned in the policy, with regard to personal accident is GR 34 of the Indian Motor Tariff, is the condition of the present policy. So, we are of the opinion that repudiation of the claim of the petitioner on the ground that the owner is not having a valid driving license at the time of insurance is legal. So, no deficiency in service can be attributed against the opposite parties in repudiating the claim. So point No. 1 is found accordingly. Point No. 2 In view of finding in point No. 1, petition is dismissed. Considering the facts and circumstances of the case . No cost and compensation is ordered. Dictated by me transcribed by the Confidential Assistant corrected by me and Pronounced in the Open Forum on this the 29th day of September, 2008.
......................Bindhu M Thomas ......................K.N Radhakrishnan ......................Santhosh Kesava Nath P
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