BEFORE THE MANDYA DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANDYA<br /> <br /> PRESENT: 1. SIDDEGOWDA, B.Sc., LLB., President,<br /> <br /> 2. M.N.MANOHARA, B.A., LLB., Member,<br /> <br /> 3. A.P.MAHADEVAMMA, B.Sc., LLB., Member, <br /> <br /> ORDER<br /> <br /> Complaint No.MDF/C.C.No.107/2009<br /> <br /> Order dated this the 8th day of December 2009<br /> <br /> COMPLAINANT/S <br /> <br /> Smt.Mangala W/o Late Puttegowda, R/o Hullahalli Village, Kasaba Hobli, Malavalli Taluk, Mandya District.<br /> <br /> (By Sri.Mahadevegowda., Advocate)<br /> <br /> -Vs-<br /> <br /> OPPOSITE PARTY/S<br /> <br /> The Branch Manager,<br /> L.I.C. of India, “Jeevan Jyothi”, B.M.Road, Kolli Circle, Maddur, Mandya District.<br /> (By Sri.S.Sudarshan., Advocate)<br /> <br /> Date of complaint 07.09.2009<br /> Date of service of notice to<br /> Opposite party 09.10.2009<br /> Date of order 08.12.2009<br /> Total Period 1 Month 29 Days<br /> Result The complaint is dismissed. However, there is no order as to costs. <br /> <br /> Sri.Siddegowda,<br /> President<br /> <br /> 1. This complaint is filed under section 12 of the Consumer Protection Act, 1986 against the Opposite party claiming accidental benefits of the Insurance policies.<br /> 2. The case of the Complainant is that her husband Puttegowda had obtained four insurance policies bearing No.720269616, 721108589, 723203909 & 723893686 from the Opposite party with double accidental benefit. Unfortunately, on 21.05.2008 at 11.30 p.m. near Hunnana Doddi Village, while riding a motor bike, died in the accident between parked lorry on the motor cycle and at that time, the documents of the motor cycle along with D.L., Tools kit, cash of Rs.6,000/-, mobile phone and gold chain and ring were stolen. Thereafter, when the Complainant claimed the insurance amount with accidental benefits, the Opposite party settled only the sum assured, but did not pay the accidental benefit. In spite of legal notice dated 25.06.2009, the Opposite party has not settled the accidental benefit and thereby committed deficiency in service and hence, the present complaint. <br /> 3. The Opposite party has filed version admitting the four policies obtained by the deceased insured and for two policies one Smt.Jayamma, the mother of the deceased assured is the nominee and the Complainant has no locus standi to file the complaint. It is admitted that the policies were issued with accident benefit and the life assured died on 21.05.2008 in an accident. The accident occurred due to the rash and negligent driving of two wheeler by the deceased life assured, which has been proved by the charge sheet filed by the Inspector of Police, K.M.Doddi. It is false that the driving licence of the life assured was stolen at the time of accident. The Complainant vide her letter dated 12.08.2008 herself had admitted that the deceased life assured had no driving licence to ride the vehicle. The Opposite party had settled the basic claim amount along with bonus, in respect of two policies, the amount settled in favour of the Complainant who is a nominee. The Complainant had not produced the original driving licence to ascertain that there is no breach of law. As per condition No.10(b) of the policy, accident benefit is not payable as a result of the life assured committing breach of law. Driving of the vehicle without valid and effective driving licence is an offence and it is a breach of law as per Motor Vehicle Act. The legal notice was suitably replied. The Opposite party has not committed any deficiency in service nor there is any delay in settling the claim. Therefore, the Opposite party is not liable to pay any amount and the complaint is liable to be dismissed with costs. <br /> 4. During trial, the Complainant has filed affidavit and she is examined and produced the documents Ex.C.1 to C.6. On behalf of the Opposite party one Officer is examined and the documents Ex.R.1 to R.10 are produced.<br /> 5. Both the sides have filed written arguments.<br /> 6. We have perused the records.<br /> 7. Now the points that arise for our considerations are:-<br /> 1. Whether the Opposite party has committed deficiency in service in not settling the accident benefit in respect of the policies obtained by the deceased life assured?<br /> 2. Whether the Complainant is entitled to the relief sought for?<br /> 8. Our findings and reasons are as here under:-<br /> 9. POINT NO.1:- The undisputed facts borne out from the materials on record are that one Puttegowda, the husband of the Complainant had obtained four life insurance policies bearing No.720269616, 721108589, 723203909 & 723893686 from the Opposite party as per Ex.C.1 to C.4 for Rs.50,000/-, Rs.30,000/-, Rs.1,00,000/ and Rs.25,000/- and it is admitted that the deceased life assured died in the motor vehicle accident on 21.05.2008 and the Complainant claimed the amount of the policies and the Complainant is a nominee for two policies and the mother of the life assured is a nominee for other two policies and the Opposite party Insurance Company settled the basic sum assured with bonus in favour of the Complainant and mother of the deceased, but not settled the accident benefit, though all the four policies are covered under double accident benefit.<br /> 10. The grievance of the Complainant is that though she is entitled to double accident benefit in respect of all four policies, since the husband is died in motor accident the Opposite party has committed deficiency in service in not paying the double accident benefit. The contention of the Opposite party is that the deceased life assured died in a motor vehicle accident and at that time, he was not possessing a valid and effective driving licence and therefore, it is a violation of law under the Indian Motor Vehicle, Act and thereby breach of conditions of the policy and further, the accident took place due to the rash and negligent riding of the motor cycle by the life assured which is proved by the charge sheet submitted by the concerned police.<br /> 11. The learned counsel for the Complainant has relied upon the decisions reported in 1996(4) Supreme Court case page 647, 2008(II) CPJ page 61 and the Order in C.C.39/2008 of this Forum. On the other hand, the learned counsel for the Opposite party has relied upon the orders passed in Appeal No.1681/2005 dated 05.02.2007 and Appeal No.1302/2006 dated 23.09.2006 rendered by our Hon’ble State Commission.<br /> 12. The relying upon the decisions, the learned counsel for the Complainant contended that though the Complainant has not produced the driving licence, the Complainant could not trace the driving licence as it was stolen at the time of accident and mere non-possession of the driving licence will not be a breach of law, in view of the decisions quoted and further, there is no proof or judgement by the Court that the accident was due to rash and negligent riding of the motor cycle by the life assured and the police report cannot be accepted.<br /> 13. Now, in the decision 1996(4) Supreme Court cases page 647 in the case of B.V.Nagaraju –Vs- Oriental Insurance Co., Ltd. The Hon’ble Supreme Court has held that breach of carrying humans in a goods vehicle more than the number permitted in terms of the insurance policy cannot be said to be such fundamental breach so as to afford ground to the insurer to deny indemnification unless there were some factors which contributed to the causing of the accident. In part II(2008) CPJ page 61 in the case of L.I.C. of India –Vs- Ratan Kaur, the Hon’ble National Commission has held that in the case of death in a motor vehicle accident, the contention that the deceased had no driving licence at accident time and vehicle was driven in rash and negligent manner is not acceptable in the absence of evidence in support. The deceased possessing valid licence at the accident time is proved by materials on record. Accident by itself is not indicative of fact that vehicle driven in rash and negligent manner and insurance company cannot escape liability to pay accident benefit. Further, the Hon’ble National Commission has held that the expression committing any breach of law mentioned in the policy is not specific rather quite vague, not each and every violation however slightest it may be, can be labelled as breach of law. The terms of the policy if vague should be interpreted for benefit of the assured. In C.C.39/2008 in the case of Nagarathnamma –Vs- L.I.C. of India by its order dated 20th June 2008 this Forum has allowed the double accidental benefit. But, that decision is not applicable to the facts of the case, because in that case due to rash and negligent driving of lorry, the accident took place and criminal case is filed against the driver of the lorry and there is no evidence that the deceased assured contributed to the accident. Though, the Complainant failed to produce the driving licence of the deceased. Our Hon’ble State Commission in the case of Lata Deepak Nangare –Vs- L.I.C. of India, in Appeal No.1681/2005 directed the Insurance Company to pay the accidental benefit provided the Complainant were to produce the driving licence of the insured and in Appeal No.1302/2005 in the case of Maimuna –Vs- L.I.C. of India, the accidental benefit was negatived on the ground that the insured did not have licence at the time of accident.<br /> 14. Though, in the complaint and affidavit, the Complainant has deposed that the driving licence of the deceased along with other articles was stolen at the spot of the accident, in her petition Ex.R.1 to the Opposite party has clearly stated that her husband Puttegowda was not possessing driving licence and it was revealed that even earlier he had not obtained the driving licence. So, there is clear admission that the deceased was not possessing any driving licence to ride the motor cycle which is mandatory as per the provisions of the Motor Vehicle Act, and riding of the motor cycle without a valid driving licence is an offence and breach of law. Of course, the Hon’ble Supreme Court and our Hon’ble National Commission, recently held that mere non-possessing of driving licence by the insured at the time of accident does not entitle, the Insurance Company to refuse the accidental benefit provided in the policy on the ground that the condition in the policy that any breach of law is not specific and it is ambiguous and therefore, that condition should be interpreted which is beneficial to the insured. It is undisputed in both the decisions of Hon’ble Supreme Court and Hon’ble National Commission, it is clearly held that if the accident was due to the factors which contributed to the causing of the accident indemnity of the vehicle insured cannot be extended. In the decision of Hon’ble National Commission it is held that there are material produced on record to prove that the deceased insured was possessing valid licence at the accident time. But, in the present case, there is no evidence i.e., the Complainant has failed to produce the driving licence of her husband Puttegowda permitting to drive the motor cycle. Though accident by itself is not indicative of fact that the vehicle was driven in rash and negligence manner and it is to be proved, in the present case, the Complainant has furnished the copy of the charge sheet filed by the police to the Opposite party and the perusal of the charge sheet reveals that on 21.05.2008 at 11.30 p.m. on Maddur – Malavalli Road, near Hunnanadoddi, the deceased assured was riding the motor cycle in rash and negligence manner and dash against the back right side wheel of the lorry which was parked and died at the spot and the accident was due to the rash and negligent riding of the motor cycle by the deceased assured. So, prima-facie there is ample evidence in the form of police charge sheet that the accident was due to the rash and negligent driving of the motor cycle by the deceased assured and he was not possessing any driving licence. It is not the case that the police have filed a false charge sheet and even Complainant has not protested by filing a complaint against the lorry driver about the accident. Even as stated above, the Complainant admitted in her petition Ex.R.1 that her husband Puttegowda was not possessing driving licence at the time of accident and even earlier he had not obtained any driving licence. Under these circumstances, it is proved by records that the rash and negligence riding of the motor cycle without driving licence by the deceased assured is the root cause for the fetal death of the deceased assured and therefore, there is breach of policy conditions and hence, the Opposite party is right in rejecting the claim of double accidental benefit to the Complainant and therefore, the Complainant has failed to prove that the Opposite party has committed deficiency in service.<br /> 15. In view of our finding on point no.1, the Complainant is not entitled to the accidental benefit of the policy and the Complainant is not entitled to any relief sought for.<br /> 16. In the result, we proceed to pass the following order;<br /> ORDER<br /> The complaint is dismissed. However, there is no order as to costs. <br /> <br /> (Dictated to the Stenographer, transcribed, corrected and then pronounced in the open Forum this the 8th day of December 2009).<br /> <br /> (PRESIDENT) (MEMBER) (MEMBER)