Punjab

Ludhiana

CC/20/80

Balwinder Kaur - Complainant(s)

Versus

Oriental Insurance Co.Ltd - Opp.Party(s)

Ripon Chadha Adv.

06 Dec 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 80 dated 26.02.2020.                                                Date of decision: 06.12.2022.

 

Balwinder Kaur aged 57 years wife of Late Sh. Iqbal Singh, resident of VPO Hans Kalan, Tehsil and District Ludhiana at present resident Village Kothe Baggu, Tehsil Jagraon, District Ludhiana.                                                                                                                                                  ..…Complainant 

•  

1. Oriental Insurance Co. Limited, having its registered & head office at A-25/27, Asaf Ali Road, New Delhi through its MD/Director/Authorized representative.
2. Oriental Insurance Co. Limited, having its branch/divisional office at 2^nd Floor, Sidhu Gias Agency, Tehsil Road, Jagraon, District Ludhiana, through its Branch/Division Manager.

…..Opposite parties.

3. Sukhdev Singh son of Sh. Chanan Singh,
4. Gurdev Kaur wife of Sh. Sukhdev Singh,
5. Gurpreet Singh son of Late Sh. Iqbal Singh,

all residents of village Hans Kalan, Tehsil Jagraon, District Ludhiana.

6. Harmeet Kaur wife of Sh. Jasvir Singh, D/o. Iqbal Singh, resident of Gorsian Qadar Baksh, Ludhiana.

       …..Opposite parties/Performa parties

Complaint under Section 12 of the Consumer Protection Act.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. Ripan Chadha, Advocate.

For OP1 and OP2          :         Sh. Rajeev Abhi, Advocate.

For OP3 to OP6             :         OP3 to OP6 are performa parties.

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Shorn of unnecessary details, the case of the complainant is that she is wife of Iqbal Singh and opposite party No.5 and 6 are children of Iqbal Singh whereas opposite party No.3 and 4 being parents of Iqbal Singh have been engaged as performa opposite parties and no relief has been claimed against opposite party No.3 to 6. According to the complainant, Iqbal Singh was owner in possession of one scooter bearing registration No.PB-36C-0591and the same was insured with opposite party No.1 and 2 vide policy No.233903/31/2019/4934 valid from 07.02.2019 to 06.02.2020. Besides the registered owner cum driver was also coved for personal accident for an amount of Rs.15,00,000/-. On 29.05.2019, when Iqbal Singh and one Sohan Singh @ Soni was going to Nankana Sahib on Bajaj Chetak scooter No.PB-36C-0591 and it was driven by Iqbal Singh and when they reached opposite Pardesi Dhaba, G.T. Road at about 08.40 AM, a truck bearing No.MH-04GC-2035 driven rashly and negligently coming from Jagraon side hit the scooter and ran over the body of Iqbal Singh. Iqbal Singh was rushed to Civil Hospital, Jagraon with assistance of ambulance where doctors declared him dead. Post mortem was conducted as Civil Hospital, Jagraon and FIR No.99 dated 29.05.2019 was registered against Baljinder Singh on the statement of Sukhjeet Singh son of Malkit Singh pertaining to the accident. After the death of Iqbal Singh, the complainant lodged the claim for a sum of Rs.15,00,000/- from opposite party No.1 and 2 for personal accident but the claim was wrongly repudiated As per the complainant, the repudiation of the claim is wrong as the policy was issued by opposite party No.1 and 2 after having accepted the premium and issued the insurance policy after verifying the registration certificate and other papers of the scooter. The complainant has undergone mental agony and harassment due to deficiency in service and unfair trade practice on behalf of opposite party No.1 and 2. The complainant prayed for the claim of Rs.15,00,000/- along with compensation of Rs.2,00,000/- and litigation expenses of Rs.22,000/-.

2.                Upon notice, opposite party No.1 and 2 filed joint written statement stating that the present complaint is not maintainable. It is further stated that immediately on receipt of the claim, it was duly registered, entrained and processed. Sh.Iqbal Singh son of Sukhdev Singh, resident of VPO Hans Kalan, Tehsil Jagraon, District Ludhiana had obtained  Motorized-Two Wheelers Liability only Policy-Zone B bearing policy No.233903/31/2019/4934  which was valid from 07.02.2019 to 06.02.2000. It was a third party policy and the vehicle was not comprehensively insured. One of the condition of the policy under the head of Personal Accident Cover for the owner driver that “the cover is subject to:

(a)     The owner – driver is the registered owner of the vehicle insured herein.

(b)     The owner – driver is the insured name in the policy

(c )     The owner – driver holds an effective driving licence in accordance with the provision of rule 3 of Central Motor Vehicle Rules, 1989 at the time of accident.”

It was further pleaded that the scooter No.PB-36-C/0591 as per registration certificate  issued by Registering Authority, Phagwara is of 2003 make and the registration certificate is valid from 14.04.2003 to 13.04.2018. Sh. Iqbal Singh has not got the registration certificate renewed by paying necessary fee and tax to the Registering Authority on 13,.04.2018 for renewal and validity of registration certificate of his vehicle. Since he did not get the registration certificate renewed w.e.f. 14.04.2018 with the competent authority. So at the time of accident, he was not having valid registration certificate of the scooter. Mr. Jagmohan Singh was appointed as investigator to investigate the personal accident claim of owner/driver under the policy of Iqbal Singh The investigator in his report has given the findings that the claim seeks repudiation for want of valid documents as on date of accident and as per terms and conditions of the policy. Mr. Suneet Jain, Surveyor and loss assessor was appointed for verification of the record and prepared the report which clearly states that as per the record of R.A. (Motor Vehicle), M.V. Jagraon no road tax has been deposited for the renewal of registration certificate of scooter No.PB-36-C-0591. After the receipt of the report of investigator Jagmohan Singh and after scrutinizing the documents placed in the claim file, the complainant was called upon to submit the renewal detail of the registration certificate vide letter  dated 23.07.2019. The complainant vide her letter dated 22.08.2019 stated that she is having only registration certificate which she had already produced along with the claim form and there is no renewal of registration certificate with the complainant. So after the receipt of the reply and due application of mind by the officials of opposite parties, the claim of the complainant was repudiated as no claim vide letter dated 06.10.2019. The claim has been rightly repudiated and there is no deficiency on the part of the opposite parties and the present complaint deserves dismissal. On merits, the opposite parties reiterated the crux of averments made in the preliminary objections and also referred to Section 39 of the Motor Vehicle Act. It has also been submitted that the insurance policy issued for the period of 07.02.2019 to 06.02.2020 without break renewal of policyNo.233903/31/2018/2979 expired on 06.02.2019 and in-continuous of renewal verification of documents was required. It is submitted that the policy was issued on good faith and it was the duty of the registered owner to keep the registration certificate of the vehicle in force and pay the renewal registration fee in accordance with Motor Vehicle Act and Motor Vehicle Rules. The insured did not disclose at the time of renewal that the validity of his vehicle registration had already expired. In the end, a prayer for dismissal of the complaint has been made.       

3.                In support of her claim, the complainant tendered her affidavit as Ex. CA in which she reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents Ex. C1 copy of insurance cover, Ex. C2 is the copy of driving licence of Iqbal Singh, Ex. C3 is the copy of registration certificate showing make and the year 2003 and validity of certificate from 14.04.2003 to 13.04.2018, Ex. C4 is the copy of FIR, Ex. C5 is the post mortem report, Ex. C6 is the death certificate, Ex. C7 is the copy of letter of repudiation dated 06.10.2019 and closed the evidence.

4.                On the other hand, the counsel for opposite party No.1 and 2 submitted affidavit Ex. RA of Sh. Jagmohan Singh, Investigator, affidavit Ex. CB of Sh. Suneet Jain, Surveyor and Loss Assessor and affidavit Ex. CC of Sh. Sukhwinder Silngh, Senior Divisional Manager of opposite party No.1 and 2 along with documents Ex. R1 copy of insurance policy, Ex. R2 is the copy of detailed condition of two wheeler package policy, Ex. R3 is the report of Sh. Jagmohan Singh, ex. R4 is the motor claim form, Ex. R5 is the statement of claimant, Ex. R6 is the copy of adhar card of the complainant, Ex. R7 is the PAN card of the complainant, Ex. R8 letter dated 27.06.2019 for verification of driving licence, Ex. R9 is the copy of driving licence of deceased, Ex. R10 is the copy of registration certificate of the vehicle n question, Ex. R11 is copy of request status, Ex. R12 is the copy of email, Ex. R13 and Ex. R14 are the copies of letters of surveyor Sh. Suneet Jain, Ex. R15 is the copy of registration certificate, Ex. R16 is the copy of letter dated 23.07.2019, Ex. R17 is copy of letter dated 22.08.2019 of Balwinder Kaur, Ex. R18 is the copy of letter dated 06.10.2019, Ex. R19 is the copy of India Motor Tariff and closed the evidence.

5.                We have heard the arguments of the counsel for the parties and also gone through the complaint, written statement, affidavits and annexed documents produced on record by both the parties.

6.                It was contended on behalf of the counsel for the complainant that the commencing period of the policy w.e.f. 07.02.2019 to midnight of 06.02.2020. At the time of renewal, opposite party No.1 and 2 were fully aware of the fact that the registration certificate had already expired and despite this, the contesting opposite parties opted to renew the insurance policy by accepting the premium. Now, the contesting opposite parties are estopped from denying the liability having been arisen out of the terms and conditions of the policy.

7.                On the other hand, the counsel for the opposite party No.1 and 2 has contended that after the submission of the claim, the matter was thoroughly investigated through Jagmohan Singh, Investigator. Even the explanation was sought from the complainant regarding renewal of registration certificate and in the absence of a valid registration certificate, the claim was rightly treated as no claim. It was further contended that in continuous renewal, the verification of the documents was not required. So it was for the deceased/insured to disclose the fact regarding the validity of the registration certificate had already expired to opposite party No.1 and 2. The counsel for opposite party No.1 and 2 in support of his arguments relied upon 2021(3) Apex Court Judgments 677(S.C.) in United India Insurance Co. Ltd. Vs Sushil Kumar Godara passed by the Hon’ble Supreme Court of India whereby it has been held that the violation of provisions of sections 39 and 192 of the Motor Vehicles Act amounts to fundamental breach of terms and conditions of the policy and the insurance company is entitled to repudiate the policy.  The counsel for opposite party No.1 and 2 further relied upon IV (2014) CPJ 11 (SC) in Narinder Singh Vs New India Assurance company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that using vehicle on public road without any registration is not only an offence punishable under Section 192 of M.V. Act but also fundamental breach of terms and conditions of the policy contract and as such, the repudiation of the claim is justified.

8.                We have weighed the rival contentions of the counsel for the parties and have gone through the record carefully.

9.                Ex. R1 is the Motor Insurance Certificate cum Policy Schedule which provides personal accident cover under Section III of Registered Owner cum Driver for Rs.15,00,000/-. Ex. R2 is the Two Wheeler Package policy and its section III stipulates the conditions for Personal Accident Cover for owner/driver. Its clause 2 provides as under:-

“(a)    The owner – driver is the registered owner of the vehicle insured herein.

(b)     The owner – driver is the insured name in the policy

(c )     The owner – driver holds an effective driving licence in accordance with the provision of rule 3 of Central Motor Vehicle Rules, 1989 at the time of accident.”

Further, documentary record pertaining to the registration certificate of the vehicle, report of surveyor and verification report of investigator shows that the registration certificate was valid from 14.04.2003 to 13.04.2018. It has also come on record that at the time of accident, the deceased had not applied for renewal of the registration certificate for another permissible term.

10.              The point of issue arises whether opposite party No.1 and 2 are estopped from denying the liability under the policy by their act and conduct?

11.              The first page of the policy document Ex. R1 carried the particulars regarding registration mark and place, Engine and Chassis number, make-model year of manufacturing, type of body, fuel and sitting capacity etc. Naturally, these particulars must have been incorporated by opposite party No.1 and 2 after pursuing the copy of registration certificate at the time of renewal of the insurance policy. Opposite party No.1 and 2 have not referred to any law, rules and regulations which postulates to the effect that in continuation renewal, verification of the documents was not required.  Therefore, opposite party No.1 and 2 were conscious of the fact that the policy is being renewed for a vehicle registration certificate, of which had already elapsed and has not been renewed. The acceptance of the premium is another factor which corroborates the factum of knowledge.   

12.              In 2022 LiveLaw (SC) 937 in M/s. Texco Marketing Pvt. Ltd. Vs TATA AIG GIC Ltd. and others passed by the Hon’ble Supreme Court of India. Appellant secured a Standard Fire & Special Perils policy which was meant to cover a shop situated in the basement of the building. However, exclusion clause of the contract specifies that it does not cover the basement. The appellant continued to pay the premium promptly. The shop met with fire accident for which the appellant raised a claim. The claim was repudiated by respondent No.1  taking the umbrage under the exclusion clause. The Hon’ble Supreme Court partly allowed the appeal and observed in para No.21 of the judgment:-

“21. On a discussion of the aforesaid principle, we would conclude that there is an onerous responsibility on the part of the insurer while dealing with an exclusion  clause. We may only add that the insurer is statutorily mandated as per Clause 3(ii) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests, Regulation 2002) Act dated 16.10.2002 (hereinafter referred to as IRDA Regulation, 2002) to the effect that the insurer and his agent are duty bound to provide all material information in respect of a policy to the insured to enable him to decide on the best cover that would be in his interest. Further, sub-clause (iv) of Clause 3 mandates that if proposal form is not filled by the insured, a certificate has to be incorporated at the end of the said form that all the contents of the form and documents have been fully explained to the insured and made him to understand. Similarly, Clause 4 enjoins a duty upon the insurer to furnish a copy of the proposal form within thirty days of the acceptance, free of charge. Any non-compliance, obviously would lead to the irresistible conclusion that the offending clause, be it an exclusion clause, cannot be pressed into service by the insurer against the insured as he may not be in knowhow of the same.”

The Hon’ble Supreme Court also further observed in para No.37 of the judgment:-

“37.Once it is proved that there is a deficiency in service and that respondent No. 1 knowingly entered into a contract, notwithstanding the exclusion clause, the consequence would flow out of it. We have already discussed the scope and ambit of the provisions under the Indian Contract Act, 1872. Even as per the common law principle of acquiescence and estoppel, respondent No. 1 cannot be allowed to take advantage of its own wrong, if any. It is a conscious waiver of the exclusion clause by respondent No. 1.”

Applying ratio of the principle contains in the aforesaid judgment, it is concluded that opposite party No.1 and 2 were not justified in invoking the exclusion clause when their agents were conscious of the fact that the validity of registration certificate has already been expired. In the given set of circumstances, it would be just and appropriate if opposite party No.1 and 2 are directed to consider the claim of the complainant for reimbursement within 30 days from the date of receipt of copy of order along with a composite costs of Rs.10,000/-.

13.              As a result of above discussion, the complaint is partly allowed with direction to opposite party No.1 and 2 to consider and reimburse the claim of the complainant within 30 days from the date of receipt of copy of order. Opposite party No.1 and 2 are further directed to pay a composite compensation and costs of Rs.10,000/- (Rupees Ten Thousand only) to the complainant. Compliance of order be made within 30 days from the date of receipt of copy of order. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

14.              Due to rush of work and spread of COVID-19, the case could not be decided within statutory period.

 

(Monika Bhagat)                    (Jaswinder Singh)             (Sanjeev Batra)                          Member                                      Member                            President         

 

Announced in Open Commission.

Dated:06.12.2022.

Gobind Ram.

Balwinder Kaur Vs Oriental Insurance Co.                               CC/20/80

Present:       Sh. Ripan Chadha, Advocate for complainant.

                   Sh. Rajeev Abhi, Advocate for OP1 and OP2.

                   OP3 to OP6 are performa parties.

 

                   Arguments heard. Vide separate detailed order of today, the complaint is partly allowed with direction to opposite party No.1 and 2  to consider and reimburse the claim of the complainant within 30 days from the date of receipt of copy of order. Opposite party No.1 and 2 are further directed to pay a composite compensation and costs of Rs.10,000/- (Rupees Ten Thousand only) to the complainant. Compliance of order be made within 30 days from the date of receipt of copy of order. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

(Monika Bhagat)                    (Jaswinder Singh)             (Sanjeev Batra)                          Member                                      Member                            President         

 

Announced in Open Commission.

Dated:06.12.2022.

Gobind Ram.