Haryana

StateCommission

A/528/2015

NATIONAL INSURANCE CO.LTD. - Complainant(s)

Versus

RAKESH - Opp.Party(s)

P.S.BEDI

23 Nov 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      528 of 2015

Date of Institution:      15.06.2015

Date of Decision :       23.11.2015

 

National Insurance Company Limited, Divisional Office-II, Narain Complex, Civil Road, Rohtak through its Regional Office, S.C.O. No.36-37, Sector 17-A, Chandigarh, through its duly constituted attorney.

                                      Appellant/Opposite Party

Versus

 

Rakesh s/o Sh. Karan Singh, Resident of 1495/1, Saini Anandpura, Behind Gaur College, Rohtak.

                                      Respondent/Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. B.M. Bedi, Judicial Member.

                                                                                                         

Present:              Shri Nitin Gupta, proxy counsel for Shri P.S. Bedi, Advocate for appellant.

                             Shri D.K. Tuteja, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

National Insurance Company Limited (for short ‘the Insurance Company)-Opposite Party, is in appeal against the order dated 13^th May, 2015 passed by District Consumer Disputes Redressal Forum, Rohtak, whereby complaint filed by Rakesh-complainant/respondent was allowed directing the Insurance Company as under:-

                   “8.     In view of the facts and circumstances of the case, it is directed that opposite party shall pay the claim amount of Rs.1,00,000/- alongwith interest @ 9% per annum from the date of filing the present complaint i.e. 04.03.2013 till its actual realization and shall also pay a sum of Rs.2200/- as litigation expenses to the complainant maximum within one month from the date of decision failing which the opposite party shall be liable to pay interest @ 12% p.a. on the awarded amount from the date of decision.  Complaint is allowed accordingly.”        

2.      Car bearing registration No.HR-12M-6082, Maruti Alto LXI, owned by Vikram was comprehensively insured with the Insurance Company for Rs.2,17,371/- from October 2^nd, 2010 to October 2^nd, 2011, vide Insurance Policy Exhibit C-3. On November 15^th, 2010 the car met with an accident and was damaged. At the time of accident, the car was being driven by Rakesh s/o Sh. Karan Singh (brother of the insured/complainant) who also suffered injuries. F.I.R. No.578 dated 20.11.2010 (Exhibit C-5) was lodged in Police Station Bhiwani.  The Insurance Company was informed. The injured remained under treatment in General Hospital, Bhiwani; Pt. B.D. Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak; Sir Ganga Ram Hospital, New Delhi. He filed claim with the Insurance Company with respect to the benefits of Insurance Policy submitting himself as insured but the Insurance Company did not compensate the complainant. Hence, complaint under Section 12 of the Consumer Protection Act, 1986 was filed before the District Forum.

3.      The Opposite Party/Insurance Company contested complaint by filing reply stating that the complainant is not entitled to get personal accident claim from the Insurance Company as per terms and conditions of the policy as he was not the insured.  Denying the averments made by the complainant, it was prayed that the complaint be dismissed.

4.      After evaluating the pleadings of the parties and evidence brought on the record, the District Forum accepted complaint issuing direction to the Insurance Company as detailed in paragraph No.1 of this order.

5.      The complainant has sought the compensation by trying to extend the definition under the heading ‘Compulsory PA Cover Premium’.

6.      It is not disputed that Personal Accident Cover is applicable to owner-cum-driver. The complainant is seeking compensation that by virtue of being brother of the insured, he also becomes the owner and since he was driving the car, therefore, was entitled to seek reimbursement of treatment expenses under the heading of compensation.  In addition, submission was also made that additional premium was also paid for the passengers and on this account also, he was entitled to seek compensation.

7.      So far as the first contention is concerned, in the instant case, the complainant was not the owner cum driver. By virtue of being relation to the owner, the complainant cannot step into the shoes of owner and he being driving the vehicle was not covered under the insurance policy and thus could not be termed as ‘consumer’.  Even under the second heading of being personal accident to unnamed passengers other than insured and the paid driver and cleaner, only passengers are covered. IMT 16, as is applicable to this coverage, reproduced below:-

“IMT 16.     Personal Accident to unnamed passengers other than insured and the paid driver and cleaner.

(For vehicles rated as Private cars and Motorized two wheelers (not for hire or reward) with or without side car)

In consideration of the payment of an additional premium it is hereby understood that the insurer undertakes to pay compensation on the scale provided below for bodily injuries hereinafter defined sustained by any passenger other than the insured and/or the paid driver attendant or clearner and/or a person in the employ of the insured coming within the scope of the Workmen’s Compensation Act, 1923 and subsequent amendment of the said act and engaged in and upto the service of the insured at the time of such injury is sustained whilst mounting into, dismounting from or traveling in but not driving the insured motor car and caused by violent, accidental, external and visible means which independently of any other cause shall within three calendar months of the occurrence of such injury result in;”

8.      In the instant case, the complainant was not a passenger in the vehicle, rather he was driving the car. So, in view of IMT 16, he is not entitled for any compensation.

9.      Even there is another aspect that under IMT 16, the compensation is payable on the scale provided therein, reproduced as under:-

 

Details of injury	Scale of Compensation
(i)   Death	100%
(ii)  Loss of two limbs or sight of two eyes or one limb and sight of one eye	100%
(iii) Loss of one limb or sight of one eye	50%
(iv) Permanent Total Disablement from injuries other than named above	100%

 

10.    Undisputedly, the complainant has not suffered any disability, he only sought compensation for treatment without falling under any of the conditions of IMT 16.

11.    In view of the above, the District Forum failed to appreciate the above stated actual and legal position and thus fell in error in allowing the complaint. So, the impugned order cannot sustain.

12.    Accordingly, the appeal is accepted, the impugned order is set aside and the complaint is dismissed.

13.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the appellant/opposite party against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced 23.11.2015

(B.M. Bedi) Judicial Member

(Nawab Singh) President

 

CL