Haryana

StateCommission

A/1090/2015

RELIANCE GEN.INSURANCE CO. - Complainant(s)

Versus

RAMKALI - Opp.Party(s)

P.M.GOYAL

19 Jan 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      1090 of 2015

Date of Institution:        18.12.2015

Date of Decision :         19.01.2017

 

Reliance General Insurance Company Limited, SCO No.401-402, 2^nd Floor, HDFC Bank Building, Model Town, Delhi Road, Rohtak, Haryana,a through Shri Amit Chawla, Manager (Legal), Reliance General Insurance Company Limited, SCO 145-146, Sector 9-C, Madhya Marg, Chandigarh.

                                      Appellant-Opposite Party

Versus

 

1.      Ramkali w/o Sh. Zile Singh

2.      Rohit

3.      Dinesh, minor sons of Shri Mukesh s/o Sh. Zile Singh, both minors through their grandmother Ramkali w/o Sh. Zile Singh,

          all Residents of Village Chhara, Tehsil Bahadurgarh, District Jhajjar.

                                                Respondents-Complainants

 

 

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

                             Shri B.M. Bedi, Judicial Member.

                             Shri Diwan Singh Chauhan, Member                                                                                                                                

Argued by:          Shri Hitender Kansal, Advocate on behalf of Shri Gaurav Sharma, Advocate for appellant.

                             Shri Naresh Kumar, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

          Reliance General Insurance Company Limited (for short ‘the Insurance Company’)-Opposite Party is in appeal against the order dated September 16^th, 2015 passed by District Consumer Disputes Redressal Forum, Rohtak (for short ‘the District Forum’) whereby complaint filed by Ramkali and others-complainants (respondents herein) seeking benefits of insurance with respect to truck No.HR-63B-0912, Tata-1109, was accepted on the following terms:-

“….Opposite Party is directed to pay brs.200000/- (Rupees two lacs only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 11.07.2012 till its actual realization and shall also pay a sum of Rs.2500/- (Rupees two thousand five hundred only) as litigation expenses to the complainants maximum within one month from the date of decision failing which the awarded amount shall fetch interest @ 12% p.a. from the date of decision. The 1/3^rd share of the awarded amount will be paid to the complainant No.1 Smt. Ramkali mother of the deceased Mukesh and remaining awarded amount will be paid to the complainant No.2 & 3 in equal shares. However the amount after disbursement on account of complainants No.2 to 3 of minor sons should be deposited in any nationalized bank till their majority. Complaint is disposed of accordingly.”    

2.                Truck bearing registration No.HR-63B-0912, Tata-1109 owned by Mukesh Kumar (since deceased)-son of complainant/respondent No.1 and father of complainants/respondents No.2 and 3 was insured with the Insurance Company-opposite party/appellant for the period July 19^th, 2010 to July 18^th, 2011 vide Insurance Cover Note Exhibit C-3. The Insured Declared Value (IDV) of the truck was Rs.9,26,250/-.  

3.                On June 13^th, 2011 when the truck was enroute Noida to Mumbai, in the area of Bandanwara, Police Station Bhinai, District Ajmer (Rajasthan), a Nilgai (Blue Bull) suddenly came in front of the truck and in the process of saving the blue bull, the truck turned turtle. At the time of accident, the truck was being driven by Surender Singh. Mukesh-owner of the truck was accompanying. He suffered injuries and died on 20^th July, 2011.  First Information Report (FIR) Exhibit C-1 was lodged in Police Station Bhinai, District Ajmer. Intimation was also given to the Insurance Company. The surveyor of the Insurance Company inspected the truck. The complainants lodged claim with the Insurance Company but the same was repudiated vide letter dated 11^th January, 2012 (Annexure A-1) on the ground that Mukesh Singh, who was co-driver of the vehicle was not holding a valid and effective driving license and therefore the Insurance Company was not liable to pay the benefits of insurance to the complainants.

4.                The Insurance Company-opposite party contested the complaint by filing written version and while reiterating the fact stated in the repudiation letter, prayed for dismissal of the complaint.

5.                After evaluating the pleadings and evidence of the parties, the District Forum vide impugned order allowed complaint and directed the Insurance Company as detailed in paragraph No.1 of this order.

6.                Learned counsel for the appellant/Insurance Company has assailed the order of the District Forum by placing reliance upon GR-36A of India Motor Tariff, reproduced as under:-

“GR.36:      Personal Accident (PA) Cover under Motor Policy (not applicable to vehicles covered under Section E, F and G of Tariff for Commercial Vehicles)

A.      Compulsory Personal Accident Cover for Owner-Driver

Compulsory Personal Accident Cover shall be applicable under both Liability Only and Package policies. The owner of insured vehicle holding an “effective” driving license is termed as Owner-Driver for the purposes of this section.

Cover is provided to the Owner-Driver whilst driving the vehicle including mounting into/dismounting from or traveling in the insured vehicle as a co–driver.

 

NB.             This provision deals with Personal Accident cover and only the registered owner in person is entitled to the compulsory cover where he/ she holds an effective driving license.  Hence compulsory PA cover cannot be granted where a vehicle is owned by a company, a partnership firm or a similar body corporate or where the owner-driver does not hold an effective driving license.  In all such cases, where compulsory PA cover cannot be granted, the additional premium for the compulsory P.A. cover for the owner - driver should not be charged and the compulsory P. A. cover provision in the policy should also be deleted. Where the owner-driver owns more than one vehicle, compulsory PA cover can be granted for only one vehicle as opted by him/her.

The scope of the cover, Capital Sum Insured (CSI) and the annual premium payable under this section are as under:-

TYPE OF VEHICLES	CAPITAL SUM INSURED (Rs.)	PREMIUM (Rs.)	COVER
Motorised Two Wheelers	1 lakh	50/-	i) 100% of CSI for Death, Loss of Two Limbs or sight of both eyes or one limb and sight of one eye.  ii) 50% of CSI for Loss of one Limb or sight of one eye. iii)100% for Permanent Total Disablement from injuries other than named above.
Private Cars	2 lakhs	100/-	i) 100% of CSI for Death, Loss of Two Limbs or sight of both eyes or one limb and sight of one eye.  ii)50% of CSI for Loss of one Limb or sight of one eye. iii)100% for Permanent Total Disablement from injuries other than named above
Commercial vehicles	2 lakhs	100/-	i) 100% of CSI for Death, Loss of Two Limbs or sight of both eyes or one limb and sight of one eye.  ii) 50% of CSI for Loss of one Limb or sight of one eye. iii)100% for Permanent Total Disablement from injuries other than those named above.

                                                                                  

7.                A bare reading of GR-36A reflects that the Personal Accident was provided only to the Owner-Driver.

8.                It is own case of the complainants that Surender Singh was driving the truck. Though Mukesh Kumar being a co-driver had also coverage under the Personal Accident Cover upto Rs.2.00 lacs, however this was subject to the condition that he was holding a valid and effective driving licence. The complainants produced driving licence of Mukesh-deceased bearing No.M-37646 allegedly issued from Licensing Authority, Faridabad to drive LMV/HTV valid from 20.11.2010 to 19.11.2013. As per Verification Report (Annexure A-2), no such driving licence was issued in favour of Mukesh-deceased. Thus, at the time of accident, the deceased Mukesh who was travelling in the truck stating to be co-driver, was not holding a valid and effective driving licence.

9.                Section 3 of the Motor Vehicle Act reads as under:-

"3. Necessity for driving licence. - (1) No person shall drive a motor vehicle in any public place unless he holds an effective driving licence issued to him authorising him to drive the vehicle; and no person shall so drive a transport vehicle other than a motor cab or motor cycle hired for his own use or rented under any scheme made under sub-section (2) of section 75 unless his driving licence specifically entitles him so to do. (2) The conditions subject to which sub-section (1) shall not apply to a person receiving instructions in driving a motor vehicle shall be such as may be prescribed by the Central Government.”

10.              Since, the deceased Mukesh Kumar was not holding a valid and effective driving licence, so there was violation of the terms and conditions of the policy.

11.              In BHS Industries versus Export Credit Guarantee Corp.& anr., III(2015) CPJ 1 (SC) Hon’ble Supreme Court held that the insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. The insured cannot claim anything more than what is covered by the insurance policy. That being so, the insured has also to act strictly in accordance with the statutory limitations or terms of the policy expressly set out therein.

12.              In view of the facts and circumstances of the case and the legal position enunciated above, the Insurance Company is not liable to pay Personal Accident benefit to the complainants. The District Forum fell in error in allowing the complaint and as such the impugned order cannot be allowed to sustain.

13.              For the reasons recorded above, the appeal is accepted, the impugned order is set aside and the complaint is dismissed.

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

 

Announced 19.01.2017

Diwan Singh Chauhan Member

B.M. Bedi Judicial Member

Nawab Singh President

CL