Tripura

StateCommission

A/24/2016

The United Insurance Company Ltd. - Complainant(s)

Versus

Sri. Goutam Ghosh - Opp.Party(s)

Mr. Sandip Datta Chowdhury

09 Feb 2017

ORDER

Tripura State Consumer Disputes Redressal Commission, Agartala.

 

 

 

Case No.A.24.2016

 

 

1. The United India Insurance Company Limited,

R.M.S. Chowmuhani, P.O. Agartala,

West Tripura, Agartala. 

 

… … … … Appellant/Opposite Party

 

 

1. Sri Goutam Ghosh,

S/o Sri Raj Kumar Ghosh,

Ananganagar, Bimanghar,

P.S. Airport, District - West Tripura,

Agartala, Pin 799009.

… … … … … Respondent/Petitioner

 

 

Present

 

Mr. Justice U.B. Saha,

President,

State Commission, Tripura.

 

Mrs. Sobhana Datta,

Member,

State Commission, Tripura.1

 

Mr. Narayan Ch. Sharma,

Member,

State Commission, Tripura.

 

 

For the Appellant:             Mr. Sandip Datta Choudhuri, Adv.

For the Respondent:        Mr. Purushuttam Roy Barman, Adv.

Date of Hearing:                11.01.2017.

Date of Delivery of Judgment: 09.02.2017

 

 

J U D G M E N T

 

 

U.B. Saha,J,

The instant appeal is filed by the appellant-opposite party, United India Insurance Company Limited, R.M.S. Chowmuhani, Agartala under section 15 of the Consumers Protection Act, 1986 against the Judgment dated 04.04.2016 passed by the Ld. District Consumers Disputes Redressal Forum, West Tripura, Agartala (hereinafter referred to as District Forum), in Case No. C.C. 35 of 2015 whereby and whereunder the Ld. District Forum while allowing the complaint petition held that the petitioner is entitled to get Rs.90,000/- from the appellant-opposite party along with litigation cost and the same shall be paid by the opposite party-Insurance Company within a period of two months from the date of judgment, if not paid, it will carry interest @9% per annum.  

2. Heard Mr. Sandip Datta Choudhuri, Ld. Counsel appearing for the appellant-opposite party, United India Insurance Company Ltd. (hereinafter referred to as opposite party/Insurance Company) as well as Mr. Purushuttam Roy Barman, Ld. Counsel appearing for the respondent-petitioner (hereinafter referred to as petitioner).
3. Facts needed to be discussed are as follows:-

The petitioner, Goutam Ghosh has obtained Policy No.1309003113P104594868, issued by the opposite party- United India Insurance Company Ltd. after paying premium in respect of the two-wheeler of him and the said insurance policy was vaild with effect from 22.10.2013 to 21.10.2014. He has also paid the necessary premium to get himself indemnified by the insurer if any eventuality covered by the policy had been there. It is also stated in the complaint that while he was driving his two-wheeler TR-01-T-4779 on 29.09.2014, from Agartala to Nalchar, on the way when he was just one kilometer away from Bishramganj Police Station, he met with an accident and suffered grievous injuries. Consequent thereto, he was taken to Bishramganj Hospital wherefrom he was referred to G.B. Hospital, Agartala and from there, again he was referred to ILS Hospital, Agartala. At ILS Hospital, he had to undergo operation as he sustained fracture of Plateau of left Tibia. Then he has claimed the expenditure from the opposite party-Insurance Company for his treatment as he purchased the policy covering the accidental risk from the opposite party. The Personal Accident Coverage was for Rs.1 lac, but the opposite party-Insurance Company refused to pay the amount. So, he filed a claim petition under section 12 of the Consumer Protection Act, 1986 before the District Forum claiming Rs.1 lac against the opposite party-United India Insurance Company Ltd. as compensation.

4. The opposite party-United India Insurance Company Ltd. after its appearance before the District Forum filed written statement denying the claim of the petitioner on the ground that the injuries sustained by the petitioner are not covered by the terms of the policy purchased by the petitioner. Thus, he is not entitled to get any amount as per terms of the policy.
5. The petitioner produced G.D. Entry, Legal Notice, Insurance Policy, discharge summery, papers relating to his treatment at G.B. Hospital and ILS Hospital, FIR, which were exhibited as Exhibit-1 series. He has also examined himself as one of the witnesses in support of his case.     
6. On the other hand, the opposite party has examined one witness namely, Animesh Dey, Assistant Manager of the opposite party who has produced the policy certificate which was exhibited as Exhibit-A.
7. The Ld. District Forum after considering the evidence on record and the terms of the policy allowed the petition as stated (supra) relying upon a decision of the Madras High Court in C.M.A. No. 3006 of 2012 (National Insurance Co. Ltd. Vs. Krishnan) wherein, the Madras High Court considered the Paragraph-106 of C.M.A. No. 2468 of 2012 of that High Court which is as follows:

“106. The contention that the Insurance Company need not pay any compensation to any grievous injury or permanent disablement, arising out of the injuries, except for Items 1 to 4, specified in the Personal Accident Cover Policy, cannot be accepted, as the contract of insurance, viz., Personal Accident Cover Policy for the owner-cum-driver, is also a Motor Transport Policy, under IMT 15, recognised by the Motor Tariff Committee. As stated supra, when the policies issued under the Insurance Act, are recognised by the Committee, subject to the regulations and instructions, issued by the Committee, it is not open to the Insurance Companies to disown, their liability to pay compensation, in respect of other bodily injuries, wherein, scales of compensation are not specifically provided. There is no negative covenant in the policy, that no compensation would be paid, in respect of other bodily injuries. It is well settled that the Motor Vehicles Act is a beneficial legislation. Reference can be made to a decision of the Apex Court in Smt. Rita Devi and others v. New India Assurance Co. Ltd., reported in AIR 2000 SC 1930, wherein, in construing the provisions of the Act, the Supreme Court held that it is to advance the beneficial purpose underlying the enactment in preference to a construction, which tends to deviate the purpose.” Ultimately, the Hon’ble Madras High Court dismissed the appeal preferred by the Insurance Company and directed to deposit the awarded amount with accrued interest and costs, up to the credit of M.C.O.P.459 of 2008, on the file of the Motor Accidents Claims Tribunal (Sub Court), Sankari, within a period of six weeks from the date of receipt of a copy of the order.

8. Being aggrieved by the impugned judgment dated 04.04.2016 of the District Forum, the opposite party, Insurance Company preferred the instant appeal. 
9. Mr. Datta Choudhuri, Ld. Counsel appearing for the opposite party, Insurance Company urging for setting aside the impugned judgment would contend that the Ld. District Forum has failed to consider the terms and conditions of the insurance policy in question. According to him, as per the terms and conditions of the policy, the Personal Accident Benefit is available only in four conditions namely, (i) death, (ii) loss of two limbs or sight of two eyes or one limb and sight of one eye, (iii) loss of one limb or sight of one eye, (iv) permanent total disablement from the injuries other than named above. He has also submitted that the Ld. District Forum passed the impugned judgment relying on the decision of the Hon’ble Madras High Court in National Insurance Co. Ltd. Vs Krishnan (supra) erroneously and as such, rewrites the terms and conditions. Therefore, the impugned judgment is liable to be set aside and the appeal should be allowed.
10. Mr. Roy Barman, Ld. Counsel for the respondent-petitioner while supporting the impugned judgment has submitted that the case in hand is fully covered by the judgment of the Hon’ble Madras High Court in National Insurance Co. Ltd. Vs Krishnan (supra) as well as a judgment of this Commission in Appeal Case No. F.A. 29 of 2014 (New India Assurance Co. Ltd. Vs Sri Sankar Deb) wherein, this Commission upheld a judgment of the District Forum in a similar nature of case and dismissed the appeal filed by the New India Assurance Co. Ltd. relying upon the judgment of National Insurance Co. Ltd. Vs Krishnan (supra). He has relied upon the paragraph 15,16 and 17 of the judgment of this Commission in New India Assurance Co. Ltd. Vs Sri Sankar Deb (supra) which are as follows:-

“15. Assuming that all four terms of personal accident cover policy granted in favour of the complainant were included in the proposal form submitted by the complainant for insuring his auto-rickshaw with the appellant-Insurance Company, in that regard, we find a decision of the Hon’ble Madras High Court being C.M.A No-3006 of 2012 between the National Insurance Co. Ltd. Vs. Krishnan delivered on 15.03.2013 wherefrom, we find that the Hon’ble Madras High Court has been pleased to hold at page 21 therein that “The contention that the Insurance Company need not pay any compensation to any grievous injury or permanent disablement, arising out of the injuries, except for Items 1 to 4, specified in the Personal Accident Cover Policy, cannot be accepted, as the contract of insurance, viz., Personal Accident Cover Policy for the owner-cum-driver, is also a Motor Transport Policy, under IMT 15, recognized by the Motor Tariff Committee. As stated Supra, when the policies issued under the Insurance Act, are recognized by the Committee, subject to the regulations and instructions issued by the committee, it is not open to the Insurance Companies to disown, their liability to pay compensation, in respect of other bodily injuries, wherein, scales of compensation are not specifically provided. There is no negative covenant in the policy, that no compensation would be paid, in respect of other bodily injuries. It is well settled that the Motor Vehicles Act is a beneficial legislation. Reference can be made to a decision of the Apex Court in Smt. Rita Devi and others V. New India Assurance Co.Ltd., reported in AIR 2000 SC 1930, wherein, in construing the provisions of the Act, the Supreme Court held that it is to advance the beneficial purpose underlying the enactment in preference to a construction, which tends to deviate the purpose. In Shivaji Dayanu Patil and another V. Vatchala Utham More reported in 1991 A.C.J. 177, the Apex Court reiterated that in the matter of interpretation of the beneficial legislation, the approach of the courts should be to advance the beneficent purpose.”

16. The Hon’ble Madras High Court was also pleased to hold at page-22 of the said judgment that “Such a narrow construction of the terms of the policy, proposed by the Insurance Company, would run contrary to the purpose of the beneficial legislation. For the above said reasons, this Court is not inclined to deny the benefit of Personal Accident Cover to the respondent/claimant, who is the owner-cum-driver of the vehicle involved in the accident. In the case on hand, according to the respondent, on 31.10.2005, when he was riding his Motorcycle, bearing Registration No-TN-40-Y-4883, on Bhavani Sagar to Puliyampatti Road, near Thoppampalayam, due to heavy rain, there was stagnation of water in the middle of the road, and though he was riding his motorcycle, at a moderate speed, while applying the brakes, the vehicle skidded, he fell down, along with the pillion and sustained injuries. When the claims Tribunal has specifically found that there was no negligence or willful neglect or want of care on the part of the respondent/claimant, in the accident, he cannot be said to be a tort-feasor. The judgments relied on, by the learned counsel for the Insurance Company would not lend any support to the contentions of the Company.”

17. The Hon’ble Madras High Court relying on a number of decisions of the Hon’ble Supreme Court mentioned in the said judgment has also been pleased to hold at page-22 of the said judgment, “In the light of the above decisions and discussion, this Court is of the view that the benefit under a Personal Accident Cover Policy, should be extended to all kinds of injuries and that depending upon the nature of injuries, disablement, expenditure incurred under various heads, the injured is entitled to make a claim for compensation. In the case of four kinds of injury, specified under the policy, the scale of compensation is 100% or 50%, as the case may be, depending upon the nature of injuries, mentioned under Items 1 to 4………”. ”

11. We have gone through the impugned judgment as well as the judgment of this Commission in Appeal Case No.FA-29/2014, wherein, this Commission discussed in details regarding the judgment of Krishnan (supra) and also considered the points raised by the Insurance Company in the instant appeal. According to us, this appeal is fully covered by the judgment of this Commission in FA-29/2014 and the District Forum did not commit any error in the impugned judgment while allowing the petition.

Thus, we are of the opinion that the appeal is to be dismissed being devoid of merit. The impugned judgment dated 04.04.2016 of the Ld. District Forum, West Tripura, Agartala is hereby affirmed and consequent thereto, the appeal is dismissed. No order as to costs.

Send down the records to the Ld. District Forum, West Tripura, Agartala.

 

 

 

MEMBER State Commission Tripura MEMBER State Commission Tripura PRESIDENT State Commission Tripura