Tripura

StateCommission

A/38/2023

NATIONAL INSURANCE COMPANY LIMITED - Complainant(s)

Versus

TANU SHARMA - Opp.Party(s)

S. K. BHOWMIK, S. BAL, MR. E. L. DARLONG

27 May 2024

ORDER

Tripura State Consumer Disputes Redressal Commission Agartala: West Tripura

Case No. A. 38 of 2023

 

 

1. National Insurance Company Limited,

Represented by its Divisional Manager (In charge),

Agartala Division, 42, Akaurah Road,

P.S. West Agartala, P.O. H.P.O. Agartala,

District - West Tripura, Pin - 799001.

..…...........................Appellant-Opposite Party

Vs

1. Smt. Tanu Sharma,

W/o Shri Pramananda Sharma, 

West Joynagar Road No.9,

Dasami Ghat, Manik Dhar lane,

P.S. West Agartala, P.O. Joynagar,

District - West Tripura, Pin - 799001.

..…...........................Respondent-Complainant

 

 

 

 

Before

 

 

Hon’ble Mr. Justice Arindam Lodh

President

State Commission

 

Smt. Daliya Saha

Member, State Commission

 

Shri Jhantu Debnath

Member, State Commission

 

 

 

 

Present:

For the Appellant:                                                    Mr. Samrat Kar Bhowmik, Sr. Adv. &

Mr. Srikanta Bal, Adv.

For the Respondent:                                                Mr. Mridul Kanti Arya, Adv.

Date of Hearing & Delivery of Judgment:             27.05.2024

whether fit for reporting:                                   

 

 

J U D G M E N T [ORAL]

This is an appeal under Section 41 of the Consumer Protection Act, 2019 against the judgment and order dated 12.05.2023 passed by the learned District Consumer Disputes Redressal Commission, West Tripura, Agartala, in connection with Case No.C.C.55 of 2021 whereby and whereunder a compensation of Rs.15,00,000/- has been awarded in favour of the complainant since two-wheeler of the son of the complainant was insured with the appellant-Insurance Company at the time of his death out of an accident.

2. The facts stated in the judgment of the learned District Commission which is reproduced here-in-under:-

“The Complainant being mother of the Complainant has filed this complaint claiming compensation over the death of her son Banti Sharma who meet with an accident on 09/02/2019 at Milan Chakra, Agartala while driving his motorbike bearing registration No. TR01 AE 8452 which was insured with the O.P. Insurance Company for the period 22/03/2018 to 21/03/2019. Banti ultimately died in ILS Hospital on 14/02/2019 due to the injuries sustained in the accident.

A.D. Nagar P.S. Case No.2019 AD No.14 dated 17/02/2019 W/S.279/338/304A IPC was registered on 17/02/2019 that accident. However ultimately FRT was submitted due to want of evidence vide No.51/2019 dated 31/12/2019.

Due to huge shock the O.P. was not informed in time. On the top of it at that period of time Covid-19 pandemic situation was prevailing everywhere. Hence on 22/03/2021 the O.P. was informed claiming the amount of P.A. Coverage and submitted relevant documents, but the O.P. repudiated the claim on the ground of raising the claim after two years.”

3. Before the learned District Commission both the parties had adduced their respective evidences, necessary documents were also submitted. Thereafter having heard learned counsel appearing for the parties, the learned District Commission had held that since the personal accident claim benefit has been enhanced to Rs.15,00,000/-, therefore, the Insurance Company i.e. the appellant herein, is liable to pay a compensation of Rs.15,00,000/- along with interest @7.5% per annum from 29.07.2021 i.e. the date of filing this case till the date of actual payment.
4. Being aggrieved by and dissatisfied with the said judgment, the appellant-Insurance Company has preferred the instant appeal before this Commission.
5. We have heard Mr. Samrat Kar Bhowmik, learned senior counsel assisted by      Mr. Srikanta Bal, learned counsel appearing for the appellant-Insurance Company and Mr. Mridul Kanti Arya, learned counsel appearing on behalf of the complainant-respondent.
6. The main issue revolves around the instant appeal is that whether the appellant-Insurance Company is liable to pay Rs.15,00,000/- as compensation to the complainant in view of the enforcement of the amended provision relating to Compulsory Personal Accident Cover by IRDA. It is the contention of learned Sr. counsel appearing for the appellant that when the policy was purchased by the son of the complainant at that time Personal Accident Coverage was Rs.1,00,000/- and the premium amount was Rs.50/-, in case of death or bodily injury sustained by the owner-cum-driver of the vehicle. The said policy has been amended by IRDA vide their Circular dated 11^th December, 2018 under circular Reference No.IRDA/NL/CIR/MOTP/158/09/2018 dated 20^th September, 2018, and circular Reference No.IRDA/NL/CIR/MOTP/170/10/2018 dated 9^th October, 2018, and these circulars came into force with effect from 1^st January, 2019.
7. We have seen the communication dated 20^th September, 2018 wherein all General Insurers carrying on motor insurance business were well informed about the enhancement of coverage to the tune of Rs.15,00,000/-.
8. The owner-driver i.e. the son the complainant had paid premium of Rs.50/- when he purchased the policy on 22.03.2018, wherein the policy lays down the conditions of Personal Accident Coverage to the tune of Rs.1,00,000/-.
9. The son of the complainant i.e. the owner-driver met with an accident on 09.02.2019 resulting his death on 14.02.2019. Thereafter, the complainant being the mother of the deceased approached the appellant-Insurance Company claiming the insured amount of Rs.1,00,000/-, but it was repudiated for certain reasons which led the complainant to file the complaint before the learned District Commission for payment of Rs.1,00,000/- i.e. the insured amount as mentioned in the policy dated 22.03.2018.
10. At the time of proceeding of the said complaint, IRDA had issued the aforesaid Notification on 11^th December, 2018 which was made effective from 1^st January, 2019 i.e. the said circular has been given prospective effect. At the time of hearing, attention was drawn by the learned District Commission as regards the above circulars enhancing the Personal Accident Coverage to the tune of Rs.15,00,000/. However, according to the learned counsel appearing for the appellant, without assigning any reasons, the learned District Commission had made an award of Rs.15,00,000/- as compensation in favour of the complainant against the Personal Accident Policy Coverage as enumerated herein-above.
11. Mr. Kar Bhowmik, learned Sr. counsel has submitted that the complainant herself has prayed for Rs.1,00,000/- i.e. the insured amount for the death of her son. There was no prayer of payment of Rs.15,00,000/- as compensation in the body of the complaint. According to learned senor counsel this is a sheer arbitrariness shown by the learned District Commission which is not tenable in law.
12. Mr. Kar Bhowmik, learned senior counsel has placed reliance on a decision of the High Court of Madras passed in C.M.A. No.984 of 2018, titled as Pon. Banu & Ors. vs. United Insurance Company Limited & Ors. decided on 08.12.2022 where the following observations had been made while dealing with the similar situation which are as follows:-

”4..............................Therefore, the liability of the insurance company is only to the extent of indemnification of the insured against the third person or in respect of damages of property. While so, the insurance company cannot be fastened with any liability under the provisions of the Motor Vehicles Act for the death of the deceased who himself was the owner of the vehicle and when no other motor vehicle was involved in this case. Therefore, the question of the insurer being liable to indemnify the deceased/owner of the vehicle does not arise........................................At the same time, it is needless to mention that the claimants are entitled for payment of Rs.1,00,000/- only towards Personal Accident Cover proportionate to the premium paid by the deceased.”

          It was further observed that:-

“27. Before parting with, we are pained to observe that as per the Indian Motor Tariff, the compensation payable to the legal heirs in case of death or bodily injury suffered by the owner of the vehicle is restricted to Rs.1,00,000/- only in case of two wheeler and Rs.2,00,000/- in case of four wheeler, by virtue of the Compulsory Personal Accident Cover mooted by the statutory authorities in charge of regulating the Motor Insurance Policies. As per the Compulsory Personal Accident Cover, in case of death or bodily injury sustained by the owner of the vehicle, he or she is eligible for compensation of Rs.1,00,000/- alone.. The amount of compensation payable by the Insurer is confined and limited to the extent of Rs.1,00,000/- as per the India Motor Tariff, which came into effect from 01.08.2002. It is noteworthy to mention that prior to 01.08.2002, even the compensation of Rs.1,00,000/- for two wheeler owner and Rs.2,00,000/- for owner of four wheeler was not envisaged and the unfortunate victim of motor accidents, whose death is caused in the motor accident or who sustain bodily injury, will be left without any amount of compensation.”

13. Mr. Kar Bhowmik, learned senior counsel has also pressed into service the decision of the Hon’ble Supreme Court in Bajaj Allianz General Insurance Company Limited Vs Mukul Aggarwal & Ors. reported in (2024) 2 SCC 344 : 2023 SCC OnLine SC 1487 where at para-17 it is observed thus:-

“17. As far as the interpretation of an insurance policy is concerned, in the case of National Insurance Company Ltd. v. Chief Electoral Officer¹, this Court reiterated that an insured cannot claim anything more than what is covered by the insurance policy. The terms of the contract have to be construed strictly without altering the nature of the contract. Moreover, the clauses of an insurance policy must be read as they are. The terms of the insurance policy, which determine the liability of the insurance company, must be read strictly. This Court also held that the rule of contra proferentem is not applicable to a commercial contract like a contract of insurance. The rule of contra proferentem contemplates that if any clause in the contract is ambiguous, it must be interpreted against the party that introduced it. For the contract of insurance, the applicability of the said concept is ruled out. The reason is that the insurance contract is bilateral and mutually agreed upon, like any other commercial contract.”

14. We have perused the policy document which laid down certain conditions and it is clearly stated that the son of the complainant who was owner-cum-driver of the said two-wheeler paid a premium of Rs.50/- for indemnifying his policy of personal accident coverage to the tune of Rs.1,00,000/-. So, according to the policy conditions in case of accident or bodily injury the victim would be entitled to claim Rs.1,00,000/-as compensation as has been specifically mentioned in the policy document itself. It is no more res integra that the policy document being a contract, mutually agreed upon between the parties, the conditionalities as mentioned in the policy paper has to be adhered strictly.
15. We have given our conscious thought to the submission of Mr. Arya, learned counsel appearing for the respondent-complainant when he has submitted that the Consumer Protection Act is welfare legislation and a liberal view should be taken by the Commission. We have also taken into consideration his submission that after the accident the amount of personal accident coverage was enhanced to Rs.15,00,000/- as such, the learned District Commission has not committed any wrong in awarding compensation of Rs.15,00,000/- in favour of the complainant.
16. According to us, the said submission has no legal force for the reasons, firstly, the deceased had paid premium of Rs.50/- for insurance coverage of Rs.1,00,000/- as Personal Accident Coverage, so, the deceased had paid a premium which was proportionate to the Personal Accident Coverage prevalent at the time of purchasing the policy, and secondly, ignorance of law cannot be an excuse for enforceability of law/statutory provisions enacted afterwards.
17. In view of this, it is held that the complainant-respondent is entitled to get compensation to the extent of Rs.1,00,000/- in terms of the policy dated 22.03.2018 and in no way a compensation of Rs.15,00,000/- which has been awarded. The appellant-Insurance Company shall pay compensation of Rs.1,00,000/- to the respondent-complainant with interest @10% per annum. The aforesaid amount has to be paid to the respondent-complainant within a period of 30 days from today.

With the above observations and directions, the instant appeal stands allowed. Consequently, the impugned judgment dated 12.05.2023 passed by the learned District Commission, West Tripura, Agartala in connection with Case No.C.C.55 of 2021 stands set aside and quashed.