IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, ALAPPUZHA

                          Friday the 27^th day of August, 2021.

                                      Filed on 11-11-2019

  Present

1. Sri.S.Santhosh Kumar  BSc.,LL.B  (President )
2. Smt. Smt.C.K.Lekhamma, B.A, LLB (Member)

In

CC/No.294/2019

   between

  Complainant:-                                               Opposite party:-

Smt.Syamala                                                       The Divisional Manager

W/o Uthaman                                                      United India Insurance Co. Ltd.

Kaniyamparambil                                               Divisional Office, Sarada shopping -

South Aryad, Avalookunnu P.O.                      Complex, Mullackal,

Alappuzha- 688006                                           Alappuzha- 688011

(Adv.Sri.Jose Y James)                                      (Adv.Sri.Thomson Pulthakady)

O R D E R

SRI. S.SANTHOSH KUMAR (PRESIDENT)

Complaint filed under Sec.12 of the Consumer Protection Act, 1986. 

Complainant’s case in brief is stated as follows:-

Complainant is the wife of Sri.Uthaman, who died on 26.05.2019 while riding his own motor cycle bearing Reg. No.KL-04-AE-2962 which was hit by a private bus at Thondankulangara, Alappuzha.  Deceased was a carpenter by profession.  Alappuzha north police had registered a case as crime No.870/2019 for the offence.  The accident happened due to the rash and negligent driving of bus driver bearing Reg. No. KL-58-9997.

The post mortem of Late Uthaman was conducted at the Medical College Hospital, Alappuzha and the cause of death was due to the multiple injuries sustained to the chest, spine and pelvis due to the motor accident.

Late Uthaman was the registered owner of the motor cycle and it was having a valid policy bearing No.1015003119P102283582 valid from 26.05.2019 to 25.05.2020 with the opposite party.  The deceased duly paid extra premium for the coverage of owner cum driver of Rs.15,00,000/- in case of motor accidental death of owner cum rider of motor cycle.  Complainant was the nominee in the policy and she is entitled to get the personal accident death benefit of Rs.15,00,000/- .  An application was filed before the opposite party on 31.05.2019 along with all relevant documents to the company but the claim was not sanctioned.  The act of opposite party is illegal and arbitrary and deficiency in service.  Hence the complaint is filed for realizing the amount along with interest and for a compensation of Rs.50,000/-.

2.      Opposite party filed a version mainly contenting as follows:-

The complaint is not maintainable either in law or on facts.  The vehicle bearing Reg. No. KL-04-AE-2962 was insured with this opposite party at the material time of the alleged accident and the said policy was valid from 26.05.2019 to 25.05.2020, in the name of the deceased Uthaman.  The said policy covered the personal accident death of owner / driver.

In front page of the policy itself it had been stated that persons or classes of persons entitled to drive which reads as follows:-

Any person including insured provided that a person holds an effective driving license at the time of accident and is not disqualified from holding or obtaining such a license.  Provided also that the person holding an effective learners license may also drive the vehicle and such person satisfied the requirement of Rule 3 of Central Motor Vehicle Rule, 1989.

At the time of accident the deceased driver/ owner was not having an effective driving license.  Since there is non-compliance of the condition for entitlement of the insurance amount, the complainant is not entitled for the reliefs.  Enquiry with the concerned Police station revealed that deceased was not having a valid driving license.  There is no deficiency in service from the side of this opposite party.  Hence the complaint may be dismissed with cost.

3.      On the above pleadings following points were raised for consideration :-

1. Whether there is deficiency of service on the part of the opposite party?
2. Whether the deceased Uthaman was having a valid driving license at the time of accident?
3. Whether there was violation of policy conditions as alleged by the opposite party?
4. Whether the complainant is entitled to realize an amount of Rs.15,00,000/- along with interest as prayed for?
5. Whether the complainant is entitled to realize an amount of Rs.50,000/- as compensation?
6. Reliefs and costs?

4.      Evidence in this case consists of the oral evidence of PW1 and Exts.A1 to A5 from the side of the complainant.   Opposite party has not adduced any oral evidence,  Ext.B1 was marked. 

For the sake of convenience these points are considered together.PW1 is the complainant in this case.She filed an affidavit in tune with the complaint and marked Ext.A1 to A5.

The case advanced by PW1, the complainant is that her husband Uthaman was the owner of motor cycle bearing Reg. No.KL-04-AE-2962.Ext.A4 is the copy of certificate of registration.Sri. Uthaman had taken an insurance policy with the opposite party which is valid from 26.05.2019 to 25.05.2020 (Ext.A3).As per Ext.A3 it is revealed that Sri.Uthaman had taken a personal accident for owner/driver paying Rs.275/-.While riding the motor cycle on 26.05.2019 at 19 hours through Alappuzha – Thanneermukkam road a private bus hit on the same and Sri.Uthaman succumbed to the injuries.Ext.A1 is the final report filed by the North Police before the Chief Judicial Magistrate Court, Alappuzha.Ext.A2 is the post-mortem certificate of deceased Uthaman.Ext.A5 is the claim form filed before the opposite party.However since it was denied by the opposite party it was marked subject to proof. According to PW1 since her husband deceased Uthaman had paid extra premium of Rs.275/- she is entitled for an amount of Rs.15,00,000/- which is the personal accident claim.Per contra the case advanced by the opposite party is that deceased Uthaman was not having a valid driving license which is a pre condition and so they are not liable to pay the insurance amount.The fact that deceased Uthaman was not having a valid driving license is not in dispute.Learned counsel appearing for the opposite party filed a petition to give a direction to the complainant to produce the driving license of the deceased.On 10.08.2021 it was endorsed by the learned counsel appearing for the complainant that deceased is not having valid driving license.Now the only question to be considered is whether complainant is entitled to claim the amount since deceased Uthaman had violated conditions of policy.The learned counsel appearing for the opposite party produced Ext.B1, copy of motor cycle/ scooter package policy issued in favour of Uthaman.It was also marked subject to proof.In page No.3 of Ext.B1 it is printed “ persons or classes of persons entitled to drive.

Any person including insured provided that a person holds an effective driving license at the time of accident and is not disqualified from holding or obtaining such a license.Again in Ext.B1 it is written as follows:-

This cover is subject to -

1. The owner-driver is the registered owner of the vehicle insured herein.
2. The owner-driver is the insured named in this policy.
3. The owner – driver holds an effective driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicles Rules, 1989, at the time of the accident.

From the evidence on record it is pellucid that deceased Uthaman was not having a valid driving license at the time of accident which was a pre condition of the policy.  It is true that as per Ext.A3 Uthaman had taken an additional personal accident policy by paying a premium of Rs.275/-.  But from Ext.B1 it is crystal clear that if the owner/ driver is not holding an effective driving license the policy holder or its nominee is not entitled for claiming the amount. 

          The law in this regard is well settled by various judicial pronouncements.  It was held by the

Hon’ble Supreme Court in 2013 KHC 4040 ‘Export Credit Guarantee Corpn. Of India Ltd. V. M/s Garg sons International.  Consumer Protection Act, 1986 – S.2, S.14, S.19 – Insurance claims – Rule of strict interpretation – Held, terms of insurance policy have to be strictly construed in order to determine the extent of the liability of the insurer – It is not permissible for the Court to substitute terms of the contract itself, under the garb of construing terms incorporated in the agreement of insurance – Insurance Law. 

It was held by the Hon’ble High Court in 2018 (5) KHC 661 (National Insurance Co. Ltd. V. Sudhakaran and others) – Insurance Law – Contract of Insurance _ Interpretation of – Held, normal rule is that the conditions specified in a policy, which is contract of insurance statutory in nature, has to be strictly construed.

          Here in this case as discussed earlier as per the policy conditions the holder of the policy is entitled to claim benefit only if he is holding a valid driving license.  It has come out in evidence that at the time of accident deceased Uthaman was not having a valid driving license.  In such circumstances applying the principles laid down by the Hon’ble Supreme Court and the Hon’ble High Court it can be safely concluded that complainant is not entitled to claim the insurance amount of deceased Uthaman.  Hence the points are found against the complainant.

Point No.6

In the result complaint is dismissed.  Parties are directed to bear their respective cost.        

Dictated to the Confidential Assistant, transcribed by her corrected by me and pronounced in open Commission on this the 27^th  day of August, 2021.

Sd/-Sri.S.Santhosh Kumar (President)

Sd/-Smt.Lekhamma C K (Member)

Appendix:-

Evidence of the complainant:-

PW1                    -        Smt.Syamala (Witness)

Ext.A1                -        Copy of final report       

Ext.A2                -        Copy of post-mortem certificate        

Ext.A3                -        Copy of policy of KL-04-AE-2962

Ext.A4                -        Copy RC book of motor cycle

Ext.A5                -        Copy of claim form

Evidence of the opposite parties:-

Ext.B1                 -        Copy of policy

// True Copy //

To

          Complainant/Oppo. party/S.F.

                                                                                         By Order

                                                                                    Senior Superintendent

Typed by:- Sa/-

Compared by:-