Tamil Nadu

North Chennai

CC/203/2018

R.Rangasaraswathi - Complainant(s)

Versus

The Manager Bajaj alliance General Insurance - Opp.Party(s)

Mr.Chandramohan

12 Apr 2023

ORDER

 Complaint presented on :27.11.2008              

   Date of disposal             :12.04.2023

                                                                                  

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (NORTH)

@ 2^ND Floor, T.N.P.S.C. Road, V.O.C. Nagar, Park Town, Chennai – 600 003.

 

                PRESENT : THIRU. G. VINOBHA, M.A., B.L.,                          :PRESIDENT

                                      TMT. KAVITHA KANNAN, M.E.,                         : MEMBER-I

                                      THIRU.V.RAMAMURTHY,B.A.,B.L.,PGDLA.,  :MEMBER-II

 

C.C. No.203/2018

 

DATED WEDNESDAY THE 12^th  DAY OF APRIL 2023

 

R.Rengasaraswathi,

No.2/685 Darka Road,

Erikarai Street,

Tirusulam, Chennai-43.

                                                             …..Complainant

 ..Vs..

The Manager,

Bajaj Allianz General Insurance Company Ltd.,

25/26, Prince Towers,

5^th Floor, College Road,

Nungambakkam, Chennai-600 006.

                                                                                          …..Opposite Party

                                               

Counsel for Complainant                            : M/s.P.Chandramohan.

Counsel for opposite party                          : M/s.K.Kumaran

 

 

ORDER

 BY PRESENT : THIRU. G. VINOBHA, M.A., B.L.,  :PRESIDENT

This complaint has been filed by the complainant against the opposite party under section 12 of the Consumer Protection Act, 1986 prays to direct the opposite party to pay personal accident cover amount of Rs.100000/-  and to pay Rs.100000/- towards deficiency in service and mental agony and hardship caused to the complainant and costs.

This complaint was originally filed before the District Commission, Chennai (South) and taken on file in C.C. No. 153/2009.  Thereafter, the said complaint has been transferred to this Commission as per the proceedings of the Hon’ble S.C.D.R.C. and taken on file as C.C. No.203/2018.

1.THE COMPLAINT IN BRIEF:

          The Complainant submitted that complainant’s husband was the owner of the vehicle bearing Reg. No. TN 22 AH 8177 TVS star city two wheeler which was insured with the opposite party under Two wheeler package policy No.G-05-1501-1802-01762746 and the said policy has personal accident cover to the owner-driver and the fact that the complainant’s husband died in a road accident on 04.01.2006. Further complainant who is the wife of the deceased person it is alleged that her husband died in a road accident and the said accident occurred when he was driving his TVS star city two wheeler which hit against a auto bearing Reg.No. TN 24 1271 and further contended that he has taken a comprehensive policy with the opposite party for his vehicle and the said policy has personal coverage to owner-driver to the tune of Rs.1 lakh and when the complainant claimed the same from the opposite party the same was repudiated by the opposite party by stating that the deceased owner-driver of the two wheeler was only having driving licence to drive LMV and TRPT vehicle and he was not having valid licence to drive motor cycle with gear and the said policy will cover only if the driver holds an effective driving licence at the time of accident and hence the complainant contended that the repudiation of the claim is not valid and amount to deficiency in service and therefore claimed the insurance amount of Rs.1 lakh and Rs.1 lakh towards deficiency in service and mental agony from the opposite party.

2.WRITTEN VERSION FILED BY THE OPPOSITE PARTY  IN BRIEF:

          The opposite party denies all the allegations and averments made in the complaint except those that are specifically admitted.  The complaint filed by the complainants was false, frivolous and vexatious and is as such liable to be dismissed.  The complainant’s husband who was the owner of vehicle TN 22 AH 8177 had insured the same with the opposite party under two wheeler package Policy No.G-05-1501-1802-01762746.  The opposite party is required to cover owner of the vehicle under compulsory personal accident to owner/driver as per policy terms framed by the Tariff Advisory Committee under Insurance Act, 1938. U/s.III of the policy which provides compulsory personal accident cover to owner driver. The policy requires the owner to hold an effective driving licence in order to eligible for benefits in the event of an accident.  Being a motor policy it is only logical that such a stipulation has been imposed since the cover is contemplated mainly when the vehicle is being driven by the owner and such driving should be in compliance with the Motor Vehicles Act and Rule. The opposite party stated that the Personal Accident Cover is a contractual cover and the owner of the vehicle having accepted the policy including the terms, the complainant cannot dispute the same. The complainant’s husband admitted did not hold any licence at the time of accident and hence the claim was not admissible in view of the stipulation in the policy.  The investigator appointed by the opposite party and his report dated 20.10.2006.  Hence the opposite party had rightly declined liability.  There is no negligence or deficiency in service on the part of the opposite party.

 

3. POINTS FOR CONSIDERATION:

1. Whether there is any deficiency in service practice on the part opposite party as alleged in the complaint?

2. Whether the complainant is entitled for the reliefs prayed in the

    complaint.  If, so to what extent?

 

The complainant filed proof affidavit and documents Ex.A1 to A9 are marked on their side and written arguments.  The opposite party filed written version, proof affidavit, written arguments and Ex.B1 and B2 documents are marked on the opposite party side.

4. POINT NO :1 :-

          The fact that the complainant’s husband was the owner of the vehicle bearing Reg. No. TN 22 AH 8177 TVS star city two wheeler which was insured with the opposite party under Two wheeler package policy No.G-05-1501-1802-01762746 and the said policy has personal accident cover to the owner-driver and the fact that the complainant’s husband died in a road accident on 04.01.2006 is not in dispute between the parties.  But according to the complainant who is the wife of the deceased person it is alleged that her husband died in a road accident and the said accident occurred when he was driving his TVS star city two wheeler which hit against a auto bearing Reg.No. TN 24 1271 and further contended that he has taken a comprehensive policy with the opposite party for his vehicle which is marked as Ex.A5 and the said policy has personnal coverage to owner-driver to the tune of Rs.1 lakh and when the complainant claimed the same from the opposite party the same was repudiated by the opposite party under Ex.A8 by stating that the deceased owner-driver of the two wheeler was only having driving licence to drive LMV and TRPT vehicle and he was not having valid licence to drive motor cycle with gear and the said policy will cover only if the driver holds an effective driving licence at the time of accident and hence the complainant contended that the repudiation of the claim is not valid and amount to deficiency in service and therefore claimed the insurance amount of Rs.1 lakh and Rs.1 lakh towards deficiency in service and mental agony from the opposite party.

          5. But on the other the opposite party contended that as per Sec.III of the Policy issued to the complainant the personal cover to owner-driver is subject to the possessing of a valid and effective driving licence as per central motor vehicle rules 1989 at the time of accident and since the deceased was not having the same and was only holding LMV and TRPT vehicle driving licence the policy was repudiated by the opposite party after appointing and investigator who has also confirmed the same by his report which is marked as Ex.B2 and therefore denied the deficiency in service on its part.

          6. It is found from Ex.A4 which is driving licence of the deceased he was only having licence to drive LMV and TRPT vehicles and further the said licence also was valid upto 04.07.2005 but the date of accident as per FIR which is marked as Ex.A1 is 04.01.2006 and hence it is evident that on the date of accident even the above said licence has expired.  There is no documentary proof to show that the said licence was renewed thereafter.  It is further found from Ex.A3 and Ex.A2 post-mortem certificate the deceased died due to heal injuries sustained in the accident and though as per FIR the deceased drove the vehicle in a drunken state but as per Ex.A2 the no alcohol was deducted during post mortem and Ex.A9 is legal heir certificate  in respect of the deceased person.  It is found from Ex.B2 investigation report that the deceased was not having valid licence to drive motor cycle with gear at the time of accident which was also confirmed by the report of MV inspector and based on Ex.B2 report since the deceased was not having valid and effective driving licence at the time of accident and thereby violated the Sec.III of the policy issued to him as found in Ex.B1 and hence the opposite party has rightly to repudiated the claim of the complainant which will not amount to deficiency in service. The opposite party counsel also relied upon II(2009) CPJ 89 SC and contended that the present complaint is not a third party case and it is a case of contractual liability between the insurer and insured and therefore contended  that since the condition imposed in the policy was violated by the owner-driver by not possessing valid and effective driving licence at the time of accident and though the complainant contended that the policy was issued by the opposite party knowing fully well that he was not having two wheeler licence for which the opposite party contended that since the policy was taken for one year even he had no licence at the time of availing policy it is possible to take a licence during the policy period but even that was not done by the owner-driver and  therefore the opposite party contended that the repudiation by the opposite party is a valid one. On perusal of entire records it is found that there is no deficiency in service on the part of the opposite party in repudiating the claim of the complainant. Point no.1 is answered accordingly.

7. POINT NO :2 :-

          Based on finding given Point No.1 there is no deficiency of service on the part of opposite party and hence the complainant is not entitled for personal cover policy amount of Rs.1 lakh and compensation of Rs.1 lakh for deficiency in service and mental agony as claimed in the complaint. Point No.2 is answered accordingly.

               In the result the Complaint is dismissed. No costs.

Dictated by the President to the Steno-Typist taken down, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 12^th day of  April 2023.

 

MEMBER – I               MEMBER – II                                   PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1	05.01.2006	First Information Report.
Ex.A2	20.03.2006	Post-Mortem certificate.
Ex.A3	31.01.2006	Death certificate.
Ex.A4		Driving licence.
Ex.A5	12.03.2005	Certificate cum policy schedule.
Ex.A6	08.11.2006	Opposite party letter to complainant.
Ex.A7		Complainant letter to opposite party.
Ex.A8	28.11.2006	Opposite party letter to complainant.
Ex.A9	24.02.2006	Legalheirship certificate.

IST OF DOCUMENTS FILED BY THE OPPOSITE PARTY:

Ex.B1	17.08.2009	Insurance policy.
Ex.B2	20.10.2006	Investigation report.

 

MEMBER – I               MEMBER – II                                   PRESIDENT

 

 

 

 

 

 

 

 

 

C.C.No.203/2018, Dated:12.04.2023 Order Pronounced,                 In the result the Complaint is dismissed. No costs.   Member-I       Member-II           President