Punjab

Sangrur

CC/1091/2021

Baljinder Kaur - Complainant(s)

Versus

The New India Assurance Company Ltd. - Opp.Party(s)

Sh. Sandip Kumar Goyal

15 Apr 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

          

                                                Complaint No. 1091

                                            Instituted on:   23.08.2021 

                                            Decided on:     15.04.2024

Baljinder Kaur W/o Late Santokh Singh S/o Amar Singh R/o Ward. No. 3 Moonak, Tehsil Moonak, District Sangrur.      

                                                          ..Complainant.                                            Versus

1.       The New India Assurance Company Ltd., Registered and Head Office, 87, Mahatma Gandhi Road, Fort, Mumbai-400001, through its MD/GM.

2.       The New India Assurance Company Ltd. Branch Office, Sunam-148028, through its Branch Manager.

3.       Sundram Finance Ltd. SCF 14, Kaula Park, Patiala Gate, Sangrur-148001, Through its Branch Manager.  

                                            ….Opposite parties 

 

QUORUM                                         

JOT NARANJAN SINGH GILL: PRESIDENT

SARITA GARG                             : MEMEBR

KANWALJEET SINGH             : MEMBER

For the complainant  : Shri S.K.Goyal Advocate              

For the OP.No.1&2.  : Shri Ashish Kumar Advocate

For the Op.No.3         : Exparte

      

ORDER

KANWALJEET SINGH, MEMBER

1.              The complainant has alleged in this complaint that the husband of complainant Santokh Singh was the owner of the Combine bearing Registration no. PB13-AL-9258 and he insured his combine vide policy no. 71070031190100017813 on 19.09.2019. Complainant was the nominee as well as the legal hire of the insured. As per the Policy the PA cover of Rs. 15,00,000/-. On 25.10.2019, the aforesaid combine met with an accident in the area of Police Station Bundi(MP). At that time the combine was driven by Rajinder Singh S/o Santokh Singh. During to accident Santokh Singh (insured) expired due to multiple injuries on his body. The Complainant approached to Op.3 and told the entire story about accident. Op.No3 said Op.1 and 2 came to the complainant and collected the claim form alongwith all relevant documents from the complainant. But till today no one come to the complainant to get the relevant documents of the policy. The documents were again sent by the counsel of Complainant namely Sandeep Kumar Goyal alongwith letter dated. 02.12.2020. The Ops neither repudiated nor allow the claim of the complainant till today. Ops Committed unfair trade practice qua the complainant and lastly prayed that the Ops may kindly be directed to pay the claim amount of Rs. 15,00,000/- alongwith interest   from the date of accident, Rs. 2,00,000/- on account of mental tension and harassment and Rs. 2,00,000/- as a litigation expenses and counsel fee.

2.         Upon notice, Op no. 1 and 2 appeared and filed a written reply. Despites notice, Op. no. 3 did not appear and proceeded exparte vide separate order dated 02.11.2021. In reply of Op.no. 1 and 2 Ops taking legal objection that the complainant has no cause of action to file the complaint. This Commission has no jurisdiction to try and decide the present complaint. In the complaint the complicated question of law and facts are involved and the same could not be decided in summary proceedings. On merits, as per the records of the Ops, Santokh Singh (now deceased) was the registered owner of the vehicle in question and the same was insured at the time of risk subject to the terms and conditions of the policy. Under the policy owner cum driver is eligible to get the claim of Rs. 15,00,000/- on account of death in road accident is admitted. According to GR-36 only the registered owner in person is entitled to personal accident cover and the owner of the insured vehicle holding an “effective” driving  license. The definition clearly restricts the meaning of owner driver, it only includes owner of the insured vehicle. The term owner driver has been defined no word can be added or deleted from the definition to extend the benefit to complainant. So, that the term “driver owner” can be stretched to mean owner or driver. At the time of accident Santokh Singh insured was not having valid or effective driving license. The proviso of 2 of section 3 runs as under :-

    “2. This cover is subject to:

1. The owner driver is the registered driver of the vehicle insured herein.
2. The owner driver is the insured named in the policy.
3. The owner driver holds an effective driving license, in accordance with the provisions of rule 3 of the central motor vehicle rules, 1989 at the time of accident. 

After receipt the intimation dated 18.11.2019 regarding the death of insured in an accident dated 25.10.2019, the Ops appointed Harwinder Pal Singh investigator for investigation of the alleged incident. Investigator submitted his report dated 30.10.2020, As per report, Rajinder Singh S/o of Santokh Singh (Insured) was driving the vehicle in question at the time of accident. Santokh Singh was traveling in the vehicle at that time. The Ops sent registered letter dated 17.06.2020 to the insured, letters dated 23.7.2020 and 25.8.2020 and 17.9.2020 sent to Rajinder Singh and letter dated 31.12.2020 and 28.5.2021 to the complainant for submitting the driving license of the insured. Ultimately, the complainant provided the driving license of the insured, which was renewed by licensing authority Moonak, District Sangrur for LMV & MCWG valid from 27.6.2008 to 11.9.2018. At the time of accident, insured was not having valid and effective driving license. Therefore, the complainant is not entitled to get Rs. 15,00,000/- and lastly prayed that the complaint may kindly be dismissed with costs.

3.         In support to prove her case the complainant tendered into evidence her self attested affidavit Ex.C-1 and some other documents which are Ex.C-2 to Ex. C-13 and closed evidence.

4.         On the other hand, to rebut the case of the complainant, the Op.no.1 & 2 have produced in their evidence some documents i.e  Ex.Op1&2/1 to Ex.Op1&2/17 and Ex.Op1&2/18 self attested affidavit and closed the evidence.

5.         We have heard the learned counsel for parties and gone through the record file carefully with the valuable assistance of the learned counsel for the parties. During arguments, the contentions of both the parties are similar to their respective pleadings, so there is no need to reiterate the same to avoid repetition.

6.         Now, come to major controversy, whether the complainant is liable for relief as claimed by her in her prayer or not?

7.         It is not disputed that the insured Santokh Singh (now deceased) was the registered owner of the vehicle in question and same was insured at the time of risk. The owner cum driver is eligible to get claim of Rs. 15,00,000/- on account of death in road accident, is admitted by the Ops in their reply on merits in para no.3. It transpires from the perusal of Ex.C2,is the policy schedule. In the policy it depicts the insured name as Santokh Singh. As per Ex. C3, it is mention that the deceased Santokh Singh has been expired due to fall from harvester combine and caused head injuries and expired on 25.10.2019. As per Ex. C4, the postmortem of the deceased Santokh Singh was conducted on 25.10.2019. We have examined the driving license of Rajinder Singh, which is Ex. C5, which was valid for transport till 22.08.2020 and non transport is valid upto 22.08.2031. While the pleadings of complaint in para no. 3(D), complainant pleaded that harvester (supra) met with an accident in MP. The combine was driven by Rajinder Singh S/o Santokh Singh. Due to accident Santokh Singh fell down and expired.

8.         The main argument point raised by the learned counsel for the complainant is that the driving license of Rajinder Singh was valid at the time of accident and he was driving the harvester combine. Furthermore, as per Ex.C3, statement of Rajinder Singh stated in his statement that he was the driver of the harvester and his father was sited with him. Meaning thereby, deceased Santokh Singh was not driving the combine. Insured was fell down from the combine on the road and expired.  To trace out the varsity of truth, this Commission has the considered view in the light of terms & Conditions of the policy clause 4 provides 3 mandatory requirements to cover the compulsory PA for owner driver (sum insured of Rs. 15,00,000/-). As per Ex.Op.1&2/3 on page no. 2 this cover is subject to which are mentioned as under :-

a)The owner driver is the registered driver of the vehicle insured herein.

b)The owner driver is the insured named in the policy.

c)The owner driver holds an effective driving license, in accordance with the provisions of rule 3 of the central motor vehicle rules, 1989 at the time of accident.

Further, it transpires from the perusal of Ex. Op.1&2/3 compulsory personal accident- stand alone policy page no. 1 provides General Regulation 36 of the India Motor tariff.

GR 36. Personal Accident (PA) Cover under Motor Policy

A. Compulsory personal accident cover for owner-driver.

Compulsory personal accident cover shall be applicable under both liabilities only and package policies. The owner of the insured vehicle holding an effective driving license is termed as owner-driver for the purpose 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.

Per contra, as per OPs evidence Ex. Op.1&2/4 claim intimation has been given by the son of the deceased on 18.11.2019 to the Ops. The investigator Harwinder Pal Singh issued letters to the son of deceased on 23.07.2020 Ex.Op.1&2/5, Letter dated 25.8.2020 which is Ex.Op.1&2/6 and letter dated 17.9.2020 which is Ex.Op.1&2/7 with regard to provide the requisite documents to finalize the investigation. Further, as per Ex.Op.1&2/8 investigation report on page no. 3, investigator visited the spot of accident on 19.7.2020. It transpires from the observation of investigator report on page.5 at serial no. 3 mentioned the sitting capacity of the vehicle is (one) as per the registration card. At serial no. 5 mentioned recording the statement of the son of the insured two persons viz Rajinder Singh and Santokh Singh insured were occupying the vehicle at the time of the accident. At serial no. 7, it is mentioned that the sitting capacity of the vehicle including driver as per the policy in question is 4(four). Serial no. 8 stated that complainant Baljinder Kaur is the wife of the insured nominee. Serial no. 21 mentioned the death of the insured has been found to be accidental in nature and occurred by traveling in the vehicle. As per Ex.Op.1&2/18 self attested affidavit of Narinder Kumar Singla, Divisional Manager of Ops pleaded in para. No. 4 that the driving license of Santokh Singh insured renewed by licensing authority Moonak, District Sangrur for LMV and MCWG valid from 27.6.2008 to 11.9.2018. At the time of accident  the deceased, Santokh Singh was not having valid and effective driving license i.e. 25.10.2019  while the driving license was expired on 11.9.2018 of the insured meaning thereby at the time of accident of the combine the driving license of the insured (now deceased) has already been expired approximately one year, one month and 15 days prior to the accident.  In the present case in hand the scope  of the insurance personal cover is very limited to the driver who is the owner of the vehicle. Insured Santokh Singh was not driving the vehicle at the time of the accident. Moreover, the complainant neither produced the original nor duplicate driving license on the record file. In this juncture, complainant failed to prove this factum that the insured having valid and effective driving license at the time of the accident.  This Commission has no hesitation to hold that the general rule 36 personal accident (PA) cover under motor policy provided (c ) the owner-driver holds an effective license in accordance with the provision of rule 3 of the central motor vehicle rules, 1989 at the time of accident is mandatory as per law. While in the present case as per the statements of the sons of the deceased Lakhwinder Singh and Rajinder Singh which are incorporated in Ex. C3, stated that his father was sitting on the harvester and Rajinder Singh was driving the harvester at the time of accident on 25.10.2019. Moreover, an affidavit of complainant which is Ex. C1 in para no. 4 , it is specifically mentioned that the combine was driven by Rajinder Singh at the time of accident. Legal Notice dated 02.6.2020 in para no. 4, which is Ex. C6, it is again mentioned that Rajinder Singh drove the combine.

9.         This Commission has the considered opinion that the interpretation of the General Regulation 36 of the India Motor Tariff, the essential element for personal accident cover “The Owner having an effective driving license at the time of the accident.” As per Ex.C5, the driving license of the Rajinder Singh Son of insured was valid at the time of accident but it does not empowered to the complainant to succeed her case. We feel that an insurance contract is known as a contract of "uberrima fides" based on "utmost good faith" which is fully applicable in the present complaint. The terms and conditions are the foundation of the insurance policy. As such, the terms and conditions are binding upon the parties. No party can go beyond the terms and conditions of the policy in question. We feel utmost important document is sufficient to clarify Law point, which is   Ex.Op.1&2/3 on second page clause (c ) of the terms and condition of the policy mentioned the owner driver holds an effective driving license, in accordance with the previsions of rule 3 of the central motor vehicle rules,1989 at the time of the accident. Apart from it transpire from the perusal of Ex.Op.1&2/8 investigation report dated 30.10.2020 has a pivotal role to solve the primary issue “whether the owner-driver compulsory PA cover policy requires an effective driving license at the time of the accident or not?”

10.               On page no. 7 of Ex.Op.1&2/8, investigation report conclusion portion serial no. 11 is reproduced as under :-

First two provisions of the GR No. 36 and conditions of Section –IV of the commercial vehicle package policy in respect of coverage of compulsory personal accident have been complied with as :

a)The owner driver is the registered driver of the vehicle insured herein.

b)The owner driver is the insured named in the policy.

c) The representative of the insured despite repeated requests and registered letters has not been provided the driving license. 

11.               Further, reply on merits of Ops in para no. 3 on page no. 4 & 5 pleaded that the investigator submitted his report on 30.10.2020, as per report Rajinder Singh driving the vehicle and the insured was traveling the vehicle at that time but the driving license of the insured was not provided to the investigator. The Ops sent registered letter dated 17.06.2020 to the insured, letters dated 23.7.2020 and 25.8.2020 and 17.9.2020 sent to Rajinder Singh and letter dated 31.12.2020 and 28.5.2021 to the complainant for submitting the driving license of the insured. We feel that at the time of accident, insured was not having the valid and effective driving license.

During arguments learned counsel for the complainant referred the judgments case titled as “The Oriental Insurance Co. Limited and Ors. Vs Smt. Manjit Kaur and Ors” in Appeal No. A/97 of 2023. We have gone through the judgments (supra) very carefully passed by the Hon’ble Chandigarh State Consumer Commission (UT). The page no. 2 of the judgment in para no. 4 mentioned that during investigation it was found that the driving license of the deceased was forged and the same was verified from the licensing authority. Further mentioned in para no. 11 of the judgment (supra) that the motor cycle of the insured was hit by the offending truck from behind as such insured had fallen and succumbed to the injuries. On the other hand, in the present complaint as per Ex.Op.1&2/8 investigation report conclusion portion at serial no. 12 described that due to sudden steering the IV, Santokh Singh (insured) who was sitting on the left side with the driver, fell off the IV on the road. In this context, this Commission has the considered opinion that the facts of the case Manjit Kaur (supra) are different as compare to the present case in hand. In this peculiar circumstance of the case in hand the referred judgment (supra) is not applicable. In this juncture, the judgments produced by the learned counsel for complainant are not helpful to clear/prove the stand of the complainant.

We rely upon the judgment produced by the Learned counsel for the Ops case titled as “Roshani Devi Vs National Insurance Company Limited” in Revision petition number 4569 of 2014 decided on 15.01.2015 . In this Case Hon’ble National Commission held that- Insurance-Death Claim- Coverage of owner cum driver- driving license- non production- violation of policy conditions-claim repudiated-Alleged deficiency in service-District Forum Allowed complaint- Non-compliance of order- State Commission Allowed appeal – Hence revision –It was incumbent upon the complainant to produce either original driving license of insured or copy of same before insurance Company, to satisfy it that deceased was holding a valid driving license at time of accident- Complainant failed to prove that deceased was holding an effective driving license- Repudiation justified.

12.               Resultantly,  keeping  in view of the  facts and the peculiar circumstances of the case   in hand  and with  careful  analysis  of the evidence available on record  and in the light of the decision of the Hon’ble National Commission, we dismiss the complaint  of the complainant.

13.               Copy of this order be supplied to the parties free of cost. File be consigned to the records after its due compliance.

 

                            Announced.                                      

                            April 15, 2024

 

( Kanwaljeet Singh)     (Sarita Garg)         (Jot Naranjan Singh Gill)    

Member             Member                     President