Oriental Insurance Company Ltd. vs Prem Lata Purohit

This revision petition has been filed against the impugned order dated 20.2.2013, passed by the Rajasthan State Consumer Disputes Redressal Commission, Circuit Bench Bikaner (hereinafter referred as the ''State Commission'') in First Appeal No. 29/2012, Smt. Prem Lata Purohit v. The Oriental Insurance Company Ltd., vide which, while accepting the appeal, the order passed by the District Consumer Disputes Redressal Forum in Consumer Complaint No. 59/2008, filed by the present respondent, dismissing the said complaint, was set aside. 2. The facts of the case are that the husband of the complainant/respondent Smt. Prem Lata Purohit, the deceased Shiv Ratan Purohit was the owner of a registered three-wheeler vehicle No. RJ07 PA 716, for which he obtained an insurance policy from the petitioner/OP Insurance Company, valid from 30.12 2006 to 29.12.2007. He also obtained a personal accident cover along with the policy. It has been stated in the consumer complaint filed by the complainant, that on 4.4.2007, her husband was returning to his village from Bikaner in the said vehicle, being driven by its driver Bal Chandra. The said vehicle was being driven in rash and negligent manner and on taking turn at Pugal Road, T Point, the vehicle overturned after it hit a military vehicle. The husband of the complainant suffered grave injuries on his head and was admitted in a hospital, where he died on 7.4.2007. A report about the accident was registered with the local police and a claim petition was also filed with the Insurance Company along with relevant documents in June, 2007. The information sought by the Insurance Company and documents demanded were also given to them, but the OP failed to settle the claim, meaning thereby, there was deficiency in service on the part of OP towards the complainant. The complainant filed the consumer complaint in question, seeking directions to the OP to pay them a sum of Rs. 2 lakh as personal accident claim, along with interest @ 18% per annum. In addition, the complainant demanded a compensation of Rs, 2 lakh on account of mental agony etc. and Rs. 5,100 as cost of litigation. 3. The complaint was resisted by the OP Insurance Company by filing a written reply before the District Forum, in which they stated that the complaint did not fall under the definition of ''consumer'', as the vehicle was being used for commercial purpose. It was further stated that the Insurance Company was liable to pay the claim in accordance with the terms and conditions of the policy only. In the present case, the owner of the vehicle did not have a valid and effective driving licence with him at the time of the accident, although he was not driving the vehicle himself at that time. The OP Insurance Company also stated that Bal Chandra who was driving the vehicle at the time of accident, did not have a licence for driving a transport vehicle. There was, therefore, violation of the terms and conditions of the insurance policy and hence, the claim was not payable. 4. The District Forum after taking into account the averments made by the parties, dismissed the consumer complaint on the grounds taken by the Insurance Company in their reply. Being aggrieved against the said order of the District Forum, the complainant challenged the same by way of an appeal before the State Commission which was allowed, vide impugned order and the Insurance Company was directed to pay the insurance amount of Rs. 1 lakh to the complainant and also to pay interest @ 9% per annum from the date of complaint and a further sum of Rs. 5,000 as compensation for mental agony and Rs. 2,000 as litigation cost. Being aggrieved against the said order of the State Commission, the petitioner Insurance Company is before this commission by way of the present revision petition. 5. At the time of hearing, the learned Counsel for the petitioner Insurance Company has drawn attention to grounds of the revision petition, stating that as per the provisions, GR-36 of the India Motor Tariff Regulations, three conditions had been laid down to get claim under the personal accident cover for the owner-driver, namely, the owner-driver should be the registered owner of the vehicle insured and he should be named in the insurance policy and also hold an effective driving licence at the time of the accident. The District Forum had, therefore, rightly concluded that the claim was not payable, because the owner of the vehicle did not have a valid and effective driving licence and moreover, the person driving the vehicle at the time of the accident, did not have proper licence to drive the same. The learned Counsel referred to an order passed by this Commission in R.P No. 3266/2008 on 16.9.2013, Bajaj Allianz General Insurance Company v. Smt. R. Suguna, saying that for allowing the personal accident cover, the owner-driver has to have a proper driving licence, even if, he is not driving the vehicle at the time of accident. 6. The learned Counsel for the complainant/respondent however, stated that it was incumbent upon the Insurance Company to ensure at the time of issuing the policy, as to whether the deceased was in possession of a valid and effective licence or not. The learned Counsel stated that the order passed by the State Commission was in accordance with law and should be upheld. 7. I have examined the entire material on record and given a thoughtful consideration to the arguments advanced on behalf of the parties. 8. It has not been disputed that at the time of the accident, the deceased husband of the complainant was not in possession of a valid and effective driving licence. It has also not been disputed that the person driving the vehicle at the time of the accident, was in possession of licence for driving private vehicles only and not for a commercial vehicles. The main point for consideration, therefore, is that in the light of these facts, whether the claim in question was payable by the petitioner Insurance Company. The learned Counsel for the petitioner has drawn attention to the provisions of GR-36 Regulations, according to which, the owner-driver is required to be holding effective driving licence. It has been held by this Commission in Bajaj Allianz General Insurance Company v. Smt. R. Suguna, IV (2013) CPJ 449 (NC), R.P. No. 3266 of 2008, that the claim is admissible only, when the insured was possessing a valid driving licence at the time of accident. In the event of not having such a licence there is apparently a violation of the terms and conditions of the ''Commercial Vehicle Package Policy'', as taken by the insured. In Section IV relating to the personal accident cover for owner-driver, it has been made clear in proviso 4 that the conditions as stated in GR-36, should be fulfilled for the grant of personal accident cover for such owner-driver. 9. From the position stated above, it is clear that the State Commission took an erroneous view that the claim was payable to the complainant. The contention of the State Commission that the Insurance Company should have ensured that all conditions regarding licence etc. are fulfilled prior to giving the policy, is not correct, because it was the duty of the insured also to make sure that the conditions mentioned in the policy are duly fulfilled. I, therefore, agree with the learned Counsel for the petitioner that the claim has been wrongly allowed by the State Commission. This revision petition is, therefore, allowed and the order passed by the State Commission is set aside. The order passed by the District Forum is restored and the consumer complaint stand dismissed. There shall be no order as to costs. Revision Petition allowed.