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2008 DIGILAW 354 (CHH)

BASANTI MANDAL v. NATIONAL INSURANCE CO. LTD.

2008-12-06

S.C.VYAS, V.K.PATIL, VEENA MISRA

body2008
ORDER As per Hon 'ble Shri S.C. Vyas, President : 1. Indisputably, the husband of the appellant complainant Nepal Chand was owner and driver of Jeep No. MP - 23/4859 on the date of accident, when said vehicle was involved in a road accident and Nepal Chand died. Complainant appellant after tiling claim before insurance company, preferred complaint case No.156/05 before District Consumer Disputes Redressal Forum, Raipur (hereinafter called "District Forum" for short), demanding Rs.l ,00,000/- more from the insurance company on the ground that this amount is payable under the accidental benefit of the insurance policy. Complaint was dismissed by District Forum vide order dated 06.03.06, hence this appeal. 2. The contention of the complainant before District Forum as well as before this Commission is that additional premium ofRs.300/- has been paid by the complainant while getting the vehicle insured for 6 persons including the person who was driving the vehicle and was also the owner of the vehicle. This contention was not accepted by the District Forum and the arguments of the insurance company that owner driver was not covered under the insurance policy, has prevailed. Apart from these arguments another objection which was taken by the insurance company was that the complaint filed before District Forum was time barred. 3. Let us first consider the question of limitation. Leaned counsel for the appellant / complainant submitted that the complainant for the first time became aware, regarding the accident benefit of the insurance policy, during the course of trial of claim case before Motor Accident Claims Tribunal (hereinafter "MACT" for short) of such insurance policy and when a witness for insurance company had deposed regarding the policy, from that date limitation has been computed and complaint has been filed. Opposing this argument learned counsel for the respondent submitted that, that date can never be said to be date of knowledge to the complainant, because the policy doclill1ent was in the possession of the complainant from the very beginning from the date when the vehicle was insured. It has also been argued that when the claim case was filed before MACT, at that time also, policy doclill1ent must have been seen by the complainant as well as by the counsel, so the date of deposition of witness before MACT cannot be said the date of knowledge. It has also been argued that when the claim case was filed before MACT, at that time also, policy doclill1ent must have been seen by the complainant as well as by the counsel, so the date of deposition of witness before MACT cannot be said the date of knowledge. This question has been dealt in detail by the District Forum and it has been held that the complaint is time barred. 4. We have gone through copy of the order of MACT as well as the copy of deposition sheet of witness Gurucharan Singh dated 06.10.04, the complainant of this case is a widow lady, normally it is not expected from widows to go through documents minutely regarding insurance policy or regarding other matters of business and accounting. House hold ladies are mostly busy in the domestic affairs. The complainant of this case is also, only a house hold wife, which shows that she does nothing except maintaining house hold affairs. There is nothing on record to show that the description of payment of premium was in her knowledge prior to filing policy document in the claim case. A copy of policy which was filed by the complainant before District Forum is an one page document which does not contain detailed description of the premium paid, in fact it is only copy of the Cover Note, which was provided by the insurance agent at the time of proposal. In this document, correct description of premium has not been given. From this document it is clear that neither the deceased, nor the wife, were aware of the fact that on which head how much amount of premium has been collected. Therefore, if complainant is saying that for the first time detailed description of the policy came to her knowledge when the policy was filed before MACT and was explained by Officers of the insurance company, then such explanation cannot be said to be false. There is nothing on record to show that this policy was sent to the insured or the complainant earlier, by insurance company or its terms were brought to the knowledge of the insured or even to the knowledge of his wife, after his death. In these circumstances, we believe on the explanation of delay given by the complainant and condone the delay, which has occurred in filing the complaint. 5. In these circumstances, we believe on the explanation of delay given by the complainant and condone the delay, which has occurred in filing the complaint. 5. Now the second question arises as to whether the complainant is entitled to receive any amount under the head of accident benefit, from the respondent, 6. Learned District Forum has held that no additional premium was paid for the coverage of owner driver or unpaid driver. As the deceased was driving the vehicle as being the owner at the relevant time, so, the complainant is not entitled to any compensatiol1iunder the insurance policy. Whereas learned cow1Sel for the appellant submitted that premium of Rs.3001- was paid for 6 persons, who were traveling in the vehicle and includes the driver owner also and therefore appellant is entitled to receive Rs.l,00,0001- compensation from the respondent ll1surance company. 7. Learned counsel for the respondent has vehemently opposed these arguments and submitted that under the policy, only passengers total in number 6, have been covered and additional premium ofRs.501- was received for third party property damage risk. He submitted that, that amount of premium has been received for the purpose of covering risk of property of third party and not of the owner driver. He also submitted that IMT-5, 19,70 and 71 has been mentioned in policy document as endorsement numbers and in IMT -5 it has been clarified that additional premium, which has been paid, was for the purpose of covering the risk of unnamed passengers. He submitted that 50 rupees additional premium, which has been collected was for the purpose of covering third party property damage risk. 8. IMT - 71 which has been referred in the policy document is most important part of the IMT, so far as this policy document is concerned and so far as its application in this policy document is concerned. It has been clarified in IMT -71 that "This extension is allowed without any additional premium, to persons who are not otherwise covered in the Workmens Compensation Act. In other words, paid drivers will not be covered under the extension", but other drivers will be covered. It has been clarified in IMT -71 that "This extension is allowed without any additional premium, to persons who are not otherwise covered in the Workmens Compensation Act. In other words, paid drivers will not be covered under the extension", but other drivers will be covered. Under this provision "Company undertakes to pay compensation on the scale provided for bodily injury 1 death as herein after defined sustained by driver (other that paid driver) of the vehicle in direct connection with the use of Motor Vehicles or whilst mounting or dismounting or driving the vehicle and caused by violent accidental external and visible means which independently of any other cause shall within 12 calendar months of the occurrence of such injury result in: a) Death, b) Total irrecoverable loss of: (i) Sight of both eyes etc., c) Total irrecoverable loss of the sight of one eye etc. In case of death the amount of compensation has been fixed as Rs.20,000/-, in case of total irrecoverable loss of sight of both eyes etc. compensation has been as Rs.20,000/-, whereas in case of total irrecoverable loss of the sight of one eye etc., an amount ofRs.l0,000/- has been fixed as compensation". 9. This provision shows that in case of death of driver other than paid driver, even without payment of additional premium Rs.20,000/- is payable by the insurance company by way of compensation under the provisions of IMT-71.This provision is fully applicable in the facts of the present case. Husband of the complainant was also driving the vehicle at the relevant time and he was unpaid driver so irrespective of the fact that additional premium has not been paid, the complainant is entitle to receive Rs.20,000/ - as compensation. 10. So far as arguments of additional premium for 6 persons and thereby coverage of Rs.l ,00,000/- is concerned, we are not satisfied with case of the complainant and are not of the opinion that any amount is payable to the complainant, as no additional premium has been paid. We feel that in this regard the finding of District Forum are appropriate. 11. Therefore, the appeal is partly allowed, the impugned order of District Forum is set aside and the insurance company is directed to pay Rs.20,000/- as compensation for accidental benefit to the complainant. We feel that in this regard the finding of District Forum are appropriate. 11. Therefore, the appeal is partly allowed, the impugned order of District Forum is set aside and the insurance company is directed to pay Rs.20,000/- as compensation for accidental benefit to the complainant. Tile an10unt will be payable with interest @ Rs.9% p.a. from the date of filing complaint, Rs.500/- are also awarded as cost of this appeal. Appeal Partly Allowed.