ORIENTAL INSURANCE COMPANY LIMITED v. VIJAY SINGH CHAUHAN
2009-01-06
C.C.PANT, IRSHAD HUSSAIN, KUSUM LATA SHARMA
body2009
DigiLaw.ai
ORDER (Per : Justice Irshad Hussain, President) This is insurer’s appeal under Section 15 of the Consumer Protection Act, 1986 against the order dated 02.07.2008 passed by the District Forum, Dehradun, allowing consumer complaint No. 22/2006 and directing the insurer to pay sum of Rs. 2,59,712/- together with interest @ 9% p.a., by way of reimbursement of the loss occasioned to the complainant on account of accident of his insured vehicle No. UA07M/0463 (Mahindra Bolero Camper. 2. The facts of the case were that the complainant purchased the above said vehicle on 18.10.20034 for his self-employment and got it insured for sum of Rs. 4,05,486/- with the insurer on that very day. The complainant had applied for registration of the vehicle and on 06.01.2005, while he was coming in the said vehicle to Dehradun for collecting the registration papers, the vehicle, at that time, being driven by Sh. Rajendra Singh met with an accident and fell in a deep gorge and was completely damaged. Information of the accident was given to the insurer on 07.01.2005 and thereafter the complainant submitted claim for indemnification of the loss by the insurer in the prescribed performa. Surveyor of the insurer vide his report dated 24.07.2005 (Paper Nos. 25kha/2 to 25kha/7 of the original record), recommended settlement of the claim on its merits on “Net of Salvage Basis” for an amount of Rs. 2,59,721/-, after adjusting sum of Rs. 1,25,000/- as salvage value of the accidented vehicle, which was to be retained by the complainant. The complainant gave his consent letter (Paper No. 25kha/15), the same day to the surveyor. Insurer did not pay the said recommended amount of Rs. 2,59,712/- to the complainant and instead called upon the complainant to submit copy of the registration certificate, copy of the driving licence of the driver and also the copy of the route permit vide letters dated 27.09.2005, 14.1.2005, 17.01.2006, 27.06.2006, 08.08.2006 and 10.10.2006. The compliance having not been made, the claim file was closed as “NO CLAIM” under intimation by registered letter dated 29.12.2006 sent to the complainant. Even prior to the said letter, the complainant had filed consumer complaint alleging deficiency in service on the part of the insurer in not making the payment of the amount recommended by the surveyor. 3.
The compliance having not been made, the claim file was closed as “NO CLAIM” under intimation by registered letter dated 29.12.2006 sent to the complainant. Even prior to the said letter, the complainant had filed consumer complaint alleging deficiency in service on the part of the insurer in not making the payment of the amount recommended by the surveyor. 3. Complainant also alleged that the vehicle had been purchased by him for his self-employment and to earn his livelihood and that he used to earn Rs. 13,000/- per month on an average and after payment of Rs. 9,393/- per month, as installment of the vehicle, he had saving Rs. 3,000/- to 4,000/- per month for his livelihood. He laid claim for sum of Rs. 5,26,986/- detailed as below : Sl. No. Particulars Amount (a) Balance amount of insurance of the vehicle Rs. 2,80,486/- (b) Toeing charges Rs. 13,500/- (c) Loss of earning at Rs. 13,000/- per month from 07.04.2005 to 07.08.2006 Rs. 2,08,000/- (d) Damages for mental agony and injuries Rs. 25,000/- Total Rs. 5,26,986/- 4. Insurance company contested the complaint mainly on the grounds that the complainant’s claim had been duly processed and it sent registered letters dated 27.09.2005, 14.11.2005, 17.01.2006, 27.06.2006, 08.08.2006 and 10.10.2006 to the complainant to complete certain formalities to facilitate finalization of the claim that the complainant had neither completed the required formalities, nor turned up in the matter and the company, therefore, closed his claim file as “NO CLAIM” on 29.12.2006 and intimation to this effect was sent to the complainant under registered post that there has not been any deficiency in service on the part of the insurance company for the settlement of the claim and that the subject vehicle had not been registered and was being plied without a proper and valid route permit at the time of the accident and that too, by the driver, who was not having a proper and valid driving licence to drive the vehicle in hilly routes at the time of the accident. According to it, the complainant was not entitled to any compensation on the basis of the policy of insurance of the vehicle in question. 5.
According to it, the complainant was not entitled to any compensation on the basis of the policy of insurance of the vehicle in question. 5. Parties adduced relevant evidence in the case and the District Forum, on an appreciation of the material on record, rejected the defence pleas to the insurance company of the insurance company by observing that the complainant had placed on record copy of the route permit as well as registration certificate (Paper No. 25kha/21); that the insurance company has not adduced any evidence to indicate that the complainant had not applied for registration registration of the vehicle and grant of route permit on 18.10.2004; that even otherwise, the accident occurred when the complainant was coming to Dehradun for collecting the registration papers and, as such, on the date of the accident, the complainant was not supposed to possess the registration certificate of the vehicle and the driver to have a hill endorsement on his driving license and that the complainant had given his comment to the amount recommended by the surveyor and, as such, the claim stand settled and the insurance company was legally obliged to pay the agreed amount of Rs. 2,95,712/-, by way of reimbursement of the loss occasioned to the complainant. The District Forum adverted to a decision of the Hon’ble National Commission in the matter of P. Shivaji Sethi vs. New India Assurance Company Limited; III (2006) CPJ 317 (NC), in support of its above view. Aggrieved by the findings and the decision of the District Forum, the insurance company, filed this appeal. 6. On the contentions raised by the learned counsel for the parties, the following points arise for consideration in this appeal : (i) Whether the subjected vehicle was being plied without registration certificate and route permit, in contravention of the provisions of the Motor Vehicles Act, 1988 and, as such, in contravention of the terms and conditions of the policy of insurance? If so, effect? (ii) Whether the driver Sh. Rajendra Singh was not having a proper and valid driving licence to drive the vehicle in hilly routes at the time of the accident and for that reason, the insurance company was legally obliged not to accept the claim under the policy of insurance of the vehicle?
If so, effect? (ii) Whether the driver Sh. Rajendra Singh was not having a proper and valid driving licence to drive the vehicle in hilly routes at the time of the accident and for that reason, the insurance company was legally obliged not to accept the claim under the policy of insurance of the vehicle? (iii) Whether the claim had been settled by the insurance company and, as such, the insurance company was not authorized to close the claim file as “NO CLAIM”? 7. Point No. (i) – Learned counsel for the insurance company persuasively argued that the subjected vehicle was being plied without registration certificate as well as valid route permit, in violation of the terms and conditions of the policy of insurance as well as the provisions of the Motor Vehicles Act, 1988 and, as such, the complainant was not entitled to be reimbursed for any loss occasioned from accident of the vehicle. Learned counsel also urged that the District Forum fell in error in saying that the registration certificate and route permit, has been placed on record and further that the insurance company failed to discharge the onus of proving that the complainant had not applied for registration of the vehicle as well as for grant of route permit on 18.10.2004, the date, when the vehicle was purchased. On the other hand, learned counsel for the complainant, would submit that the copy of the registration certificate had been placed on record before the District Forum and the same has been considered in taking the view that the relevant provisions of the Motor Vehicles Act, 1988, have been complied with in the case by the complainant. Having considered the material on record in the light of the legal aspects of the case, we see merit in the argument of the learned counsel for the insurance company that on account of breach of the terms and conditions of the policy of insurance as well as the provisions of the Motor Vehicles Act, 1988, the complainant was not entitled to be reimbursed for any loss occasioned from the accident of the vehicle. 8. The reasons for the above decision are that the invoice dated 18.10.2004 (Paper No. 16 kha/2) relating to the purchase of the subjected vehicle by the complainant, reveal that at the time of the purchase, speedometer reading of the vehicle was 10 kms.
8. The reasons for the above decision are that the invoice dated 18.10.2004 (Paper No. 16 kha/2) relating to the purchase of the subjected vehicle by the complainant, reveal that at the time of the purchase, speedometer reading of the vehicle was 10 kms. Complainant’s own paper, i.e., service estimate dated 24.01.2005 (Paper Nos. 16kha/4 to 16kha/7), reveal that the subjected vehicle has been plied for the purpose, it was purchased and on the date of the accident, speedometer reading of the vehicle was 11381 kms. As pleaded by the complainant, the vehicle had been purchased for his self-employment and to earn his livelihood and that the complainant used to earn Rs. 13,000/- per month on an average by use of the vehicle for his self-employment. The speedometer reading, thus clearly indicate that right from the date of the purchase, the vehicle had been regularly used and plied for earning by the complainant, although till date of the accident on 06.01.2005, neither the vehicle had been registered, nor route permit had been issued by the competent authority. “Permit” has been defined under Section 2(31) of the Motor Vehicles Act, 1988 and it means, “a permit issued by a State or Regional Transport Authority or an authority prescribed in this behalf under this Act authorising the use of a motor vehicle as a transport vehicle”. Omitting the three provisions, sub-section (1) of Section 66 of the Motor Vehicles Act, 1988, which is relevant, reads as under : “66. Necessity for permits – (1) No owner of a motor vehicle shall use or permit the use of the vehicle as a transport vehicle in any public place whether or not such vehicle is actually carrying any passengers or goods save in accordance with the conditions of a permit granted or counter-signed by a Regional or State Transport Authority or any prescribed authority authorizing him the use of the vehicle in that place in the manner in which the vehicle is being used ……………” 9. The above provisions would indicate that these create a total bar on use of a vehicle in any public place, whether or not such vehicle is carrying any passenger or goods, unless the owner thereof holds a permit as defined under Section 2(31) of the Act.
The above provisions would indicate that these create a total bar on use of a vehicle in any public place, whether or not such vehicle is carrying any passenger or goods, unless the owner thereof holds a permit as defined under Section 2(31) of the Act. Admittedly, on the date of the accident, the vehicle was neither registered, nor was issued any permit as defined under the said provision. The copy of the registration certificate (Paper No. 25kha/21), referred thereto as the registration certificate and route permit by the District Forum, would indicate that the vehicle was registered on 20.12.2005 and the tax had been paid upto 31.12.2005. There is nothing to indicate that the complainant had applied for registration and issuance of permit by the Regional Transport Authority soon after the purchase of the vehicle. In the face of the facts of the case, the District Forum took an entirely incorrect view that the onus to show that the complainant had not applied for registration and route permit on 18.10.2004, lay upon the insurance company and that, in fact, the complainant himself was legally obliged to place on record the relevant documents to indicate that he had applied for registration and grant of permit of the vehicle before the date of the accident and on his failure to do so, adverse inference was required to be drawn against him. 10. In the face of the facts of the case, it is of significance that, as stated above, the vehicle was shown to have been registered on 20.12.2005, although the accident had taken place on 06.01.2005 and in the accident, the vehicle had been completely damaged. The surveyor had submitted his report on 24.07.2005, whereafter, as is admitted to the complainant, the salvage of the vehicle had been sold for sum of Rs. 1,25,000/- and the amount had been retained by him, much before the date of registration of the vehicle on 20.12.2005. On this date, no motorable vehicle was, in fact, in existence and it does not stand to reason as to how the transport authorities could have even got the said vehicle registered, without even the pencil impression of the engine number as well as chassis number, which are necessarily obtained by the assigned officer for facilitating the registration of a motorable vehicle.
There can be no denying the fact that something had gone wrong and the action of the transport authorities, is also questionable as to how the vehicle, which was not in existence, got to be registered on 20.12.2005 and registration No. UA07M/0463 as shown in the copy of the registration certificate (Paper No. 25kha/21), placed on record by the complainant, had been issued. (This appear to be a matter of inquiry by the transport authorities). 11. Not only this, the state of affair in this case, was that no route permit for plying the vehicle on a prescribed route, had been obtained by the complainant, who had without such a permit, went on to ply the vehicle for long, even upto the speedometer reading at 11381 kms and that too, on his own showing, as has been pleaded in the complaint. The District Forum failed to take into account these broad aspects of the case and on incorrect inferences, went on to accept that the complainant had obtained the route permit under the provisions of the Motor Vehicles Act, 1988 to ply the vehicle, by way of his self-employment to earn his livelihood. It was a clear case of breach of the terms and conditions of the policy of insurance (Paper No. 25 kha/30), which stipulated that, “the policy covers the use only for carriage of passengers in accordance with the permit issued within the meaning of the Motor Vehicles Act” and further that there was violation of the provisions of the Motor Vehicles Act, 1988 as regards the registration as well as the route permit to ply the vehicle. Therefore, the complainant was not entitled to be reimbursed for any loss occasioned as a result of the accident of the vehicle. Under similar circumstances, the insured had been deprived of the compensation by the Hon’ble National Commission in the case of United India Insurance Co. Ltd. Vs. Dharam Raj; IV (2005) CPJ 115 (NC), which had also been pressed into service before the District Froum, which fell in error in not placing reliance on it, in favour of the plea raised by the insurance company. In other words, the insurance company could not have been saddled with the responsibility of making any deficiency in service in settling the claim in favour of the complainant. Point is answered accordingly. 12.
In other words, the insurance company could not have been saddled with the responsibility of making any deficiency in service in settling the claim in favour of the complainant. Point is answered accordingly. 12. Point No. (ii) – After the accident, complainant gave intimation to the insurance company on 07.01.2005 (Paper No. 16kha/3). Accident occurred on Chakrata Road, near Kawasi Village, Do Pul and as per the intimation given by the complainant, the vehicle fell in a 300-400 deep gorge on the hilly road. Driver Sh. Rajendra Singh’s licence (Paper No. 25 kha/19) as well as documents verification report dated 19.09.2005 (Paper No. 25kha/20), reveal that there was no hill endorsement in the licence of the driver. Insurance Company had raised specific plea that the driver of the subjected vehicle was not having a proper and valid driving licence to drive to vehicle in hilly route at the time of the accident and the same was rejected by the District Forum, by an improper finding that since the vehicle was on its way to collect the registration certificate/permit from the transport office, the absence of such an endorsement in the driving licence, was immaterial and on that ground, the claim would not be defeated. The view taken being incorrect, need to be inferred with, in view of the provision of Rule 193 of the Uttar Pradesh Motor Vehicles Rules, 1988 and regarding which, we have taken consistent view that in the absence of endorsement of hill routes in the driving licence, the insurance company would be justified to repudiate the claim. Our decision in the case of Branch manager, The New India Assurance Co. Ltd. Vs. Sh. Yogender Kumar Aggarwal in First Appeal No. 311/2006 decided on 23.05.2008 (Paper Nos. 27kha/3 to 27kha/7) and another decision in the case of National Insurance Company Limited vs. Sh. Devendra Narayan Dubey in First Appeal No. 248/2006 decided on 12.02.2008 (Paper Nos. 27 kha/8 to 27kha/12), were not relied upon by the District Forum. Considering the above legal aspect of the matter that hill endorsement was required to be made in the driving licence, to entitle the driver to drive the vehicle on hill route, we are of the view that in this case, the driver Sh. Rajendra Singh’s driving licence, having no such endorsement, the insurance company was not obliged to settle the claim in favour of the complainant.
Rajendra Singh’s driving licence, having no such endorsement, the insurance company was not obliged to settle the claim in favour of the complainant. Point is answered accordingly. 13. Point No. (iii) – As stated above, the surveyor has merely recommended settlement of the claim for a particular sum, about which consent had been given by the complainant. That would not indicate that the claim had been settled by the insurance company. In that regard also, the District Forum fell in error in coming to the conclusion that the claim had been settled by the insurance company and, as such by virtue of the decision of the Hon’ble National Commission in the matter of P. Shivaji Sethi (supra), the insurance company was legally obliged to allow the claim, as recommended by the surveyor. Mere recommendation by the surveyor, does not amount to claim settlement, despite consent having been given by the complainant and in the face of the facts of the case, the insurance company was justified in closing the claim file as “NO CLAIM” for want of non-compliance of the formalities and submission of necessary documents pertaining to the route permit etc. Rule 9 of the Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002, pressed into service by the learned counsel for the complainant, would also be of no help to the cause of the complainant, as there was no claim settlement by the insurance company. Point is answered accordingly. 14. In view of the answers to the points, this appeal succeed and is to be allowed accordingly. 15. Appeal is allowed with cost of Rs. 5,000/-. Order impugned dated 02.07.2008 of the District Forum , Dehradun is set aside and consumer complaint No. 22/2006 is dismissed. A copy of this order be sent to the District Forum, Dehradun and Transport Commissioner, Sahastradhara Road, Dehradun.