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2014 DIGILAW 155 (JK)

Reliance Gen. Insurance Co. Ltd. v. Mohd. Sharief Naik

2014-04-03

M.M.KUMAR, MUZAFFAR HUSSAIN ATTAR

body2014
Muzaffar Hussain Attar, J. 1. An unfortunate accident of a mini-bus near Charsoo on 13.10.2008 resulted in terrestrial exit of seven on board persons and injuries to twenty one others passengers. The vehicle was insured with the appellant insurance company. The contract of insurance commenced from 02.11.2007 and was to last up to 1st of November, 2008. At the time of accident, the vehicle was covered by the insurance policy issued by the appellant company. The appellant insurance company, after receipt of the intimation of the accident, deputed an independent IRDA approved surveyor for making evaluation of the loss suffered by the owner of the vehicle/insured. Surveyor assessed the net loss to the tune of Rs. 6,30,000/-, in full and final settlement with the condition that the insured/owner of the vehicle would retain the damaged vehicle. 2. The insured/owner’s claim for indemnification of the loss suffered by him, however, was repudiated by the appellant insurance company on the premise that permitted capacity of the vehicle was 22+1 and the premium was paid for covering the risk of 22 passengers. 3. The insured/owner of the vehicle approached the J&K State Consumer Disputes Redressal Commission, Jammu (for short the Commission) on 27.01.2010 and the Commission vide its order dated 14.01.2013 directed the appellant insurance company to pay an amount of Rs. 6,30,000/- plus consolidated compensation of Rs. one lac and litigation charges of Rs. 5,000/- to the insured/owner of the vehicle. 4. It is this order which is called in question in this statutory appeal filed under the J&K State Consumer Protection Act, 1987. 5. Learned counsel for the appellant-insurance company submitted that appellant-insurance company is not liable to indemnify the respondent/owner of the vehicle for the loss suffered by him on account of damage caused to the vehicle in the accident on the ground that there was breach of route permit and the terms and conditions of the insurance policy. Learned counsel submitted that vehicle was permitted to carry 22 passengers, whereas at the time of accident, it was carrying seven more passengers on board which was the cause of the accident. Learned counsel, however, while referring to a document about the settlement of non-standard claims, submitted that respondent/owner of the vehicle would be entitled to receive 75% of the admissible claim. Learned counsel, however, while referring to a document about the settlement of non-standard claims, submitted that respondent/owner of the vehicle would be entitled to receive 75% of the admissible claim. Learned counsel has produced copy of communication dated 29.07.1988 which shows as to how and in which manner the non standard claims are to be settled. Copy of the document is taken on record. Learned counsel, in support of his contention, referred to decision of Hon’ble the Supreme Court rendered in Amalendu Sahoo v. Oriental Insurance Co. Ltd., 2010 AJJ 1250 and submitted that the Hon’ble Supreme Court has relied upon the procedure prescribed for settlement of non-standard claims in the aforesaid judgment. Learned counsel, in view of the law laid down by the Hon’ble Supreme Court, prayed that the award be modified. 6. Learned counsel for the respondent/owner of the vehicle submitted that cause of the accident as reflected in the FIR is negligent driving of the vehicle by the driver, who also died in the accident. Learned counsel submitted that at no point of time, it was pleaded that cause of accident of the vehicle was overloading. Learned counsel submitted that award impugned, in these circumstances, cannot be interfered with. 7. It is not in dispute that vehicle at the time it met with the fatal accident was having more passengers on board than its permitted capacity. The insurance company and the respondent-owner of the vehicle are governed by the terms and conditions of the insurance policy which constitutes a contract between the parties. Breach of the terms and conditions of the policy may, at times and in the circumstances enumerated by the Hon’ble Supreme Court in plethora of Judgments, not entitle the claimant to seek compensation. The owner may not be indemnified for the loss suffered, in case of breach of terms and conditions of the insurance policy or the statutory provisions, which at times in view of the averments of the contract are deemed to be part of such contract. 8. The insurance company, however, has prescribed a procedure for settlement of non standard claims which mode of settlement of claims has been approved by the Hon’ble Supreme Court in the Amalendu Sahoos case (Supra). 8. The insurance company, however, has prescribed a procedure for settlement of non standard claims which mode of settlement of claims has been approved by the Hon’ble Supreme Court in the Amalendu Sahoos case (Supra). Item-10-non standard claims for the purpose of this case is taken note of: Following types of claims shall be considered as non standard and shall be settled as indicated below after recording the reasons: S. No. Description Percentage of Settlement i. Under declaration of licenced carrying capacity Deduct three years difference in premium from the amount of claim, if the difference between the licenced carrying capacity or that declared for Insurance is one ton or less. Where the difference is more than one ton, deduct three years difference in premium or 25% of the claim amount, whichever is higher from the amount of claim, subject to maximum of Rs. 20,000/-. ii. Overloading of vehicles beyond licenced carrying capacity: i. Where excess load is beyond licenced carrying Pay in full. capacity but within weight for which premium is charged due to rounding up. ii. Where the excess load is beyond licenced carrying Deduct three year difference in capacity but not premium from the amount exceeding 10% thereof. of claim. iii) Where excess load is beyond Pay claims not exceeding licenced carrying capacity 75% of admissible claim and exceeding 10% thereof. 9. Admittedly, the vehicle at the time it met with an accident was carrying passengers beyond the prescribed limit and there was breach of terms and conditions of the permit/route permit which would consequently result in violation of terms and conditions of the insurance contract. However, in view of Item 10-non standard claims which binds the insurance company, the respondent- owner of the vehicle would be entitled to receive 75% of the admissible claim. The undisputed and admitted claim as stated in the memo of the appeal is 6,30,000/-. Respondent-owner of the vehicle would, thus, be entitled to received 75% of the admissible claim i.e. 6,30,000/- and would also be entitled to receive Rs. 75,000/- as compensation. 10. For our afore-recorded reasons, we, accordingly, allow the appeal and modify the award passed by the J&K State Consumer Disputes Redressal Commission, Jammu in the following manner: Respondent-owner of the vehicle would be entitled to receive 75% of the admitted claim of Rs. 6,30,000/- and would also be paid additional amount of Rs. 75,000/- instead of Rs. 10. For our afore-recorded reasons, we, accordingly, allow the appeal and modify the award passed by the J&K State Consumer Disputes Redressal Commission, Jammu in the following manner: Respondent-owner of the vehicle would be entitled to receive 75% of the admitted claim of Rs. 6,30,000/- and would also be paid additional amount of Rs. 75,000/- instead of Rs. 1.00 lac as compensation. Award passed by the commission, accordingly, stands modified. Deposited amount, if not already, released shall be released in favour of the respondent-owner of the vehicle on his proper identification by the learned counsel.