United India Insurance Company Ltd. v. Raiklal Tulsibhai Patel
2024-03-15
VIMAL K.VYAS
body2024
DigiLaw.ai
JUDGMENT : VIMAL K. VYAS, J. 1. Being aggrieved by the findings fastening the liability on the Insurance Company to pay compensation and also the quantum of compensation of Rs. 1,00,188/- awarded with interest at the rate of 9% per annum from the date of the claim, the United India Insurance Company has filed the present Appeal under Section 173 of the Motor Vehicles Act, 1988 (for short the ‘MV Act’). 2. Short facts giving rise to the present Appeal are as follows: 2.1 That on 2.11.2001 at about 6:00 p.m. the claimant (respondent no. 2 herein) and one Rasiklal (respondent no. 1 herein) were going from Visnagar to Pilodara on a scooter bearing registration No. GJ-2P-9044 and that Rasiklal was driving the scooter and the claimant, who was also the owner of the scooter was a pillion rider. At that time, respondent no. 1 Rasiklal had applied a sudden brake to save a cow came on the road, due to which his scooter skidded and the claimant sustained serious injuries on his left hand. He was treated in the Jay Orthopedic Hospital, Mehsana, as an indoor patient. 2.2 The claimant filed the claim petition before the Motor Accident Claims Tribunal under Section 166 of the Motor Vehicles Act, impleaded himself as one of the respondents and claimed that he suffered injuries by travelling on his own scooter, which was driven by respondent no. 1-Rasiklal. Therefore, he is entitled to get compensation from the Insurance Company. 3. On issuance of the summons, the appellant-Insurance Company appeared and filed its written statement at Exh.14, inter-alia, contended that the claimant, being the owner of the vehicle, is not entitled to get compensation as he is not the third party and, therefore, the Insurance Company cannot be made liable to pay compensation to the claimant. In other words, on the principle that the Insurance Company is vicariously liable to indemnify the liability of the owner of the vehicle only to third party and not to the owner himself, the Company questioned the maintainability of the claim petition filed under Section 166 of the MV Act. 4. Upon evaluation of the pleading and the evidence, the Tribunal held that the claimant has paid additional premium for personal accident, and as such, the risk of both, the owner and the driver is covered.
4. Upon evaluation of the pleading and the evidence, the Tribunal held that the claimant has paid additional premium for personal accident, and as such, the risk of both, the owner and the driver is covered. However, the Tribunal did not consider the contention regarding maintainability of the claim petition filed under Section 166 of the MV Act. 5. The Tribunal, after considering the income of the claimant, awarded compensation of Rs. 1,00,188/- under the following heads: S. No. Head/Details Amount 1. Future Loss of Income Rs. 51,024/- 2. Medical Expenditure Rs. 28,000/- 3. Pain, Shock and Suffering Rs. 5,500/- 4. Attendant Charges Rs. 2,000/- 5. Actual Loss of Income Rs. 9,664/- 6. Transportation Expenses Rs. 2,000/- 7. Diet Rs. 2,000/- TOTAL Rs. 1,00,188/- 6. Learned advocate Mr. Vibhuti Nanavati for the appellant-Insurance Company has taken a specific contention in the written statement that the claimant, being the owner of the vehicle involved in the accident, cannot take advantage of his own driver’s negligence. It is submitted that the Tribunal has committed a grave error in entertaining the claim petition preferred under Section 166 of the M.V. Act, as the claimant himself is the owner of the vehicle involved in the accident. Mr. Nanavati, therefore, submitted that the claimant is not entitled to maintain the claim petition against the Insurance Company. He submitted that the claimant is the owner of the vehicle and not a third party. Therefore, he is not entitled to be indemnified by the Insurance Company in case of injury suffered by him in the accident. 7. Learned advocate Mr. Nanavati, while drawing attention of this Court to the policy of the vehicle involved in the incident, which is a ‘two wheeler package policy’ has submitted that the Tribunal has failed to appreciate that the liability of the Insurance Company is as per the terms, conditions, limitation and exceptions of the policy. 8. Learned advocate for the appellant relied upon the decision of the Supreme Court in the case of Dhanraj vs. New India Assurance Co.
8. Learned advocate for the appellant relied upon the decision of the Supreme Court in the case of Dhanraj vs. New India Assurance Co. Ltd. and Another, 2004 (8) SCC 553 and contended that the insurance policy covers the liability incurred by the insured in respect of death of or bodily injury to any person including an owner of the goods or his authorised representative carried in the vehicle or damage to any property of a third party caused by or arising out of the use of the vehicle. He has also relied upon the provisions of Section 146 of the Act to contend that the said provisions provide the necessity for insurance against a third party risk. Section 147 of the Act was also referred to contend that it provides requirements of policies and limits of liability. Learned advocate for the appellant thereafter referred to Section 165 of the Act, which falls under Chapter 12, whereby the Claims Tribunals are defined as the Claim Tribunals for the purpose of adjudicating upon the claims for compensation in respect of accidents involving the death of, or bodily injury to, persons arising out of the use of motor vehicles, or damages to any property of a third party so arising, or both. An application for compensation is to be made under Section 166 of the Act for compensation arising out of an accident of the nature specified in Sub-Section (1) of Section 165 of the Act. 9. Learned advocate for the appellant further relied upon the decision of the Supreme Court in the case of Oriental Insurance Co. Ltd. vs. Meena Variyal and Others, (2007) 5 SCC 432, wherein the Supreme Court has held as under: “10. Before we proceed to consider the main aspect arising for decision in this Appeal, we would like to make certain general observations. It may be true that the Motor Vehicles Act, insofar as it relates to claims for compensation arising out of accidents, is a beneficent piece of legislation. It may also be true that subject to the rules made in that behalf, the Tribunal may follow a summary procedure in dealing with a claim. That does not mean that a Tribunal approached with a claim for compensation under the Act should ignore all basic principles of law in determining the claim for compensation. Ordinarily, a contract of insurance is a contract of indemnity.
That does not mean that a Tribunal approached with a claim for compensation under the Act should ignore all basic principles of law in determining the claim for compensation. Ordinarily, a contract of insurance is a contract of indemnity. When a car belonging to an owner is insured with the insurance company and it is being driven by a driver employed by the insured, when it meets with an accident, the primary liability under law for payment of compensation is that of the driver. Once the driver is liable, the owner of the vehicle becomes vicariously liable for payment of compensation. It is this vicarious liability of the owner that is indemnified by the insurance company. A third party for whose benefit the insurance is taken, is therefore entitled to show, when he moves under Section 166 of the Motor Vehicles Act, that the driver was negligent in driving the vehicle resulting in the accident; that the owner was vicariously liable and that the insurance company was bound to indemnify the owner and consequently, satisfy the award made. Therefore, under general principles, one would expect the driver to be impleaded before an adjudication is claimed under Section 166 of the Act as to whether a claimant before the Tribunal is entitled to compensation for an accident that has occurred due to alleged negligence of the driver. Why should not a Tribunal insist on the driver of the vehicle being impleaded when a claim is being filed? 11. As we have noticed, the relevant provisions of the Act are not intended to jettison all principles of law relating to a claim for compensation which is still based on a tortious liability. The Tribunal ought to have, in the case on hand, directed the claimant to implead Mahmood Hasan who was allegedly driving the vehicle at the time of the accident. Here, there was also controversy whether it was Mahmood Hasan who was driving the vehicle or it was the deceased himself. Surely, such a question could have been decided only in the presence of Mahmood Hasan who would have been principally liable for any compensation that might be decreed in case he was driving the vehicle. Secondly, the deceased was employed in a limited company.
Surely, such a question could have been decided only in the presence of Mahmood Hasan who would have been principally liable for any compensation that might be decreed in case he was driving the vehicle. Secondly, the deceased was employed in a limited company. It was necessary for the claimants to establish what was the monthly income and what was the dependency on the basis of which the compensation could be adjudged as payable. Should not any Tribunal trained in law ask the claimants to produce evidence in support of the monthly salary or income earned by the deceased from his employer Company? Is there anything in the Motor Vehicles Act which stands in the way of the Tribunal asking for the best evidence, acceptable evidence? We think not. Here again, the position that the Motor Vehicles Act vis-a-vis claim for compensation arising out of an accident is a beneficent piece of legislation, cannot lead a Tribunal trained in law to forget all basic principles of establishing liability and establishing the quantum of compensation payable. The Tribunal, in this case, has chosen to merely go by the oral evidence of the widow when without any difficulty the claimants could have got the employer company to produce the relevant documents to show the income that was being derived by the deceased from his employment. Of course, in this case, the above two aspects become relevant only if we find the insurance company liable. If we find that only the owner of the vehicle, the employer of the deceased was liable, there will be no occasion to further consider these aspects since the owner has acquiesced in the award passed by the Tribunal against it. 12. Chapter XI of the Act bears a heading “Insurance of Motor Vehicles against third party risks.” The definition of “third party” is an inclusive one since Section 145(g) only indicates that “third party” includes the Government. It is Section 146 that makes it obligatory for an insurance to be taken out before a motor vehicle could be used on the road. The heading of that Section itself is “Necessity for insurance against third party risk.” No doubt, the marginal heading may not be conclusive. It is Section 147 that sets out the requirement of policies and limits of liability.
The heading of that Section itself is “Necessity for insurance against third party risk.” No doubt, the marginal heading may not be conclusive. It is Section 147 that sets out the requirement of policies and limits of liability. It is provided therein that in order to comply with the requirements of Chapter XI of the Act, a policy of insurance must be a policy which is issued by an authorised insurer; or which insures the person or classes of persons specified in the policy to the extent specified in Sub-Section (2) against any liability which may be incurred by the owner in respect of the death of or bodily injury or damage to any property of a third party caused by or arising out of the use of the vehicle in a public place. With effect from 14.11.1994, injury to the owner of goods or his authorised representative carried in the vehicle was also added. The policy had to cover death of or bodily injury to any passenger of a public service vehicle caused by or arising out of the use of the vehicle in a public place. Then, as per the proviso, the policy shall not be required to cover liability in respect of the death, arising out of and in the course of his employment, of the employee of a person insured by the policy or in respect of bodily injury sustained by such an employee arising out of and in the course of his employment, other than a liability arising under the Workmen's Compensation Act, 1923 in respect of the death of, or bodily injury to, an employee engaged in driving the vehicle, or who is a conductor, if it is a public service vehicle or an employee being carried in a goods vehicle or to cover any contractual liability. Sub-Section (2) only sets down the limits of the policy. 13.
Sub-Section (2) only sets down the limits of the policy. 13. As we understand Section 147 (1) of the Act, an insurance policy thereunder need not cover the liability in respect of death or injury arising out of and in the course of the employment of an employee of the person insured by the policy, unless it be a liability arising under the Workmen's Compensation Act, 1923 in respect of a driver, also the conductor, in the case of a public service vehicle, and the one carried in the vehicle as owner of the goods or his representative, if it is a goods vehicle. It is provided that the policy also shall not be required to cover any contractual liability. Uninfluenced by authorities, we find no difficulty in understanding this provision as one providing that the policy must insure an owner against any liability to a third party caused by or arising out of the use of the vehicle in a public place, and against death or bodily injury to any passenger of a public service vehicle caused by or arising out of the use of vehicle in a public place. The proviso clarifies that the policy shall not be required to cover an employee of the insured in respect of bodily injury or death arising out of and in the course of his employment. Then, an exception is provided to the last forgoing to the effect that the policy must cover a liability arising under the Workmen's Compensation Act, 1923 in respect of the death or bodily injury to an employee who is engaged in driving the vehicle or who serves as a conductor in a public service vehicle or an employee who travels in the vehicle of the employer carrying goods if it is a goods carriage. Section 149(1), which casts an obligation on an insurer to satisfy an award, also speaks only of award in respect of such liability as is required to be covered by a policy under clause (b) of Sub-Section (1) of Section 147 (being a liability covered by the terms of the policy). This provision cannot therefore be used to enlarge the liability if it does not exist in terms of Section 147 of the Act. 14.
This provision cannot therefore be used to enlarge the liability if it does not exist in terms of Section 147 of the Act. 14. The object of the insistence on insurance under Chapter XI of the Act thus seems to be to compulsorily cover the liability relating to their person or properties of third parties and in respect of employees of the insured employer, the liability that may arise under the Workmen's Compensation Act, 1923 in respect of the driver, the conductor and the one carried in a goods vehicle carrying goods. On this plain understanding of Section 147, we find it difficulty to hold that the insurance company, in the case on hand, was liable to indemnify the owner, the employer Company, the insured, in respect of the death of one of its employees, who according to the claim, was not the driver. Be it noted that the liability is not one arising under the Workmen's Compensation Act, 1923 and it is doubtful, on the case put forward by the claimant, whether the deceased could be understood as a workman coming within the Workmen's Compensation Act, 1923. Therefore, on a plain reading of Section 147 of the Act, it appears to be clear that the insurance company is not liable to indemnify the insured in the case on hand.” 10. Referring to the above observations of the Supreme Court, learned advocate for the appellant submitted that this Court has also, in the case of Iffco Tokio General Insurance Company Ltd. vs. Deepakbhai Bhikhabhai Patel, 2017 (2) GLR 1100 , has held that when the claimant is insured, Chapter 11 of the Act is not applicable and, therefore, the petition for claim made by the original claimant is not maintainable under the Act. This Court further held that the liability arises between the parties by virtue of the contract and in case of breach of contract, the party to the contract can avail legal remedy either before the competent Civil Court or before the Consumer Forum, but for breach of such contract, he cannot maintain the claim petition before the Tribunal constituted under the Act of 1988. 11. Learned advocate for the appellant further relied upon the decision of this Court in the case of United India Insurance Company Limited vs. Legal Heirs of Decd. Barot Bharatbhai Arvindbhai, 2017 (0) ACJ 1800 .
11. Learned advocate for the appellant further relied upon the decision of this Court in the case of United India Insurance Company Limited vs. Legal Heirs of Decd. Barot Bharatbhai Arvindbhai, 2017 (0) ACJ 1800 . Relying upon the said decision, it was submitted that the Insurance Company cannot be made liable as per the terms of the contract between the parties and under the provisions of the Act. 12. While drawing the attention of this Court to the terms of the insurance policy with regard to the personal accident cover for owner/driver, learned advocate Mr. Nanavati has submitted that the Insurance Company is liable to pay compensation for the nature of the injuries stated in the personal accident clause of the policy only. 13. The respondent no. 1, who is the driver of the vehicle, though served, no one has appeared on his behalf, whereas, learned advocate Mr. Saurabh Patel appearing on behalf of the respondent no. 3 is not present. 14. Considering the evidence on record and also considering the submissions made by the learned advocate for the appellant, it is not in dispute that the claimant is the owner of the Scooter bearing registration No. GJ-2P-9044, which is involved in the accident. It is also not in dispute that no other vehicle is involved in the accident. 15. As per the settled legal position, the issue with regard to, whether the claimant, who himself is the owner of the vehicle, is entitled to compensation under the provisions of the Act, is no more res integra in view of the following decisions of the Apex Court as well as this Court: (i) Dhanraj vs. New India Assurance Co. Ltd. and Another, 2004 (8) SCC 553 (ii) Oriental Insurance Co. Ltd. vs. Meena Variyal and Others, (2007) 5 SCC 432 (iii) Iffco Tokio General Insurance Company Ltd. vs. Deepakbhai Bhikhabhai Patel, 2017 (2) GLR 1100 (iv) United India Insurance Company Limited vs. Legal Heirs of Decd. Barot Bharatbhai Arvindbhai, 2017 (0) ACJ 1800 16. Now, the only issue which remains to be considered is as to whether the Insurance Company is liable to pay compensation to the claimant as per the terms of the policy for the personal accident cover for owner or driver.
Barot Bharatbhai Arvindbhai, 2017 (0) ACJ 1800 16. Now, the only issue which remains to be considered is as to whether the Insurance Company is liable to pay compensation to the claimant as per the terms of the policy for the personal accident cover for owner or driver. The said terms and conditions contained in Section-III of the policy is produced at Annexure-A Page-6 of the Civil Application No. 1 of 2019 in First Appeal No. 4380 of 2008, which is ordered to be taken on record of the present Appeal. The same are reproduced herein-below: “Section III - PERSONAL ACCIDENT COVER FOR OWNER-DRIVER Subject otherwise to the terms exceptions conditions and limitations of this policy the Company undertakes to pay compensation as per the following scale for bodily injury/ death sustained by the owner-driver of the vehicle, in direct connection with the vehicle insured or whilst mounting/dismounting from or travelling in the insured vehicle as a co-driver, caused by violent accidental external and visible means which independent of any other cause shall within six calendar months of such injury result in: Nature of Injury Scale of Compensation (i) Death 100% (ii) Loss of two limbs or sight of two eyes or one limb and sight of one eye 100% (iii) Loss of one limb or sight of one eye 50% (iv) Permanent total disablement from injuries other than named above 100% Provided always that: (A) Compensation shall be payable under only one of the terms (i) to (iv) above in respect of the owner-driver arising out of any one occurrence and the total liability of the insurer shall not in the aggregate exceed the sum of Rs. 1 Lakh during any one period of insurance. (B) No compensation shall be payable in respect of death or bodily injury directly or indirectly wholly or in part arising or resulting from or traceable to (a) intentional self injury suicide or attempted suicide physical defect of infirmity or (b) an accident happening whilst such person is under the influence of intoxicating liquor or drugs. (C) Such compensation shall be payable directly to the insured or to his/her legal representatives whose receipt shall be the full discharge in respect of the injury to the insured. (1) This cover is subject to: (a) the owner-driver is the registered owner of the vehicle insured herein. (b) the owner-driver is the insure named in this policy.
(C) Such compensation shall be payable directly to the insured or to his/her legal representatives whose receipt shall be the full discharge in respect of the injury to the insured. (1) This cover is subject to: (a) the owner-driver is the registered owner of the vehicle insured herein. (b) the owner-driver is the insure named in this policy. (c) the owner-driver holds an effective driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicles Rules, 1989, at the time of accident.” 17. On perusal of the aforesaid terms and conditions contained in the policy, it is clear that the Insurance Company is liable to pay compensation only if the owner or driver suffers injury stated in Item Nos. (i) to (iv) in the aforesaid clause only. If any of the above injuries is suffered by the owner or driver, then in that case, the total liability of the Insurance Company shall not be exceeded the sum of Rs. 1 Lakh during any one period of insurance. 18. In the facts of the case on hand, the claimant has suffered injury of fracture on his hand due to the accident which took place on 2.11.2001, involving the Scooter bearing registration No. GJ-2P-9044, which was owned by the claimant himself. On perusal of the certificates at Exhibits-30 and 31, none of the injuries was as per the aforesaid four injuries stated in the clause for personal accident of owner and driver. Therefore, the clause contained in Section-III of the Insurance Policy is required to be considered stricto sensu, i.e. strictly as per the decision of the Supreme Court in the case of General Assurance Society Ltd. vs. Chandmull Jain and Another, 1966 SC 1644, wherein the Supreme Court has held as under: “11. A contract of insurance is a species of commercial transactions had there is a well-established commercial - practice to send cover notes even prior to the completion of a proper proposal or while the proposal is being considered or a policy is in preparation for delivery. A cover note is a temporary and limited agreement. It may be self-contained or it may incorporate by reference the terms and conditions of the future policy. When the cover note incorporates the policy in this manner, it does not have to recite the term and conditions, but merely to refer to a particular standard policy.
A cover note is a temporary and limited agreement. It may be self-contained or it may incorporate by reference the terms and conditions of the future policy. When the cover note incorporates the policy in this manner, it does not have to recite the term and conditions, but merely to refer to a particular standard policy. If the proposal is for a standard policy and the cover note refers to it, the assured is taken to have accepted the terms of that policy. The reference to the policy and its terms and conditions may be expressed in the proposal or the cover note or even in the letter of acceptance including the cover note. The incorporation of the terms and conditions of the policy may also arise from a combination of references, in two or more documents passing between the parties. Documents like the proposal, cover note and the policy are commercial documents and to interpret them commercial habits and practice cannot altogether be ignored. During the time the cover note operates, the relations of the parties are governed by its terms and conditions, if any. but more usually by the terms and conditions of the policy bargained for and to be issued. When this happens the terms of the policy are incipient but after the period of temporary cover, the relations are governed only by the terms and conditions of the policy unless insurance is declined in the meantime. Delay in issuing the policy makes no difference. The relations even then are governed by the future policy if the cover notes give sufficient indication that it would be so. In other respects there is no difference between a contract of insurance and any other contract except that in a contract of insurance there is a requirement of uberrima fides i.e. good faith on the part of the assured and the contract is likely to be construed contra proferentem that is against the company in case of ambiguity or doubt. A contract is formed when there is an unqualified acceptance of the proposal. Acceptance may be expressed in writing or it may even be implied if the insurer accepts the premium and retains it. In the case of the assured, a positive act on his part by which he recognises or seeks to enforce the policy amounts to an affirmation of it.
Acceptance may be expressed in writing or it may even be implied if the insurer accepts the premium and retains it. In the case of the assured, a positive act on his part by which he recognises or seeks to enforce the policy amounts to an affirmation of it. This position was clearly recognised by the assured himself, because he wrote, 510 close upon the expiry of the time of the cover notes, that either a policy should be issued to him before that period had expired or the cover note extended in time. In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties because it is not for the court to make a new contract, however reasonable, if the parties have not made it themselves. Looking at the proposal, the letter of acceptance and the cover notes, it is clear that a contract, of insurance under the standard policy for fire and extended to, cover flood, cyclone etc. had come into being.” 19. In view of the aforesaid legal position and interpreting the contract of insurance between the parties in stricto sensu, the Insurance Company is liable to pay compensation only to the extent as stated in the policy. Therefore, the Insurance Company cannot be made liable to pay compensation to the claimant as determined by the Tribunal under the provisions of the Act. The Tribunal has committed grave error in entertaining the claim petition at the first place and thereafter determining the compensation. 20. This Court, while admitting the Appeal on 5th September 2008, has, by way of an interim order passed in Civil Application (for stay) No. 10443 of 2008, directed the Insurance Company to deposit the entire amount together with cost and interest before the Claims Tribunal and further directed the Tribunal to invest the said amount in any Nationalized Bank for a period of three years with periodical renewal in the name of Nazir Department of the concerned Claims Tribunal and the claimant was entitled to only the interest upon the said FDR till the Appeal is finally decided by this Court. 21. For the forgoing reasons, the Appeal succeeds and is hereby allowed. The impugned judgment and award passed by the Tribunal is hereby quashed and set aside.
21. For the forgoing reasons, the Appeal succeeds and is hereby allowed. The impugned judgment and award passed by the Tribunal is hereby quashed and set aside. The Tribunal is directed to refund the entire amount lying in the Fixed Deposit to the appellant- Insurance Company. Records and proceedings be sent back to the Tribunal. 22. In view of the disposal of the main Appeal, the Civil Application would not survive and the same is disposed of accordingly.