State Consumer Disputes Redressal Commission
United India Insurance Co. Ltd. vs Ravinder Pal Singh on 13 January, 2023
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH
First Appeal No.214 of 2022
Date of Institution : 22.03.2022
Date of Reserve : 06.01.2023
Date of Decision : 13.01.2023
United India Insurance Co. Ltd., through its DM/Authorised Officer,
D.O. -2, 45, 3rd Floor, Dharam Singh Market, Amritsar through its
regional office i.e. U.I.I.C., 136, Feroze Gandhi Market, Ludhiana
through Assistant Manager Shama Arora Mittal.
....Appellant/Opposite party
Versus
Ravinder Pal Singh S/o Late Daljit Singh R/o H.No.6/2432, Street
No.2, Krishan Nagar, Near Dera Sant Surjit Singh, Tarn Taran
Road, Amritsar.
.......Respondent/Complainant
First Appeal under Section 41 of the
Consumer Protection Act, 2019 against the
order dated 24.01.2022 of the District
Consumer Disputes Redressal Commission,
Amritsar.
Quorum:-
Mr.Harinderpal Singh Mahal, Presiding Judicial Member
Mrs. Urvashi Agnihotri, Member Present:-
For the appellant : Sh.Lalit Garg, Advocate
For the respondent : None
First Appeal No 214 of 2022 2
HARINDERPAL SINGH MAHAL, PRESIDING JUDICIAL MEMBER This appeal has been preferred by the appellant/opposite party- United India Insurance Co. Ltd against the order dated 24.01.2022 passed by the District Consumer Disputes Redressal Commission, Amritsar, whereby the complaint filed by the respondent /complainant was allowed against the opposite party with the direction to the opposite party to pay PA claim amount of Rs.15 lacs to the legal heirs of the deceased life assured in equal share by taking their affidavits, Aadhar Cards etc. along with interest @9% p.a. from the date of filing of the complaint till realization. Opposite party was further directed to pay litigation expenses to the tune of Rs.3,000/-.
It would be apposite to mention that hereinafter the parties will be referred, as have been arrayed before the District Commission.
2. In nutshell, briefly stated facts of the case are that Sh.Daljit Singh, who was father of the complainant, purchased a Honda Scooter having Registration No. PB 02 CN 2506 and he got insured his vehicle from opposite party, vide policy No.2003003118P15406972 for the period 27.02.2019 to 26.02.2020. At the relevant time of the purchase he was having valid Driving License No.PB-0220080134407. As per the terms and conditions of the policy, insured was entitled for personal accident cover to the tune of Rs.15,00,000/-, as per the Government Policy and the premium was also charged by the opposite party from Daljit Singh against the said policy. Sh.Daljit First Appeal No 214 of 2022 3 Singh, father of the complainant and original owner of the vehicle, met with an accident and died on 21.04.2019. Copy of Death Certificate is Ex.C-3, copy of GD is Ex.C-4 and copy of post mortem is Ex.C-5. The complainant being the son and the legal heir of Daljit Singh lodged the claim of the personal accident of his father with the opposite party by submitting all the relevant documents, vide Claim No.2003003119C050022001 but the opposite party repudiated the claim of the complainant, vide letter dated 25.09.2019, Ex.C-6 on the ground that Daljit Singh was not holding valid driving license at the time of accident. No report was called from DTO concerned regarding the validity of the said driving license. The father of the complainant also got his driving license renewed but the complainant was not having in possession of any such document and he supplied the only driving license of his father, found from the record. It is further alleged that the driving license, if expired, can be got renewed at any time by paying the late fees and its validity cannot be challenged. The driving license was valid and legal and it was not fake. The opposite party has intentionally repudiated the claim of the claimant on frivolous grounds, which amounts to deficiency in service. Feeling aggrieved, the complainant filed the complaint before the District Commission and sought the following reliefs:
i) to pay Rs.15 lacs as insurance amount to the complainant along with interest at the rate of 12% per annum;
First Appeal No 214 of 2022 4
ii) to pay Rs.50,000/- as compensation for causing mental tension, harassment and agony; and
iii) to pay Rs.10,000/- as litigation expenses.
3. Upon notice, opposite party appeared and filed its reply taking preliminary objections that the deceased violated the basic terms and conditions of the policy, in question, so this complaint is not maintainable. The GR-36 of the Motor Tariff deals with Personal Accident Cover and registered owner is entitled to the compulsory cover where she or he holds an effective driving license. The deceased Daljit Singh was not holding a valid and effective driving license at the time of accident, which amounts to violation of the terms and conditions of the policy and barring the maintainability of the present complaint. The complainant has not approached this Forum with clean hands and has concealed the material facts from the Forum. The complainant is estopped by his own act and conduct by filing the present complaint as the deceased was not having any valid driving license at relevant time. Repudiation of the claim by the opposite party on 25.09.2019 is valid and parties are strictly governed by the terms and conditions of the policy, in question, where it has been mentioned that the Insurance Company will not be liable to pay any claim in case of violation of basic conditions of the policy. The complainant has adopted frivolous means to file the claim which the Insurance Company is not liable to pay. The complaint is bad for mis-joinder of the parties as the complainant has not impleaded all the legal First Appeal No 214 of 2022 5 heirs of the deceased as a party to the present case. On merits, similar averments have been mentioned in para wise reply with the prayer to dismiss the complaint.
4. The parties led their evidences in support of their respective contentions before the District Commission and after hearing learned counsel for the parties, the complaint was allowed, vide impugned order dated 24.01.2022.
5. Aggrieved by the said order, this appeal has been filed by the appellant/opposite party for setting aside the impugned order dated 24.01.2022 and to allow the appeal.
6. We have heard the contentions of the appellant/opposite party as none has appeared on behalf of the respondent/complainant at the time of final arguments. We have also carefully gone through the record as well as written arguments filed by the appellant and we have given our thoughtful consideration to the same.
7. Uncontroverted facts of the case are that the father of the respondent/complainant Daljit Singh purchased a Honda Scooter having RC No.PB 02 CN 2506 and got insured his vehicle from the appellant/opposite party, vide policy No.2003003118P15406972 for the period 27.02.2019 to 26.02.2020. It was also not disputed that at the time of purchase the deceased was having a valid driving license bearing No.PB-0220080134407. The insured was having personal accidental cover of Rs.15,00,000/- as per the Government Policy, to which the deceased paid the premium. It is not disputed that the insured met with an accident and died on 21.04.2019. First Appeal No 214 of 2022 6
8. Learned counsel for the appellant/opposite party contended that the District Commission has erred while granting the compensation to the respondent/complainant beyond the terms and conditions of the Insurance Policy because it is very well provided in the Insurance Policy that the person who was insured must be having a valid driving license at the time of accident. He also referred to the provisions of Motor Vehicles Act and alleged that as per these provisions of the Motor Vehicles Act, a person who has a valid driving license can only purchase the vehicle and drive the same. He further pleaded that as per the Personal Accident Cover the owner-driver must be having a proper driving license at the time of accident and this cover cannot be granted where the vehicle is owned by company or partnership firm. This shows that as per the terms and conditions of the policy as well as Indian Motor Tariff Regulation Act GR-36 makes it clear that if the registered owner is driving the vehicle he or she should hold an effective driving license and only then the Insurance Company would be liable to pay the amount under the cover. The District Commission has wrongfully placed his reliance on the fact that since there was no verification of the driving license by the insurance company so they are bound to pay the compensation of personal accident cover, which is not correct in the proposition of law.
9. Per contra, learned counsel for the respondent/complainant pleaded that the contentions raised by the learned counsel for the appellant/opposite party are totally irrelevant because the vehicle First Appeal No 214 of 2022 7 was purchased by Daljit Singh, father of the complainant, who was having a legal and valid driving license from 23.01.2008 to 25.09.2018. However, unfortunately on 21.04.2019, when the accident took place, his father could not get the same renewed due to personal constraints and that does not render the driving license illegal and this is merely an irregularity which cannot cause any dent to the claim of the respondent/complainant as his father was holding a legal and effective driving license prior to that.
10. The ownership of the Honda Scooter bearing registration No.PB 02 CN 2506, Ex.C-1, rest with the deceased Daljit Singh, who was father of the respondent/complainant and it is not denied by the appellant/opposite party that he was holding a policy bearing No.2003003118P15406972 for the period 27.02.2019 to 26.02.2020 and he was insured under the personal accident to the tune of Rs.15 lacs. During the policy period, Daljit Singh met with an accident and died on 21.04.2019, which has been proved from the General Diary dated 22.04.2019, Ex.C-4, post-mortem report dated 22.04.2019, Ex.C-5 on record. After death of his father, the respondent/complainant, who is the son of Daljit Singh filed the claim for personal accident cover. The perusal of the driving license dated 23.01.2008, Ex.C-2 shows that it is properly issued by the concerned Licensing Authority, which was valid upto 25.09.2018, whereas the accident took place on 21.04.2019. The claim was filed by the respondent/complainant against personal accident claim policy, whereas the claim of the claimant was repudiated on 25.09.2019, vide Ex.C-6 on the following grounds: First Appeal No 214 of 2022 8
"....The owner was not holding the valid driving license at the time of accident. The claim is payable to the owner driver, who is the registered owner of the vehicle and holding the valid driving license as on date of accident. Since there is a violation of policy terms and conditions. The claim stands repudiated."
11. The perusal of the repudiation letter shows that the only ground on which the claim of the respondent/complainant was disallowed is that Daljit Singh, deceased, was not holding a valid driving license at the time of accident.
12. Learned counsel for the appellant/opposite party pointed out that license was not renewed at the time of accident, however, the careful perusal of the policy bearing No.2003003118P115406972 as Ex.OP-1/5 shows that the policy was issued on 27.02.2019 to 26.02.2020 and even at that time, the driving license of Daljit Singh was in the same position as before the time of death as the driving license expired on 25.09.2018 and the policy was issued on 27.02.2019. This shows that the appellant/opposite party was not having any objection at the time of issuance of the policy regarding the expiry of the driving license and instead of all these facts they issued the policy. Although, it was their prime duty to ascertain the validity of the license as they are claiming at this stage.
13. Once the appellant/opposite party has admitted the validity of the license at the time of issuance of the policy then at this stage when the accident occurred they cannot wriggle out for payment of compensation on the ground that Daljit Singh, deceased, who expired on 21.04.2019 was not having valid and effective driving First Appeal No 214 of 2022 9 license. This is a general practice on behalf of the Insurance Companies that they shown green pesters at the time of issuance of the policy but at the time to repay the claim they sort different excuses one after another as has been done in the present case by the appellant/opposite party by taking the ground that the deceased was not having a valid and effective driving license, which was not necessitated. It has been held by the Hon'ble Punjab and Haryana High Court in a case titled 'New India Assurance Company Ltd. Vs. Smt. Usha Yadav & Ors.' 2008(3) RCR (Civil) Page 111 that the Insurance Companies are only interested in earning the premiums and find ways and means to decline claims.
14. We also rely upon the judgment passed by the Hon'ble National Commission in "National Insurance Co. Ltd. Vs. S. VenkataLakashmamma" in Appeal No.1784 of 2005 decided on 16.10.2012, wherein it has been held as under:
"We further note that in the instant case, petitioner/Insurance Company also erred in not verifying before issuing the policy whether a person seeking cover under the personal accident insurance policy had a valid driving license which was a necessary pre-condition for insurance under this cover."
15. The District Commission while deciding the complaint has rightly held that once without verifying the fact regarding expiry of driving license of the deceased, the premium was charged for the PA cover, the opposite party cannot avoid its liability. First Appeal No 214 of 2022 10
16. Sequel to the above discussions and as per the law laid down, we do not find any merit in the appeal and the same is hereby dismissed. The order of the District Commission is upheld.
16. The appellant/opposite party had deposited a sum of Rs.9,12,021/- at the time of filing of the appeal. This sum, along with interest accrued thereon, if any, shall be remitted by the Registry to the District Commission after the expiry of 45 days of the sending of certified copies of the order to them. The concerned party may approach the District Commission for the release of the above amount to the extent of his/its entitlement and the District Commission may pass the appropriate order in this regard, in accordance with law.
17. The appeal could not be decided within the statutory period due to heavy pendency of court cases.
(HARINDERPAL SINGH MAHAL) PRESIDING JUDICIAL MEMBER (URVASHI AGNIHOTRI) MEMBER January 13th ,2023 parmod