State Consumer Disputes Redressal Commission
Liberty General Insurance Ltd.Through ... vs Smt.Ujwala S.Bhosale on 20 September, 2024
1 (A/18/1056)
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
MAHARASHTRA, MUMBAI
FIRST APPEAL NO. A/18/1056
Liberty General Insurance Limited
10th floor, Tower A,
Peninsula Business Park,
Ganatrao Kadam Marg,
Lower Parel (W),
Mumbai 400 013. Appellant
versus
Smt. Ujwala Sambhaji Bhosale
R/o Pokharpur,
Taluka Mohol,
Dist. Solapur Respondent
BEFORE :
Hon'ble Mr. Justice S.P.Tavade, President
Hon'ble Vijay C. Premchandani, Member
PRESENT:
For the Advocate Harshada Rane
Appellants :
For the
Respondents: None present
:- ORDER :-
(Dated: 20th September, 2024)
Per: Hon'ble Mr. Vijay C. Premchandani, Member
1. Being aggrieved by the judgement and order, the appellant liberty General Insurance Limited has filed this appeal the order of District Consumer Dispute Redressal Forum, Central Mumbai in Consumer Complaint No.CC/17/33 dated 09/10/2018.
2 (A/18/1056)
2. The appellant Liberty Videocon General Insurance Co. Ltd is the Opponent, the Respondent is Complainant in Original Consumer Complaint. The appellant and the respondent are hereinafter referred to as per their status in the Original Consumer Complaint. The District Consumer Dispute Redressal Forum is herein after referred to as District Forum for the sake of convenience.
3. It is submitted by the appellant that the deceased Nagesh Babruvan shete died in Road Traffic Accident while he was driving Two Wheeler involved in the said accident. It is also admitted fact that deceased was NOT HOLDING valid and effective driving licence authorizing him to drive such Vehicle. That the original complainant has failed to provide the copy of the driving license of deceased to this Opponent in spite of several reminder, hence claim was rejected for want of vaild driving license. The Complainant filed Consumer Complaint before District Forum Mumbai. The Hon'ble District Forum without appreciating the documentary evidence available on record, without giving any heed to the true intent of contracting parties, without detailed discussing qua the defenses raised and or authorities cited by this appellant, by its judgment directed this appellant to pay Rs. 1 lakh with interest @ 12% from 21/02/2015 Rs. 3000/- towards costs of complaint to the respondent.
4. Being aggrieved and /or dissatisfied by the Judgement and order dated 21/07/2017 in Consumer Complainant No.171 of 2016 passed by District consumer Forum.
5. The appellant prefers this appeal on the following grounds:
a. As per the proposal of Government of Maharashtra, present appellant had issued Janta personal Accident Policy in the name of M/s. The Commissioner ( Agriculture), Commissionerate of Agriculture, Govt of Maharashtra Pune Division thereby cover in 3 (A/18/1056) the risk of tis registered farmers against the accidental deaths for the period from 01/11/2014 to 31/10/2015 subject to the terms and conditions in the Policy.
b. The Important and specific exclusion for subject dispute:
Valid Driving Licence- Considering the motor vehicle facilities in the area in which the farmers are staying, claims arising due to some accidents as stated in (1) to (3) below will be considered as payable in case the documents stated above are submitted
1....
2. Accident occurring where the driver not have a valid driving license-
All farmers except the one who is driving should be eligible for the claim.
c. The element of negligence is not of any value in contractual liability matters rather they are relevant in claims based on tortious liability i.e Motor Accident Compensation Cases. The Claims under contractual liability are solely governed by the terms and conditions of such contract. Thus, finding of learned forum basis negligence are not sustainable and deserves to be set aside.
d. An act of repudiation of claim of respondent being purely in accordance with the stipulated terms and conditions exclusion of the Policy, no element of "deficiency in services" as envisaged in the Consumer Protection Act. The Judgement and award of the lower Court is wrong and erroneous.
Therefore the appellant prayed to set aside the Original Order passed in the Consumer Complaint and Original Complaint may be dismissed.
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6. The Present appeal was admitted and notice was issued to the other party i.e. Original Complainant. The Advocate for Complainant appeared.
Hared Advocate for Appellant, Advocate for Respondent remain absent. The Advocate for Appellant argued that District forum failed to consider that the deceased does not hold valid license at the time of accident. The Appellant company rightly repudiated the complainants claims in view of the terms and conditions of the policy. The order of District forum deserves to be set a side and Consumer Complaint may be dismissed.
7. After hearing and submissions, the issue comes for our determination that, whether there is necessity of submission of valid and effective driving licence of the deceased while filing of the insurance claim under Farmers Accident Insurance claim.
8. The Advocate for Appellant referred citations in support of his contention:
a. Liberty General Insurance Ltd. Vs Pranali Popat.
(NATIONAL CONSUMER COMMISSION) Decided on 10/04/2019.
b. Chaitrali C Rajwade Vs Future General India Insurance Co. Ltd. State Consumer Commission Mumbai Decided on 16/04/2019. c. Liberty General Insurance Ltd. Vs.Renuka Santosh Waghmare.(State Commission Mumbai ) d. Bajaj Allianz general Insurance Company Ltd Vs. Smt. R. Suguna ( NC) e. Oriental Insurance Co. Ltd. Vs. Zaharulnisha (SC) f. National Insurance Co. Ltd. Vs Laxmi Narain Dhut (SC) g. Ravneet Singh Bagga vs KLM Royal Dutech Airlines (SC) h. R. Muthukkrishnan Vs. Manager, ( NC).
5 (A/18/1056)
9. We would like to discuss the provisions in the GR dated 04/12/2009. It stated the guidelines and instructions to various agencies involved in implementation of the scheme in details. The condition of necessity of valid driving license is also discussed in the said GR. Amongst the clause/instruction No.21 in the said GR states the necessity of having valid and effective driving license of the person who is dead, if he was driving the vehicle. However, the Clause No.6 of the Part E in the GR states that in case of accidents, all the farmers should be held eligible except the driver who is at fault. Therefore, it can be safely interpreted that, in case of accident occurred not because of fault of the driver, such driver cannot be deprived from the benefit of the scheme. Also, there is one annexure/praptra D, which prescribes for the submission of documents to be submitted for insurance claim which include FIR, spot panchanama, PM report. It does not include valid and effective driving license of the deceased driver.
10. There is also an exclusion clause, provided in part C in the GR dated 04/12/2009, which is also not stating the provision for rejection/dismissal of the Insurance claim on the ground of non- submission of valid and effective licence of the driver in the road/Railway accident cases.
11. Also, from the GR dated 04/12/2009, it is sufficiently clear that the scheme is for protecting the farmer/farmers and their families in case of accidents. Thus, the scheme is basically benevolent in nature.
12. To support our discussion in aforesaid para, we would to rely upon the judgements in the above context.
(i) The Hon. High Court, Bombay Bench at Aurangbad in Bhagyashri Dhage -Vs- State of Maharashtra & Ors.
6 (A/18/1056) W.P.No.9650/2014 wherein it is held that, prima facie, clause 21 contained in the Government Resolution cannot be considered to be mandatory and the benefits of the scheme framed for social advancement cannot be denied to the heirs of the deceased.
(ii) In Shakuntala W/o Dhonddiram Mundhe -Vs- State of Maharashtra [2010(2)Mh.L.J] wherein it is held that "Personal accident insurance policy for benefit of farmers-said scheme is social welfare scheme and is beneficial to the family members of farmers who expire in accidental death-Farmer having died in accident, Insurance company declined to grant the claim for compensation on ground that deceased was not registered farmer-Insurance company adopted obstructive attitude and deprived the petitioner from the claim of compensation-Government Resolution dated 5-1-2005 & 31- 3-2005, from where the said scheme of personal accident insurance emanates, nowhere whispers about the term, "registered farmer".
(iii) In United India Insurance Co.Ltd. -Vs- Gajpal Singh Rawat, reported in 2009 STPL 8188 NC while deciding the said matter, the Hon'ble National Commission relied upon the judgment of Hon'ble Apex Court in National Insurance Co.Ltd. -Vs- Swaran Singh wherein it is held that "In each case, on evidence led before the Claims Tribunal, a decision has to be taken whether the fact of the driver possessing licence for one type of vehicle but found driving another type of vehicle, was the main or contributory cause of accident. If on facts, it is found that accident, was caused solely because of some other unforeseen or intervening cause like 7 (A/18/1056) mechanical failures and similar other causes having no nexus with driver not possessing requisite types of licence, the insurer will not be allowed to avoid its liability, merely for technical breach of conditions concerning driving licence".
13. Therefore, in view of aforesaid discussion, there reveals deficiency on the part of insurance company towards the complainant in repudiating the Insurance claim.
14. In view of the above, we are of the opinion that the District Commission has passed a just and well-reasoned Order, which does not call for any interference by this Commission. Hence, we pass the following order:
:-ORDER:-
1] The Appeal is dismissed.
2] No order as cost.
3] The copy of Order be provided free of cost to both the parties.
[JUSTICE S. P. TAVADE] PRESIDENT [VIJAY C. PREMCHANDANI] MEMBER