State Consumer Disputes Redressal Commission
Bajaj Allianz General Insurance Co Ltd vs Bababhai Shivabhai Raval & Ors. on 7 November, 2025
«3-
IN THE NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
RESERVED ON : 15.09.2025
PRONOUNCED ON : 07.11.2025
REVISION PETITION NO. 40 OF 2024
(From the order dated 18.05.2023 in F.A. No. 179/2023 of the
State Consumer Disputes Redressal Commission, Gujarat)
Bajaj Allianz General Insurance Co. Ltd.
29, 3rd Floor, Aroma Arcade,
H.D.F.C. Bank Palampur,
Banaskantha Petitioner
Versus
1. Bababhai Shivabhai Rava I
2. Lilaben Bababhai Raval
3. Ashaben Bhagwani Raval
All Respondent(s) Residing at Bhatamal,
Taluka : Palanpur
District: Banaskantha -385010 Respondents
BEFORE:
HON'BLE DR. INDER JIT SINGH, PRESIDING MEMBER
HON'BLE DR. JUSTICE SUDHIR KUMAR JAIN, MEMBER
For the Petitioners Ms. Aishwarya Sinha, Proxy Counsel (V.C.)
For the Respondents Mr. Vikas Saini, Proxy Counsel (V.C.)
ORDER
DR. INDER JIT SINGH, PRESIDING MEMBER
1. The present Revision Petition (RP) has been filed by the Petitioner against Respondents as detailed above, under section 58(l)(b) of Consumer Protection Act, 2019 against the order dated 18.05.2023 of the State Consumer Disputes Redressal Commission, Gujarat (hereinafter referred to as the 'State Commission'), in First Appeal (FA) No. 179/2023 in which order dated 11.07.2022 of District Consumer Disputes Redressal Commission, Palanpur (hereinafter referred to as District Commission) in Consumer RP 40 OF 2024 Page 1 of 12 Complaint (CC) No. 339/2021 was challenged, inter alia praying for setting aside the order dated 18.05.2023 passed by the State Commission.
2. While the Revision Petitioner (hereinafter also referred to as OP/Insurance Company) was Appellant before the State Commission and Opposite Party before the District Commission, the Respondent(s) (hereinafter also referred to as Complainants) were Respondents before the State Commission in FA/179/2023 and Complainants before the District Commission in Complaint No. 339/2021. Notice was issued to the Respondent(s) on 24.01.2024. Parties filed Written Arguments on 29.09.2025 (Petitioner) and 22.09.2025 (Respondents-1 to 3) respectively.
3. The Revision Petition has been filed with a delay of 46 days as per calculations made by the Registry. Appellant has filed an application IA 256/2024 for condonation of delay in filing the Revision Petition. Considering the reasons given in the application for condonation of delay, delay is condoned. The case is taken up on merits.
4. Brief facts of the case, as emerged from the RP, Order of the State Commission, Order of the District Commission and other case records are that: -
Son of Respondents-1 & 2 and husband of Respondent No. 3, Bhagwanbhai was owner of a rickshaw. The rikshaw was covered with Insurance policy, which covered own damage and the personal accident insurance of owner driver. The policy was valid from 09.10.2020 to 08.10.2021. The life insurance of personal accident for owner- driver covered Rs. 15,00,000/-. On 23.05.2021, while Bhagwanbhai, alongwith his son Prince, was going towards Bhatamal Village of Vaghrol Village of Palanpur Taluka, met with an accident with a Jeep coming from wrong side. The insured/Bhagwanbhai and his son Prince died in the accident.
FIR was lodged on 23.05.2021. The Complainants lodged their claim RP 40 OF 2024 Page 2 of 12 with the Insurance Company. The Insurance Company repudiated the claim vide letter dated 03.08.2021 on the ground of non-production of valid Motor Driving License of the deceased. Hence, the Complainants filed Complaint before the District Commission.
5. Vide Order dated 11.09.2022 passed in the CC 339/2021, the District Commission allowed the Complaint. Aggrieved by the order dated 11.09.2022 of the District Commission, the Insurance Company preferred an Appeal No. 179/2023 before the State Commission. The State Commission dismissed the Appeal vide order dated 18.05.2023 and confirmed the order passed by the District Commission.
6. Petitioner/ Insurance Company has challenged the said Order dated 18.05.2023 of the State Commission mainly on following grounds:
(i) The State Commission failed to consider that it is the duty of the insured to provide the relevant documents required to assess the claim made by them in terms of the Insurance Policy.
(ii) State Commission has erred in holding that it is the duty of the Petitioner herein to gather the information that the insured did not possess valid and effective driving license. On the contrary it submitted that it is the duty of the insured to furnish the driving license of the driver of the insured vehicle in order to claim compensation from the Insurer.
(iii) The State Commission erred in placing reliance on the judgment of this Commission in Oriental Insurance Co. Ltd. vs. Prabhu Desai in RP/1527/2009.
(iv) The State Commission has erred in passing the impugned judgment in ignorance of the settled law and the terms and conditions of the insurance policy which has to be strictly read as the insurance RP 40 OF 2024 Page 3 of 12 company has agreed to compensate the insured only is case of compliance of the terms of the insurance policy.
(v) The State Commission has erred in considering the plea of the Petitioner that the insurance policy is issued based on the facts and documents provided to it by the insured at the time of obtaining the policy and it is a contract of utmost good faith. The insured has undertaken to ply the vehicle in compliance of the terms and conditions of the policy and in case the insured is in violation of the terms of the policy, the insurance company is not liable to compensate the insured in the event of loss.
(vi) The State Commission erred in overlooking the peculiar aspect that deceased had opted for commercial vehicle package policy for his vehicle. The Respondents were asked to provide various documents for processing the claim. Since the Respondents failed to provide the Valid and effective driving license of the deceased, the claim was repudiated.
The State Commission failed to appreciate that the Petitioner had intimated all details regarding the status of the claim of the Respondents and again sought required documents.
(vii) State Commission failed to understand that the absence of essential documents renders it impossible; on the part of the Petitioner to process an insurance claim.
(viii) It is apparent from the record of both the Fora below that despite repeated reminders, the Respondent did not provide the required documents/details essential for the processing of the claim. The State Commission failed to consider that the Respondents were at fault in not providing the required documents and the Petitioner cannot be burdened for the faults of the Respondents. The State Commission erred in not properly scrutinizing the documentary evidences and saddling the liability on the Petitioner Insurance Company.
RP 40 OF 2024 Page 4 of 12(ix) The State Commission failed to appreciate that the finding of fact record by the District Commission with respect to breach of terms and conditions of policy and deficiency in service on the part of the insurance company is misconceived and not tenable at law in view of the decision of Hon'ble Supreme Court in Ravneet Singh Bagga v. KLM Royal Dutch Airlines (2000) 1 SCC 66.
(x) The State Commission failed to appreciate that there is nothing on record which could establish or even indicate that the Petitioner was in anyway negligent or anyhow lacking bonafides in its dealing with the Respondents.
(xi) State Commission has passed the impugned order based on the discussion that took place in other matters before it, contrary to the well-established principles of jurisprudence applicable to judicial and quasi-judicial authorities that every case must be determined on the basis of its own peculiar facts and circumstances.
(xii) The impugned order is based on reasons and justifications beyond the pleadings, contrary to evidence on record, and there is error apparent on the fact of the record, and the State Commission has erred in confirming the order of District Commission.
7. Heard counsels of both sides. Contentions/pleas of the parties, on various issues raised in the RP, Written Arguments, and Oral Arguments advanced during the hearing, are summed up below.
7.1 In addition to the averments made under the grounds above (para 7), the petitioner contended that the list of documents required for claim settlement clearly stated that a copy of the Motor Driving License along with other requisite documents was mandatory and had to be submitted at the nearest office of the Petitioner for processing the claim. It is further contended that as per the Driver clause in the Policy Document, it has been RP 40 OF 2024 Page 5 of 12 clearly stated that the person driving holds and effective driving license at the time of the accident. As per the terms of the policy wordings in case of Personal Accident Cover for Owner-Driver the insurance cover was subject to pre-condition that the owner-driver holds an effective driving license, in accordance with the provision of Rule 3 of the Central Motor Vehicles Rules, 1989, at the time of acceding. It is also contended that Read with the above Rule, Section 3 of the Motor Vehicles Act, 1988 also delineates the necessity of a driving license while on road. It is further contended that the policy wordings of the Insurance Policy under 'Conditions' expressly stipulate that any liability of the insurer to make payment is conditional upon the insured furnishing all necessary information relating to the occurrence of the alleged loss. As the Respondents did not provide the complete set of documents required for processing the claim, including the mandatory driving license of the deceased, the Petitioner repudiated the claim in accordance with the terms and conditions of the insurance policy. The Petitioner has relied upon the following judgments:
i) General Assurance Society Ltd. vs. Chandmull Jain (1966) 3 SCR 500.
ii) United India Insurance Co. Ltd. vs. Harchandrai Chandanmal (2004) 8 SCC 644.
iii) M/s Majestic Graphic and Machinery Pvt. Ltd. vs. United India Insurance Co. Ltd.
iv) Smt. Meena & Ors. vs. Sri Anil Kumar Gupta & Anr. -passed by Hon'ble Allahabad High Court.
V) Oriental Insurance Co. Ltd. vs. Sony Cheriyan (1999) 6 SCC 451.
Vi) Ravneet Singh Bagga (supra).
7.2 On the other hand, Respondents contended that the Insurance
Company repudiated the claim lodged by the legal heirs of the deceased on the ground that the deceased's driving license was not submitted, which is RP 40 OF 2024 Page 6 of 12 arbitrary, excessive and against settled principles of law as Driving License was lost in accident and the Respondents made bonafide efforts to procure the same. The father of the deceased vide letter dated 09.01.2021 informed the Insurance Company that the deceased always kept his license with him and it was lost in the accident, as is common in fatal road incidents. The Respondents also assured that if a copy is recovered, it would be submitted.
Despite this, the claim was rejected summarily without even seeking verification from the RTO or conducting any independent investigation as onus is on Insurance Company to verify Driving License. It is further contended that as per law, once a claim is made and reason for non availability is explained, it is for the insurer to verify the driving license from the RTO. In support of their contention the Respondents relied upon the judgments passed by this Commission in New India Assurance Co. Ltd. v. Late Bhupatbhai Shah , Appeal No. 548/022 and Oriental Insurance Co. Ltd. vs. Prabhu Desai , RP No. 1527/2009. It is further contended that these are the undisputed facts that the vehicle was insured and the policy was valid on the date of accident, the deceased was the registered owner and driver, accident was occurred and FIR, PM report, RC Book, Aadhaar, Death Certificate, Claim Form etc. were submitted and no allegation of rash/negligent driving or breach of terms was made by the Insurance Company. In such circumstances, the absence of driving license along cannot be fatal to the claim, particularly, when the license was reportedly lost in the accident and the insurer took no steps to verify the same. It is also contended that the Personal Accident Cover for Owner-Driver is governed by IRDAI Guidelines and does not require separate proof of negligence or civil claim and Personal Accident insurance is a no-fault benefit, and the requirement of having a valid license is to ensure lawful driving, which is presumed in absence of contrary evidence. Relied upon the judgment passed in National Insurance Co. Ltd. v. Swaran Singh & Ors. (2004) 3 SCC 297. It is also contended that the RP 40 OF 2024 Page 7 of 12 Respondents have made all efforts to trace and procure the driving license of the deceased, which was lost in the fatal accident. Despite continuous efforts, including approaching the concerned RTO for retrieval or issuance of a duplicate or extract, the license could not be obtained till date due to circumstances beyond their control. The insurance contracts are based on utmost good faith, which the insurance company failed in its duty to act fairly and in good faith when they ignored the written explanation for the lost license, failed to initiate any RTO verification and rejected the claim based on a minor procedural lapse.
8. We have carefully considered the orders of the State Commission, District Forum, other relevant records and rival contentions of the parties. The main reason for the repudiation of the claim was that the insured was not having a valid driving license and claimant did not submit a copy of the driving license. It is admitted that all other required documents were duly submitted. The Respondents have contended that the deceased always kept a valid license with him, which was lost in the accident as is common in such fatal road accidents. No doubt, driving of a vehicle without a valid driving license entitles the Insurance Company to repudiate the claim but the onus to prove that the driver was not having a valid driving license, is on the Insurance Company. In this case, the insurance company has not placed on record any evidence to show that the vehicle was being driven by the driver, who himself was the insured, without a valid driving license. The Respondents on the other hand have submitted that the insured driver was having a valid driving license but the same was lost in the fatal accident which led the death of the insured driver as well as one of his son died. The Insurance Company should have tried to obtain some records from the office of the RTO to prove that the insured driver was without a valid driving license. Non-production of the copy of the valid driving license cannot be assumed that the insured driver was RP 40 OF 2024 Page 8 of 12 without a valid driving license. In this regard, extract of the relevant paras of the State Commission's order is reproduced below:
"Merits of the case
6. Certain facts are undisputed for deciding the presence case that the deceased insured was the owner of the rickshaw bearing registration no. GJ 27 1/ 5431. The said vehicle was insured with the opponent Insurance Company for own damage claim on IDV Rs.98.000/- personai accident coverage of Rs.15,00,000/-. The period of Policy, occurrence of accident is not disputed.
7. The claim of the complainant is rejected /not granted only for the reason that the complainant could not submit extract copy of Motor Driving License of Mr. Bhagahhai Bababhai Rava! i.e. insure. The copy of the letter dated 10 August 2021 is produced on page no. 67 which is reads as under:
"please refer our earlier letter dated 10-08-2021, 03-08-2021,27- 07- 2021 & 20-07-2021 wth reference to your reported OD & O PA claim under the above mentioned policy, l/l/e acknowledge your letter dated 16-06-2021 without any supporting documents which is not satisfactory and our stand remain unchanged.
1. Kindly subunit MDL. Extract copy of MR BHAGABHAIBABBHAI RA VAL at the time of loss.
In view of above we repudiate your above subject claim, This is without prejudice to our right to repudiate our liability on any specific ground/ grounds which are available to us for the time being or which may be available to us in future, which please kindly be noted. Please note that nothing contained in this letter is or should be construed as a waiver of any one or more rights on our part und all our rights under and in relation to the policy remain fully reserved."
8. The only reason for not processing the claim is non-production of Motor Driving License of the insured owner driver for that the father of the deceased had written tetter to the branch manager Motor Claim Department. Copy of letter dated 09/01/2021 by the father of deceased Bhagabhai is produced at page no. 64. Where it is categorically stated that deceased Bhagabhai was always keeping his driving licence with him. The Bhagabhai expired at the time of accident hence his driving license is lost from the place of accident. The RP 40 OF 2024 Page 9 of 12 complainant try to find out the Xerox copy/dupHcate from the house but he cannot lay his hand and hence could not submitted the driving license. It is further stated that as when the driving license will be found it will be submitted to the Insurance Company.
9. The following documents have been produced by the complainant
1. Copy ofInquest panchnama
2. Copy of PM report
3. Copy of Registration certificate of vehicle
4. Copy ofAdhar card
5. Copy of FIR
6. Copy of Death certificate
7. Copy ofpolicy
8. panchnama ofplace of incident
10. Looking to the affirmationed documents and as per the FIR the vehicle coming from the wrong side dashed with the rickshaw of the deceased insured and as per the PM report the death has occurred due to the injury sustained by the accident. Hence, the death of the insured was due to accident and as per the version of the FIR because of the rash and negligent driving of the driver of another vehicle involved in the accident, the accident had occurred. It is not the case of the insurance company that the driver of the rickshaw was negligent and was not possessing the driving skills. It is in the Insurance Company to produce the documentary evidence supporting to its repudiation. It is for the Insurance Company to gather the information that the insured was not possessing valid and effective driving license.
11. Here we refer to the judgment New India Ins. Co. Ltd. V/s late Bhupatbhai Shah (NCDRC), in Appeal no.548/2022.
In this judgment reference is made to the judgment Oriental Ins. Co. V/s Prabhu Desai dated22/07/2021 (NCDRC), in RP no.1527/2009:
RP 40 OF 2024 Page 10 of 12In Para 14.1 "Position of the appellants can be better imagined than explained as their sole bread winner had died in the accident, his driving license could not be traced, and wherefrom the deceased had obtained the same, learned counsel for the appellants submitted that his clients are not aware. For the view that has been taken that agent/development officer was bound to satisfy himself and in fact was duty bound to have ascertained the fact that the driver was possessed of a valid and effective driving license only then he covered the risk is another ground to negate the plea of learned counsel for the respondent. In this view of the matter plea ofpersons traveling on the tractor at the time of accident is neither relevant nor has any bearing so far claim of the appellants is concerned..... Counsel for the petitioner contends that proof of having a valid driving license at the time of accident is a condition precedent and in the absence of the same, the insurance company is not bound to pay the insured amount. We have no quarrel with this proposition of law but, in the peculiar facts and circumstances of the case, we draw an inference in favour of the respondent that the deceased Sher Singh had a valid driving license."
12. The Ld. District Commission has held that if the appellant insurance company takes the ground that the deceased life assured did not have a driving license then it could have filed production application or procured from other sources. The Insurance Company has not made any efforts to get the MDL of the deceased.
13. In the instant case the appellant insurance company has failed to substantiate the ground taken in the appeal that the DLA did not have a valid driving license.
14. From the discussions and observations made hereinabove, we are of the opinion that the appellant insurance company has not succeeded in establishing both the grounds taken in the appeal and therefore we are of the view that this appeal is required to be dismissed.
15. We find no infirmity or error in law in the judgment and order passed by the Ld. District Commission and hereby confirm the same."
9. We are in agreement with the observations and findings of the State Commission. There are concurrent findings of both the Fora below with regard to the deficiency in service on the part of the Insurance Company. As has RP 40 OF 2024 Page 11 of 12 * been held by Hon'ble Supreme Court in catena of judgments11 that the revisional jurisdiction of the National Commission is extremely limited, it should be exercised only in case as contemplated within the parameters specified in the provision i.e. when State Commission had exercised a jurisdiction not vested in it by law or had failed to exercise jurisdiction so vested or had acted in the exercise of its jurisdiction illegally or with material irregularity. It is only when such findings are found to be against any provisions of law or against the pleadings or evidence or are found to be wholly perverse, a case for interference may call for at the second appellate (revisional) jurisdiction. In exercising of revisonal jurisdiction, the National Commission has no jurisdiction to interfere with concurrent findings recorded by the District Forum and the State Commission, which are on appreciation of evidence on record.
10. In view of the foregoing, we are of the considered view that State Commission has given a well-reasoned order and we find no reason to interfere with its findings. We find no illegality or material irregularity or jurisdictional error in the order of the State Commission, hence the same is upheld. Accordingly, Revision Petition No. 40 of 2024 is dismissed.
11. The pending IAs in the case, if any, also stand disposed off.
Sd/-
( DR. INDER JIT SINGH ) PRESIDING MEMBER Sd/-
( DR. SUDHIR KUMAR JAIN, J.)
jr/Court-3/AB MEMBER
1 Ruby ( Chandra ) Dutta Vs. United India Insurance Co.Ltd. [(2011) 11 SCC 269, Sunil Kumar Maity Vs. State Bank of India and Ors. (2022) SCC OnLine SC 77, Lourdes Society Snehanjali Girls Hostel and Another Vs. H & R Johnson ( India ) Limited and Ors. (2016) 8 SCC 286, T.Ramalingeswara Rao ( Dead) Through Legal Representatives and Anr. Vs. N. Madhava Rao and Ors. (2019) 4 SCC 608, Rajiv Shukla Vs. Gold Rush Sales and Services Limited and Anr. (2022) 9 SCC 31 RP 40 OF 2024 Page 12 of 12