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Showing contexts for: Personal accident coverage in The Oriental Insurance Co Ltd vs Mohammed Rafi on 23 January, 2023Matching Fragments
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MFA No. 116 of 2015
21. In Ramkhiladi's case stated supra by dismissing the claim petition filed under Section-163A of M.V. Act as not maintainable, the Hon'ble Apex Court has granted compensation under personal accident coverage as per the insurance policy. Further, in Ramkhiladi's case stated supra the owner died, therefore a compensation of Rs.1 lakh was granted as per insurance policy, as it has coverage of personal accident claim. But in the present case, no death is occurred in the accident, this makes difference in factual matrix involved in the case of Ramkhiladi and in the present case.
stated judgment is applicable on the ground that even the disability is not coming under three events stated in General Regulation No.36A, but the compensation can be granted according to the proportionate percentage of disability and the sum assured for personal accident coverage. In the present case, the claimant/owner/insured had sustained 14% of partial disablement and the sum assured is Rs.2,00,000/- under personal accident coverage. Therefore, according to this proportion, owner/claimant/insured is entitled.
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MFA No. 116 of 2015insurer promised to the insured to pay certain sum according to the injuries sustained or death occurred. For such injuries only, the same shall have to be awarded by the Insurance Company under PA coverage is some what not sound to the practical realities and logic. Therefore, under these circumstances, even though in GR 36 A for three categories of disabilities or death, the CSI amount is covered also in other cases of partial disablement, as proved from the medical evidence, the compensation to be granted under personal accident coverage is also covered.
is awarded under the personal accident coverage. Therefore, for the aforesaid reasons, the appeal filed by the Insurance Company is allowed. The judgment and award passed by the tribunal is modified holding that the claim petition filed presumably under section 163A is not maintainable. Thus, the claim petition is to be dismissed. Under the personal accident coverage, the owner insured is entitled to compensation of Rs.28,000/- as discussed above.