Date of filing:04/03/2022

Date of disposal:24/3/2023

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL

COMMISSION: MEDAK AT SANGAREDDY

PRESENT:Smt. P. Kasthuri,….. President

Sri Gajjala Venkateswarlu…. Member
Sri Makyam Vijay Kumar…. Member

Friday, the 24th day of March, 2023

CC.No.13 of 2022

Between:
Avusula Santhoshi w/o Ramakrishna,
Aged about 32 years, Occ: House hold,
R/o H.No.2-5, VajipalleJulkal,
Shankarampet (M), Medak District.
…Complainant.
And

The General Manager,

Chola MS General Insurance Company Limited,
Registered office: 2nd Floor,
Dare house, 2, N.S.C.Bose Road,
Chennai – 600 001.
…Opposite party
Counsel for the Complainant: Sri M.Govardhan.
Counsel for the Opposite party:Sri M.Anil Kumar

This case came up for final hearing before us on 14.03.2023, in the

presence of Sri M.Govardhan, Advocate for the Complainant, Sri M.Anil
Kumar, Advocate for the Opposite party, upon perusing the material
papers on the record, upon hearing and having stood over for
consideration till this day, this Commission passed the following:

ORDER
(Per se Sri Gajjala Venkateswarlu, Member)

This Complaint is filed U/S-35 (1)of the Consumer Protection

Act,2019, praying the Commission to direct the opposite partyto release
the insurance policy amount of Rs.15,00,000/- (Rupees Fifteen Lakhs
only) to the complainant and to award costs of the litigation.

The case of the complainant in brief: -

1. It is alleged that the Complainant has purchased a two wheeler

Motor vehicle HondaC.B.Shinemodel, bearing No.TS-35F-7247on

25.10.2021 from Sri Venkateshwara Honda, Autonagar, Medak District

and same was insured by the opposite party vide Policy-cum-Certificate

No.3397/02979704/000/00 “Compulsory Personal Accident(CPA) for

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Owner Driver”. On 26.12.2021 while the husband of the complainant

coming from Shankarampet to Virojipally on the said vehicle, he met with

an accident due to sudden coming of wild forest pig on the road and he

sustained severe injuries. Immediately after shifting him to the

Government hospital, he was declared died at the time of undergoing

treatment. The police Shankarampet has registered a case vide Crime

No.122/2021 U/S.304-AIPC and conducted inquest Panchanama and the

Post Mortem report was given by the Government Medical Officer,

Narayankhed on 27.12.2021. At the time of accident, the driver/husband

of the complainant has got valid driving license. Even though the

Compensation has not be paid by the Opposite Party. Hence, the present

complaint.

2. Written version of Opposite Party:-

The opposite party filed written version by denying all the allegations

made by the complainant as false, fabricated and created. Further

specifically denied that Complainant is wife of the deceased and that she is

only legal heir and there are no other legal heirs and she is alone entitled

for claim/compensation. It is also contended that the insurance is a

contract of the indemnity to be viewed as a normal contract as per Indian

Contract Act and any violation of the Insurance contract becomes void and

the opposite party will not be liable to pay the claim of the party.

Moreover, the complainant did not approach the opposite party in proper

prescribed manner. It is also contended that the deceased has not covered

as he is not the owner/insured. As per terms of the policy Owner-cum-

Driver is only covered under the Insurance Policy, whereas the deceased is

not the Owner/Insured in the said policy. The insurer undertakes to

compensate the loss suffered by the insured on account of the risk covered

by the insurance policy, the terms of the agreement have to be strictly

construed to determine the extent of liability of the insurer. The insurance

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policy, R.C of the vehicle on the face reveals that the complainant herein is

the Owner and Insured under the Insurance Policy. As such, coverage to

the deceased will not arise. Hence, the complainant has no locus-standi to

file the present case and the application is bad for mis-joinder of the

parties and non-joinder of the necessary parties and devoid of merits.

Hence, the complaint is liable to be dismissed inlimini.

3) The Complainant has filed her evidence Affidavit and examined

herself as PW.1 and got marked her documents as Ex.A.1 to Ex.A.7 on her
behalf.

4) The Opposite party after receiving notice from this Commission has
filed their written version, evidence affidavit of Sri P.Ayyappa Kumar S/o
P.Narayana Deputy Manager, Legal on behalf of the opposite party and
examined himself as RW.1 and got marked their document as Ex.B.1 on
their behalf.

5) The Complainant and the opposite party have filed written

arguments and made oral submission.

6) Now the points for consideration are: -

(a) Whether denial of insurance compensation on account that the

Policy is not covered to the Complainant’s husband is deficiency of service
or unfair trade practice?

(b) Whether the complainant is entitled for the relief Claimed?

(c)If so, to what relief?

7). Point No. (a)& (b) : -

It is undisputed fact that the Complainant purchased a two

wheeler Motor Vehicle Honda CB Shine Model, bearing No.TS-35F-7247 on
25.10.2021 from Sri Venkateswara Honda, Autonagar, Medak District and
the said vehicle is insured by the opposite party company vide policy cum
certificate No.3397/02979704/000/00 dated 25.10.2021 and the said
policy is valid from 25.10.2021.18:28hours to midnight 24.10.2022. The
said vehicle is insured by policy called “Compulsory Personal Accident
(CPA) for Owner Driver” and the complainant has paid premium amount
to the opposite party as per the terms and conditions of the policy.The said
vehicle is brand new vehicle. On 26.12.2021 at 6.00 hours, the
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complainant’s husband while proceeding from Shankarampet (A) to

Virojipally Village on the said two wheeler Motor Vehicle bearing No.TS-
35F-7247, Chasis No.ME4 JE 855GMD096889, when he reached near to
old road junction of Uthloor Village in the out skirts of the village, the
husband of the complainant noticed that the sudden movements of the
wild forest pigs on the Road and while trying to avoid the pigs lost control
over the bike and the bike was overturned on the left side of the road and
fell on the stones, due to which the husband of the complainant sustained
severe injuries on the face. Then the ambulance staff shifted the husband
of the complainant to the Government hospital for the treatment at
Narayankhed, while he was undergoing treatment he died on
26.12.2021.The Shankerampet (A) Police station registered a case as
Crime No.122/2021, U/S 304(A) IPC and took up investigation and the
said FIR is marked as Ex.A.1 and Shankarampet (A) P.S also conducted
inquest Panchanama and the Government medical officer, Narayankhed
conducted post mortem and provided report dated 27.12.2021and the
same are marked as Ex.A.2 and the deceased is having a valid driving
license. The complainant has got issued legal notice to the opposite party
on 14.2.2022 to pay the insurance amount of Rs.15,00,000/-.On receiving
the said notice the opposite party neither paid the insurance amount nor
gave any reply to the said legal notice and the same legal notice is marked
as Ex.A.6. The opposite party has repudiated the claim of the complainant
stating that as per the terms of the insurance policy owner cum driver is
only covered under the policy “Compulsory Personal Accident (CPA)
Owner-Driver” whereas the deceased is not the owner/insured in the said
policy.

The Opposite Party claimed that the husband of the complainant

was died due to road traffic accident and the vehicle is insured by the
opposite party company under “Compulsory Personal Accident (CPA)
Owner-Driver” vide policy-Cum-Certificate No.3397/02979704/000/00,
dated 25.10.2021. The insurance coverage is limited only to the Owner-
Driver and not to the third parties and in case third parties to be covered
that would attract separate premium which the complainant has not
purchased.

The very terminology i.e., OWNER-DRIVER is misleading in that

any prudent consumer would understand that it is Owner or Driver of the
vehicle; however the interpretation of the Opposite Party as Owner/Driver
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as one person cannot be sustained. Furthermore as per Motor two

wheelers policy Bounded-Schedule-Cum-Certificate of Insurance, which is
marked as Ex.A.5 it is clearly stated in the Driver clause as follows “any
person including insured provided that a person who is driving holds
an effective driving license at the time of the accident”, hence, the
deceased complainant husband i.e., Late A.Rama Krishna holding a valid
driving license at the time of the accident as stated in the driver clause is
eligible for compensation under the insurance and Opposite Party is liable
to pay the same. Also in the said Insurance Certificate Limits of liability
clause specifically narrates P.A.Cover for the owner cum driver U/S IV
(CSI) Rs.15,00,000/- which indicates that it is not only owner but also
Driver is covered for Personal Accident. Even admitting to the arguments
of the opposite parties the “Compulsory Personal Accident (CPA)cover is
restricted only to the owner alone is nothing but unfair trade practice
specially when the owner who is complainant is not having valid driving
license and is house wife.
Therefore, in view of the above facts and circumstances of the case,
we are of the opinion that there is deficiency in service/unfair trade
practice on the part of the opposite party and the complainant is entitled
to release the “Compulsory Personal Accident (CPA) for Owner-Driver”
insurance policy amount of Rs.15,00,000/-(Rupees Fifteen Lakhs only)
from the opposite party along with interest and also costs of the litigation.
The points No.(a) and (b) are answered accordingly.

In the result: the complaint of the complainant is partly allowed and

direct the opposite party:-
1. to release the “Compulsory Personal Accident (CPA) for Owner-Driver”
insurance policy amount of Rs.15,00,000/- (Rupees Fifteen Lakhs only) to
the complainant along with interest @ 9% p.a from the date of the
complaint i.e., 04.03.2022 till the date of realization.

2. to pay a sum of Rs.5,000/- (Rupees Five thousand only) towards costs

of the litigation.

Time for compliance (40) days from the date of receipt of copy of this order.

Typed to dictation, Corrected and pronounced by us in the open

Court, on this the 24th day of March,2023.

Sd/- Sd/- Sd/-

MEMBER MEMBER PRESIDENT
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APPENDIX OF EVIDENCE

WITNESSES EXAMINED

For complainant: For opposite party: -

-None- -None-

DOCUMENTS MARKED
For Complainant:

Ex.A1/dt.27.12.2021 – Photostat copy of FIR.

Ex. A2/dt.27.12.2021 - Photostat copy of Post Mortem Form.
Ex. A3/dt.27.12.2021 - Photostat copy of Panchanama.
Ex. A4/dt.28.12.2021 - Photostat copy ofDeath Certificate pertaining to
the deceased Ramakrishna.
Ex. A5/dt.25.10.2021 - Photostat copy of Policy-cum-certificate.
Ex.A6/dt.14.2.2022- Photostat copy of Legal notice.
Ex.A7/dt.14.2.2022- Photostat copy of Postal acknowledgement card.

For Opposite Party:-

Ex.B.1/dt.06.5.2022- Motor to – Wheelers Policy Bundled – Schedule –

cum Certificate of Insurance.

Sd/- Sd/- Sd/-

MEMBER MEMBER PRESIDENT

Copy to:
1) The Complainant
2) The Opp.party
3) Spare copy