Case BriefsHigh Courts

Bombay High Court: S.M. Modak, J., examined the jurisdiction of the Motor Accident Claims Tribunal in regard to claim made by the insured/owner under a personal accident claim against the insurance company.

Liability of Insurance Company

The circumstance involved in the present appeal about the liability of the insurance company to pay as per clause ‘personal accident cover’ in the insurance policy.

Crux of the issue

What will be the extent of liability of the insurance company when the insured/owner of the Jeep was himself the driver-cum-deceased and when no other vehicle was involved?

Does Motor Accident Claims Tribunal have jurisdiction to decide the above-stated claim?

Legal representative of the deceased claimed compensation from the respondent-Insurance Company from the MACT by invoking the provisions of Section 163-A of the Motor Vehicles Act, 1988. Though MACT had denied the same.

The Insurance Company — respondent had denied their liability. The policy does not cover loss occasioned to the insured person, because he is not the third party.

Withdrawal of earlier claim petition under Section 166 of the M.V. Act and non-maintainability of a fresh petition under Section 163-A of the M.V. Act was also emphasized.

Trial Court held:

“the owner/insured cannot be said to be a third party and hence exonerated the company”.

The correctness of the above-stated decision was challenged.

Scope of the appeal:

1) Whether the Insurance Company is liable to reimburse under the caption personal accident of the insured?

2) Whether the MACT can award compensation?

Bench noted that the Question is always raised whether the registered owner can be said to be a ‘third party’. This question is no more res-integra. There are numerous judgments available in regard to the said issue.

Supreme Court had the occasion to decide the correctness of the decision of the High Court in the case of National Insurance Company Limited v. Ashalata Bhowmik, (2018) 9 SCC 801.

The insurance company was held responsible to pay to the legal representatives of the deceased to driver/owner of the vehicle. Supreme Court reiterated the law regarding the liability of insurance companies in case of the death of the owner/its own insured. When the insured is not liable, the question of liability of the insurer does not arise.

Insurance company relied on the following two decisions:

[Karnataka High Court] Sangeetha Subramani v. Sri Krishna Chari Puttachari,2018 SCC OnLine Kar 3835.

“Whether rider of a two-wheeler (who is not the owner) can claim compensation as a third party for an accident where no other vehicle is involved?”

Claimants were held not entitled to claim compensation under Sections 163-A or 166 of M.V. Act.

[Madras High Court] Cholamandalam MS General Insurance Company Ltd. v. Ramesh Babu,2020 SCC OnLine Mad 2164

A similar issue was involved in the said case regarding the liability of the insurance company to comply with the promises given as per the personal accident coverage clause of the package policy. MACT allowed the claim. Number of contentions were raised on behalf of the insurance company before the High Court. It includes the jurisdiction of M.A.C.T., entitlement to compensation (more than the maximum limit mentioned in the clause) under the phrase ‘just compensation’. All the contentions were answered in favour of the insurance company and the claim petition was dismissed.

Decision

Bench diverged from the view taken by the Karnataka and Madras High Court on the issue involved.

Supreme Court’s Decision in National Insurance Co. Ltd. v. Laxmi Narain Dhut, (2007) 3 SCC 700 was found to be relevant in the present matter.

Observation in the case of Laxmi Narain Dhut:

“21. Where the claim relates to own damage claims, it cannot be adjudicated by the insurance company, but it has to be decided by another forum i.e. forum created under the Consumer Protection Act, 1986 (in short “the CP Act”). Before the Tribunal, there were essentially three parties i.e. the insurer, the insured and the claimants. On the contrary, before the Consumer Forums there were two parties i.e. owner of the vehicle and the insurer. The claimant does not come into the picture. Therefore, these are cases where there is no third party involved”.

High Court stated that the Madras High Court’s view in Cholamandalam MS General Insurance Company Ltd. v. Ramesh Babu  2020 SCC OnLine Mad 2164 was restricted with the issue of jurisdiction of MACT.

Adding to its observations, Court stated that the provisions of Section 165 of the M.V. Act deal with the jurisdiction of MACT.

When certain conditions are fulfilled, MACT gets jurisdiction. They are:

a) Claim for compensation in respect of accidents.

b) Arising out of use of the motor vehicle.

Section 165 of the M.V. Act nowhere contemplates dealing with a claim only when the policy is obtained under Section 147 of the M.V. Act.

Court held that,

Petition before the MACT will be maintainable once the condition under Section 165 of M.V. Act are fulfilled. So, in the given case, there is a clause of personal accident coverage in case of motor accident, MACT can entertain the petition.

Bench also stated that it was fortified with the observations made in the followings cases:

Thiruvalluvar Transport Corpn. v. Consumer Protection Council, (1995) 2 SCC 479

Bajaj Allianz General Insurance Company Ltd. v. C. Ramesh, 2013 (1) TN MAC 325.

Concluding the decision, Court rejected the contention that MACT cannot entertain the claim made by the insured/owner under a personal accident claim against the insurance company.

The present appeal was allowed and the Insurance Company was directed to pay Rs 2,00,000 to the appellants with the interest @6%. [Mangala v. National Insurance Company Limited, 2020 SCC OnLine Bom 974, decided on 29-09-2020]


Also Read:

Madras HC | Can MACT deal with claims & policies other than Accident Claims provisions of MV Act? Contractual & Statutory liability cannot be equated: HC elaborates

Case BriefsHigh Courts

Madras High Court: S.M. Subramaniam, J., while addressing a motor accident claim, observed that,

Once, the policy is contractual in nature and the parties have signed the agreement, then such a contract cannot be construed or brought within the ambit of statutory liability.

The Cholamandalam MS General Insurance Company Limited is the appellant. Respondent/Owner of Tata Indica Tourist Taxi TN-32-L-8595 dashed against the palm tree on the roadside due to unavoidable reasons, causing road traffic accident.

Respondent filed the claim petition under Section 163 of the Motor Vehicles Act seeking compensation of Rs 2,00,000 from the Insurance Company.

The Claim Petition was filed only against the appellant/Insurance company as the respondent car was insured with the appellant/Insurance company.

Appellant though defended the claim petition on the ground that the respondent was not some third party infcat he was the owner of the vehicle, therefore no statutory coverage in terms of Section 147(1) of the Motor Vehicles Act, 1988 can be granted.

The Claim Petition was filed under Section 166 of the Motor Vehicles Act. However, the Tribunal has referred the Claim Petition as if it was filed under Section 163A of the Motor Vehicles Act. However, misquoting of the provision could not disentitle the claimant from availing the rights.

Tribunal directed the Insurance Company to pay the compensation to the respondent.

Bench on perusal of the facts and circumstances of the present matter, stated that in the absence of any statutory liability on the part of the Insurance company, the provisions of the Motor Vehicles Act cannot be invoked nor an adjudication can be done before the Tribunal.

The very purpose and object of the Motor Accident Claims Tribunal are to adjudicate the Claim Petitions and grant ‘just compensation’ with reference to the provisions of the Motor Vehicles Act.

If a particular Personal Accident Policy is contractual in nature, then statutory liability cannot be fixed on the Insurance company.

Contractual liability cannot be equated with statutory liability.

Owner’s Package Policy with reference to the Personal Accident Cover for owner-cum driver is contractual in nature. There is no third party involvement with reference to the Personal Accident Cover.

Tribunal granted compensation beyond the agreed contract between the parties to the Personal Accident Cover.

The Tribunal is bound to see the nature of the insurance policy as well as the coverage with reference to the terms and conditions stipulated, which were agreed between the parties.

Court added that in the vent of no coverage under the policy, the insurance company cannot be held liable to pay compensation.

No person is entitled to claim any benefit beyond the scope of the terms and conditions agreed between the parties.

MV Act being a Special Legislation and the Motor Accident Claims Tribunal constituted to deal with the Accident Claims specifically under the provisions of the Motor Vehicles Act, the tribunal has no jurisdiction to deal with all other policies issued by the Insurance Company, which all are contractual in nature and the terms and conditions agreed between the parties specifically.

Insurance Policy

Motor Vehicle policies are issued by the Insurance company for the purpose of grant of compensation and the language employed is “Compensation”. However, the Personal Accident Coverage Policy reveals that it is “benefit” is to be granted.

Motor Accident Policies are strictly within the ambit of the provisions of the Motor Vehicles Act. The Personal Accident Coverage Policy is strictly in accordance with the terms and conditions agreed between the parties.

Court also added that the tribunals are bound to look into the nature of the Policy at the first instance, before entertaining the Claim Petition as the tribunal cannot adjudicate the terms and conditions agreed between the parties in a contract and grant compensation under the Motor Vehicles Act.

In the present case, the Personal Accident Coverage Policy has been agreed between the insurance company and respondent under the Personal Accident Coverage Policy of amount Rs 2,00,000.

For availing the benefit of the Personal Accident Coverage Policy, the respondent/claimant has to establish the nature of the ‘disablement’ and the same is to be established before the competent Court of law and the Motor Accident Claims Tribunal is not empowered to entertain the Claim Petition under the Motor Vehicles Act.

Hence if the Insurance Company has deposited any award amount before the Tribunal, then they can withdraw the said amount with accrued interest.[Cholamandalam MS General v. Ramesh Babu, 2020 SCC OnLine Mad 2164, decided on 02-09-2020]