IN THE HIGH COURT OF KARNATAKA
C.M. Joshi, J.
The Branch Manager, National Insurance Co. Ltd. - Appellant
Versus
Vijay Praveen Cutinha and ors. - Respondents
M.F.A. No. 188 of 2017, M.F.A.No.637 of 2018
Decided On : 14-12-2023
| Table of Content |
|---|
| 1. details of the accident and injuries sustained. (Para 1 , 2) |
| 2. insurance company denies liability based on policy terms. (Para 3 , 4) |
| 3. tribunal's findings on factual issues and compensation awarded. (Para 5 , 10 , 11) |
| 4. insurance company's liability under the policy. (Para 6) |
| 5. arguments regarding adequacy of compensation. (Para 8 , 9) |
| 6. evaluation of insurance policy coverage. (Para 12 , 13 , 14) |
| 7. interpretation of package policy terms. (Para 18 , 20 , 21 , 22) |
| 8. comprehensive policy covering all occupants. (Para 23) |
| 9. assessment of injuries and appropriate compensation. (Para 24 , 26 , 30) |
| 10. conclusion on compensation amount and interest. (Para 34 , 37) |
JUDGMENT :
C.M. Joshi, J.
Being aggrieved by the judgment and the award passed by the learned III Addl. Senior Civil Judge and JMFC Mangaluru, D.K. in MVC.No.1723/2012 dated 22.06.2016, the respondent No.2-National Insurance Company Limited as well as the petitioner have approached this Court in appeal.
2. The brief facts are as below:
That on 05.07.2012 at about 3.00 p.m., when the petitioner was proceeding to the work site as per the direction of the employer, from Falneer towards Adyaru in Tata Magic Tempo bearing No.KA-21-N-2148, the said tempo was driven by its driver in rash and negligent manner and at Adyarukatte on NH-75 dashed to the hind side of the bus bearing No.KA-19-D-4505. Due to the said impact, the petitioner sustained grievous injuries and immediately shifted to Father Muller Hospital. The Petitioner was admitted as inpatient in the hospital from 05.07.2012 to 01.08.2012. The petitioner was discharged from the hospital with an advice to take bed rest and follow up treatment. The petitioner had spent a sum of Rs. 1,00,000/- for medical expenses and further requires Rs. 50,000/- for future medical expenses. The petitioner was hale and healthy at the time of accident and aged about 20 years. The petitioner was working as an electrician under the respondent No.1 and earning a salary of Rs. 12,000/- p.m. The entire family depended on his earning and due to fracture, now it is difficult to lift heavy objects, to walk, bend, squat and stand for long time. The accident occurred only due to the rash and negligent driving of the tempo driver. The driver was in the course of employment under respondent No.1 and also his agent. The respondent No.2 being the insurer is liable to pay the compensation.
3. After service of notice, respondent No.1 did not appear before Tribunal and therefore, he was placed ex-parte. However, respondent No.2-Insurance Company has appeared through its counsel and filed written statement.
4. Respondent No.2-Insurance Company denied that the accident occurred due to the negligence on the part of the driver of the vehicle owned by respondent No.1. It also denied the age, occupation and income of the petitioner and that the compensation claimed as highly exorbitant, imaginary and untenable in law. It was contended that the driver of the said vehicle bearing No.KA-21-N-2148 was not having valid driving license at the time of accident and there was violation of the conditions of the policy and as such, the liability deserves to be absolved. It is contended that the bus bearing No.KA-19-D-4505 was guilty of violations of law and therefore, the owner and insurer are also necessary parties to the petition. It was contended that the liability to pay compensation to the petitioner is not covered under the policy and the respondent No.1 has not paid any premium towards the coverage of the inmates of the vehicle. It was contended that the policy does not cover the wider liability and there was no contractual relationship between the respondent No.1 and respondent No.2-Insurance Company, with regard to the indemnifying injuries suffered by inmates of the vehicle. Therefore, respondent No.2-Insurance Company sought for dismissal of the petition as against it.
5. On the basis of the above pleadings, the Tribunal framed appropriate issues and aft
Bhagyalakshmi v. United Insurance Company Limited (2009) 7 SCC 148
Jagtar Singh Alias Jagdev Singh v. Sanjeev Kumar (2018)15 SCC 189
National Insurance Company Limited v. Balakrishnan AIR 2013 SC 473
Oriental Insurance Company Limited v. Surendra Nath Loomba (2012) 13 SCC 792
A comprehensive/package insurance policy covers the risks of all vehicle occupants, including employees, regardless of additional premium payment for inmate coverage.
Motor Accident – Liability of Insurance Company - When vehicle is insured by Company, insurer is liable to pay compensation in case of "comprehensive/package policy" but not in case of "Act policy".
A Comprehensive/Package policy covers liability for occupants, including pillion riders, while an Act only policy does not.
The court affirmed that an employee traveling in a Goods Auto Rickshaw is covered under the insurance policy, and compensation must reflect the claimant's permanent functional disability.
Insurance companies are not liable for employee injuries in vehicles unless additional premiums are paid for coverage under the policy.
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