IMPORTANT POINTS
1. The conceptual difference between third-party right and own damage cases has to be kept in view. Initially, the burden is on the insurer to prove that the licence was a fake one.
2. If the driver had no valid driving license, claim can be repudiated.
3.Difference is required to be made between the third party claim and self-claim in respect of defective/no license to drive.

ORDER (ORAL)

V.K. Jain, Presiding Member—No one is present for the complainant/respondent despite service having been affected on her on 29.01.2019. I have therefore, heard the learned counsel for the petitioner and have considered the record.

2. The husband of the complainant/respondent was a farmer whose life was covered under a welfare scheme of the Government. He having died in a road accident on 02.08.2015, a claim was lodged for payment of the benefit available under the said policy in the event of his death. The claim having not been paid, the complainant/respondent who is the widow of the deceased, approached the concerned District Forum by way of a Consumer Complaint seeking benefit of Rs.1,00,000/- with compensation etc.

3. The complaint was resisted by the petitioner company primarily on the ground that the deceased had died while driving a vehicle and that the complainant had failed to produce the Driving License of the deceased meaning thereby that he was not holding a valid Driving License at the time he died in an accident.

4. The District Forum, having allowed the complaint, the petitioner approached the concerned State Commission by way of an appeal. The said appeal also having been dismissed, the petitioner is before this Commission.

5. The insurance policy under which the life of the deceased was covered, to the extent it is relevant, reads as under:—

Part III: General Exclusions

Provided Always That the Company shall not be liable under this Policy for—

3. (vi) driving any vehicle without a valid driving license;

Part IV: General Terms & Conditions

2. Observance of Terms and Conditions

The due observance and fulfillment of the terms, conditions and endorsements of this Policy insofar as they related to anything to be done or complied with by the Insured/Insured Person/s shall be a condition precedent to any liability of the Company to make any payment under this Policy.

6. Tripartite agreement executed between the Government, the petitioner and Deccan Insurance & Re-insurance Brokers Pvt. Ltd., also shows that in the event of accident where the driver did not have a valid Driving License, the farmers, except the one who was driving, were eligible for the claim.

7. It would thus be seen that as far as the deceased was concerned, in case he died in a road accident while himself driving a vehicle without possessing a valid Driving License, no benefit in the event of his death was payable.

8. No Driving License was produced by the complainant despite opportunity having been given for this purpose. The inevitable inference therefore, is that the driver was not holding a valid Driving License at the time he met with an accident while driving a vehicle. Therefore, no claim under the policy was payable in the event of his death.

9. The question involved in this petition came to be considered by this Commission in RP No.2086 of 2016 Sharda Bai Vs. Manager, Liberty Videocon General Insurance Company Limited & Ors. decided on 03.03.2017. In that case, the husband of the complainant had an account with a Co-operative Bank which had taken a Group Personal Accident Policy for its account holders. He was driving a tractor when the said tractor met with an accident resulting in his death. A claim for payment of the benefit available under the Group Insurance Policy taken by the Co-operative Bank was then submitted. The claim was repudiated on the ground that the deceased did not possess any effective and valid Driving License at the time he met with an accident. Being aggrieved, the complainant approached the concerned District Forum by way of a Consumer Complaint. The complaint was resisted by the insurer on the grounds on which the claim had been repudiated. The District Forum having dismissed the Consumer Complaint, the complainant approached the concerned State Commission by way of an appeal. The said appeal also having been dismissed, she approached this Commission by way of a Revision Petition. Dismissing the complaint