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HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Sunita Sharma, R.K. Verma JJ.
SMT. BHAWNA GUPTA — Appellant
Vs.
UNITED INDIA INSURANCE COMPANY LIMITED — Respondent
First Appeal No. 192 of 2019
Decided On : 04-11-2020
Advocate Appeared:
For the Appellant : Mr. Arush Matlotia.
For the Respondent: Ms. Rajvinder Sandhu.
The main legal point established in the judgment is the interpretation of the insurance policy exclusion clause related to driving under the influence of intoxicating liquor or drugs, and the admissibility of evidence in quasi-judicial proceedings under the Consumer Protection Act, 1986.
Headnote:
Consumer Protection Act - Insurance Claim - 15 of Consumer Protection Act, 1986 - [Section 15] - [Summary of Acts and Sections: Consumer Protection Act, 1986, Section 13(4), Motor Vehicles Act, 1988, Section 185] - The court discussed the provisions of the Consumer Protection Act, 1986, particularly Section 15, and the interpretation of the insurance policy exclusion clause related to driving under the influence of intoxicating liquor or drugs. The court also referred to the Motor Vehicles Act, 1988, Section 185, to determine the admissibility of evidence related to the driver's alcohol consumption.
Fact of the Case:
The complainant filed an appeal under Section 15 of the Consumer Protection Act, 1986 against the dismissal of her insurance claim for a vehicle involved in a fatal accident. The insurance company repudiated the claim based on the driver's alleged intoxication, leading to a dispute over the admissibility and interpretation of evidence.
Finding of the Court:
The court found that the evidence presented by the insurance company, including reports from the Regional Forensic Science laboratory, was not proven and therefore not admissible. The court also interpreted the insurance policy exclusion clause related to driving under the influence of intoxicating liquor or drugs, and found that the complainant was entitled to the insurance claim as the driver's alcohol consumption was within permissible limits.
Issues: The issues involved the admissibility of evidence, interpretation of the insurance policy exclusion clause, and the liability of the insurance company for the claim.
Ratio Decidendi: The court's decision was based on the interpretation of the insurance policy exclusion clause, the admissibility of evidence, and the application of the Motor Vehicles Act, 1988, Section 185, in determining the driver's alcohol consumption.
Final Decision: The appeal was allowed, and the court directed the insurance company to pay the complainant the insurance claim amount along with interest, compensation for mental agony, and litigation costs.
JUDGMENT :
1. Present appeal has been filed by the complainant under Section 15 of Consumer Protection Act, 1986 against the order dated 05.04.2019 passed by District Consumer Disputes Redressal Forum, Mandi, H.P, whereby the complaint of complainant has been dismissed.
2. Brief facts necessary for adjudication of this appeal are that complainant is the registered owner of vehicle No. HP31B-3692 (Tata Zest car). The said vehicle was insured with the opposite party and the risk was covered from 02.11.2016 to 01.11.2017. It is further pleaded that IDV of the car was Rs.5,75,975/-. It is further pleaded that on 14th April, 2017 her sons Himanshu and Puneet Gupta along with Abhishek, Aditya and Sonu were travelling in the vehicle and Himanshu was driving the vehicle in question. The vehicle in question skidded and fell into BSNL Canal. In the accident, Himanshu (driver), Abhishek, Aditya and Sonu expired, whereas, Puneet Gupta swam to safety and survived. Puneet Gupta was not in a position to depose properly since he went under depression and shock. Relatives of Abhishek, Aditya and Sonu (all deceased) succeeded in manipulating and getting a false FIR bearing No. 72/2017, dated 15.04.2017 registered against Shri Puneet Gupta in Police Station, Balh, District Mandi, Himachal Pradesh. Despite application dated 23.09.2017 moved by Shri Puneet Gupta before the police, the case was not properly investigated. The vehicle was totally damaged in the mishap. Information regarding the incident was given to the opposite party. It is further pleaded that signatures of complainant were taken on some blank papers/pro-formas by the officials of the opposite party by saying that the claim will be paid soon, but neither any claim form was filled nor the particulars of driver were disclosed by her before the opposite party. Police officials forcibly took into possession the driving licence of her son namely Puneet Gupta. A letter dated 12.12.2017 was received from the opposite party. Her genuine claim was repudiated wrongly and illegally on the ground that the driver Shri Puneet Gupta was driving the vehicle under the influence of liquor. It is further pleaded that at the time of accident late Shri Himanshu was driving the car and Puneet Gupta was sitting in the same. It is further pleaded by the complainant that she has been harassed and suffered financial loss. The opposite party committed deficiency in service and unfair trade practice.
3. The complaint so filed has been contested by the opposite party by filing reply taking preliminary objections therein to the effect that the dispute raised by the complainant cannot be termed as a consumer dispute and that the complaint is not maintainable. It is further pleaded that complex questions of law and facts are involved in the case and detailed evidence is required to be adduced to prove and disprove the facts. It is further pleaded that controversy involved in the present complaint cannot be adjudged by the Forum in a summary manner and remedy lies before the Civil Court. On merits, it has been admitted that the vehicle in question belongs to the complainant and the same was insured with the opposite party. It has been admitted that vehicle in question met with an accident during the period of insurance policy. However, it has been pleaded that after receiving intimation regarding the occurrence, Shri Mohinder K. Sharma, an independent Surveyor and Loss Assessor, was deputed to inspect the vehicle and assess the loss. who gave the report dated 31.10.2017 and recommended the indemnity payable as Rs.4,65,000/- on net of salvage basis subject to the terms and conditions of insurance policy. During police investigation, it surfaced that Shri Puneet Gupta (surviving son of the complainant) was driving the vehicle after consuming alcohol. His medico legal certificate and report of laboratory showed consumption of alcohol. Since the car was being plied in breach of the policy conditions, the claim was rightl
