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2024 Supreme(HP) 24

IN THE HIGH COURT OF HIMACHAL PRADESH AT SHIMLA
SANDEEP SHARMA, J.
Nand Lal and Another – Appellants
Versus
Manohar Lal and Another – Respondents
F.A.O. No. 104 of 2019
Decided On : 07-05-2024

Advocates:
Advocate Appeared:
For the Appellants : Jiya Lal Bhardwaj, Sanjay Bhardwaj.
For the Respondents: Devyani Sharma, Basant Pal Thakur, Ashwani K. Sharma, Ishan Sharma.

The insurance policy terms dictate liability for occupant injuries; liability under an Act Policy is valid if occupant coverage premiums are paid.

Headnote:(A) Motor Vehicles Act, 1988 - Section 173 - Appeal against the award of MACT granting compensation for injuries sustained in an accident, challenging the liability of the insurance company. (Para 5)

(B) Insurance Liability - The terms of the insurance policy must be interpreted to determine coverage for occupants; even under an Act Policy, if premium for occupant coverage is paid, liability exists. (Paras 24, 30)

(C) Burden of Proof - It is the insurance company's responsibility to prove that the driver lacked a valid license, failure to produce witness to verify the claim leads to adverse inference. (Paras 46-54)

(D) Assessment of Compensation - When calculating compensation, courts should consider loss of future prospects and the severity of injuries to determine fair compensation, especially in cases of life-altering disabilities. (Paras 66-79) (E) Result - The appeal modifies the compensation to Rs. 50,66,762/- with interest at 7%. (Para 79)

Facts of the case:
The claimant alleged 100% disability due to a car accident caused by the negligent driving of the vehicle by the second appellant. The tribunal awarded Rs. 21,36,762/- with interest at 6% and litigation expenses. Key findings highlight disputed insurance coverage, with substantial evidence indicating the responsibility of the insurance company for occupant injuries.

Findings of Court:
The court found that insurance coverage was valid under the policy terms, and the driver’s licensing status needed re-evaluation.

Issues: Whether the insurance policy included occupant coverage and whether the driver had a valid license.

Ratio Decidendi: The doctrine of implied coverage under Act Policies ensures that if specific premiums for occupant injuries are paid, the insurer cannot evade liability. The assessment must reflect actual future economic impacts on the claimant’s dependency potential due to injuries.

Result: The appeal is allowed, amending the compensation amount positively.

Table of Content
1. document submission by insurance company regarding policy terms. (Para 1 , 4)
2. details of the vehicular accident and claimant's injuries. (Para 5 , 8 , 12)
3. court's interpretation of policy terms and claimant's rights. (Para 21 , 24 , 40)
4. extent of insurance company liability as per policy terms. (Para 29 , 41)
5. final determination of compensation amount. (Para 79 , 80)

1. By way of this application, the respondent No. 2/insurance company seeks to place on record Policy Schedule (Annexure A-1) and terms and conditions of the policy (Annexure A-2). It is stated in the application that during evidence before learned Tribunal below, incorrect terms and conditions of policy (Exhibit RW-1/B) were exhibited, which, in fact, were of ‘comprehensive policy’ and not of ‘Act Policy’.

2. Respondents/appellants have filed reply to the said application stating therein that respondent No. 2 has not challenged the award and as such, application is not maintainable, Order 41 rule 27 CPC, vests right with the appellant to place on record additional documents/evidence. Respondents/appellants have also stated that the application has been filed at a belated stage, i.e. at the stage of arguments. For comparison, the appellants have annexed Annexure R-1/A, which is a private car package policy, to show that no extra premium was deducted to cover third party liability and only basic premium qua third party cover has been charged. It has been denied that while tendering Exhibit RW-1/B, the concerned officer of the insurance company, wrongly tendered policy/terms and conditions of a package policy.

3. Though the application at hand has been resisted by tooth and nail by the respondents/appellants, on aforesaid grounds, but keeping in view the controversy involved in the appeal, this court deems it fit to take on record the documents Annexure A-1 and A-2, as they would help this court adjudicate the controversy in an effective manner.

4. Consequently, in view of the above, present application is allowed and Annexure A-1 and A-2 i.e. policy schedule and the terms and conditions of policy are ordered to be taken on record. Application stands accordingly disposed of. However, it is clarified that the aforesaid Annexure are being taken on record just for the sake of comparison.

F.A.O. (MVA) No. 104 of 2019

5. By way of present appeal filed under S.173 of the MOTOR VEHICLES ACT , 1988 (hereinafter referred to as, ‘Act’) the appellants, who were respondents Nos. 1 and 2 before learned Motor Accident Claims Tribunal-I, Solan, District Solan, Himachal Pradesh (hereinafter, ‘appellants’) in MAC Petition No. 59-S/2 of 2013, filed by respondent No. 1/petitioner (hereinafter, referred to as, ‘claimant’) have laid challenge to the Award dated 21.3.2018 passed by the learned Tribunal below, thereby awarding a sum of Rs. 21,36,762/- alongwith interest at the rate of 6% per annum from the date of filing of the petition, till realization of the amount, besides Rs. 10,000/- as litigation expenses, to be paid by the appellants, jointly and severally.

6. Summary of facts is that on 25.2.2012, claimant was travelling in Car bearing registration No. HP-15-9434 being driven by respondent No. 2. While returning from a marriage function at Village Banasar, at about 8.30 pm, when claimant reached near Village Sanwli, the vehicle met with an accident, as a result of which, claimant sustained multiple injuries and remained under treatment at ESI Hospital, Parwanoo, from where he was referred to P.G.I. Chandigarh. The claimant is stated to have suffered 100% permanent disability rendering him incapable of performing his daily routine activities and pursuits, in which he was engaged. Averments contained in the petition reveal that the claimant was self-employed and working as a Plumber. Claimant claimed to have been earning Rs. 25,000/- per month by working as a Plumber and Rs. 50,000/- from agriculture. Besides this, claimant claimed to have spent Rs. 1,50,000/

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