The interpretation of the risk and coverage under the insurance policy is crucial in determining the liability of the insurance company in motor accident claims.

1. The appellant/2nd respondent has preferred the appeal in C.M.A.No.1037 of 2004, against the judgment and decree made in M.C.O.P.No.417 of 2000, on the file of the Motor Accident Claims Tribunal, Additional District Judge, Dindigul.

2. The petitioner has filed the claim in M.C.O.P.No.417 of 2000, claiming compensation of a sum of Rs.1,00,000/- from the respondents, for the injuries sustained by him in a motor vehicle accident. It was submitted that on 26.04.1996 at about 11.30 a.m., when the petitioner was riding his moped on the Dindigul railway station road, from east towards north and when he was nearing Nagal near water tank, the 1st respondents Jeep bearing registration No.KL-11-2293, coming on the same road and driven by its driver at a high speed and in a rash and negligent manner dashed against the petitioner and caused the accident. The petitioner fell down and sustained injuries. He was admitted at the Dindigul Yoga Hospital. Hence, the injured petitioner, has filed the claim against the 1st and 2nd respondents, who are the owner and insurer of the Jeep bearing registration No.KL-11-2293.

3. The 2nd respondent in his counter has submitted that the averments made in the claim regarding age, income and occupation of petitioner, nature of injuries sustained, medical treatment taken, medical expenses have to be proved through documentary evidence. It was submitted that the claim was excessive. It was submitted that 1st respondents Jeep driver had driven Jeep in a careful and cautious manner and sounded horn and that the petitioner had suddenly crossed the road and collided against the jeep. It was submitted that as the accident had been caused by the negligence of the petitioner, the 2nd respondent cannot be held liable to pay any compensation. It was submitted that the petitioner should prove that the jeep was covered under a valid policy of insurance with them and that the driver of the jeep had a valid driving licence to drive the jeep at the time of accident.

4. The Motor Accident Claims Tribunal had framed three issues for consideration in the case namely: (1) Due to whose negligence was the accident caused?; (2) What is the quantum of compensation which the petitioner is entitled to get? (3) To what other relief is the petitioner entitled to get?.

5. On the petitioners side, two witnesses were examined and four documents were marked as Exs.P1 to P4 namely: Ex.P1-F.I.R; Ex.P2-wound certificate dated 30.04.1996; Ex.P3-disability certificate dated 04.122001 and Ex.P4- x ray. On the respondents side, no witness, no documents.

6. PW.1, the petitioner had adduced evidence that on the date of accident, at about 11.30 a.m., when he was proceeding in his moped bearing registration No.TTZ-7456, on the left side of the road on the Dindigul railway station road and nearing Nagal Nagar Bus stop, the 1st respondents jeep, coming from behind him, on the same road, bearing registration No.KL11-2293, driven by its driver at a high speed and in a rash and negligent manner had dashed behind his moped. He deposed that he was thrown out of his vehicle. In support of his evidence, he had marked the exhibits listed as P1 to P4.

7. It is seen from the scrutiny of the F.I.R, that injured petitioner had been taken in the jeep of the 1st respondent and admitted at a private hospital and that the jeep driver had then left. The Tribunal observed that no witnesses had been examined on the side of the respondents to show the mode of occurrence of accident. Hence, the Tribunal on scrutiny of evidence of PW.1 and on perusal of F.I.R marked as Ex.P1 held that the accident had been caused by the rash and negligent driving by the driver of the 1st respondents jeep. The Tribunal on observing that the 1st respondents jeep had been insured with the 2nd respondent liable to pay compensation to the petitioner.

8. PW.1, had adduced evidence that in the accident, he sustained fracture of his bone below his right knee joint and injuries on hi