The main legal point established is that the Insurance Company is liable to pay compensation for injuries covered under the Personal Accident cover, and admissible medical expenses under the policy, as per the terms of the Motor Vehicles Act and the insurance contract.

JUDGMENT :

G. JAYACHANDRAN, J.

Prayer: Civil Miscellaneous Appeal has been filed under Section 173 of the Motor Vehicles Act, 1988, against the decree and judgment dated 13th October, 2015, passed in M.C.O.P. No. 891 of 2009 by the Motor Accident Claims Tribunal (II Additional District Court), at Salem.

The case has been heard through video conferencing.

1. The appeal is filed by the Insurance Company being aggrieved by the liability fixed on the Insurance company by the Motor Accident Claims Tribunal.

2. On 26.11.2008, when the claimant Balaji was travelling with goods in his van bearing Registration No. TN-30-E-6257, the driver of the van drove the van with rash and negligent manner and the van was capsized. In the accident, the claimant Balaji sustained fracture in his right leg, right side feet, left shoulder, deep cut injury and abrasion over left leg and both hands. He was admitted in the hospital as inpatient and continuing his treatment for the injury. Hence, he has filed claim petition seeking Rs. 5,00,000/- as compensation.

3. The Insurance Company contested the claim petition on the ground that the claimant is the owner of the van, which was capsized. The van has been insured under the Bajaj Alliance Insurance Company. As per the terms and conditions of the Insurance policy, the owner of the vehicle is not entitled to pay any compensation, except under personal liability coverage. Since the Personal Accident cover is only for specified injuries mentioned in the policy. Since the injuries sustained by the claimant does not fall under the categories of injuries specified, the claimant is not entitled for any compensation for the nature of the injury he sustained.

4. The claimant is not a third party. The claim petition under Section 166 of Motor Vehicles Act is not maintainable. In addition to the above defence, it was also contended that the van driver Balaji had no valid driving license. The claimant as owner of the vehicle failed to furnish details of his policy viz. date, time, place of accident and particulars of the injury as mandated under Section 134 C of M.V. Act.

5. Before the Tribunal, the claimant examined himself as PW-1 and the Doctor, who has given disability certificate, was examined as PW-2. 11 Exhibits were marked on behalf of the claimant. The Insurance Company examined one Mr. S. Hariharan, Law Officer and one Exhibit was marked.

6. On considering the evidence, the Tribunal has fixed 45% disability for the injury sustained by the claimant in the accident and taking note of the medical bills furnished to tune of Rs. 2,03,700/- for loss of income, pain and suffering, nourishment and transport, totally a sum of Rs. 3,39,700/- was awarded. The said award is challenged in the present appeal.

7. The Learned Counsel appearing for the appellant submitted that the Insurance Coverage is for third party risk. Though premium of Rs. 100/- was collected for the personal accident cover with restricted limited liability up to Rs. 2,00,000/- the injury sustained should fall under any one of the category specified under the terms and conditions of the insurance contract. The Tribunal has erred by awarding a sum of Rs. 3,39,700/- as if, the claimant is a third party. The owner of the vehicle the insured, is the party to the contract and bound by terms of contract.

8. The Learned Counsel for the appellant relying upon the terms and conditions found in the Insurance Policy regarding Personal Accident Cover for owner-cum-driver submitted that the nature of injury listed in the terms and conditions alone is covered under the policy. The injury sustained by the claimant does not fall under the injury mentioned in the policy. Therefore, he is not entitled for any compensation.

9. To buttress his submission, the Learned Counsel relying upon the following three judgment of this Court in C.M.A. No. 2434 of 2019 dated 02.09.2020 M/s.