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2025 Supreme(MP) 970

IN THE HIGH COURT OF MADHYA PRADESH AT GWALIOR
Rajendra Kumar Vani, J.
United India Insurance Company Limited – Appellant
Versus
Smt. Asha And Others – Respondents 
Misc. Appeal No. 211 of 2013, Civil Revision No. 20 of 2013, Misc. Appeal No. 212 of 2013, Misc. Appeal No. 213 of 2013 
Decided On : 26-06-2025

Advocates Appeared:
For the Appellant :Shri Arvind Kumar Agarwal - Advocate
For the Respondent:Shri Arun Sharma - Advocate

An insurer cannot raise a new defense on appeal, such as the lack of insurance coverage for passengers, if such a plea was not explicitly raised in the written statement or supported by evidence during the trial proceedings.

Headnote:(A) Motor Vehicles Act, 1988 - Insurance coverage - Compensation for injury - Principles of 'pay and recover' - Where an insurer seeks to avoid liability on the ground that the insurance policy is an 'act only' policy and does not cover passengers, such a specific plea must be raised in the written statement and supported by evidence - In the absence of such pleadings and evidence, the insurer cannot raise this ground for the first time in an appeal. (Paras 9, 10, 13)

(B) Pleadings and Evidence - Procedural fairness - It is a settled legal principle that in the absence of any pleading, no amount of evidence will help the party - An appellate court is not obligated to adjudicate upon a point that was neither pleaded nor established through evidence before the trial court. (Paras 11, 12, 14)

Facts of the case:
Multiple appeals were filed by an insurer against a tribunal's award granting compensation to passengers injured in a vehicle accident. The tribunal had directed the insurer to pay the compensation and subsequently recover it from the vehicle owner. The insurer contested this, arguing on appeal that the insurance policy was an 'act only' policy and did not cover the passengers involved.

Findings of Court:
The court observed that the insurer had failed to plead the 'act only' defense in the written statement and had not produced evidence during trial to prove lack of coverage for passengers. The defense at trial was focused exclusively on breach of policy conditions regarding usage and driver qualifications. Consequently, the appellate court held that the insurer could not introduce a new defense that lacked any foundation in the trial proceedings.

Issues: Whether the insurer can challenge its liability for passenger claims in an appeal based on the nature of the policy, when that specific defense was not raised or proven in the original trial.

Ratio Decidendi: The court maintained that a party is bound by its pleadings. Since the insurer did not dispute the coverage for passengers in the trial court and specifically focused on other breaches, the appellate court cannot consider the new challenge to the policy coverage, and the 'pay and recover' order remains valid.

Result: Appeals dismissed.

Table of Content
1. consolidation of appeals and summary of factual history. (Para 1 , 2)
2. parties' contentions regarding insurance policy coverage and procedural lapses in pleadings. (Para 4 , 5)
3. judicial assessment of insurance policy nature and effectiveness of evidence presented. (Para 6 , 7 , 8 , 9 , 10)
4. requirement of formal pleading and evidence for insurers to avoid liability. (Para 11 , 12 , 13)
5. affirmation of pay and recover order due to meritless appeals. (Para 15)

ORDER :

Rajendra Kumar Vani, J.

This order shall govern disposal of all the three Misc. Appeals and one civil revision as they arise out of common award dated 01.11.2012 passed by the Additional Motor Accident Claims Tribunal, Sheopur in Claim cases Nos.01/2012, 02/2012, 03/2012 and 05/2012; whereby, learned Claims Tribunal has awarded compensation of Rs.96,600/- in favour of claimant Mukesh, Rs.35,000/- in favour of claimant Ashabai, Rs.3,87,000/- in favour of claimant Banti and Rs.9,000/- in favour of claimant Lalaram.

2. Briefly stated, the facts of the case are that on 13.05.2011 the claimants along with others were travelling in Jeep No.MP-33 D-0192 from Vijaypur to Narvar Lodi Devi Mata temple. Respondent- Bharatlal was driving the said jeep rashly & negligently, due to which the offending vehicle capsized, as a result of which the claimants sustained injuries.

3 . It is submitted by the learned counsel for the Insurance Company that the policy Ex.D/3 is a private car act only policy. Only premium has been paid for third party as well as for employee under Workmen Compensation Act, but no premium has been paid for the passenger travelling in the vehicle, therefore, the claimants are not covered under this policy, and therefore, the Insurance Company is not liable to pay the compensation at all. There is no question of pay and recover arises. He placed reliance on the following judgments :-

(i) National Insurance Co. Ltd. Vs. Balakrishnan and another , 2013 ACJ 199

(ii) Oriental Insurance Co. Ltd. vs. Surendra Nath Loomba and others , 2013 ACJ 321

(iii) M.P. Electricity Board vs. Laxminaraya & Ors., 2008(1) T.A.C. 88 (M.P.)

(iv) Smt. Guddi and others vs. Pooran Singh & Ors. decided on 10.11.2022 in M.A.No.976/2011

Therefore, the learned Tribunal erred in issuing the order as regards pay and recover and prays for setting aside the impugned award to the extent it directs the Insurance Company to first pay the compensation to the claimants and then recover it from the owner and driver of the offending vehicle.

4. Per contra, learned counsel appearing for the respondents/driver and owner of the offending vehicle submits that neither Insurance Company has pleaded such objection in their reply nor any issue has been framed in this regard nor any evidence has been adduced in this regard to show that policy (Ex.D/3) was only private car act policy and no premium was paid for the passengers travelling in the vehicle, and therefore, the claimants are not covered under the policy. The Insurance Company has pleaded and proved the fact that offending vehicle was being driven in violation of the conditions of the policy. It was used as a commercial vehicle and the driver of the vehicle did not have any driving licence to drive commercial vehicle. On both the counts, the case is found to be of violation of conditions of the policy. Learned Tribunal has also found it proved by considering the evidence on record, and therefore, Insurance Company is not found responsible for payment of compensation, but learned Tribunal in para 40 has considered the law in this regard and held that since the conditions of policy has been violated, therefore, by statutory obligation the Insurance Company is liable to pay the compensation and then to recover the same from the owner and driver of the offending vehicle. There is no argument put forth by learned counsel for the Insurance Company that because of only private car act policy, the Insurance Company was not at all liable to pay

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