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HIGH COURT OF BOMBAY
Smt. Anuja Prabhudessai, J
Reliance General Insurance Company Ltd. – Appellant
Versus
Shaikh Sadik Shaikh Rafique – Respondent
First Appeal No.1202 of 2019 | Cross Objection St. No.1525/2021
For the Appellants/Petitioners: Shri H.N. Verma
For the Respondents: Shri P.R. Agrawal, Ms. Vidya Umale
Insurance companies must prove defenses regarding non-coverage of liability; failure to plead such defenses may not absolve them from indemnification obligations in claims involving employees.
Headnote:(A) Motor Vehicles Act, 1988 - Section 173 and Section 166 - Appeal against judgment and Award of Claims Tribunal - Compensation awarded for injuries sustained due to vehicle collision - Claimant suffered permanent disablement and was awarded Rs.16,00,000/- with interest - Appeal filed to contest the quantum and liability of the insurance company regarding indemnification - Tribunal assessed the claim based on 100% disability and future loss of income. (Paras 1-17)
(B) Insurance Liability - The court affirmed the insurer's liability to indemnify the insured, emphasizing the need for specific pleadings to exclude liability which were not raised in this case. The court held that the Claimant being an employee is covered under the policy provisions. (Paras 10, 16)
Facts of the case:
The Claimant sustained grievous injuries in a collision while traveling in a truck, leading to permanent disablement and a claim for substantial compensation. He was under the impression he earned more than what the Tribunal assessed for loss of income.
Findings of Court:
The court found that the Tribunal erred in considering notional income too low and emphasized that the Claimant's total compensation must reflect his complete disability and loss of income.
Issues: Whether the compensation is just and reasonable; whether the insurer is liable to indemnify the insured under the insurance policy conditions; whether the Claimant was a gratuitous passenger or an employee.
Ratio Decidendi: The court determined that non-pleaded defenses regarding the insurance terms could not absolve the insurer from liability and reaffirmed that employees are insured under commercial vehicle policies.
Result: The Appeal is dismissed; the Claimant entitled to enhanced compensation of Rs.26,00,000/- with interest.
01] This is an Appeal under Section 173 of the Motor Vehicles Act, 1988 (hereinafter referred to as “the said Act”) challenging the judgment and Award dated 13/03/2018 in Claim Petition No.213/2015. By the impugned judgment, the Claims Tribunal has partly allowed the Petition under Section 166 of the said Act and directed the Appellant and the Respondent Nos.2 and 3 to pay to the Claimant compensation of Rs.16,00,000/-/- with interest @ 8% per annum from the date of the petition till final realization.
02] The brief facts necessary to decide this Appeal are as under:
The Respondent No.1 (hereinafter referred to as “the Claimant”), had filed Petition under Section 166 of the said Act alleging that he along with other labourers was returning to village Nerpinglai by Tata 407 Truck bearing No.MH-11/AG-2161. The said truck was driven by the Respondent No.2 at excessive speed and in a rash and negligent manner. When they reached near Talani Phata on Morshi-Amravati Road, one Tata Ex Vehicle bearing No.MH-27/X-4621 came from the opposite direction, in a rash and negligent manner, resulting in collision between both the vehicles. As a result, the Claimant sustained grievous injuries resulting in permanent disablement.
03] The Claimant claimed that at the time of the accident, he was 25 years of age and was earning Rs.9,000/- per month as a labourer. The Claimant further claimed that he is unable to work due to the injuries sustained in the said accident. The Claimant further claimed that he had incurred medical expenses of Rs.4,00,000/-. The Claimant claimed total compensation of Rs.68,44,000/- under pecuniary and non-pecuniary heads.
04] The Respondent No.2 denied that he had driven the Tata 407 Truck bearing No.MH-11/AG-2161 in a rash and negligent manner. The Respondent Nos.2 and 3 claimed that the accident was caused due to rash and negligent driving by the driver of the Tata Ex Vehicle bearing No.MH-27/ X-4621. The Respondent Nos.2 and 3 also denied the age, occupation and income of the Claimant and contended that the Claimant is not entitled for compensation as claimed. The Respondent No.2 stated that the vehicle was duly registered with the Appellant – Insurance Company.
05] The Appellant – Insurance Company, the insurer of the Tata 407 Truck bearing No.MH-11/AG-2161, claimed that said truck was driven without a valid driving licence. It was also averred that the vehicle was driven without fitness certificate, permit and PUC certificate. The Appellant – Insurance Company also claimed that the Claimant was travelling in a goods carriage vehicle as a gratuitous passenger and hence denied its liability to indemnify the insured for breach of terms and conditions of the policy.
06] The driver and the owner of the Tata Ex Vehicle bearing No.MH- 27/X-4621 also filed their written statement denying the mode and manner of the accident as well as the age, occupation and income of the Claimant. They claimed that the accident was caused due to rash and negligent driving by the Respondent No.2 - driver of the Tata 407 Truck bearing No.MH-11/AG-2161.
07] The Tribunal, after considering the evidence on record, held that the accident was caused due to rash and negligent driving by the Respondent No.2 - driver of the Tata 407 Truck bearing No.MH-11/AG-2161. The Tribunal has also recorded a finding that the Claimant had suffered 100% disability.
The Claimant was 25 years of age and considered his notional income as Rs.4,500/- per month and on applying multiplier of 17, the Tribunal assessed future loss of income at Rs.9,18,000/-. The Tribunal has also awarded compensation on other heads such as medical expenses, attendance charges, permanent disability etc. and awarded total compensation of Rs.16,00,000/-. Being aggrieved by the judgment, the Appellant – Insurance Company has filed this Appeal and not being satisfied with the quantum of compensation awarded by the Tribunal, the Claimant has filed Cross-objection under Order XLI Rule 22 CPC.
