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2019 Supreme(Online)(Del) 5649

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Not Mentioned, Not Mentioned
New India Assurance Company Ltd. v. Ashok Kumar
Revision Petition | First Appeal No. 447/2014



Insurance claims must adhere strictly to policy conditions, especially regarding vehicle capacity violations.

Headnote:The revision petition, filed against the order of the State Consumer Disputes Redressal Commission, addresses the repudiation of an insurance claim due to driver licensing issues and overcapacity of passengers. The District Forum initially awarded a claim, which was partially upheld by the State Commission, leading to this revision. The core issues addressed are the validity of the grounds for repudiation and the extent of violation of insurance policy conditions. The court ruled that the settled amount be further reduced to account for the significant violation, emphasizing strict adherence to vehicle carrying capacity regulations. The modified order directs the insurance company to pay Rs. 2,05,145 with interest from the date of the District Forum's order.

Table of Content
1. overview of the insurance claim and prior decisions. (Para 1 , 2)
2. discussion on facts and legal implications of the case. (Para 3 , 4 , 5 , 6)
3. assessment of violations and rationale for claim adjustment. (Para 7)
4. final directive on the claim settlement amount. (Para 8)

1. This revision petition has been filed by the petitioner New India Assurance Co. Ltd., against the order dated 24.4.2015 of the State Consumer Disputes Redressal Commission, Himachal Pradesh, (in short ˜the State Commission') passed in First Appeal No. 447/2014.

2. Brief facts of the case are that the respondent is the owner of a bus and the bus met with accident during the currency of the Insurance policy. The accident had happened on 8.5.2013 and the bus was badly damaged. The severity of the accident can be imagined from the fact that in the accident about 20 persons died. The insurance claim was repudiated by the Insurance Company on the ground that the driver was not having valid licence at the time of accident and that bus was carrying 65 persons as against the total capacity of 44 passengers. The respondent / complainant preferred complaint bearing No. 10/2014 before the District Consumer Disputes Redressal Forum, Kullu, (in short ˜the District Forum'). The complaint was resisted on the same grounds on which the repudiation was made. The District Forum however, allowed the complaint vide its order dated 12.11.2014 and directed the Insurance Company to pay the amount of Rs. 5,16,088 along with 9% p.a. interest from the date of filing of the complaint together with a compensation of Rs. 4,000 and litigation cost of Rs. 2,000 . The Insurance Company preferred an appeal before the State Commission bearing No. 447/2014. The State Commission ordered the claim to be paid on non - standard basis and accordingly, ordered Insurance Company to pay Rs. 3,87,066 with 9% p.a. interest along with litigation cost as ordered by the District Forum.

3. Hence the present revision petition.

4. The revision petition was dismissed in default on 12.6.2017, however, the same was restored after allowing the application for restoration vide order dated 13.10.2017 and the matter was listed for final hearing on 1.3.2018. However, on 1.3.2018 none was again present on behalf of the petitioner though the respondent was present, who came from Kullu, Himachal Pradesh. Respondent was heard.

5. Respondent in person argued that it is true that there were about 32 deaths in the accident, however, claims of all the persons have been settled by the Insurance Company, but the claim regarding the bus is still pending. Both the Fora below have given orders in favour of the respondent / complainant and the scope under the revision petition is very limited. This Commission cannot reassess the facts. On the basis of the facts and circumstances, the District Forum has allowed the complaint and ordered the opposite party to pay the insurance claim as recommended by the surveyor. However, the State Commission, in appeal filed by the opposite party has allowed the claim only on non - standard basis i.e. 75% of the amount assessed by the surveyor. Thus, the claim has already been reduced for violation of condition of the policy and therefore, revision petition does not have any merit and deserves to be dismissed.

6. I have carefully gone through the material on record and have considered the argument advanced by the respondent in person. It is true that there is concurrent finding of the Fora below in respect of allowing the insurance claim. In the revision petition, the facts cannot be reassessed by this Commission as held in Mrs. Rubi (Chandra) Dutta v. United India Insurance Company, (2011) II CPJ 19 (SC) : IV (2011) SLT 303 : 2011 (3) Scale 654. However, in my view, there is a question of law involved in the matter. The repudiation has been made on two grounds. The First ground was that the person driving the vehicle at the time of accident was not having valid licence and second

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