Insurance companies must establish a driver's alleged breach of policy terms regarding licensing and intoxication with proper evidence; mere allegations are insufficient for claim denial.

ORDER

JUSTICE A.P SAHI, PRESIDENT

This Complaint has been instituted by the owner of a “Lamborghini Gallardo” car bearing registration number DL-3CBU-7700 which met with a fateful accident on 19/02/2012. The vehicle was insured with the Opposite Parties under a comprehensive Insurance Policy effective from 07/12/2011 to 06/12/2012. At the time of the accident the vehicle was undisputedly being driven by one Mr. Anukool Rishi S/o Mr. Prem Rishi. It is stated that he was a family friend of Mr. R.K Sharma, who was then the Chief Executive Officer of the Petitioner Company, who had lent the vehicle to him for some personal work on 18/02/2012. It is the case of the Complainant that Mr. Anukool Rishi was the holder of a valid driving licence and the accident occurred round about 05:30 a.m near Krishi Vihar Bus stand, BRT Corridor, New Delhi on 19/02/2012. The first information report was lodged with Greater Kailash, Police Station. Mr. Anukool Rishi was rushed to the hospital where he was declared dead.

2. The Insurance Company was informed about the said accident on 19/02/2012 itself and a letter was received from one Mr. Jitender on behalf of the Insurance Company, who demanded certain documents. The same was supplied whereafter another letter was received demanding the driving licence, photographs and other documents of the deceased. According to the Complainant neither any Surveyor was sent nor any appropriate reply was received. A Mechanical Inspection was conducted and reported by one Mr. Shadi Lal, a Retired foreman of the Delhi Transport Corporation. The loss was assessed indicating that it was a total loss case. Having failed to get any response regarding reimbursement, a Legal Notice was issued to the Opposite Parties whereafter on 29/03/2014, a repudiation letter was received from the Company. The said letter of repudiation is extracted herein under:-

“This is with reference to our earlier letters dated 02^nd March, 2012, 18^th May, 2012, 30^th November, 2012, 7^th January, 2013, 21^st January, 2013, 23^rd March, 2013, 12^th Sep., 2013 and 17^th October, 2013 and your reply letters dated 7^th March, 2012, 23^rd January, 2013, 16^th Sep., 2013, 19^th September, 2013, 15^th October,2013.

In the light of the aforesaid correspondence with your goodself, we have not received the requisite documents and information to confirm the admissibility of the claim.

It is to bring to your notice that by relying on the information and documents made available to us and also placing reliance on the investigation carried out by the Police authority, it has been revealed that the material time of accident the driver of vehicle Shri Anukool Rishi was not holding valid driving licence and same amounting to the breach of Terms and Conditions laid down under Contract of Insurance and same may be read as mention herein under:-

Driver: Any person including the insured Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a licence. Provided also that the person holding an effective Learner’s licence may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 .

You are also note that, as per the medical documents made available to us, it has also been revealed that at the material time of accident driver of Insu