NATIONAL INSURANCE COMPANY LTD vs MANI DEVI

HEARD learned Counsel for the parties and with their assistance, have also examined the record of the complaint file.

ALONG with this appeal, two applications being M. A. No. 385/2007 for additional evidence i. e. for production of copy of the policy with terms and conditions, and M. A. No. 386/2007 for amendment of reply, have been filed by the appellants. Prayer to allow these applications is based on the fact that due to inadvertent bona fide oversight, complete copy of Policy of Insurance could not be produced and also the plea based on Section IV "personal Accident Cover for Owner Driver" could not be set out in the original reply filed before the District Forum below. However, in response to our specific query, Mr. Tajta pointed out that complete copy of Policy of Insurance along with its terms and conditions was in the possession of his client. He however submitted that technicality should not be allowed to come in the way of grant of substantial justice. Further according to Mr. Tajta, in any event, when insurance is admitted, non-filing of the complete copy of Insurance Policy should not be denied to his client by way of additional evidence. Per Mr. Tajta, respondent shall get an opportunity to controvert/rebut the additional evidence. All these pleas have been controverted by the learned Counsel for the respondent Mr. Paul, who urged that the filing of both the applications is nothing but an abuse of the process of law and Court on the part of the appellants. In this behalf, he urged that there is no reason much less a good and valid reason given for not filing the complete copy of Policy of Insurance as also basing its defence on the terms thereof as now intended by way of amendment of reply to the complaint.

So far application for amendment of written statement is concerned, it is dependent on production of additional evidence because the appellant-Insurance Company wants to rely upon Section IV, Personal Accident Cover For Owner Driver. Therefore, firstly plea has to be raised and thereafter it was to be supported with the evidence as now intended by way of additional evidence. Merely saying that due to bona fide inadvertent mistake, complete copy of the insurance policy could not be filed, is no ground for allowing this application. This question has otherwise been set at rest by the National Commission in the case of Sanatan Financier and Real Estate Pvt. Ltd. v. Surinder Singh ghally and Ors. , I (2006) CPJ 127 (NC)=2006 (1) CPR 144 (NC ). Accordingly, while disallowing the application for additional evidence, the other application for amendment of reply to the complaint based on the terms and conditions of this policy is also rejected. Both these applications stand disposed of.

NOW coming to the merits of the case as urged by Mr. Tajta. According to learned Counsel on the following grounds also, this appeal deserves to be allowed: (a) Driving licence of owner-cum-driver deceased Jagdish Chand was not produced. (b) Personal accident claim intimation was not given. (c) Personal accident claim form duly complete was not furnished; (d) Copy of FIR and final report was not submitted; (e) Death certificate of deceased Jagdish Chand was not furnished; and (f) Legal heirs certificate was not given.

As such till all these documents were furnished, his client was justified in not paying the amount in question. Thus, according to him, appeal deserves to be allowed and he prayed for accordingly. Per Mr. Tajta, in response to the legal notice issued by the mother of the deceased Jagdish Chand, the admitted owners-cum-driver of the vehicle vide Annexure C8, aforesaid documents were demanded. Since needful was not done, as such complaint was not maintainable and District Forum below fell into error in allowing the same while awarding the compensation.

THESE pleas have been contested on behalf of the respondent and her learned Counsel submitted that as an extended arm of the welfare state, appellant has adopted unfair trade practice besides being deficient in providing service by not paying the amount in question and instead forcing his client to come to Court by way of complaint. Thus, he prayed for dismissal of the appeal with costs and punitive damages. We shall deal with each grounds urged in support of this appeal, one by one. So far as plea regarding driving licence of the deceased as owner-cum-driver having not been given is concerned, this plea is being noted simply to be rejected. Reason being that while insuring the vehicle in question which included the benefit of risk in case of the death, etc. of the owner-cum-driver as in the present appeal, it is presumed that the insurer i. e. the appellant had satisfied itself regarding not only of the ownership but also of the said owner holding a valid and effective driving licence. In case the deceased was not holding such a licence as required under law, we have no hesitation in observing that the deceased would not have been insured so far as benefit available to him as owner-cum-driver is concerned. Further issuance of this particular type of policy pre-supposed that on being fully satisfied, it was issued by the appellant. And it is not the case of the appellant that policy was not issued without being satisfied on this aspect. As such this plea is devoid of any merit and, therefore, rejected.

SO far as the non-furnishing of the accident claim intimation as well as personal accident claim form duly complete having not been filed are concerned, we are taking up these pleas together. Own damage claim has been admittedly settled and paid. And as per documents on the file, it is clear that the amount in queestion was paid to the financier. It is not the case of the appellants that it was not aware regarding the death of Jagdish Chand, the insured owner-cum-driver. Therefore, mere non-furnishing of personal accident claim intimation is a plea which is raised simply for the sake of argument without any substance. In what manner, the personal accident claim form was incomplete, learned Counsel for the appellant was not in a position to point out anything from the record, save and except by reiterating that it was not submitted duly complete. This submission on behalf of the appellants goes to show that the form had been submitted but it was not complete and in what manner it was incomplete, there is no material placed on record. As such, this plea likewise is totally frivolous raised on behalf of Insurance Company. From the material on record including reply to the notice, death of Jagdish Chand is admitted besides being otherwise clearly established.

FOR what purpose the death certificate was required, we are not able to understand. Facts which are admitted need not be proved. Therefore, on this ground also, no fault can be found with the order of the District Forum below. In the facts of this case non-filing of death certificate is wholly immaterial. Now coming to the last plea regarding non-submission of legal heir certificate by the respondent. Admittedly, the respondent is mother of the deceased and is class-I heir under law. In case there was any other legal heir, who is he or she, nothing could be pointed out on behalf of the appellants. We may observe in this behalf that it is not the case of the appellants that any one else has come forth till date, after the accident which in the instant case took place on 21. 3. 2004, staking claim being a legal heir of the deceased in addition to the respondent.

Before parting with this case, we may observe that it is high time that the Insurance Companies like the appellant No. 1 which are wholly controlled and owned by the Government of India, come out of the slumber and become more professional, particularly when the private players have entered the field and the competition in the business is cut throat rather than treating the cases in a cursory and casual manner as they are dealing with the public money and are its custodians. There cannot be a better example on the part of the Insurance Company of its casual approach in the light of the facts of this case.

FACED with the aforesaid facts, learned Counsel for the appellants tried to catch the last straw. He submitted that his client has already settled the own damage claim as noted hereinabove. Had the necessary documents been supplied, they would have settled the same, as such there is neither any deficiency in service nor any unfair trade practice on the part of his client. Therefore, on this ground he prayed for allowing this appeal. We are not at all impressed by this submission of Mr. Tajta. At the risk of repetition, we may observe that approach of the appellants have to be more business-like in the face of the hard competition not amongst the Government owned Companies, but also with the private players in the field of insurance. As such this plea also merits rejection. Ordered accordingly. No other plea was urged. In view of the aforesaid discussion, there is no merit in this appeal which is accordingly dismissed, leaving the parties to bear their own costs. All interim orders passed from time-to-time in this appeal shall stand vacated forthwith. Learned Counsel for the parties have undertaken to collect the copy of this order from the Reader free of cost. Appeal dismissed.