The Himachal Pradesh State Consumer Disputes Redressal Commission, presided over by Justice Inder Singh Mehta (President), found ‘Shriram General Insurance Company’ accountable for denying a personal accident claim on the grounds that the insured owner was not driving the vehicle during the accident. The Commission determined that the insurance policy covered the deceased owner, who had the right to designate another individual as the driver.
Summary of Events
Mr. Ramesh (the ‘Deceased’) owned a vehicle insured by Shriram General Insurance Company (‘Insurance Company’). The Deceased also held personal accident coverage with the same insurer. While the policy was in effect, the vehicle was involved in an accident resulting in the Deceased’s death. The Complainants, who are the legal heirs of the Deceased, submitted a claim to the Insurance Company. Initially, a surveyor was appointed to assess the claim, but later, the Insurance Company rejected it. Dissatisfied with this decision, the Complainants filed a consumer complaint with the District Consumer Disputes Redressal Commission, Una, Himachal Pradesh (‘District Commission’).
In its defense, the Insurance Company argued that upon receiving notice of the incident, the appointed surveyor assessed the damage at Rs. 55,250 for repairs. However, it was discovered that at the time of the accident, the vehicle was carrying four individuals, including the driver, which constituted a violation of the insurance policy’s terms and conditions.
The District Commission ruled in favor of the complainants, ordering the Insurance Company to release the insurance payout to them. Unhappy with this decision, the Insurance Company filed an appeal with the State Consumer Disputes Redressal Commission, Himachal Pradesh (‘State Commission’).
In its defense, the Insurance Company argued that upon receiving notice of the incident, the appointed surveyor assessed the damage at Rs. 55,250 for repairs. However, it was discovered that at the time of the accident, the vehicle was carrying four individuals, including the driver, which constituted a violation of the insurance policy’s terms and conditions.
The District Commission ruled in favor of the complainants, ordering the Insurance Company to release the insurance payout to them. Unhappy with this decision, the Insurance Company filed an appeal with the State Consumer Disputes Redressal Commission, Himachal Pradesh (‘State Commission’).
It was observed that the Insurance Company rejected the claim citing that there were 3+1 persons in the vehicle, exceeding the seating capacity specified in the insurance policy of 2+1. However, this reason for denying the claim was deemed unjustified since the additional passenger did not contribute to the accident. Upon reviewing the FIR, which attributed the accident to the driver’s excessive speed rather than overloading, the State Commission dismissed the Insurance Company’s appeal. Consequently, the Insurance Company was instructed to pay Rs. 2 lakh to the Complainants as compensation for the personal accident claim.
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