Case Law Details
The Cholamandalam MS General Insurance Company Limited Vs Ramesh Babu (Madras High court)
In the present case, the Personal Accident Coverage Policy has been agreed between the appellant/Insurance company as well as the respondent. Rs.2,00,000/- is fixed under the Personal Accident Coverage Policy. The Tribunal has granted a sum of Rs.2,16,500/-towards compensation. The Tribunal has not adjudicated the maintainability of the Claim Petition by looking into the terms and conditions stipulated in the Insurance Policy. With reference to the nature of injuries, there must be an adjudication strictly with reference to the Personal Accident Coverage Policy. Suffering an injury is one aspect. The Coverage provided under the terms and conditions of the policy is also important, so as to decide the entitlement of compensation.
For instance, the Personal Accident Coverage Policy states that the compensations are payable under 4(a), which is stated in Section IV of Personal Accident Cover for owner-cum-driver. Therefore, if the injuries are within the scope of the agreement, then alone, the person covered under the Personal Accident Cover is entitled to get compensation. Even otherwise, the said entitlement cannot be adjudicated by the Motor Accident Claims Tribunal as the terms and conditions are contractual in nature and not statutory in character. Only the statutory liability are amenable to the jurisdiction of the Motor Accident Claims Tribunal and not the contractual liability. All such contractual liabilities are falling within the scope of the Indian Contract Act and the aggrieved persons to the contract can approach the competent Court of Law and not the Motor Accident Claims Tribunal under the Motor vehicles Act.
This being the scope of the policy now in dispute in the present appeal, this Court is of the considered opinion that the Tribunal has not adjudicated these grounds raised by the appellant in their counter before the Tribunal. This apart, for availing the benefit of Personal Accident Coverage Policy, the respondent/claimant has to establish the nature of the ‘disablement’ and the same is to be established before the competent Court of law and the Motor Accident Claims Tribunal is not empowered to entertain the Claim Petition under the Motor Vehicles Act. This being the principles to be followed, this Court is of the considered opinion that the Tribunal has committed an error in not adjudicating the legal issues raised by the appellant/insurance company nor decided the issue with reference to the terms and conditions of the Personal Accident Coverage Policy. For all these reasons, the judgment and decree is perverse.
Accordingly, the judgment and decree dated 10th July 2018 passed by the Motor Accidents Claims Tribunal / III Additional District Court, Kallakurichi in M.C.O.P.No.27 of 2013 is set aside and the Civil Miscellaneous Appeal in C.M.A.No.2434 of 2019 stands allowed.
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