Branch Manager The Oriental Insurance Company Limited Vs Rakesh Kumar Sahu

1 - Thalendra Kumar @ Rupesh Kumar Sahu S/o Mohan Lal Sahu, Aged About 29 Years R/o Village Bhatgaon, Police Station Rudri, Tahsil And District Dhamtari, Chhattisgarh

¶11

2 - Harvinder Singh Juneja S/o Mangat Singh, Aged About 53 Years R/o Sundarganj Ward Dhamtari, Tahsil And District Dhamtari, Chhattisgarh

¶12

3 - Dwarika Prasad Sharma S/o Shri B.P.Sharma, R/o Mahoba Road, Chhatarpur M.P. Through Harvindar Singh Juneja S/o Mangat Singh, R/o Sundarganj Ward Dhamtari, Tahsil And District Dhamtari, Chhattisgarh

¶13

4 - Branch Manager, The Oriental Insurance Company Limited, M.B.Trade Centre, Nearby Ghadi Chowk, Dhamtari, Tahsil And District Dhamtari, Chhattisgarh

¶14

--- Respondents

¶15

MAC No. 665 of 2017

¶16

Branch Manager The Oriental Insurance Company Limited M.B.Trade Center, Near To Ghadi Chowk, Dhamtari, Tehsil And District Dhamtari, Chhattisgarh Policy No. 192000/31/2015/12750 Limitation Date- Till 30.03.2015 To 29.03.2016, Chhattisgarh

--- Appellant

2

Versus

1 - Rakesh Kumar Sahu S/o Shri Roop Kumar Sahu, Aged About 20 Years Resident Makeshwar Ward Dhamtari, Teh. And District Dhamtari, Chhattisgarh

¶21

2 - Thalendra Kumar Alias Rupesh Kumar Sahu S/o Mohan Lal Sahu, Aged About 39 Years Village Bhatgaon Thana Rudri, Tehsil And District Dhamtari, Chhattisgarh

¶22

3 - Harvindar Singh Juneja S/o Mangatsingh, Aged About 53 Years R/o Sundarganj Ward Dhamtari, Tahsil And District Dhamtari, Chhattisgarh 4 - Dwarika Prasad Sharma S/o Shri B.P.Sharma, R/o Mahoba Road Chhatarpur M.P. Through- Harvindar Singh Juneja S/o Mangatsingh, R/o Sundarganj Ward Dhamtari, Teh. And District Dhamtari, Chhattisgarh

¶23

	... Respondents
(Cause-title tak	en from Case Information System)
For Claimant	: Ms. Gurprit Kaur Bhatia, Advocate on behalf of Mr. H.A.P.S. Bhatia, Advocate
For Insurance Company	: Mr. Sudhir Agrawal, Advocate

¶24

Hon’ble Shri Amitendra Kishore Prasad, Judge

¶25

Judgment on Board

¶26

27.01.2026

¶27

1. Since both the appeals arise out of same accident, they have been clubbed together, heard together and decided by this common judgment.

¶28

2. Challenge in these appeals is to the award dated 31.01.2017 passed by the learned Additional Motor Accident Claims Tribunal, Dhamtari (C.G.) (hereinafter referred to as 'Claims Tribunal') in Claim Case No.111/2015 whereby learned Claims Tribunal allowed claim application in part of the claimant in an injury case.

¶29

3

¶30

3. MAC No.661/2017 has been filed by the claimant for enhancement of amount of compensation, whereas MAC No.665/2017 has been filed by the Insurance Company challenging the quantum of compensation as also breach of policy conditions.

¶31

4. Brief facts of the case, in a nutshell, are that, on 06.06.2015, the claimant was traveling on a bicycle from his residence at Makeshwar Ward, Dhamtari, via Sihawa Road towards FCI Godam Chowk, when the driver of Truck No. MP 16/M/0621 (for short, ‘offending vehicle’), non-applicant No. 1, allegedly driving rashly and negligently, hit him from behind. The claimant was thrown off the bicycle and dragged for 10–15 feet, resulting in severe injuries, including the entire skin of the back portion below the ankle of his right leg being torn off, nerve damage, and internal injuries. The claimant was initially admitted to Christian Hospital, Dhamtari, and later transferred to Shri Balaji Hospital, Raipur, on 08.06.2015 for advanced treatment. He underwent multiple surgeries, including operations on his right leg and plastic surgery on both thighs, incurring medical expenses of approximately Rs. 4,00,000/-, with treatment still ongoing.

¶32

5. The claimant has filed the claim petition claiming compensation of Rs.10,02,000/- from the non-applicants therein.

¶33

6. Non-applicants Nos. 1 and 2, in their counterclaim, denied the allegations, stating that the accident was due to the claimant’s

¶34

4

¶35

own negligence and pre-existing weakness in his right leg. They further contend that the vehicle was driven by a skilled and licensed driver and was duly insured.

¶36

7. Non-applicant No. 4 denied liability, alleging that the accident occurred due to the claimant’s own negligence, disputes the hospitalization claims, and asserts that the vehicle was driven without a valid license and fitness certificate, violating insurance conditions. They submit that if any award is made, it should be recovered from the other non-applicants, not from them.

¶37

8. On appreciation of pleadings, oral and documentary evidence brought on record by the respective parties, Claims Tribunal awarded compensation of Rs. 2,62,802/- along with 6% per annum from the date of filing of the claim application till its realization and fastened the primary liability to pay the amount of compensation upon the Insurance Company of offending vehicle.

¶38

9. Learned counsel for the claimant submits that the award passed by the learned Claims Tribunal is bad in law as learned Claims Tribunal has failed to properly appreciate the evidence and documents placed on record, and overlooked that prior to the incident the claimant was working as a labourer earning Rs. 200/per month, whereas after the incident he is unable to perform the work he was performing earlier. While the learned Claims Tribunal awarded Rs.2,50,399/- towards medical expenses and Rs.5,000/each for special diet, transportation, and pain and suffering, no

¶39

5

¶40

amount has been awarded towards loss of earnings during the course of treatment. It is lastly submitted that a direction should be issued to the insurance company to meet the ends of justice, and the instant appeal may accordingly be allowed.

¶41

10. On the other hand, learned counsel for the Insurance Company submits that the claim of the claimant is wholly without merit and deserves to be dismissed. It is contended that the accident, as alleged, occurred due to the contributory negligence of the claimant himself, who was riding the bicycle without due care. The claimant, it is submitted, had pre-existing weakness in the right leg, possibly due to polio or other physical infirmity, which contributed to the injuries sustained, and the learned Claims Tribunal has completely failed to consider this crucial aspect while passing the award. It is further submitted that the vehicle involved in the accident was allegedly being driven in violation of the insurance policy conditions. On the date of the accident, the driver, non-applicant No. 1, did not possess a valid and effective driving license, and there was no fitness certificate available for the vehicle. In such circumstances, the insurer cannot be fastened with liability for the alleged accident, as per the terms of the policy.

¶42

11. Learned counsel also submits that the claimant has not produced sufficient or credible evidence regarding the alleged medical expenses, hospitalization, and treatment. The documents filed by the claimant are vague, incomplete, and fail to establish the

¶43

6

¶44

duration of treatment, nature of surgeries, and actual expenditure incurred. Further, the award passed by the learned MACT is excessive, arbitrary, and without any basis in law, as it fails to consider the claimant’s own negligence, contributory factors, and the violation of insurance policy conditions. It is, therefore, prayed that if the Court is inclined to grant any compensation to the claimant, the liability should rest solely on the other nonapplicants, and the claim against the insurance company, being legally untenable, should be dismissed.

¶45

12. Reliance is placed on the decisions of National Insurance Co. Ltd. v. Swaran Singh (1992) 1 SCC 699 and United India Insurance Co. Ltd. v. B. V. Suresh (2002) 6 SCC 628 , which establish that an insurer cannot be fastened with liability where the vehicle is driven in violation of policy conditions or where contributory negligence is established. In view of the above, it is submitted that the claim against the respondent insurance company is legally untenable and should be dismissed, and if any compensation is awarded, the liability should be borne by the other non-applicants.

¶46

13. Reliance is also placed upon the decisions of the Hon'ble Apex Court in Rikhi Ram and another v. Sukhrania (Smt.) and others, (2003) 3 SCC 97 as well as Vaibhav Jain v. Hindustan Motors Pvt. Ltd., 2024 INSC 652 decided on 03.09.2024 as also the decision rendered by this Court in MAC No.123/2015

¶47

7

¶48

decided on 01.02.2021; parties being Radhakant Keshri v. Ku. Radha @ Sadha Sahu and others , to buttress his submissions.

¶49

14. I have heard learned counsel for the parties and perused the record of the claim case, including pleadings, documents, and evidence on record.

¶50

15. This Court shall first deal with the appeal filed by the claimant being MAC No.661/2017.

¶51

16. Learned Claims Tribunal has categorically dealt with the issue regarding the award of compensation in paragraphs 13 to 17 and held that prior to the incident, the claimant was earning Rs.200/per day working as a labourer and in a grocery store. As a result of the accident, he remained bedridden for six months and continues to be unable to perform his earlier work. Although the claimant claimed higher income, he admitted in cross-examination that he had not produced any documentation to substantiate his earnings. The Tribunal considered the current economic scenario and, in line with judicial precedents, fixed the claimant's notional income at Rs.4,000/- per month.

¶52

17. The Claims Tribunal examined the medical evidence and bills submitted by the claimant, including discharge summaries from Shri Balaji Hospital, Raipur (Ex.P/10 - P/13), and cash memos from Christian Hospital, Dhamtari, and other medical establishments (Ex.P/14 - P/150). While some documents did not specify the amount, the Tribunal identified and accepted the

¶53

8

¶54

admissible expenses, totaling Rs.2,50,399/-, which the claimant is entitled to receive. Additionally, considering the nature of the injuries, the Tribunal awarded Rs.5,000/- towards nutritious food, transportation, and related expenses, and Rs.5,000/- for pain and suffering, which is justified in the circumstances.

¶55

18. The Claims Tribunal awarded a total compensation of Rs.2,62,802/- along with interest at the rate of 6% per annum from the date of filing of the claim application, i.e., 12.10.2015, till the date of actual payment.

¶56

19. On careful consideration of the entire record, including the pleadings, evidence, medical documents, and the submissions of learned counsel for the parties, it is evident that the learned Claims Tribunal has meticulously examined the claim of the claimant and assessed the compensation in accordance with law. The Tribunal has taken into account the nature and extent of the injuries sustained by the claimant, the hospitalization and treatment undergone, the medical expenses incurred, and the loss of income during the period of incapacity. The total compensation of Rs.2,62,802/- awarded by the Tribunal, along with interest at the rate of 6% per annum from the date of filing of the claim application till payment, is reasonable, justified, and in consonance with settled principles of law governing motor accident claims.

¶57

9

¶58

20. There is no material on record to indicate any error or omission on the part of the Tribunal in evaluating the evidence or in determining the compensation. Consequently, the claim for enhancement of the awarded amount lacks merit and the appeal filed by the claimant in this regard is accordingly dismissed.

¶59

21. Now, this Court shall deal with the appeal filed by the Insurance Company being MAC No.665/2017.

¶60

22. The learned Claims Tribunal, while adjudicating issue No.3 relating to the alleged breach of terms and conditions of the insurance policy, has recorded a detailed finding in paragraph 12 of the award. It was contended by non-applicant No.4–Insurance Company that, on the date of the accident, the offending vehicle was being driven by non-applicant No.1 under the influence of alcohol and without holding a valid and effective driving licence, and further that non-applicant No.2 had failed to maintain a valid fitness certificate for the vehicle. On the basis of these allegations, it was urged that the vehicle was being driven in violation of the terms of the insurance policy, absolving the Insurance Company from its liability. The learned Tribunal rightly observed that the burden to establish such breach squarely lay upon non-applicant No.4–Insurance Company. However, despite raising the aforesaid pleas, the Insurance Company neither examined any witness nor adduced any documentary evidence to substantiate the alleged violation of policy conditions. On the contrary, the property seizure

¶61

10

¶62

memo (Ex.P/9) placed on record clearly reflects that, at the time of seizure, the insurance policy of the offending vehicle as well as the driving licence of the driver, Thalendra Kumar Sahu, were seized by the investigating agency, indicating due compliance with the statutory requirements. In view of the same, the learned Claims Tribunal arrived at a categorical conclusion that the plea of breach of insurance policy remained unproved and accordingly fastened the primary liability to satisfy the award upon the Insurance Company.

¶63

23. Upon anxious consideration of the entire record, including the pleadings, oral and documentary evidence, and the findings recorded by the learned Claims Tribunal, this Court finds no infirmity or perversity in the impugned award so far as it relates to the fastening of liability upon non-applicant No.4–Insurance Company. It is well-settled that the onus to prove breach of policy conditions lies upon the insurer, and such breach must be established by cogent and reliable evidence. In the present case, except for making bald allegations in the written statement, the Insurance Company has failed to lead any evidence whatsoever to demonstrate that the driver was under the influence of alcohol, was not holding a valid driving licence, or that the vehicle lacked a valid fitness certificate. The property seizure memo (Ex.P/9), on the contrary, lends support to the case of the claimants by showing that both the insurance policy and the driving licence of the driver were in existence. In the absence of any material

¶64

11

¶65

establishing violation of the policy conditions, the statutory liability of the Insurance Company to indemnify the insured cannot be avoided. Consequently, the appeal filed by the Insurance Company, being devoid of merit, is liable to be and is hereby dismissed.

¶66

24. In the result – both the appeals; such as (i) MAC No. 661/2017 filed by the claimant and (ii) MAC No. 665/2017 filed by the Insurance Company are dismissed .

¶67

25. The record of the concerned Motor Accident Claims Tribunal be sent back forthwith along with a copy of this judgment for information and necessary compliance.

¶68

Sd/-

¶69

(Amitendra Kishore Prasad) Judge

¶70

Yogesh

Branch Manager The Oriental Insurance Company Limited v. Rakesh Kumar Sahu

Case brief

What is this about?

Branch Manager The Oriental Insurance Company Limited v. Rakesh Kumar Sahu

Case brief

What is this about?

What did the court decide?

Why is it important?

What the court decided

Issues for consideration

Cases cited

Procedural history

Parties & counsel

Coram

Case details

Similar cases

Rashid Mohammad Vs State of Chhattisgarh

Prabha Markam Vs State of Chhattisgarh

Dilip Singh Thakur Vs State of Chhattisgarh

Mohan Marco Vs Mohan Singh Gond @ Golu Gond

Santosh Lohana Vs Ku. Neha Banjare

Rakesh Kumar Sahu Vs Thalendra Kumar @ Rupesh Kumar Sahu