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Ncdrc Raps Insurance Company For Ambiguous Term; Ordered The Insurance Company To Pay Additional Compensation Of 2 Lakhs For Unfair Trade Practice

The National Consumer Disputes Redressal Commission (NCDRC), New Delhi rapped United India Insurance Co. Ltd for using an ambiguous term, “owner-driver” in their policy and then refusing a woman’s claim relying on the same.

The complaint was filed by the parents of Shobhit Kumar, who had died in a road accident while driving a motorcycle insured with the petitioner insurance company. The registered owner of the vehicle was the mother of the deceased, Shobhit Kumar. The award of insurance amount was challenged mainly on the ground that the term “owner-driver” in the policy meant that the policy covered only the owner as the driver, and since the vehicle was not being driven by the owner at the time of the accident, the insurance amount should not have been awarded. The complainants, on the other hand, had contended that the term ‘owner–driver’ includes the owner as well as their son, who was driving the motorcycle with the consent of the registered owner– premium payer, the mother and was a major with a valid driving license.

The NCDRC Bench comprising Dr. SM Kantikar and Mr. Dinesh Singh was hearing a revision petition filed by the insurance company, challenging the order passed by the District Forum and the State Commission, finding it guilty of deficiency in service. The impugned orders had directed it to pay the insured amount of Rs. 1,00,000 to the complainants, with interest at 8% per annum from the date of filing the consumer complaint till the date of actual payment.

The NCDRC Bench analysed the facts and stated that the term ‘owner – driver’ is in itself ambiguous and unclear. In case it was meant to construe only the owner-cum-driver herself driving, the same should have been unambiguously and clearly stated in the insurance policy. As would appear to a reasonable person, the proposition intended to be conveyed and understood was that the owner, as well as the driver, will be covered under the policy. Also, Court observed that in the case of a lady who purchased a motorcycle in a district like Mainpuri in the State of Uttar Pradesh, where the terrain is difficult, the ordinary residents / consumers of the area are simple, innocent, hard-working. A lady purchasing a motorcycle in her registered name would in all probability be purchasing it for her husband or sonor brother etc. Again, the lady paying an extra premium of Rs. 50/- for personal accident cover would in all probability be doing so out of concern and fear for her husband or son or brother.

The National Commission added that the onus was on the insurance company to make its terms and conditions unambiguous and clear, at the time of selling the policy to the consumers. Having included the ambiguous term in the policy, NCDRC opined that the insurance company was not just guilty of deficiency of service but also of unfair trade practice.

Further, the National Commission directed that the insurance company shall discontinue its unfair trade practice and shall make its term ‘owner – driver’ unambiguous and clear in its future insurance policies.

The Commission said that after buying the personal accident cover with extra premium in good faith as ordinary simple consumer, and after the death of her major son in accident, the registered owner – mother(and also the father) were made to undergo litigation in one, two, three consumer forum, one after the other, after first rejecting the claim with mechanical application of ‘rules’ and without the due and conscious application of mind and coming forth with its own interpretation of its own ambiguous and unclear term after the accident and death occurred and after the claim was made, and repudiating the claim at its own end on the basis of its own interpretation and considering the loss and injury, continuous harassment and difficulty, the Commission directed the insurance company to pay addition compensation of Rs.2,00,000/- with interest .

Consumer justice in the true sense has to be met. The National Commission said that once the amount awarded for deficiency in service and the amount awarded in addition for unfair trade practice are adjudicated and determined, the onus is on the insurance company to be prompt and dutiful in making the necessary payments within the stipulated time. Therefore, if the insurance company delays the adjudicated payments beyond the time stipulated, it would and should attract higher /penal interest and other compensation / costs, which will be determined by the Commission if the contingency so arises. And the unfair trade practice must end promptly and fully, the Commission said.

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