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2012 (11) TMI 692 - SC - Indian LawsLiability of Insurance Company - To indemnify appellant not being a third party - Workman s Compensation Act - The insurer resisted the claim on the grounds that the claimant had suppressed the fact that he was the Managing Director of the company and hence, the application deserved to be thrown overboard; that even if the petition was entertained the insurance company could not be held liable to indemnify the respondent as the appellant was himself the owner being the Managing Director and under no circumstances he could be treated as a third party; that the policy taken by the company did not cover an occupant in the vehicle but only covered the owner for a limited quantum and hence, the claim was not allowable as sought for. Held that - Before the High Court, the Competent Authority of IRDA had stated that on 2nd June, 1986, the Tariff Advisory Committee had issued instructions to all the insurance companies to cover the pillion rider of a scooter/motorcycle under the comprehensive policy and the said position continues to be in vogue till date. The question that emerges for consideration is whether in the case at hand, the policy is an Act Policy or Comprehensive/Package Policy . - Matter remanded back to the tribunal to scrutinize the policy in a proper perspective and, if necessary, by taking additional evidence and if the conclusion is arrived at that the policy in question is a Comprehensive/Package Policy , the liability would be fastened on the insurer.
Issues Involved:
1. Entitlement of the Managing Director to claim compensation from the insurer. 2. Liability of the insurer to indemnify the claimant. 3. Classification and coverage of the insurance policy (Act Policy vs. Comprehensive/Package Policy). Detailed Analysis: 1. Entitlement of the Managing Director to Claim Compensation from the Insurer: The primary issue was whether the Managing Director of the respondent company could claim compensation for bodily injuries sustained in an accident. The tribunal held that the accident occurred due to the rash and negligent driving of the driver, and the Managing Director, as an occupant, was entitled to compensation. The High Court concurred, treating the Managing Director as a third party, thus making the insurer liable. 2. Liability of the Insurer to Indemnify the Claimant: The insurer contested the claim on several grounds, including the argument that the Managing Director, being the owner, could not be treated as a third party, and the policy did not cover non-fare paying passengers. The tribunal and the High Court found the insurer liable, as the vehicle was registered in the company's name, and the Managing Director was considered a passenger. The Supreme Court analyzed various precedents, including *United India Insurance Co. Ltd. v. Tilak Singh* and *Oriental Insurance Co. Ltd. v. Jhuma Saha*, which clarified that statutory policies do not cover gratuitous passengers or owners unless specified. 3. Classification and Coverage of the Insurance Policy (Act Policy vs. Comprehensive/Package Policy): A significant aspect was determining whether the insurance policy was an "Act Policy" or a "Comprehensive/Package Policy." The Supreme Court noted that comprehensive/package policies cover occupants in the vehicle, unlike Act policies. The court referred to circulars from the IRDA and the Tariff Advisory Committee, which mandated that comprehensive/package policies cover liabilities towards occupants. The Supreme Court emphasized that the tribunal and the High Court did not adequately discuss the nature of the policy. Therefore, the matter was remitted to the tribunal to scrutinize the policy terms and determine if it was a comprehensive/package policy. Conclusion: The Supreme Court set aside the High Court and tribunal's findings regarding the insurer's liability and remitted the matter to the tribunal for further adjudication on the policy's nature. If the policy is found to be comprehensive/package, the insurer would be liable to indemnify the claimant. Other findings by the tribunal and the High Court were left undisturbed. The appeal was allowed to the specified extent, with no order as to costs.
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