Orissa High Court
M/S. Orissa Tourism Development vs M/S Oriental Insurance Company Ltd. ... on 25 June, 2024
Author: S.K. Panigrahi
Bench: S.K. Panigrahi
Signature Not Verified
Digitally Signed
Signed by: BHABAGRAHI JHANKAR
Reason: Authentication
Location: ORISSA HIGH COURT, CUTTACK
Date: 18-Jul-2024 16:37:51
IN THE HIGH COURT OF ORISSA AT CUTTACK
W.P.(C) No.13362 of 2013
(In the matter of an application under Articles 226 and 227 of the
Constitution of India, 1950).
M/s. Orissa Tourism Development .... Petitioner (s)
Corporation Ltd., Bhubaneswar
-versus-
M/s Oriental Insurance Company Ltd. .... Opp. Party (s)
and Anr.
Advocates appeared in the case:
For Petitioner (s) : Mr. Sailaja Nandan Das, Adv.
-versus-
For Opp. Party (s) : Mr. S. Ray, Adv.
(for O.P.1)
CORAM:
DR.JUSTICE S.K. PANIGRAHI
DATE OF HEARING:-19.04.2024
DATE OF JUDGMENT:-25.06.2024
Dr. S.K. Panigrahi, J.
1. This Writ Petition has been filed seeking a Writ in the nature of
Mandamus against the inaction on the part of the Opposite Party
No.1 for not disposing/settling of the insurance claim in respect of
the Insurance Policy No.345300/31/2009/1588 in
disposing/settlement of the insurance claim in respect of the vehicle
bearing No. OR-02-AR-2388 (Innova) and the medical claim of the
pg. 1
Location: ORISSA HIGH COURT, CUTTACK
Opposite Party No.2, the Junior Driver of the said vehicle inter alia
on the groundthat the vehicle in question which they are legally
bound to settle under the Motor Vehicle Act, 1988, and Workmen's
Compensation Act, 1923.
I. CASE OF THE PETITIONER:
2. Succinctly put, the facts of the case are as follows:
(i) The vehicle, bearing Registration No. OR-02-AR-2388 (Innova),
is one of such vehicle owned by the petitioner having valid
insurance under the Opposite Party No.1, bearing Insurance
Policy No. 345300/31/2009/1588. The Policy covers the claim
under the Motor Vehicle Act so also under the
Workmens'Compensation Act.
(ii) The Opposite Party No.2 is working as a junior driver in the
establishment of the petitioner. The Opposite Party No. 2 was
assigned the duty to drive the vehicle bearing No. OR-02-AR-
2388 (Innova) on 18.05.2009 and while he was on duty on
18.05.2009, near Gandia P.S. in the district of Dhenkanal, some
miscreants stopped the vehicle, assaulted the Opposite Party
No.2 and snatched away the vehicle from him. Consequently,
the Opposite Party No.2 sustained grievous injury and
undergone treatment and remained in hospital for some days.
(iii) The Opposite Party No.2 submitted a medical bill amounting to
Rs. 3,08,433/- for reimbursement, claiming to have made the
expenditure towards treatment. It is further submitted that the
pg. 2
Location: ORISSA HIGH COURT, CUTTACK
Petitioner No.1 has already paid an amount of Rs.2,10,000/- as
an advance to the Opposite Party No.2 for his treatment.
(iv) Soon after the accident, the Divisional Manager (TTT) of the
petitioner informed the Opposite Party No.1 about theft of
Innova car and the injuries sustained by the Opposite Party No.2
vide Office letter No. 2736 dated 19.05.2009. Subsequently, the
Divisional Manager (TTT) vide letter No. 2826 dated 26.05.2009
made a request to the Opposite Party No.1 to provide insurance
help to the Opposite Party No.2.
(v) Thereafter, on the advice of Opposite Party No.1, the General
Manager of the Petitioner submitted the medical bills of the
Opposite Party No.2 with request to settle the claim vide Office
letter No.5361 dated 07.10.2009. However, no steps were taken
by the Insurance Company for which the Opposite Party No.2
filed a Writ Petition before this Court.
(vi) The Opposite Party No.2 had filed W.P.(C) No.17661 of 2009
before this Court claiming reimbursement of the medical claim.
This Court by order dated 01.02.2010 was pleased to dispose of
the said writ petition directing the Petitioner to take steps to
dispose of the representation of the Opposite Party No.2 in
accordance with law with the observation that if necessary
moved the Insurance Company.
(vii) It is submitted that the said case was disposed of at the stage of
admission without notice to the Petitioner. Pursuant to the order
pg. 3
Location: ORISSA HIGH COURT, CUTTACK
of this Court, the Opposite Party No.2 submitted a
representation dated 20.02.2010 along with the order of this
Court to consider for release of his medical bills.
(viii) The Divisional Manager of the petitioner made request to the
Opposite Party No.1 to dispose of the medical insurance claim in
respect of the Opposite Party No.2 immediately for compliance
of the order of this Court vide letter No. 1414 dated 15.03.2010
with intimation to the Opposite Party No.2 and again similar
request was made to the Opposite Party No.1 vide Office letter
No. 5298 dated 02.08.2011 with intimation to theOpposite Party
No.2.
(ix) Besides the request made in writing the Divisional Manager (P)
of the petitioner has been approaching the Opposite Party No.1
in person on several occasion though the Opposite Party No.1
assured to settle the claim but till date no settlement has been
made on the claim under the Insurance Policy. The Insurance
Policy under Annexure-1 is a comprehensive policy/first party
wherein the Opposite Party No.1 has taken the
responsibility/liability to settle the claim towards the damage,
cost of the vehicle so also the loss to driver, helper and the
passengers etc. The Opposite Party No.2 is a driver in the
vehicle in question and he was sustained injuries while driving
the vehicle, thereby the Opposite Party No.1 is legally bound to
settle the claim.
pg. 4
Location: ORISSA HIGH COURT, CUTTACK
(x) The petitioner has furnished the claim and medical bill of the
Opp. Party No.2 and copy of the order of this Court to the
Opposite Party No.1 and has been approaching in writing so
also in person to the Opposite Party No.1 for settlement of the
said claim. But no action has been taken by the Opposite Party
No.1 on the claims, thereby putting the Petitioner as well as
Opposite Party No.2 to an embarrassment position and such
inaction is amount to denial of getting thebenefits under the
Insurance Policy.
(xi) The Petitioner has taken all steps to help him making available
of the benefit to the Opp. Party No.2. Due to in action of the
Opp. Party No-1, the Petitioner is not in a position to dispose of
the representation of the Opp. Party No.2 as per the order of the
Court.
(xii) The Opp. Party No.1 is legally bound to consider the claim of
the Petitioner and the Opp. Party No.2 as per the terms and
condition of the Insurance Policy under Annexure-1. The
Petitioner as well the Opp. Party No.2 has accrued right to bet
the claim, which is a fundamental right. Non-consideration of
the claim is an act of violation of the Insurance Policy.
II. SUBMISSIONS ON BEHALF OF THE OPPOSITE PARTY:
3. Per Contra,the counsel appearing on behalf of the Opp. Party No.1
urged the following submissions:
pg. 5
Location: ORISSA HIGH COURT, CUTTACK
(i). The Petitioner had been issued a Motor Insurance Certificate-
cum-package policy in respect of the Car bearing Reg. No. OR-02-
AR-2388 in accordance with the provisions of Chapter X and
Chapter XI of the Motor Vehicles Act to cover the risk of own
damage as well as to cover the risk of Third Party liability.
(ii). The policy in question is neither a Mediclaimpolicy nor it is
Group Insurance Policy, so the medical expenses relating to the
treatment of the Opp. Party No.2 is not covered under the Motor
Policy issued by the Opp. Party No. 1. Further, the Opp. Party
No.2 is only entitled to get compensation if any, under
Employee's Compensation Act, if it is proved that the Opp. Party
No. 2 has suffered permanent physical disability as well as Loss
of earning capacity due to the injuries sustained in the accident
which is a disputed question of fact and cannot be adjudicated in
writ jurisdiction.
(iii). The petitioner being the employer of Opp. Party No.2, it has an
onerous duty to look after the welfare of its employees and ought
to have reimbursed the medical bills of the Opp. Party No.2
instead of approaching the Opp. Party No.1 to reimburse the
medical bills submitted by the Opp. Party No.2 which this Opp.
Party No.1 is not liable to pay/reimburse.
III. COURT'S ANALYSIS AND REASONS:
4. Heard the Parties at length and perused the materials placed on
record.
pg. 6
Location: ORISSA HIGH COURT, CUTTACK
5. Medical compensation can be claimed under a motor vehicle
insurance policy. The process and eligibility for such compensation
depend on the type of insurance coverage and the specific
circumstances of the accident.
6. The petitioner was issued a Motor Insurance Certificate-cum-
package policy for the car with registration number OR-02-AR-2388,
in compliance with Chapter X and Chapter XI of the Motor Vehicles
Act. This policy covers both own damage and third-party liability
risks. However, this policy is not a Mediclaim policy nor a Group
Insurance Policy, which means it does not cover medical expenses
incurred by Opp. Party No. 2 for treatment. Therefore, the medical
costs related to Opp. Party No. 2's treatment are not covered under
the motor insurance policy issued by Opp. Party No. 1.
7. Furthermore, Opp. Party No.2 is eligible for compensation only
under the Employee's Compensation Act. This is contingent upon
proving that Opp. Party No. 2 has sustained a permanent physical
disability and a loss of earning capacity due to the injuries from the
accident. This determination involves disputed facts that cannot be
resolved through writ jurisdiction.
8. As the employer of Opp. Party No. 2, the Petitioner has a significant
responsibility to ensure the welfare of its employees. The Petitioner
should have reimbursed Opp. Party No.2's medical bills themselves/
instead of seeking reimbursement from Opp. Party No.1, who is not
obligated to cover these medical expenses.
pg. 7
Location: ORISSA HIGH COURT, CUTTACK
9. With respect to the aforesaid discussion, this Court is not inclined to
allow the prayer of the Petitioner. However, the employer of
Opposite Party No.2 is directed to reimburse the medical expenses
incurred on account of the treatment of the junior driver as he had
suffered the injury while on duty. The said reimbursement to be
settled within a period of three months from today.
10. This Writ Petition is dismissed.
(Dr. S.K. Panigrahi)
Judge
Orissa High Court, Cuttack,
Dated the,25th June, 2024/
pg. 8
