Search This Blog

Thursday, July 3, 2014

MACT - No Fault liability .................... fraudulent claim on Insurers

Every road in every city bustles with traffic - with the increasing no. of vehicles, congested roads, speed, recklessness, urbanization, transport vehicles – accidents on the road are common place. Many of us have seen some accidents – death and injuries are not to be construed at medico legal phenomena alone. There are many profound psychological and social consequences apart from the death or the injuries. The sufferings can seldom be quantified in financial terms. More significant would be the horrific trauma caused to those bereaved by the sudden, unexpected snatching away of the bread winner.  Motor Insurance is compulsory ~ all vehicles on public road should compulsory have insurance – not a policy covering the vehicle or its owner but some, which are stated in the Motor Vehicles Act itself.

In days of yore, to give effective rights to the person injured or expired in an accident, Fatal Accidents Act, 1885 was enacted in India. This Act provided only a procedure and a right of named legal heirs to claim compensation from the person committing negligence. In 1939, Motor Vehicles Act, a statute consolidated the laws relating to motor vehicles. This has since been replaced by MV Act 1988.  Motor Accident Claims Tribunal [MACT] have been set up in accordance with the statute and the injured or the legal representatives of deceased can file claim application in MACT.

The Motor Vehicles Act and the setting up of MACT is considered beneficial legislation in nature – a legislation that has a broader view considering the welfare of people.  MACTs are set up for providing correct and speedy compensation to the victims of road accidents.  One of the sections is Sec 140 – which provides for liability to pay compensation in certain cases on the principle on no fault. Under this, the claimant shall not be required to plead and establish that the death or permanent disablement in respect of which the claim has been made was due to any wrongful act, neglect or default of the owner or owners of the vehicle or vehicles concerned or of any other person.

It would appear that the Insurers would on receipt of copy of petition should deposit at least the ‘no fault liability’ – but it has been the experience of Insurers that in some instances, the involvement of the vehicle that allegedly caused the accident as also its subsisting insurance, also become contentious issues. Now read this article that recently appeared in Times of India, Chennai edition titled ‘Court fines women who faked evidence to get accident claim’

The two widows perhaps had good reason to claim compensation after their husbands died in a hit-and-run case. But in the absence of evidence to buttress their claim, they resorted to deception and succeeded in receiving a combined compensation of Rs.14.5 lakh. But after their fraud was exposed, the Madras high court has quashed the claim.

On May 5, 2005, Stephen Chelladurai was riding a bike with N Illangovan on the pillion. They were going from the city to Chengalpet when near Peramanur village on GST Road they were hit by an unidentified vehicle driven in a rash manner. Chelladurai died on the spot while IIangovan died on his way to a hospital. The next year, Chelladurai's wife Chitra and Illangovan's wife E Pushparani approached the Motor Accident Claims Tribunal (MACT) stating an auto belonging to A R Iyappan and driven by A R Boobalan caused the accident. After investigation, S Krishnan, inspector of MM Nagar police station, confirmed the auto was involved in the accident. The tribunal in August 2011 ordered a compensation of `7.32 lakh to Chitra and `7.28 lakh to Pushparani.

Against the order, United India Insurance, Royapettah, filed an appeal in the Madras high court. After granting an interim stay in February , the court in July 2012 said a chargesheet had not been filed against the driver. It then directed the Superintendent of Police, Kancheepuram, to investigate and file a report.  In Mar 2014, the district crime branch submitted its report stating the wives of the victims had made a false complaint. The report also said the police had filed a chargesheet against the owner of the auto, the auto driver, the two women and the police inspector on charges of fraud. There was a collusion between the accused to defraud the insurance company , said the report, adding that while the owner had been arrested, others remained absconding.

Explaining the “apparent fraud,“ Justice S Manikumar said the forensic department had said the injuries were severe and could not have been caused by an auto. The auto involved in the accident was sold four days after the accident and found to be fit by RTO authorities. As such there was a nexus between the accused who “played a fraud in making a bogus claim“ and “roped in the auto.”  Rapping the tribunal for allowing the claim, the court said “it is the duty of the tribunal to examine the evidence thoroughly...“ The court slapped the two women with a fine of Rs.10,000 each and rejected their plea to file a special leave petition in the Supreme Court against its order.

Insurers are custodians of public money – and policy pay outs be it indemnity or compensation must be fair and to the rightful recipients.

With regards – S. Sampathkumar.
27th June 2014.

No comments:

Post a Comment