Page No.# 1/6 GAHC010085252023 2025:GAU-AS:463 THE GAUHATI HIGH COURT (HIGH COURT OF ASSAM, NAGALAND, MIZORAM AND ARUNACHAL PRADESH) Case No. : WP(C)/2235/2023 THE RELIANCE GENERAL INSURANCE COMPANY LTD. HAVING ITS REGISTERED OFFICE AT 19, RELIANCE CENTRE, WALCHAND HIRACHAND MARG, BALLARD ESTATE, MUMBAI-400001 AND CORPORATE OFFICE AT 570, RECTIFIER HOUSE, NAGUAM CROSS, NEXT TO ROYAL INDUSTRIAL ESTATE, WADALA (W), MUMBAI-400031 AND ONE OF THE BRANCH OFFICES AT PRAG PLAZA, 5TH FLOOR, M.S.S. PATH, G.S. ROAD, BHANGAGARH, GUWAHATI-781005, REPRESENTED BY THE ASSOCIATE LEGAL CLAIMS MANAGER. VERSUS THE INSURANCE OMBUDSMAN AND ANR. LAKHTOKIA, GUWAHATI-781001. 2:AYNAL HAQUE S/O- SAKED ALI VILL.- DAROGAR ALGA P.O. DUBAPARA P.S. PANCHARANTA DIST. GOALPARA ASSAM PIN- 783101 Advocate for the Petitioner : MR. A J SAIKIA, MR. S. PEGU Advocate for the Respondent : MR M HOQUE (r-2), MR. R ALOM (R-2),MR. M ISLAM (R-2),MR S HOQUE (R-2),MD A WADUD ,MR. R A CHOUDHURY (r-2) Page No.# 2/6 BEFORE HON’BLE MR. JUSTICE KARDAK ETE O R D E R 20.01.2025 Heard Mr. A.J. Saikia, learned counsel for the petitioner. Also heard Mr. S. Hoque, learned counsel for the respondent no.2. None appears for the respondent no.1. 2. By filing this writ petition, the petitioner has put to challenge the order and award dated 11.01.2023 passed by the Insurance Ombudsman in complaint reference No. GUW-G- 035-2223-0115, whereby, the repudiation of the claim by petitioner has been held to be invalid and directed to process the claim and settle as per merits by complying with the award within 30 days of the received of the award and intimate the compliance of the same to the Insurance Ombudsman. 3. The petitioner is a Private Sector undertaking engaged in General insurance business having its registered and Head office at 19, Reliance centre, Walchand Hirachand Marg, Ballard Estate, Mumbai and its branch offices at Prag Plaza, 5th Floor, M.S.S. Path, (G.S. Road), Bhangagarh, Guwahati. It issues various insurance policies as per proposals made by or received from the prospective insured/owner of the vehicle. 4. The facts of the case are that on 04.10.2022, at around 02:30 A.M. while the vehicle of the respondent no.2 bearing registration no.AS-18/K-5337, while travelling towards Nagarbera from Dhupdhara on Dhupdhara-Nagarbera PWD road, met with an accident at Dighali under Dhupdhara police station when the vehicle of the respondent no.2 had hit a tree causing substantial damage to the vehicle. The information of the accident was lodged before the Dhupdhara police station, upon which an entry was made vide Dhupdhara P.S. GDE No. 69 dated 04.10.2022. The said vehicle of the respondent no.2 was inspected by the Motor Vehicle Inspector, Goalpara and submitted its report. Thereafter, the respondent no.2 being an owner of the said vehicle lodged a claim before the petitioner Insurance Company claiming damage in terms of the policy. The claim was registered as Insurance Claim No. Page No.# 3/6 3122286694 dated 10.10.2022. Thereafter, the respondent no.2 was directed to furnish certain necessary documents to enable the Company to process the claim. 5. Upon registration of the claim of the respondent no.2, the petitioner Insurance Company had deputed surveyor/investigator to assess the damage of the vehicle of the respondent no.2 and to collected necessary relevant documents from the respondent no.2 as well as from the police. In the course of survey and investigation, it is contended by the petitioner Insurance Company that the respondent no.2 had given written intimation to the petitioner to the effect that the vehicle was driven at the time of accident by himself and he along with all the occupants of the said vehicle were under the influence of alcohol. It is the further contention of the petitioner that since the respondent no.2, being the owner of the vehicle has admitted the fact that he had consumed alcohol at the time of driving of the vehicle which led to accident, same is not only clear breach of the agreed terms and conditions of the Insurance Policy but also violation of the provisions of the Motor Vehicles Act, 1988. 6. The claim petition filed by the respondent no.2 has been repudiated vide letter dated 17.12.2022 as the respondent no.2 along with all the other occupants of the said vehicle at the time of accident was under influence of alcohol, which is clear breach of condition of policy warranting repudiation of the claim. 7. Being aggrieved by the repudiation of the claim, the respondent no.2 has approached the Insurance Ombudsman to redress his grievance by filing a complain being complaint reference No. GUW-G-035-2223-0115. The Insurance Ombudsman heard the matter finally on 09.01.2023 and dispose of the claim reference No. GUW-G-035-2223-0115, thereby passing the award with a direction to the petitioner to process the claim and settle as per merits by complying with the award within 30 days of the received of the award and intimate the compliance of the same to the Insurance Ombudsman vide impugned order dated 11.01.2023. 8. Mr. A.J. Saikia, learned counsel for the petitioner, submits that the impugned order has been passed by the learned Insurance Ombudsman without due application of mind, as the petitioner has acted as per the agreed terms and conditions subject to which the Insurance Page No.# 4/6 policy was issued. He submits that the learned Ombudsman had failed to take into consideration relevant materials on record inasmuch as it is the admitted case of the respondent no.2 that he being the owner/driver of the insured vehicle along with all the occupants were under the influence of alcohol at the time of accident, which is a clear breach of policy condition as well as the violation of the provisions of the Motor Vehicles Act, 1988. He submits that since the impugned order dated 11.01.2023 has not been passed in accordance with law and contrary to the records, the same may be set aside and quashed. 9. Mr. S. Hoque, learned counsel appearing for the respondent no.2, raises a preliminary objection to the maintainability of the present writ petition on the grounds that there is no violation of fundamental or legal rights of the petitioner and availability of alternative remedy. 10. He submits that since the vehicle of the respondent no.2 is duly been insured with the petitioner and the accident had occurred, the petitioner is liable to pay the damage as claimed by the respondent no.2 in terms of the Insurance Policy. He submits that the said ground of repudiation of having been admitted the fact that the respondent no.2 and the occupants of the said vehicle were under the influence of alcohol has been obtained fraudulently as after the accident the representative of the petitioner Insurance Company met the respondent no.2 and fraudulently advised him to give statement that the driver and the occupants of the vehicle were little drunk at the time of accident, otherwise the claim will not be settled by showing some instances of other accidents that they gave statements of using alcohol at the time of driving and accordingly they got the benefit immediately. Since the representatives of the petitioner Insurance Company convinced the respondent no.2 and fraudulently compelled him to give the written statement on the same line and had used the same for the purpose of repudiating the claim, same is not tenable. He submits that the respondent no.2 being an illiterate person and could not understand the implication of such statement as influenced by the representative of the petitioner Insurance Company, the respondent no.2 had to give the said statement. 11. While referring to the impugned order/award by the Insurance Ombudsman, Mr. Hoque submits that such statement of the respondent no.2 has been accepted by the Ombudsman as it is clearly observed that the allegation made by the complaint in the manner in which the written statement was obtained from him is deprecated. Therefore, the writ petition is not Page No.# 5/6 only maintainable but requires to be dismissed on merits also and as such may be dismissed. 12. Considered the submissions of the learned counsel for the parties and perused the materials available on record. 13. Admittedly, the said vehicle bearing registration No. AS-18/K-5337 (Renault Triber) is under Insurance cover of the petitioner Insurance Company. The petitioner Insurance Company had issued Insurance Policy No.993192223740007525 on 15.06.2022 covering the risk of the said vehicle for the period from 15.06.2022 to 14.06.2023. The accident took place on 04.10.2022 at Dighali under Dhupdhara police station within the period of Insurance coverage. It is taken note that the respondent no.2 had submitted an application addressing to the Claim Manager Reliance General Insurance Company, Calcutta respondent no.2 stating that he along with his six friends had consumed alcohol on the way to Nagar Bera. No doubt, if the driver/owner drives the vehicle under the influence of alcohol, it would amount to breach of the conditions of insurance policy and also violation of the provisions of the Motor Vehicles Act, 1988. However, in the present case what requires to be taken note is that whether the said statement is supported by any other documents. 14. On the consideration of the materials, except for the said statement written on 15.12.2022 by the respondent no.2 addressing to the claim Manager, there is nothing on record to show that the respondent no.2 was under the influence of alcohol. After the accident, the police had made a GD entry and the said damaged vehicle was inspected by the Motor Vehicle Inspector. There is nothing on record to show that there was any indication of the respondent no.2 having been under the influence of alcohol. 15. At the same time, it is hard to believe the stand of the respondent no.2 that it was at the insistence and influence of the representatives of the petitioner Insurance Company that he had to admit that he was under the influence of alcohol along with friends, when the accident had occurred. However, if the driver of the vehicle who met with an accident is alleged to have been under the influence of alcohol, it is the duty of the authority i.e. police etc., to act in accordance with the law to establish such allegations. 16. In the present case, no efforts appears to have been made by any of the authority and including the petitioner Insurance Company to find out the actual facts. Page No.# 6/6 17. Concededly, the accident took place on 04.10.2022 and the said letter has been given on 15.11.2022. As noted above, no efforts appears to have been made by the authority as well as the petitioner Insurance Company to find out the actual fact except blindly relying on an alleged statement, which the respondent no.2 has denied to the fact that he was influenced and fraudulently obtained which has been accepted by the Insurance Ombudsman clearly in the impugned order by observing that such an allegation requires to be deprecated. 18. Having considered the entire facts and circumstances and the materials available on record, this Court finds no infirmity in the impugned order dated 11.01.2023 passed by the Insurance Ombudsman as no material is shown by the petitioner to substantiate that the respondent no.2 was under the influence of alcohol in breach of the terms and conditions of the insurance policy except the said alleged letter of admission by the respondent no.2. As noted above, there is nothing on record to show that any effort was made to find out the actual facts as to whether the respondent no.2 was under the influence of alcohol, which would be the breach of terms and conditions of the insurance policy. 19. In view of the foregoing discussion, I am of the considered view that the petitioner Insurance Company has failed to make out a case for interference with the impugned order/award of the Insurance Ombudsman dated 11.01.2023. Accordingly, the writ petition stands dismissed being devoid of merit. 20. Writ petition is disposed of. No order as to costs. JUDGE Comparing Assistant