Karnataka High Court Declines Insurance Company's Plea Alleging Claimant Committed Fraud In Connivance With Insured Lawyer To Secure Compensation

A Single Bench of Justice T G Shivashakare Gowda said the insurance company failed to prove MLC report as per which the injuries were a result of self-fall. It said,

"On perusal of it nothing is mentioned as such that the petitioner has suffered injuries due to self-fall while triple-riding. When the Insurance Company relies on Ex.R3, it is required to prove the said document through proper evidence. The entry refers to the name of Dr. Manjula who is the Medical Officer of Primary Health Centre, Anandapura. The contents of Ex.R3 required to be proved through Dr. Manjula. No efforts are made to secure her presence. Who gave the information and who brought the injured to the hospital are not forthcoming. Under such circumstances, it is unsafe to rely upon Ex.R3 which was not even confronted to the petitioner during the course of her cross-examination. Mere production of such a document through the Officer of the Insurance Company is not enough to prove its genuineness.”

It thus dismissed the appeal filed by the Branch Manager of National Insurance Co Ltd challenging the award of Rs 2,41,760 compensation.

The company had argued that the Tribunal did not consider the fraud played by the petitioner (victim) and that when the Advocate's motorcycle was not involved in the accident since it is a case of self-fall, the question of its owner paying compensation does not arise and the Insurance Company cannot indemnify a false claim.

The appeal was opposed by the rider of the motorcycle contending that being a practising Advocate, he knows the consequences of a criminal trial and hence, he would not play fraud on court merely to facilitate the third-person to secure compensation.

The claimant also submitted that if the owner of the motorcycle was not involved in the accident, he ought to have challenged the criminal prosecution, but despite being an Advocate the bike owner faced criminal trial, indicating the genuineness of the claim.

The Court concluded, “In the absence of proof of Ex.R3, the argument canvassed on behalf of the Insurance Company is not persuasive in nature. Hence, the alleged fraud without any proof will not stand to its reason.”

Accordingly it dismissed the appeal and directed the insurer to deposit the compensation within 8 weeks.

Appearance: Advocate A.N. Krishnaswamy for Appellant.

Advocate Halesha. R.G for R1.

Advocate Suresh. M for R2.

Citation No: 2024 LiveLaw (Kar) 222

Case Title: The Branch Manager AND Sarojamma & ANR

Case No: MFA NO. 7795 OF 2013