What action Insurance Company can take if its agent has issued fake insurance policy?

The Learned Tribunal after considering the evidence on

record has reasoned in its impugned Judgments as follows;

MAC App. Nos.07, 08 and 09 of 2020 10

“27. Shri Bikash Roy Pradhan, the Branch

Manager of the Opposite Party No. 3 clearly admitted

that Shri Rajen Tamang is the authorized agent of

Opposite Party No.3. Exhibit-10 is the certified copy of

the Insurance Policy of the vehicle. In Exhibit-10, in

place of the details of the agent/Broker, the name

of Shri Rajen Tamang with his agent code number as

„BA000015623‟ has been clearly mentioned. Exhibit-

10 was served upon the Opposite Party No.3. The

Opposite Party No. 3 failed to produce and examine

Shri Rajen Tamang, Authorized Agent of Oriental

Insurance Company Limited (Opposite Party No. 3)

despite several opportunities having been given to it.

By perusal of Exhibit -10, it is difficult to identify the

fake and the genuine policy. There is no evidence

produced by the Opposite Party No.3 that the

Opposite Party No.1 owner of the vehicle had

involved himself or influenced the said Shri Rajen

Tamang to illegally issued the fake insurance policy to

him. The Opposite Party No. 3 has not exhibited any

complaint/document against the Opposite Parties No.

1, 4 or Shri Rajen Tamang, authorized agent of

Opposite Party No. 3 stating that the Opposite Parties

No.1 and 4 had obtained a fake insurance policy of

the Oriental Insurance Company Limited or Shri Rajen

Tamang handed over the fake insurance policy to the

Opposite Parties Nos.1 and 4 and the same was in

their personal knowledge. There is no evidence to the

effect that the Opposite Parties No.1 and 4 had

obtained fake insurance policy in collusion with the

staff or agent of Opposite Party No.3. From evidence

on record, no apparent role appears to have been

played by the owner in obtaining the fake insurance

policy. It is very difficult to pin point who is

responsible for issuance of the fake insurance policy.

It is unbelievable that an insured would obtain a fake

certificate by paying the same premium at his own

risk and peril. The Opposite Party No.4 Shri Biren

Gurung further establishes that in order to obtain

Exhibit-10, Opposite Party No.1 had given him ₹

14,500/. He personally knows Rajen Tamang as he

is the agent of the Opposite Party No.3. Opposite

Party No.4 paid a sum of ₹ 14,500/- to Rajen

Tamang, agent of the Opposite Party No. 3 through

one Palden Bhutia and Rajen Tamang handed over

Exhibit-10 to Opposite Party No.4. Opposite Party No.

4 further establishes that as per the direction of

Rajen Tamang, he handed over premium amount to

Shri Palden Bhutia. On the facts and circumstances of

the case at hand, it cannot be held that Opposite

Party No.1 (Owner of the vehicle) has any role to

play in issuance of the fake policy, on the other hand

evidence on the record cast suspicion towards the

authorized agent of the insurance company. Since,

Opposite Party No. 3 has admitted that Shri Rajen

Tamang is its authorized agent, there is master and

servant relation between the Opposite Party No.

3 and the said Shri Rajen Tamang. From this angle

MAC App. Nos.07, 08 and 09 of 2020 11

also Opposite Party No. 3 is liable for the act of the

said Rajen Tamang. However, the Opposite Party No.

3 is as liberty to conduct an inquiry against its agent

Rajen Tamang in respect of issuance of Exhibit 10 to

find out the actual fact as narrated supra and if found

guilty, it can recover the amount paid to the Claimant

by way of the Award in the instant claim petition from

the said Rajen Tamang.” [emphasis supplied]

13. The observations of the Learned Tribunal in arriving at

its conclusions is perfectly reasoned and brooks no interference.

{Para 12}

 THE HIGH COURT OF SIKKIM : GANGTOK

(Civil Appellate Jurisdiction)

MAC App. No.07 of 2020

The Branch Manager, Oriental Insurance Company Limited Vs

 Padam Bahadur Rai and Others

Coram: Meenakshi Madan Rai, J.

DATED : 2nd December, 2022.

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Under which circumstances it can be said that Insurance Company has failed to prove that insurance policy produced by claimant in motor accident claim petition is fake?

 It is evident from the facts and undisputed that the accident occurred on 09.06.2012, as a result of which Jepu Khan succumbed to injuries whereas, for insurance of the vehicle in question. However, the case set up by the appellant company is that the insurance policy (Ex. 11) produced by the owner is fake and correct copy of insurance policy was tendered in evidence on behalf of appellant company as Ex. A/1 being Policy No. 2313200275427800000 according to which the vehicle was insured for the period 12.06.2012 to 11.06.2013 whereas, the accident took place on 09.06.2012. Thus, the burden of proving the fact that the insurance policy produced by the owner is forged and fabricated and the vehicle in question was in fact insured for the period 12.06.2012 to 11.06.2013 was upon the appellant insurance company. The appellant insurance company in support of contention produced NAW/1 Pankaj Sharma in evidence who stated that the policy produced by the owner is forged and in this regard a complaint was lodged before the Superintendent of Police, Jaisalmer. However, the said witness has categorically stated that complaint in this regard was not filed for four years from 15.09.2012 to 12.04.2016. Further the said witness has also denied having any knowledge with regard to the agent who issued the said policy. The said witness has also denied having any knowledge with regard to the fact whether the amount against the premium was received in cheque or cash and also failed to produce any record with regard to the receipt of premium by the company. {Para 11}

12. It is pertinent to note that in the matter in hand, the insurance company has admitted coverage of vehicle through insurance policy Ex. A/1 but denied the period of coverage with regard to which claim petition was filed under insurance policy Ex. A/11 filed by the owner/claimant.

13. The accident was caused on 09.06.2012 and the claim petition was pending before the Tribunal from year 2012 but the insurance company did not initiate any proceedings against the owner for producing forged and fabricated policy and it is only in the year 2016 that a complaint was sent to the Superintendent of Police, Jaisaler. The appellant insurance company could have produced the record containing the receipt of premium, proposal form, name of agent and code etc to prove that the policy produced by the company as Exhibit A/1 is the genuine one and was issued for the period 12.06.2012 to 11.06.2013. However, as rightly noticed by the learned Judge, MACT Cases, the appellant insurance company has failed to prove the same.

14. As far as the case of Sobina Iakai (Supra) relied upon by the learned counsel for the appellant insurance company, the same relates to the date and time from which the policy would be effective. Hon'ble Supreme Court in the said case has held that when the specific time and date is mentioned, then the insurance policy becomes effective from that point of time and not from an earlier point of time. Herein this case, the respondent had produced the policy issued by the appellant insurance company which was very much effective on the date of accident and the appellant insurance company has failed to prove that the said insurance policy was forged or fabricated and therefore, the case relied upon by the counsel for the appellant is not applicable in the facts and circumstances of the present case.

 IN THE HIGH COURT OF RAJASTHAN AT JODHPUR

S.B. Civil Misc. Appeal No. 2623/2016

Decided On: 03.02.2017

HDFC ERGO General Insurance Company Ltd. Vs. Nimaji and Ors.

Hon'ble Judges/Coram:

Goverdhan Bardhar, J.

Citation: MANU/RH/0086/2017,2017 ACJ 2830 Raj

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