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Insurance: Intentional self-injury explained

In Mala Sahni Seth vs New India Assurance Co. Ltd., the insured died while trying to ride a high end bike. It was found on enquiring that the company owning the bike had specifically asked riders to get oriented with the bike before riding which the insured had not done. The claim of the legal heirs of the insured was however repudiated by the insurer as per Exception No. 5(a) of the policy which says that the company shall not be liable under this policy for Payment of compensation in respect of Death, Injury or Disablement of the Insured from Intentional self-injury.

The matter reached the NCDRC which observed that in view of the decision of the Hon'ble Supreme Court in Galada Power and Telecommunication Limited Vs. United India Insurance Company Ltd. & Anr. (2016) 14 SCC 161,  the insurer cannot be allowed to contest the consumer complaint beyond the ground on which the claim has been repudiated. A perusal of the repudiation letter would show that the claim was repudiated solely on the ground that M/s Eagle Rider who had given the motor cycle to its pillion rider Mr. Neeraj Sethi on hire had advised  the person driving the motor-cycle to undergo an orientation and the deceased had not undergone such orientation with the vehicle before he drove the vehicle and, therefore, this was a case of intentional self-injury.  The use of the term 'intentional self-injury' in the insurance policy would mean that the person who suffered the injury must have wanted such an injury to be caused to him.  Ordinarily, this would happen in a case where a person either wants to committee suicide or he wants to cause injury to himself. The intention of a person is a state of mind which cannot be proved by way of direct evidence but has to be inferred from the attending facts and circumstances. There is no evidence to prove that Late Sh. Sunil Seth wanted to commit suicide or he wanted to cause injury to himself.  Therefore, there was no basis for the insurer to even claim that this is a case of intentional self-injury. In my opinion an intentional self-injury cannot be inferred even if driving this particular motor-cycle required some special orientation or even a special training which late Mr. Sunil Seth did not possess.  M/s Eagle Rider owned the vehicle and, therefore, must be quite keen to insure that the vehicle is not damaged while being driven by the hirer. That would the purpose of requiring the hirer to take an orientation of the vehicle so that he is able to familiarize himself with the machine being taken on hire and did not cause an accident resulting in damage to the vehicle. A person driving a high-end motor cycle without taking the orientation which the owner of the vehicle wants to be taken by the driver of the vehicle may be said to be negligent if he drives the vehicle without such an orientation, but it can never be said that his intention behind driving such a motor cycle without orientation, desired by its owner, was to cause injury to himself.  A negligent act such as driving a motor cycle without taking the orientation desired by its owner can never be equated with an intentional self-injury if driving the vehicle result in an accident.  The intention being a state of mind required resolve on the part of the insured to either kill himself or to cause injury to himself. If a person drives a vehicle without having a driving licence it would be difficult to say that his intention is to cause self-injury. The intention of such a person would be to enjoy the driving though he may not be possessing the skill required for the purpose. If a person driving a vehicle meets with an accident it would be difficult to say merely from his driving without a licence that his intention was to cause injury to himself. The position of a person who otherwise possesses a valid driving licence but does not take the orientation advised by the owner giving the vehicle on hire would be much better than the position of a person driving a vehicle without requisite licence. Therefore, I have no hesitation in holding that the present case was not covered under exception No. 5(a) of the policy.

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