State Consumer Disputes Redressal Commission
The Oriental Insurance Company Limited vs C.G. State Power Holding Co.Ltd & Others on 16 January, 2015
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G).
Appeal No.FA/14/311
Instituted on : 03.05.2014
The Oriental Insurance Company Limited,
Through : Divisional Manager,
Divisional Office No.1, Madina Building,
Raipur (C.G.)
(Insurer / Opposite Party) ... Appellant
Vs.
1. C.G. State Power Holding Co. Ltd.
Through Additional General Manager (HR),
Danganiya, Raipur (C.G.)
(Complainant / Insured)
2. Smt. Sudha Burman, Wd/o Suresh Burman,
3. Ku. Sati Burman, D/o Late Suresh Burman,
Aged 12 years.
4. Ku. Vandana Burman, D/o Late Suresh Burman
Aged 7 years.
Both through their Natural Guardian
the Mother Smt. Sudha Burman. ... Respondents
PRESENT :
HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE MISS HEENA THAKKAR, MEMBER
COUNSEL L FOR THE PARTIES :
Shri Shishir Bhandarkar, for the appellant.
Shri M.K. Vyas, for the respondent No.1.
Shri Pradeep Shukla, for the respondent No.2 to 4.
ORDER
DATED : 16 /01/2015 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. This appeal is directed against the order dated 03.04.2014, passed by District Consumer Disputes Redressal Forum, Raipur (C.G.) // 2 // (henceforth "District Forum") in Complaint Case No.366/2010. By the impugned order, learned District Forum has allowed the complaint of the respondent (complainant) and directed the appellant (O.P. No.1) to pay within a month from the date of order a sum of Rs.5,00,000/-, which is insured amount under Group Personal Accidental Insurance Policy, along with interest @ 9% p.a. from the date of filing of the complaint i.e. 13.08.2010 till realisation to the respondent No.1 (complainant). From the above amount paid by the appellant (O.P.No.1), after adjusting a sum of Rs.3,98,800/- with interest, the respondent No.1 (complainant) will pay the remaining amount of Rs.1,01,200/- with interest to the legal heirs of the deceased Late Suresh Burman i.e. respondent No.2 to 4 (O.P.No.3 to 5). The District Forum has also directed the appellant (O.P. No.1) to pay a sum of Rs.25,000/- towards compensation for mental agony and a sum of Rs.5,000/- as cost of litigation to the respondent No.1 (complainant).
2. Briefly stated the facts of the complaint are that : the respondent No.1.(complainant) purchased Group Personal Accidental Insurance Policy from the appellant (O.P. No. No.1) for its employee, who are working with it. In this regard a consent letter (agreement) was also executed in writing between both the parties on 06.09.2008. According to the consent letter (agreement), in case of accidental death of any employee of the respondent No.1 (complainant), the appellant (O.P. No.1) will pay the insured amount under Group Personal Accidental // 3 // Insurance Policy to the respondent No.1 (complainant). The deceased Suresh Burman was working as Lineman Grade - 3 with the respondent no.1 (complainant) and had died on 22.09.2008 due to electrocution. The claim in this regard was submitted by the respondent (complainant) before the appellant (O.P. No.1), but the appellant (O.P. No.1) repudiated the claim of the respondent No.1 (complainant) on flimsy ground, therefore, the respondent no.1 (complainant) filed consumer complaint before the District Forum and prayed for granting reliefs, as mentioned in the relief clause of the compliant.
3. The appellant (O.P. No.1) filed written statement before the District Forum and denied all the allegations leveled by the respondent No.1 (complainant) against the appellant (O.P. No.1) in the complaint. The appellant (O.P.No.1) averred that there is no contract between the appellant (O.P.No.1) and the respondent No.1 (complainant), and the deceased Suresh Burman was insured, therefore, the respondent No.1 (complainant) is not "consumer". Intimation regarding the death of the deceased has not been given immediately. The deceased himself was negligent and he himself was liable for his death as he was working without wearing safety rubbers and other safety measures. The appellant (O.P. No.1) has rightly repudiated the claim of the respondent No.1. (complainant). The appellant (O.P. No.1) has not committed any deficiency in service and the respondent No. 1 (complainant) is not entitled to get any compensation from it.
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4. The respondent No.2 to 4 (O.P.No.3 to 5) have also filed written statement before the District Forum and averred that the respondent No.1 (complainant) is employer of the deceased Suresh Burman and it had obtained Group Accidental Insurance Policy for its employees for sum assured Rs.5,00,000/-. The legal heirs of the deceased are entitled to get the insured amount under the policy and not the respondent No.1 (complainant). The agreement between the respondent No.1 (complainant) and the appellant (O.P.No.1)) has been executed for the benefit of the employees of the respondent No.1 (complainant) and not for the profit of the respondent No.1 (complainant). In the document P-5 it is mentioned immediately make arrangement to pay the insured amount under Group Accidental Insurance Policy to the legal heirs of the deceased. In document P-6 also it is mentioned that payment be made to nominee of the deceased Smt. Sudha Burman. The respondent No.2 to 4 (O.P.No.3 to 5) are entitled to get insured amount from the appellant (O.P.No.1).
5. After due appreciation of the material available before it, learned District Forum has allowed the complaint and directed the appellant (O.P.No.1) to pay compensation to the respondent No.1 (complainant), as mentioned in para 1 of this judgment.
6. The respondent (complainant) filed documents. Document A-1 are photocopy of GPA Unnamed Policy Schedule, receipt for payment // 5 // of insurance premium,, terms and conditions Personal Accident Insurance Policy (Group), A-2 is letter dated 06.09.2008 sent by Additional Secretary, Chhattisgarh State Electricity Board, Raipur to The Oriental Insurance Company Limited, Branch Office No.1, Bhilai, District Durg (C.G.), Agreement (Consent Letter) executed between Chhattisgarh State Electricity Board & The Oriental Insurance Company Limited, A-3 is letter dated 17.10.2008 sent by Executive Engineer (O & M) of Chhattisgarh State Electricity Board to the Oriental Insurance Company Ltd. Office No.1, Bhilai (C.G.), Personal Accident Claim Form, Proforma Report, Intimation regarding the incident given by the Junior Engineer, C.G. State Electricity Board, Chirmiri to Incharge Police Station, Chirmiri, District Koriya (C.G.), death certificate of Suresh Kumar Burman issued by Registrar Birth and Death, Chirmiri, Service Verification Certificate, Application for post mortem, Post Mortem report, Inquest, letter dated 22.11.2008 sent by Executive Engineer (O & M) Dn. C.G. State Electricity Board, Manendragarh to Industrial Relation Officer, C.G. State Electricity Board, Raipur, PLCC / SAVINGRAM, Statement of Shri R.K. Sahu, Junior Engineer, Statement of Shri Sudhanram (A.L.M.), Statement of Shri Purshottam Ram, Helper, A-4 is photocopy of order No.031- 45/Estt./1471 dated 18.10.2008 issued by Executive Engineer (O & M) Dn. C.S.E.B. Manendragarh, A-5 is letter dated 06.04.2009 sent by Divisional Manager I/c of The Oriental Insurance Co. Ltd. Divisional // 6 // Office, Bhilai to the Industrial Relation Officer, C.S.E.B. Raipur, A-6 is letter dated 20.04.2009 sent by Industrial Relation Officer, C.G. State Power Holding Company Ltd. Raipur to Divisional Manager (Incharge), The Oriental Insurance Co. Ltd. Bhilai (C.G.), A-7 is letter dated 22.05.2-2009 sent by the Divisional Manager I/c of the Oriental Insurance Company Ltd. Divisional Office, Bhilai (C.G.) to the Industrial Relation Officer, C.S.E.B. Raipur (C.G.), A-8 is letter dated 12-10-2009 / 09-12-2009 sent by Divisional Manager of The Oriental Insurance Company Limited, Divisional Office, Bhilai to the Executive Engineer, CSEB, Corporate Office, Raipur (C.G.).
7. The appellant (O.P.No.1) has also filed documents. Document are - OP-1 are photocopy of GPA Unnamed Policy Schedule, receipt for payment of insurance premium,, terms and conditions Personal Accident Insurance Policy (Group), OP-2 is Personal Accident Claim Form, OP-3 is Investigation Report dated 12.01.2009 of Shri Ashish Gupta, Investigator, OP-3A is Investigation Report dated 10.09.2009 of Shri Ashish Gupta, Investigator, OP-4 is letter dated 12-10-2009 / 09-12- 2009 sent by Divisional Manager of The Oriental Insurance Company Limited, Divisional Office, Bhilai to the Executive Engineer, CSEB, Corporate Office, Raipur (C.G.), OP-6 is letter dated 06.04.2009 sent by Divisional Manager I/c of The Oriental Insurance Co. Ltd. Divisional Office, Bhilai to the Industrial Relation Officer, C.S.E.B. Raipur, OP-6 is letter dated 15.04.2009 sent by Executive Engineer (O & M) C.G. State // 7 // Power Distribution Co. Ltd. Manendragarh to the Divisional Manager, Oriental Insurance Co. Ltd. Bhilai.
8. Shri Shishir Bhandarkar, learned counsel appearing for the appellant (O.P. No.1) has argued that the impugned order passed by the District Forum is erroneous. He further argued that the respondent No.1 (complainant) has no locus standi to file complaint. The Insurance Policy was issued in favour of C.G. State Electricity Board and the respondent No.1 (complainant) is C.G. State Power Holding Co. Ltd. which is a different entity, therefore, the respondent No.1 (complainant) has no locus standi to file complaint and complaint is liable to be dismissed. The insurance policy was issued in favour of C.G. State Electricity Board and only contractual liability of the Insurance Company is to indemnify C.G. State Electricity Board, therefore, the complaint is liable to be dismissed.
9. Shri Manish Vyas, learned counsel appearing for the respondent No.1 (complainant) has argued that according to the Agreement (Consent Letter) executed between both the parties, the premium of the Group Personal Accidental Insurance policy, was paid by the respondent No.1 (complainant) to the appellant (O.P. No.1). The Agreement (Consent Letter) has been executed between the appellant (O.P.) and respondent No.1 (complainant), in which it is mentioned that if any accident is occurred and any employee of the respondent // 8 // (complainant) is died in the accident, then the appellant (O.P. No.1) will pay the insured amount to the tune of Rs.5,00,000/- to the respondent No.1 (complainant), therefore, the impugned order passed by the District Forum, is just, proper and does not suffer from any jurisdictional error, irregularity or illegality and does not call for any interference of this Commission, hence the appeal of the appellant (O.P.No.1), is liable to be dismissed. He placed reliance on judgment of Hon'ble National Commission in LIC of India vs. Ratan Kaur, II (2008) CPJ 61 (NC); Revision Petition No.14 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental Insurance Company Ltd. and Revision Petition No.15 of 2010 - Chhattisgarh State Power Holding Company Limited vs. M/s. Oriental Insurance Company Ltd., decided by Hon'ble National Commission vide common order dated 22.02.2010, judgment of this Commission dated 28.09.2011 in Appeal No.368/2011 Chhattisgarh State Power Holding Co. Ltd. vs. The Oriental Insurance Co. Ltd. and others and Appeal No.385/2011 - The Oriental Insurance Co. Ltd. Through Divisional Manager, vs. Managing Director, Chhattisgarh Power Holding Co. Ltd. & others.
10. Shri Pradeep Shukla, learned counsel appearing for the respondent No.2 to 4 (O.P.No.3 to 5) has supported the impugned order passed by the learned District Forum.
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11. Firstly we shall consider whether the complaint is maintainable and the respondent No.1 (complainant) has locus standi to file the instant complaint ?
12. The respondent No.1 (complainant) pleaded that by virtue of Gazette Notification dated 19.12.2008, C.G. State Power Holding Company Limited came into existence. The respondent No.1 (complainant) filed a document Annexure A- 1 i.e. GPA Unnamed Policy Schedule Policy No.152501/48/2009/864. According to the said document, the policy was issued in favour of Chhattisgarh State Electricity Board, Raipur for the period from 11.09.2008 to 10.09.2009 In the insurance policy, the name of the insured is mentioned as Chhattisgarh State Electricity Board, Raipur (C.G.). The Insurance Policy deems to be transferred with transfer of ownership and policy will not lapse even when intimation is not given. In the instant case initially the contract was entered between the Chhattisgarh State Electricity Board and The Oriental Insurance Co. Ltd. and after issuance of gazette notification, the ownership and liability of the Chhattisgarh State Electricity Board has been merged with C.G. State Power Holding Co. Ltd.
13. We have perused the order dated 22.02.2010 passed by Hon'ble National Commission in Revision Petition No. 14 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental // 10 // Insurance Company Limited and Revision Petition No.15 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental Insurance Company Limited as well as complaint and judgment passed by Hon'ble National Commission in the case of The Oriental Insurance Company Limited vs. Additional Secretary, Chhattisgarh State Power Holding Company Limited reported in 2012 (1) CCC 531 (NC).
14. In Revision Petition No. 14 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental Insurance Company Limited and Revision Petition No.15 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental Insurance Company Limited, the incident took place on 09.02.2005 and 02.07.2004 respectively i.e. prior to existence of Chhaattisgarh State Power Holding Company. It means that in the said cases at the time of incident Chhattisgarh State Power Holding Company was not in existence but the complaints have been filed by the Chhattisgarh State Power Holding Company Limited. The Revision Petition No.14 of 2010 and 15 of 2010 filed by the Chhattisgarh State Power Holding Company were also allowed by the National Commission. It appears that Chhattisgarh State Power Holding Company Limited is competent to file the complaint.
15. In Appeal No.368/2011 - Chhattisgarh State Power Holding Company Limited vs. The Oriental Insurance company Limited & // 11 // others which was arising out of Complaint Case No.130/2007, the complaint was filed by Chhattisgarh State Power Holding Company Limited, in which the incident was occurred on 09.02.2005. It appears that the employee was died when Chhattisgarh State Electricity Board was in existence whereas the complaint was filed by Chhattisgarh State Power Holding Company Limited and no objection was raised by the Insurance Company in this regard.
16. Looking to the above facts and circumstances, in the instant case also the Chhattisgarh State Power Holding Company Limited has acquired all rights, therefore it has locus standi to file the complaint and the complaint is maintainable.
17. Agreement (Consent Letter) has been executed between the Chhattisgarh State Electricity Board and the Oriental Insurance Co. Ltd. in which it is mentioned that :-
"1. This Scheme will also be effective when all officers/employees died during their employment due to accident, even when the officer/employee is present in the work or not (not on duty). In this Scheme all regular employees of the Power Company as well as Chairman, all Managing Director & all permanent/daily wages/trainee employees who are in contract are also included (Contracted employees are not included).
4. The period of insurance will commence from intervening night of 04.10.2010 i.e. 04.00 PM to intervening night of 03.10.2011 i.e. till 24.00 hours it means the Insurance Company will pay the fixed risk // 12 // amount and other benefits (if payable) in the matter even when the accidental death occurred after period of insurance.
5. As this Scheme is of Group and Non-Contributory nature, it means under the Scheme the annual premium will be payable by Chhattisgarh State Power Holding Co. Ltd. Therefore, the Insurance Company will issue cheque/draft etc. in favour of Chhattisgarh State Power Holding Co. Ltd. Raipur and sent the same through Industrial Relation Officer, Chhattisgarh State Power Holding Co. Ltd. Raipur.
6. The Insurance Company agreed that it will compulsorily pay the risk amount to the Power Company within 30 days from the receipt of entire claim form, otherwise the Insurance Company will pay penalty Rs.100/- (Rs. One hundred only) per day for delay for per case, payment of which will be made by the Insurance Company to the Power Company along with claim. The all relevant documents required by the Insurance Company are :-
(a) Intimation regarding death (b) claim form (filled up) (c) First Information Report (F.I.R.) (d) Post Mortem Report (e) Death Certificate (certified by First Class Officer of Power Company)
(f)) details regarding action taken by Police (g) service certificate of Power Company.
Besides above seven documents, no other documents will be given to the Insurance Company.
7. Besides the above seven agreed points, if the claim is repudiated by the Insurance Company referring any other point then the Power Company has a right to file complaint before Insurance Regulatory and Development Authority (I.R.D.A) and other courts, and the Insurance Company will liable to pay the cost of litigation, penalty and interest etc. in that connection."
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18. We have perused the para 5 & 6 of the said Agreement (Consent Letter). From perusal of the same, it appears that the risk amount will be paid by the appellant (O.P.) to the Chhattisgarh State Electricity Board. From bare perusal of this Agreement (Consent Letter). The respondent No.1 (complainant) also filed copy of Order No.031- 45/Estt./1471 dated 22.10.2008 by which the amount of Rs.3,98,800/- was sanctioned for payment of compensation to Smt. Sudha Burman, Wd/o Late Shri Suresh Burman.
19. In Revision Petition No.14 of 2010 - Chhattisgarh State Power Holding Co. Ltd. vs. M/s. Oriental Insurance Company Ltd. and Revision Petition No.15 of 2010 - Chhattisgarh State Power Holding Company Limited vs. M/s. Oriental Insurance Company Ltd., decided by Hon'ble National Commission vide common order dated 22.02.2010, Hon'ble National Commission, has observed thus :-
"..........Strictly speaking, going by the entirety of the facts and circumstances of these cases and considering that the contract of insurance was entered into between the petitioner and the respondent insurance company, it was not necessary to implead the nominees/beneficiaries of the deceased employees as complainants. However, it appears that in order to avoid any controversy between the petitioner and the beneficiaries of the deceased employees and with the intention that the amount of insurance reached the right hands, the State Commission has directed the petitioner to implead the legal heirs of the deceased employees. Though we do not agree with the view expressed by the State Commission, in our opinion no harm would be // 14 // caused if the nominees/beneficiaries of the deceased employees are also joined either as co-complainants or co-respondents along with the insurance company so as to obviate any possible objection. We would thus not like to interfere with the said finding of the State Commission......
20. The respondent No.1 (complainant) has specifically pleaded that a sum of Rs.3,98,800/- was deposited by the respondent No.1 (complainant) with Commissioner Workmen Compensation Labour Court and learned District Forum has directed the appellant (O.P.) to pay the respondent No.1 (complainant) a sum of Rs.5,00,000/- which is insured amount under Group Personal Accidental Insurance Policy along with interest @ 9% p.a. from the date of filing of the complaint i.e. 13.08.2010 till realisation. The District Forum has further directed that from the above amount paid by the appellant (O.P.) i.e. Rs.5,00,000/- to the respondent No.1 (complainant), after adjusting a sum of Rs.3,98,800/- with interest, the respondent (complainant) will pay the remaining amount of Rs.1,01,200/- with interest to the legal heirs of the deceased Suresh Burman.
21. In para 12 of the impugned order, learned District Forum has held that after perusal of the matter, we find that the deceased was working with C.G. State Electricity Board, Chirmiri, District Korea (C.G.) and on 22.09.2008 during performing his duty he sustained injuries and he died.
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22. In the instant case, we did not find any circumstance which indicates that intimation regarding death of the deceased Suresh Burman was given belatedly. The appellant (O.P.No.1) failed to establish that the deceased himself was negligent while performing his duty.
23. In the instant case, the respondent No.1 (complainant) filed merg intimation and letter dated 22.09.2008 sent by Junior Engineer (D), C.S.E.B., Chirmiri to Station House Officer, Chirmiri, District Korea (C.G.), post mortem report and inquest. It appears that the deceased while repairing transformer, the deceased suffered electricity current and due to electrocution he died, therefore, it is established that the death of the deceased Suresh Burman was accidental in nature.
24. Learned District Forum vide impugned order has directed the appellant (O.P.No.1) to pay a sum of Rs.25,000/- towards compensation for mental agony to the respondent (complainant) and has also directed the appellant (O.P.) to pay interest @ 9% p.a. from the date of filing of the complaint i.e. 13.08.2010 till the date of realisation on the amount of Rs.5,00,000/-. It appears that learned District Forum, has awarded interest @ 9% p.a. on Rs.5,00,000/- from the date of filing of the complaint as well as compensation for mental agony to the respondent (complainant) together. The District Forum has already awarded interest @ 9% p.a. on Rs.5,00,000/- from the date of filing of the // 16 // complaint i.e. 13.08.2010 till realisation, therefore, there was no necessity for the District Forum to separately grant compensation for mental agony to the tune of Rs.25000/- in favour of the respondent No.1. (complainant). The respondent No.1 (complainant) is a limited company, therefore, there appears no question of suffering mental agony by the respondent No.1 (complainant).
25. In Appeal No.FA/12/418 - The Oriental Insurance Company Limited, Through Senior Divisional Manager, Divisional Office No.1, Raipur & another vs. Chhattisgarh State Power Holding Co. Ltd., Through : Additional General Manager (Human Resources), Raipur & 3 others, this Commission vide order dated 20.11.2012 has observed thus :-
"10. Further contention of learned counsel for the Insurance Company is that District Forum has unnecessarily burdened the Insurance Company by directing it to pay penalty @ Rs.100/- per day from 17.01.2009 and further to pay Rs.10,000/- as compensation for mental agony. In this regard, we find some force in the argument of learned counsel for the Insurance Company, but at the same time we are of the view that the Insurance Company has repudiated the claim on untenable grounds and thus, committed deficiency in service, so it is liable to pay sum assured, along with interest @ 6% p.a. from the date one month after lodging of the claim i.e. 17.01.2009 till date of payment."
26. Looking to the facts and circumstances of the case, it appears that the District Forum has unnecessarily awarded a sum of // 17 // Rs.25,000/- as compensation for mental agony to the respondent No.1 (complainant), therefore, the above direction of the District Forum, is liable to be set aside.
27. In view of aforesaid discussions, the appeal filed by the appellant (O.P.No.1), is partly allowed and the impugned order of the District Forum dated 03.04.2014, is modified only to the extent that the appellant (O.P.No.1) will not be liable to pay a sum of Rs.25,000/- to the respondent No.1 (complainant) towards compensation for mental agony and that part, is set aside. The remaining part of the impugned order will remain unaltered and is affirmed. No order as to the cost of this appeal.
(Justice R.S. Sharma) (Ms. Heena Thakkar)
President Member
/01/2015 01/2015
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