State Consumer Disputes Redressal Commission
The Oriental Insurance Co.Limited & Anr vs Chhattisgarh Rajya Vidyut Holding ... on 16 January, 2015
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G).
Appeal No.FA/14/470
Instituted on : 02.07.2014
1. The Oriental Insurance Co. Limited,
Through Divisional Manager,
Divisional Office, Bhilai, 9/1, South Gangotri,
G.E. Road, Bhilai, District Durg (C.G.)
2. The Oriental Insurance Company Limited,
Through : Chief Regional Manager,
1st Floor, Regional Office, R.K. Plaza, Pachpedi Naka,
Raipur (C.G.) ... Appellants
Vs.
Chhattisgarh Rajya Vidyut Holding Co. Maryadit,
Through : Welfare Office - Shri R.P. Gurudiwan,
Office - Industrial Relation Officer,
Chhattisgarh Rajya Vidyut Holding Co. Maryadit,
Danganiya, District Raipur (C.G.) ... Respondent
PRESENT :
HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE MISS HEENA THAKKAR, MEMBER
HON'BLE SHRI D.K. PODDAR, MEMBER.
COUNSEL FOR THE PARTIES :
Shri Gunjan Giri Goswami, for the appellant.
Shri R.K. Bhawnani, for the respondent.
ORDER
DATED : /01/2015 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. This appeal is directed against the order dated 28.04.2014, passed by District Consumer Disputes Redressal Forum, Raipur (C.G.) (henceforth "District Forum") in Complaint Case No.147/2011. By the impugned order, learned District Forum has allowed the complaint of // 2 // the respondent (complainant) and directed the appellants (OPs) 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 @ 6% p.a. from the date of filing of the complaint i.e. 13.04.2011 till realisation. The District Forum has also directed the appellants (OPs) to pay a sum of Rs.1,00,000/- towards compensation for mental agony. The respondent (complainant) will pay the aforesaid amount to the legal heirs of the deceased Gendram Sahu, within a month from the recovery of the above amount from the Insurance Company. The District Forum has also directed the appellants (OPs) to pay a sum of Rs.1,000/- as cost of litigation to the respondent (complainant).
2. Briefly stated the facts of the complaint are that : the respondent (complainant) purchased Group Personal Accidental Insurance Policy from the appellants (OPs) for its employee, who are working with it. In this regard an Agreement (Consent Letter) was also executed in writing between both the parties to the effect that in the case of accidental death of any employee of the respondent (complainant), the respondent (complainant) will take all action and the respondent (complainant) will have a right to take action against the appellants (OPs) (Insurance Company) on behalf of the legal heirs of the deceased. According to the Agreement (Consent Letter), in case of accidental death of any employee of the respondent (complainant), the appellants // 3 // (OPs) will pay the insured amount under Group Personal Accidental Insurance Policy to the respondent (complainant). The deceased Gendram Sahu, was working as Line Parichalak Grade - 1 with the respondent (complainant). On 26.06.2009 at about 12.00 P.M. the deceased was working and due to electrocution he fell down and thereafter he died on 19.07.2009 in the Hospital. The matter was reported to Police Station, Sarkanda, District Bilaspur (C.G.) where Merg Intimation No.48/09 was recorded and inquest on dead body of the deceased was prepared. The dead body of the deceased was sent to C.I.M.S. Bilaspur (C.G.) for post mortem examination and post mortem was conducted. The claim in this regard was submitted by the respondent (complainant) before the appellants (OPs), but the appellants (OPs) repudiated the claim of the respondent (complainant) on flimsy ground, therefore, the respondent (complainant) filed consumer complaint before the District Forum and prayed for granting reliefs, as mentioned in the relief clause of the compliant.
3. The appellants (OPs) filed written statement before the District Forum and denied all the allegations leveled by the respondent (complainant) against the appellants (OPs) in the complaint. The appellants (OPs) pleaded that the appellants (OPs) have not committed any deficiency in service and the respondent (complainant) is not entitled to get any compensation from it. The District Forum has no jurisdiction to entertain the complaint. Legal heirs of the deceased are // 4 // necessary party in the complaint and without adding them as party in the complaint, the complaint is not maintainable before the District Forum. The amount under the GPA insurance policy was not liable to pay and hence not paid by the respondent (complainant) and nothing has been produced regarding payment of compensation as per Group Personal Accidental Insurance Policy by the respondent (complainant). The deceased himself was negligent and he himself was liable for his death. The complaint was not filed with clean hands, therefore, the compliant is liable to be dismissed.
4. After due appreciation of the material available before it, learned District Forum has allowed the complaint and directed the appellants (OPs) to pay compensation to the respondent (complainant), as mentioned in para 1 of this judgment.
5. The respondent (complainant) filed documents. Document A-1 are photocopy of GPA Unnamed Policy Schedule, A-2 are photocopy of letter dated 07.08.2009sent by Executive Engineer (O & M) Dn. C.S.P.D.C.L. Champa, Personal Accident Claim Form, letter dated 20.07.2009 sent by the Junior Engineer, C.S.P.D.C. Ltd. Baloda sent to Executive Engineer (O & M) Division Champa, C.S.P.D.C. Ltd. Champa, Meg Intimation,, Accident Injury Police Intimation, Inquest, application for post mortem, post mortem report, death certificate issued by Apollo Hospital, Service Certificate issued by Executive // 5 // Engineer (O & M) Dn. C.S.P.D.C.L. Champa, mark sheets, form of appointment of beneficiary, letter dated 29.09.2010 sent by the Executive Engineer (O & M) Dn. C.S.P.D.C.L. Champa, Medical Report, A-3 is photocopy of letter dated 29.10.2010 sent by the appellants (OPs) to the Industrial Relation Officer, Chhattisgarh State Power Holding Co. Ltd. Raipur, A-4 is order dated 18.03.2011 issued by Executive Director (Human Resource), C.G. State Power Holding Co. Ltd. Raipur, A-5 is order dated 21.03.2011 issued by Executive Director (Human Resource), C.G. State Power Holding Co. Ltd. Raipur, A-6 is photocopy of letter dated 01.10.2010 sent by Executive Director (Human Resource), C.G. State Power Holding Co. Ltd. Raipur to the appellants (OPs), A-7 is photocopy of letter dated 22.10.2010 sent by Executive Director (Human Resource), C.G. State Power Holding Co. Ltd. Raipur, to the appellants (OPs)
6. Shri Gunjan Giri Goswami, learned counsel appearing for the appellants (OPs) has argued that the impugned order passed by the District Forum, is erroneous. The District Forum did not consider the material placed before it by the appellants (OPs). The legal heirs of the deceased Gendram Sahu, are necessary party in the complaint and for want of the necessary party, the complaint is not maintainable before the District Forum, but the learned District Forum, did not appreciate the above facts and passed the impugned order, which is erroneous. The insurance policy which is issued in favour of the respondent // 6 // (complainant) is not Workmen's Compensation Policy but it is Group Personal Accidental Insurance Policy, therefore, the legal heirs of the deceased Gendram Sahu, are necessary party in the complaint and the appellants (OPs), is not liable to indemnify the respondent (complainant), therefore, the impugned order is liable to be set aside and the appeal be allowed.
7. Shri R.K. Bhawnani, learned counsel appearing for the respondent (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 (complainant) to the appellants (OPs). The policy is a non- contributory policy (xSj v'aknk;h), therefore, the legal heirs of the deceased, are not necessary party in the complaint. The Agreement (Consent Letter) has been executed between the appellant (OPs) and respondent (complainant), in which it is mentioned that if any accident is occurred and any employee of the respondent (complainant) is died in the accident, then the appellant (O.P.) will pay the insured amount to the tune of Rs.5,00,000/- to the respondent (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.), is liable to be dismissed. He placed reliance on // 7 // judgment of Hon'ble National Commission in Revision Petition No.2139 of 2011 - Additional Secretary, Chhattisgarh State Power Holding Company Limited vs. Bajaj Allianz Insurance Company Limited decided on 19.03.2014.
8. We have heard learned counsel for both the parties and have also perused the record of the District Forum.
9. The respondent (complainant) filed a document Annexure A-1 i.e. Group Personal Accidental Insurance Policy No. 152501/48/2009/864. According to the said insurance policy, the policy was issued in favour of Chhattisgarh State Power Holding Co. Ltd. Raipur (C.G.) 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 and premium amount Rs.73,41,625/- was paid by the respondent (complainant) to the appellants (OPs). The said insurance policy is GPA named policy. From bare perusal of the insurance policy, it appears that the insurance policy has been issued in the name of the respondent (complainant) and the same was not issued in the favour of individual employee of the respondent (complainant).
10. Agreement (Consent Letter) has been executed between the appellant (O.P.) and the respondent (complainant) in which it is mentioned that :-
// 8 // "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 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.
// 9 // 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."
11. 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 respondent (complainant).
12. 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 // 10 // of the deceased employees. Though we do not agree with the view expressed by the State Commission, in our opinion no harm would be 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......"
13. Looking to the above facts and circumstances of the case, the legal heirs of the deceased , are not necessary party in the complaint. By the impugned order, the learned District Forum has directed the appellants (OPs) to pay the respondent (complainant) a sum of Rs.5,00,000/-, which is insured amount under Group Personal Accidental Insurance Policy along with interest @ 6% p.a. from the date of filing of the complaint i.e. 13.04.2011 till realisation The contract of insurance has been entered into between the respondent (complainant) and appellants (OPs) and it was not necessary to implead the nominees / beneficiaries of the deceased employees, therefore, in the instant case non-impleadment of the legal heirs of the deceased Gendram Sahu, cannot affect the maintainability of the complaint and the complaint is maintainable.
14. In para 7 of the impugned order, learned District Forum has held that after perusal of the matter, we find that in the case Group Personal Accidental Insurance Policy has been issued for the complainant, which has been issued by the OPs. From the perusal of the matter, it is clear // 11 // the deceased died during his employment as he sustained grievous injuries when he was repairing the electricity and he died in the hospital. Generally, a person will do this type of work when he is healthy. In these circumstances it cannot be presumed that the death of the deceased has not been occurred due to accident.
15. In the instant case, in the Merg Intimation, it is mentioned that deceased Gendram suffered electric burn on 26.06.2009 and was admitted in the hospital for treatment and on 19.07.2009 he died. In the inquest it is mentioned that due to electrocution he fell down and during his treatment at Apollo hospital, deceased Gendram died on 19.07.2009 at 9.30 A.M. From bare perusal of merg intimation, inquest post mortem report, it appears that the deceased died due to accident. The autopsy surgeon also opined in the post mortem report that the cause of the death of the deceased is due to electric burn with head injury. It appears that the cause of death of the deceased, was accidental.
16. Learned District Forum vide impugned order has directed the appellants (OPs) to pay a sum of Rs.1,00,000/- towards compensation for mental agony to the respondent (complainant) and has also directed the appellants (OPs) to pay interest @ 6% p.a. from the date of filing of the complaint i.e. 13.04.2011 till realisation on the amount of Rs.5,00,000/-. It appears that learned District Forum, has awarded // 12 // interest @ 6% 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 @ 6% p.a. on Rs.5,00,000/- from the date of filing of the complaint i.e. 13.04.2011 till realisation, therefore, there was no necessity for the District Forum to separately grant compensation for mental agony to the tune of Rs.1,00,000/- in favour of the respondent (complainant). The respondent (complainant) is a Limited Company, therefore, there appears no question of suffering mental agony by the respondent (complainant).
17. 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 // 13 // one month after lodging of the claim i.e. 17.01.2009 till date of payment."
18. Looking to the facts and circumstances of the case, it appears that the District Forum, has unnecessarily awarded a sum of Rs.1,00,000/- as compensation for mental agony to the respondent (complainant), therefore, the above direction of the District Forum, is liable to be set aside.
19. In view of aforesaid discussions, the appeal filed by the appellants (OPs), is partly allowed and the impugned order of the District Forum dated 28.04.2014, is modified only to the extent that the appellant (OPs) will not be liable to pay a sum of Rs.1,00,000/- to the respondent (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) (D.K. Poddar)
President Member Member
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