NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION

                                                NEW DELHI

 

REVISION PETITION NO.  1382   OF 2001

(From the order dated   18.5.2001 in  appeal No.218/99

  of the State Commission,   Himachal  Pradesh)

 

The New India Assurance Co. Ltd.                               …               Petitioner

Vs.

Smt. Jamuna Devi &  Ors.                                            …               Respondents

 

BEFORE:

                        HON’BLE MR. JUSTICE D.P. WADHWA,

                                                                        PRESIDENT

                        HON’BL MR. JUSTICE J.K. MEHRA, MEMBER.

MR.  B.K. TAIMNI, MEMBER.

 

Employer floated  a scheme for payment of compensation on the death of the employee- tripartite agreement - insurance policy in the name of the employer - premium regularly deducted from the salary of the employees -  death - insurance company repudiated the  claim on the ground that death  was not on account of accident.   Held -  employer will be liable as the scheme covered  natural death.

 

 

 

For the  petitioner                     :           Mr. A.K. Raina, Advocate

 

For the respondent Nos. 1 to 3 :           Mr. G.D. Sharma, Advocate

 

For the respondent Nos. 4 & 5 :           Mr. Rajiv Nanda & Mr. S. Anand, Advocates.

 

                                                                        O R D E R

DATED THE   29th    May,   2002.

 

JUSTICE D.P. WADHWA, J.(PRESIDENT).

 

                        It is the Insurance Company which has filed this revision against the order of the State Commission which had allowed the appeal filed by the respondent Nos. 1 to 3 -complainants against the   Insurance Company. Respondent Nos. 4 and 5 herein are  Financial Commissioner-cum-Secretary (PW) Government of Himachal Pradesh, Shimla and Executive Engineer, I & PH  Division  Arkit Distt. Solan respectively.  They were also respondents in the appeal before the State Commission filed by the  complainants.    

                        Narpat Ram   was subscriber  to Janta Personal Accident Insurance Policy  under  tripartite  agreement   between  the employees, employers, being the

respondent Nos. 4 and 5 above,  and the petitioner-Insurance Company.    The   Scheme   under  which the insurance policy was floated came into existence 25.1.1996.  Policy was executed between the employer and  the Insurance Company.

                        Narpat Ram was working as  Keyman, a class-IV employee  in the I&PH-Division   at Arki,  District Solan in the State of Himachal Pradesh.  During the course of  his working  on a particular day, i.e.  on 17.12.1996 he collapsed and died.  It was  the case of the complainants  who were the widow and children of Narpat Ram that Narpat Ram   died on account of accident  as at the time of collapse  he was operating  the nut  in the pipe  supplying  water.    Contention of the insurer was that it was a case of  natural death and as such it was not covered under the policy in question.   District Forum on a complaint filed  by the complainants came to the conclusion that death  of Narpat Ram was not on account of any accident, mishap  or  other catastrophic  events during  the course of his employment so as to bring  their case within the ambit and purview of the policy.  Complaint was accordingly dismissed.

                        Complainants filed appeal before the State Commission which during the course of hearing  called the officers of   I&PH Division and wanted to know  if any enquiry was made as to the case of death of Narpat Ram.   Their reply was in negative.   In this view of the matter, State Commission concluded that since there was no enquiry made into the cause of death by the employer complainant could not be deprived of the benefit under the policy.  Complaint was,

therefore, allowed  against the  petitioner-Insurance Company, as well as respondent Nos.4 and 5 were held jointly and severally  liable to make the payment

of the insured  amount of Rs.1.00 lakh with interest @ 9% per annum  from the date of filing of the complaint.  A sum of Rs.1,000/- was also  awarded as cost.

                        Against the order of the State  Commission it is the Insurance Company which has  filed this revision petition challenging  that order.   Respondent Nos. 4 and 5  being the employers have not  challenged that order.   After having gone through the orders of the District Forum and State  Commission it is  difficult for us to conclude that death of Narpat Ram was accidental  and as such  claim advanced by the complainants was rightly repudiated by the petitioner-Insurance Company.   However, that does not conclude the matter.  Narpat Ram had always been  given  to  believe  by the employer that the policy covered  natural death as well and that  for that  premium has been deducted from his salary regularly and given to the  Insurance Company.  Before introduction of  Janata Personal Accident Insurance Policy Scheme  for daily  wage and work charge workkers of various Departments/Boards of the Himachal Pradesh a communication was addressed by the  Financial Commissioner-cum-Secretary (PW) to the Government of Himachal Pradesh to all the  Heads of the Departments, the Administrative Secretaries to the Government of  Himachal Pradesh and others  giving details of the policy and benefits   realising therefrom.   This letter is dated  23rd January, 1996 and the insurance policy in question  has been issued thereafter.    It   is  not  necessary  for  us  to set out this letter in detail

except to note  that under the insurance scheme coverage was for various contingencies as under:

 

            “1.  COVERAGES:  the poliy               i.    Death.

                                             will cover ii.   Loss of body parts

iii.   Permanent total disability     and

iv.    Permanent  partial disability due to any type of accident  including

… natural calamities like     landslides, avalanches, floods

drowning, tree falling, snake bites etc.

 

                        The letter describes in detail sum insured, benefits in the case of any of the contingencies arising; insurance policy to be issued to the Head of the Department,  mode of payment of premium, eligibility for insurance cover, claims etc.   Once having made  Narpat Ram , a daily wage worker  to believe that the insurance policy taken  for him would cover his natural death, respondent  Nos.  4 and 5 could not go back  on their promises and the widow and children of Narpat Ram  could not  be denied the insurance claim on the ground that the policy did not cover natural death. Coverage under the  scheme which we have mentioned above  certainly applies to the natural death as well.  This could not be disputed .  Drawing strength from the judgment of the Supreme Court in the case of  Basanti Devi Vs. DESU -  (1999) 8 SCC 229, it has to be held that respondent No. 4 and 5 - Financial Commissioner-cum Secretary, (PW) Government of  Himachal Pradesh,   Shimla  and   Executive  Engineer,  I & PH  Divison  Arki,  Distt. Solan

 

respectively  would be liable to  make  payment as directed by the State Commission.     As far as petitioner-Insurance Company is concerned, this petition

has to be allowed and Insurance Company  is discharged from its liability under the  insurance policy.

                        Accordingly respondent Nos.  4 and 5 are directed to make the payment  to the complainants as  awarded by the State Commission. Though we would allow the  revision petition and  set aside the order of the State Commission to the extent   that it   directs  the petitioner  to pay the insured amount,  yet petitioner will pay Rs.2,000/- as costs to the widow  and children of the deceased  of this petition.

 

 

            ……………………………………J

(D.P. WADHWA)

                      PRESIDENT

 

                                                                                                                                    ……………………………………J

(J.K. MEHRA)

            MEMBER

 

                     

……………………………………….

(B.K. TAIMNI)

     MEMBER