New India Assurance Co. Ltd. vs Jamuna Devi

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 Arki, 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 on 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 inquiry 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 inquiry made into the couse 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 for that premium has been deducted from his salary regularly and given to the Insurance Company. Before introduction of Janta Personal Accident Insurance Policy Scheme for daily wage and work charge workers 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 therafter. 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 : "I Coverages the (i)Death policy 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 gound 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 Delhi Electric Supply Undertaking v. Basanti Devi & Anr., III (1999) CPJ 15 (SC)=VIII (1999) SLT 279=IV (1999) CLT 36 (SC)=(1999) 8 SCC 229, it has to be held that respondent Nos. 4 and 5-Financial Commissioner-cum-Secretary (PW), Govern-ment of Himachal Pradesh, Shimla and Executive Engineer, I & PH Division, 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. Revision Petition allowed.