PEERLESS GENERAL FINANCE AND INVESTMENT Company LIMITED vs SHANKAR PRASAD

THIS appeal is directed against an order dated 21.9.1996 passed by District Forum, Patna in Case No. 58/89. By the impugned order the District Forum directed opposite party No. 2- National Insurance Company Limited (respondent No. 2 in this appeal) to pay Rs. 10,000.00 to the complainant (respondent No. 1 in this appeal) as the insured amount with interest @ 18% from the date of institution of the complaint case, i.e., with effect from 19/12/1989 till the date of payment. The District Forum further directed both the opposite parties (Peerless General Finance and Investment Company Limited and National Insurance Company Limited) to pay jointly Rs. 15,000.00 to the complainant as cost of litigation and Rs. 20,000.00 as compensation for the mental agony and harassment caused to him.

THE case of the complainant (respondent No. 1) before the District Forum was that his father namely Sita Ram Lal was the holder of Welfare Endowment Certificate No. E1212187/ 311 of Rs. 10,000.00 under the Social Welfare Scheme of the Peerless General Finance and Investment Company Limited (appellant) which covered the accidental death benefit introduced by the said Company in collaboration with National Insurance Company Limited (respondent No. 2). THE father of the complainant had an accidental fall from the stair case of his residential house at 7.40 a.m. on 16/4/1986 as a result of which he sustained injury and was admitted in local Popular Nursing Home at Bakhtiyarpur on 16/4/1986 at 8 a.m. After examination and first aid he was referred to Barh Sadar Hospital for further treatment. He was admitted in the emergency ward of Sadar Hospital, Barh on 16/4/1986 at 6.30 p.m. but died at 7 p.m. on the same day. THE complainant being the nominee of his father in the aforesaid Endowment Certificate lodged his claim with regard to the amount of the certificate but the same was repudiated. Under the circumstances, he filed complaint case before the District Forum. The complaint case was dismissed on merit by the District Forum vide order dated 22/3/1991. The complainant preferred Appeal No. 42/91 before this Commission which was dismissed. The complainant then filed Revision No. 535/94 before the National Commission against the order of this State Commission and the National Commission set-aside the orders of the District Forum and that of the State Commission and remanded the case to the District Forum for a fresh decision with a direction to give opportunity to the parties to produce their evidence. After remand the District Forum passed the impugned order against which this appeal has been preferred.

The National Insurance Company Limited (opposite party No. 2) had filed written statement before the District Forum and had contested the case. The Peerless General Finance and Investment Company Limited (appellant in this appeal) had neither filed any written statement before the District Forum nor had contested the case. The case of the National Insurance Company Limited before the District Forum was that there was no direct contract between the complainant and the National Insurance Company Limited and hence the complainant had no cause of action against the National Insurance Company Limited. Further case was that the National Insurance Company Limited takes the risk of personal accident policy duly hypothecated to it through the Peerless General Finance and Investment Company Limited and has got no direct dealing whatsoever with the complainant. The moment the said accident was reported to the Insurance Company, an Investigator was appointed and on the basis of the report submitted by the Investigator the claim of the complainant was found to be non existent. Reporting of such accident to the police under Sections 40 and 174 of the Criminal Procedure Code is a must for substantiating accidental claim but nothing like this had been done in this case. From the Investigator''s report it transpired that the alleged accident was never authenticated from the reliable sources like hospital where the father of the complainant is said to have succumbed to the injury or from the police station where such cases are registered. The claim of the complainant being not maintainable, communication to this effect was sent to him. On the allegations aforesaid the prayer in the written statement of the Insurance Company was for disallowing the claim of the complainant.

NOW it has to be seen if the impugned order passed by District Forum is sustainable in law or not. Certain facts are not disputed. There is no dispute regarding the fact that Sri Sita Ram Lal, the father of the complainant was the holder of a Welfare Endowment Certificate of Rs. 10,000.00 under the Social Welfare Scheme of the Peerless General Finance and Investment Company Limited and as such he was entitled to the accidental death benefit introduced by the said Company in collaboration with National Insurance Company Limited. It is also not disputed that the complainant is the nominee of the certificate holder, Sita Ram Lal. It is also not disputed that he preferred his claim for the insured amount which was repudiated by opposite party No. 2 (National Insurance Company Limited) vide its letter dated 11/4/1989 on the following grounds : "It is observed from the relevant claim papers that the death of the certificate holder was neither reported to the police station nor any post-mortem examination was conducted on the body of the deceased. Further the admission of the patient in the hospital could not be traced and report of death had not been found recorded in the register. Under the above circumstances we have no other alternative but to repudiate the claim and filing the papers as No claim which please note."

The complainant has brought on record photo copy of a letter dated 10th August, 1987 addressed by the Branch Manager of the appellant-Company to its Deputy Manager, Claim, at Calcutta. The said letter shows that police report issued by the Officer Incharge of Bakhtiyarpur Police Station and the post-mortem report had been made available by the complainant to the appellant-Company and the Branch Manager of the appellant-Company had sent the same to its Calcutta office under the aforesaid letter dated 10th August, 1987. In the holding of post-mortem examination also it is implied that there must have been information to the police. That being so, the ground that there was no post-mortem examination and report to the police does not hold good. Furthermore, the said letter shows that the complainant had also made available to the appellant-Company death certificate issued by the Municipal Corporation, Barh as well as death certificate issued by the Gram Panchayat. The genuineness of the said letter dated 10th August, 1987 has not been challenged either in the aforesaid written statement dated 19.9.1990 of the contesting opposite party or in any petition filed on behalf of the opposite parties including the appellant. From the papers filed by the complainant it further appears that he had filed photo copy of the prescription of Dr. Girish Chandra Singh of Popular Nursing Home at Bakhtiyarpur which was to the effect that Sita Ram Lal was admitted in the said Nursing Home on 16.4.1986 at 8 a.m. in unconscious condition with head injury due to fall from stair-case and after some treatment was referred to Barh Sadar Hospital for further treatment. The report of the Investigator is an annexure to the written statement filed by the National Insurance Company. In the said report there is mention about the certificate issued by the Popular Nursing Home. Apart from that photo copy of the certificate dated 16/4/1986 issued by the doctor of Subdivisional Hospital, Barh, has been brought on record by the complainant. It bears the seal of the said hospital. It supports the case of the complainant that his father Sitaram Lal attended Barh Subdivisional Emergency on 16/4/1986 at 6.30 p.m. in unconscious condition with signs and symptoms of head injury on being referred by Dr. Girish Chandra Singh of Popular Nursing Home, Bakhtiyarpur and died at 7 p.m. on 16/4/1986. Copy of letter No. 273 dated 27/4/1989 addressed by the Deputy Superintendent of Subdivisional Hospital, Barh, to the Investigator appointed by Insurance Company, in response to his letter No. 147/8/3/1989 dated 8/3/1989 and brought on record by the complainant is also to the same effect.

THE complainant has also brought on record two affidavits of his own. In one of the affidavits which is dated 2.8.1995 it has been stated that his father Sita Ram Lal died on 16/4/1986 due to fall from the stair-case of his house and his death took place in Subdivisional Hospital at Barh. Besides his own affidavit the complainant has brought on record an affidavit sworn by one Prabhakar Narain Singh, a Pharmacist of the Subdivisional Hospital, Barh. His affidavit is to the effect that from the records of the Barh Subdivisional Hospital, he found that a patient namely Sita Ram Lal S/o Hari Lal of Bakhtiyarpur was treated in the said hospital by Dr. Nageshwar Prasad on 16/4/1986 at 6.30 p.m. and he died at 7 p.m. on the same day and this fact was inserted in the injury register of the hospital vide Serial No. 1072 at pages 104-105. His further statement is to the effect that the said patient had been referred by Dr. Girish Chandra Singh of Popular Nursing Home, Bakhtiyarpur. He has further stated that the death certificate concerning deceased Sita Ram Lal was issued by Dr. Nageshwar Prasad and the same bears the seal of Barh Subdivisional Hospital. As against the aforesaid evidence/affidavit adduced by the complainant there is no counter affidavit on behalf of the opposite parties. It is true that the relevant register of the hospital and other papers concerning the deceased in the hospital have not been brought on record as exhibits but in absence of any counter affidavit on behalf of the opposite parties, there appears no reason to disbelieve the statement of the complainant and the aforesaid Pharmacist in their aforesaid affidavits. Under the circumstances, the repudiation of the claim of the complainant by the Insurance Company was not justified. From the papers brought on record by the complainant it appears that the amount of Rs. 2,730.00 which had been paid by the certificate holder as subscription to the Peerless General Finance and Investment Company Limited had been paid back to the complainant by the said Company. This fact has also been mentioned in para 10 of the impugned order. It was not disputed that the Insurance Company had taken the risk of personal accident policy of the deceased duly hypothecated to it through Peerless General Finance and Investment Company Limited (appellant). That being so, the Insurance Company was undoubtedly liable to pay the endowment certificate amount to the complainant who is undisputedly the nominee of the certificate holder. In view of this the direction of the District Forum to the National Insurance Company Limited to pay Rs. 10,000.00, the certificate amount, to the complainant does not call for any interference by this Commission. The District Forum has further directed for payment of interest @ 18% over the said amount of Rs. 10,000.00 from 19/12/1989, the date of filing of the complaint petition, till the date of payment. This direction is modified to this extent that the interest payable by the Insurance Company over the said amount of Rs. 10,000.00 will be 12% only instead of 18%. Keeping in view the fact that the complainant had been dragged into prolonged litigation for several years the District Forum has directed the National Insurance Company as well as the appellant to pay jointly to the complainant a sum of Rs. 15,000.00 as cost. As pointed out earlier, the appellant-Company had neither filed written statement before the District Forum nor had contested the case. Under the circumstances, making liable the appellant also for payment of cost of litigation does not appear to be justified. So this direction is also modified to the extent that aforesaid amount awarded by District Forum as cost will be payable by the Insurance Company only. Keeping in view the fact that interest has been allowed on the insured amount and Rs. 15,000.00 has been allowed as cost, there appears no justification for allowing Rs. 20,000.00 as compensation to the complainant and that too when there is no such claim in the original complaint petition. So the direction of the District Forum for payment of Rs. 20,000.00 as compensation to the complainant by the opposite parties jointly is not sustainable in law.

FROM the above discussion, it is apparent that the Insurance Company (respondent No. 2) is liable to pay Rs. 10,000.00 to the complainant with interest @ 12% per annum with effect from 19/12/1989. The Insurance Company is further liable to pay Rs. 15,000.00 as litigation cost to the complainant. The opposite parties including the appellant are not liable to pay any amount as compensation to the complainant. With the above modification in the impugned order, this appeal is hereby dismissed. There will be no order as to cost of this appeal. Appeal dismissed.