NATIONAL INSURANCE CO. LTD. vs RAJBALA

THIS revision is directed against the order dated 26.8.2004 of Consumer Disputes Redressal Commission Haryana, Chandigarh dismissing appeal against the order dated 12.7.2004 of a District Forum whereby petitioner/opp.party No.1 was directed to pay under Devi Rakshak Scheme an amount of Rs.1 lakh being the insured sum along with interest at the rate of 12% per annum with effect from 24.10.2003 and Rs.5,000/- by way of compensation towards mental agony to the respondent/complainant.

FACTS giving rise to this revision lie in a narrow compass. The Government of Haryana had taken an insurance policy from the petitioner insurance company for a period of one year commencing from 2.10.2003 and the conditions of policy were incorporated in the Memorandum of Understanding (MOU) entered into between the parties on 1.10.2003. Scheme was to be confined to all the bread-earners of all families in Haryana except Government employees and income-tax payees whose names appeared in the voters list or ration cards issued by the Civil Supplies Department, Haryana. A dependant on death/permanent disability of the bread-earner due to accidents like snake-bite, was to get an amount of Rs.1 lakh from the petitioner under the said scheme. It was alleged that Jagbir Singh, husband of the respondent who was doing agricultural work in the field, was bitten by a snake on 30.9.2003 and was taken to PGI, Chandigarh for treatment where he expired on 21.10.2003. At the time of death, Jagbir Singh was aged 45 years and was the only bread-earner in the family and holding a ration card. On claim made by the respondent under the said scheme not being settled, she filed a complaint which was contested by the petitioner. In the written version it was alleged that the respondent is not covered under the scheme as Jagbir Singh was bitten by the snake on 30.9.2003 while the scheme became effective from 2.10.2003. Further, the deceased was an employee of co-operative institution which fell in the category excluded by the scheme. Both the pleas were decided against the petitioner by the District Forum. It was pointed out by Shri Atul Nanda for petitioner that the policy (copy at Pg.26) was a Group Insurance Policy and was for a period of one year starting from 2.10.1993. Jagbir Singh was bitten by a snake on 30.9.2003 when the policy was not in force though he died on 21.10.2003. Petitioner was, thus, not liable to pay any amount under the policy to the respondent. In support of the submission, he invited our attention to para-6.29 under the Chapter ''Commencement and Termination of Risk'' of MacGillivray on Insurance Law, 9th Edition and decision in Kelly Vs. Norwich Union Fire Insurance Society Ltd. - (1989) 2 All. E. R. 888. Relevant portion of the said para is reproduced below: ''Most policies would not render the insurer liable for a loss suffered during the currency of the risk from a peril operating wholly before the commencement of the cover. Neither would he ordinarily be liable for a loss suffered after expiry of the insurance whether due to a peril operating after the operative risk or during it.''

THIS principle was deduced from Kelly''s case (supra) wherein it was held - ''On the true construction of the policy, the events referred to therein were the happenings of any of the specified insured perils and not the loss or damage to the house caused by any of those perils. Accordingly, the defendant''s liability to indemnify the plaintiff could only be brought about by the occurrence of one of the insured perils during the period of policy. The policy therefore protected the plaintiff against specified perils occurring during the period of insurance and not against damage occurring during the period of insurance but resulting from the peril which had occurred before the policy came into effect. Since the water main had burst before the policy came into effect and loss or damage consequential on the burst main which had occurred during the period of policy, the plaintiff was not entitled to be indemnified under the policy for the loss or damage. The appeal would therefore be dismissed.'' (Emphasis supplied)

ADMITTEDLY on the date Jagbir Singh was bitten by a snake the policy was not in force. Applying the ratio in Kelly''s case, as the peril of snake-bite had not occurred during the insurance period of one year, the petitioner insurance company is not liable to pay any amount on ground of Jagbir Singh having died during the currency of the policy/scheme. Orders passed by both the fora below, thus, deserve to be set aside being not legally sustainable. Accordingly, while allowing revision, aforesaid orders passed by fora below are set aside and complaint dismissed. No order as to cost.