Oriental Insurance Co. Ltd vs Bedan Bai & 2 Ors

Subhash Chandra, Presiding Member

1.The present revision petition has been filed against the judgment dated 27.12.2011 of the Chhattisgarh State Consumer Disputes Redressal Commission, Raipur (‘in short, ‘the State Commission’) in First Appeal no. 2726 of 2011.

The brief facts of the case are that the  petitioner – insurance company  herein was the opposite party before the District Consumer Disputes Redressal Forum, Raipur, (Chhattisgarh) (in short, ‘the District Forum’). The insurance company issued a group personal accident insurance policy to the Employees of the Chhattisgarh Power Holding Company Ltd., - respondent no. 4, covering 17,601 employees vide offer/ proposal dated 11.09.2003 and thereafter received a premium of Rs.11,40,544/- from respondent no.4. A policy no.42/204/27 was operative and effective from 11.09.2003 to 10.09.2004. The claim was filed with the Insurance Company on 30.10.2006 along with all particulars including death certificate, post mortem report, FIR and service certificate of CSEB. The insurance company repudiated the claim on 07.12.2006 treating ‘no claim’ due to inordinate delay in intimating the loss to the insurance company. Late Beni Ram was an employee of respondent no.4 and was working as motor vehicle driver in Nawapara Rajin Division Line. According to the complainant, Late Beni Ram was murdered by some unknown persons on 02.07.2004. Respondent no.4 has stated that CSEB has number of offices throughout the State and that one such office at Navapara, Rajim took some time to collect requisite information from the beneficiary’s family resulting in delay in lodging the claim. As the delay was not deliberate, the claim should have been sympathetically considered by the revision petitioner herein. By repudiating the claim on a minor ground, the respondent claims that the insurance company committed deficiency in service. Respondent no.4 had claimed a sum of Rs.2,00,000/- with interest @ 9% per annum from the insurance company and filed an affidavit of Shri P K Chauhan in support of their claim.

Respondent no.4 has prayed that the insurance company be directed to settle the claim of Beni Ram and pay Rs.2,00,000/- to the Electricity Board for further disbursement to the legal representative of the deceased employees and to pay interest @ 9% on the amount of Rs.2,00,000/- along with costs.

The District Consumer Disputes Redressal Forum, Raipur (Chhattisgarh) (in short, ‘the District Forum’) in complaint no. 165 of 2007 decided on 13.07.2011 observed that succession certificate was obtained from the competent court by legal heirs of Beni Ram which caused the delay in presenting the claim before the Insurance Company. The District Forum after analysis of the application under section 12 of the Consumer Protection Act, 1986 and after accepting the complaint, ordered that the insurance company shall pay Rs.2,00,000/- to the respondent no.4 – Electricity Board within one month from the date of the order.

Dissatisfied by the order of the District Forum, the petitioner herein – insurance company approached the Chhattisgarh State Consumer Disputes Redressal Commission, Pandri, Raipur (in short, ‘the State Commission’) vide appeal no. 445 of 2011. The State Commission vide its order dated 27.12.2011 has held as under:

“It is a case of group insurance of thousands of employees and one of them was murdered, which was intimated late to the insurance company and the claim was preferred, but if the intimation to the insurance company was given late, even then in view of guidelines of IRDA dated 20.09.2011, the insurance company was required to consider the claim to ascertain, if the delayed claim would have been rejected, if it was reported in time. Apart from it when early, the matter was brought before us as well as the National Commission in Appeal and Revision then the question of limitation was not pressed.

Thus, examining the matter from all angles, we find that the District Forum has not committed any mistake in passing award against the insurance company on account of accidental death of employee of respondent no.1 – Power Holding Company. The appeal has got no substance and is dismissed. No order as cost.”

The present revision petition has been filed by the insurance company impugning this order on the ground that the orders of the fora below are perverse since the intimation of death/ murder was given after more than 27 months and murder is not covered under the group personal accident insurance policy. The delayed intimation of the incident to the insurance policy was in violation of the condition of the policy.

We have heard the learned counsel for the petitioner as well as respondent no.4. None appeared on behalf of respondent nos. 1 to 3 on the date of final arguments. Respondent no.4 was represented by counsel on record.

Learned counsel for the revision petitioner argued that the claim was inordinately delayed and the fact of the murder which was not covered under the policy had not been intimated for over two years to the petitioner. On behalf of respondent it was contended by the learned counsel for respondent no.4 as per his written synopsis. Reliance was placed upon the guidelines of IRDAI and the judgment of the Hon’ble Apex Court that no claim should be repudiated on the ground of delay. It was argued that the impugned order was well-reasoned and correct.

This Commission, in exercise of its revisional jurisdiction, is not required to re-assess and re-appreciate the evidence on record when the findings of the lower fora are concurrent on facts. It can interfere with the concurrent findings of the fora below only on the grounds that the findings are either perverse or that the fora below have acted without jurisdiction. Findings can be concluded to be perverse only when they are based on either evidence that have not been produced or are based on conjecture or surmises i.e. evidence which are either not part of the record or when material evidence on record is not considered. The power of this Commission to review under section 21 of the Act is, therefore, limited to cases where some prima facie error appears in the impugned order. Different interpretation of same sets of facts has been held to be not permissible by the Hon’ble Supreme Court.

The Hon’ble Supreme Court in Mrs Rubi (Chandra) Dutta vs M/s United India Insurance Co. Ltd., (2011) 11 SCC 269 has held that:

“23. Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view than what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous) interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that the jurisdiction conferred on the National Commission under Section 21 (b) of the Act has been transgressed. It was not a case where such a view could have been taken by setting aside the concurrent findings of two Fora.”

Reiterating this principle, the Hon’ble Supreme Court in Lourdes Society Snehanjali Girls Hostel and Ors vs H & R Johnson (India) Ltd., and Ors  (2016) 8 Supreme Court Case 286 held:

“17. The National Commission has to exercise the jurisdiction vested in it only if the State Commission or the District Forum has either failed to exercise their jurisdiction or exercised when the same was not vested in them or exceeded their jurisdiction by acting illegally or with material irregularity. In the instant case, the National Commission has certainly exceeded its jurisdiction by setting aside the concurrent finding of fact recorded in the order passed by the State Commission which is based upon valid and cogent reasons.”

The Hon’ble Supreme Court in T Ramalingeswara Rao (Dead) Through LRs and Ors vs N Madhava Rao and Ors, dated 05.04.2019 again held as under:

“12. When the two Courts below have recorded concurrent findings of fact against the Plaintiffs, which are based on appreciation of facts and evidence, in our view, such findings being concurrent in nature are binding on the High court. It is only when such findings are found to be against any provision of law or against the pleading or evidence or are found to be perverse, a case for interference may call for by the High Court in its second appellate jurisdiction.”

From the records it is apparent that the petitioner has challenged the impugned order on the very same grounds which were raised before the District Forum as well as the State Commission in appeal. The concurrent findings on facts of these two foras are based on evidences led by the parties and documents on record. The present revision petition is therefore an attempt by the petitioner to urge this Commission to re-assess, re-appreciate the evidence which cannot be done in revisional jurisdiction. Learned counsel for the petitioner has failed to show that the findings in the impugned order are perverse.

The foras below have pronounced orders which are detailed and have dealt with all the contentions of the petitioner. It is seen that the orders of these fora are based on evidence on record.  In view of the settled proposition of law that where two interpretation of evidence are possible, concurrent findings based on evidence have to be accepted and such findings cannot be substituted in revisional jurisdiction, this petition is liable to fail.

I therefore, find no illegality or infirmity or perversity in the impugned order. The present revision petition is, therefore, found to be without merits and is accordingly dismissed.