Universal Sompo General Insurance Company Limited vs Anju Garg & 4 Ors.

The present revision petition has been filed by Universal Sompo General Insurance Company Ltd., against the judgment and order dated 18.03.2020 of the Uttar Pradesh State Consumer Disputes Redressal Commission, Lucknow ('the State Commission') in Appeal no. 2643 of 2016.

Heard the learned counsel for the petitioner at the admission stage. Learned counsel for the petitioner states that his basic ground in the revision petition is that the District Forum had allowed the compensation of Rs.5.00 lakh whereas the insurance per person was only for Rs.4.00 lakh as per the policy and as per the calculations. He states that the total sum insured in the group insurance policy and the total number of persons insured implies Rs.4.00 lakh as the insured amount per person.

Learned counsel further states that there is also an issue of Form 11 which relates to the registration of the firm with the Commercial Tax Department. It is stated that the deceased was not registered with the Commercial Tax Department as no Form 11 was issued. Thus, the deceased was not covered under the policy. Learned counsel for the petitioner also states that both the grounds were taken in the appeal before the State Commission, however, the State Commission has not looked into the issue of insured amount for one person. Therefore, the present revision petition has been filed.

We have perused the revision petition and the connected documents filed by the learned counsel for the petitioner. Learned counsel for the petitioner has stated that there is no clear mention of Rs.4.00 lakh in the policy as the sum insured for every person and he has been instructed by his client/ opposite party that as per the calculation, the sum insured per person is Rs.4.00 lakh only and not Rs.5.00 lakh as allowed by the District Forum. Neither the proposal form has been filed nor have any details of such calculation been filed. Moreover, the policy is a group insurance policy and the amount of sum insured for every person of the group has not been clarified in the policy. In fact, the learned counsel for the petitioner could not clarify the basis for his assertion that the insurance amount per person was only Rs.4.00 lakh. His argument that Rs.4.00 lakh is arrived at by dividing total sum insured by the total insured persons of the group cannot be accepted because the policy covers not only the death cases but also covers disability cases where only part of the sum insured is to be provided. If the Insurance Company has not purposely mentioned the sum insured for one person of the group in the policy, that ambiguity cannot be read against the insured.

Moreover, both the fora below have given concurrent finding of fact and the facts cannot be reassessed at the revision stage against the concurrent finding given by the fora below as held by the Hon'ble Supreme Court in the case of Mrs Rubi (Chandra) Dutta vs M/s United India Insurance Co. Ltd., 2011 (3) Scale 654 wherein the following has been observed:-

"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."

Thus, no factual error has been found in the orders of the fora below. The only legal point raised by the petitioner which can be looked into by this Commission is the issue of Form 11 which has already been dealt with by the learned State Commission by observing the following:-

"That from the perusal of aforesaid documents filed with appeal memo, it is evident that the certificate for this purpose was issued that the Firm M/s Deepak Engineering Works whose proprietor was Late Shri Deepak Garg, was registered with Commercial Tax Department on the date of his death. That the Commercial Tax Department has not issued any such certificate that the business of firm of Late Shri Deepak Garg was not being continued till the date of his death. That from the perusal of certificate issued by the Commercial Tax Department, it is evident that Commercial Tax Department has also proved that this firm has submitted Form - 7 and 8 in the office within time on 29.02.2008, but Form no.11 was not issued in the absence of biometrics.

Therefore, it is clear that Commercial Tax Department has admitted that the firm of deceased was registered on the date of his death with the Commercial Tax Department. The Department has considered the claim as genuine and did not raise any objections for it. That Form - 7 and 8 were duly submitted by Shri Deepak Garg as per the rule for getting registration under VAT Act vide Form - 11. The Commercial Tax Department has not stated that Form - 7 and 8 are erroneous. The Department has itself admitted that due to absence of biometrics, Form no.11 was not issued. Under these circumstances, the firm of deceased Shri Deepak Garg cannot be considered unregistered with the Commercial Tax Department".

We do not find any infirmity in the finding of the State Commission because the Insured, the Commercial Tax Department has accepted the registration of the firm and the policy does not mandate the issuance of Form 11 as a precondition for payment of claim. As per the policy, the member has to be registered with the Commercial Tax Department and such registration has been verified by the Commercial Tax Department. So, there seems to be no doubt about the registration of the firm in the present case.

On the basis of the aforesaid discussion, we do not find any merit in the present revision petition No. 872 of 2020 and the same is dismissed at the admission stage.