Unknown vs Chairman Cum-Managing Director
2021 Latest Caselaw 1110 Jhar

           IN THE HIGH COURT OF JHARKHAND AT RANCHI
                         W.P.(S) No.1831 of 2010
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1(i) Shankar Prasad Mehta

(ii) Subash Mahto

(iii) Kajal Kumari

(iv) Most. Manju

(v) Sangita Devi

(vi) Sahil Mahto

(vii) Bina Devi

(viii)Sunita Devi ..... Petitioners Versus

1. Chairman cum-Managing Director, Central Coal-Field Limited, Ranchi

2. General Manager, Kuju Area, Central Coal-fields Ltd., Kuju, District Ramgarh

3. Senior Personnel Officer, Aara Colliery, Central Coal Fields Limited, Distt. Ramgarh

4. Project Officer, Aara Central Coal Fields Ltd, District Ramgarh

5. Divisional Manager, Oriental Insurance Company Ltd., Circular Road, Lalpur, Ranchi ..... Respondents

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CORAM: HON'BLE MR. JUSTICE DEEPAK ROSHAN

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For the Petitioners : Mr. Yogendra Prasad, Advocate For the Respondents : Mr. A.K. Das, Advocate Mr. G.C. Jha, Advocate

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C.A.V. on 05.03.2021 Delivered on 07.06.2021 Heard learned counsel for the parties through V.C.

2. The instant writ application was initially preferred by the widow of the deceased employee who died while in service praying therein for a direction upon the respondent authorities, especially Respondent No.5 to pay the Group Personal Accident Insurance Claim of Rs.5,00,000/- to the petitioner.

During pendency of this writ application the widow-Parwati Devi died and other legal heirs were substituted pursuant to order of this court.

3. Brief facts relevant for disposal of the instant writ application are that the husband of the original-petitioner, namely Nageshwar Mahto was employed under Respondent Coal Company and he was insured with Respondent No. 5 under Group Personal Accident Insurance Scheme as the employer C.C.L. entered into an agreement with the Insurer Company in the interest of the employees. As per the scheme,

premiums were also deducted from the salary of the deceased employee.

On 20.04.2008, while the deceased employee was on duty in the workshop in the second shift and was doing his work, he fell down and become injured. Consequently, with the help of the co-workers he was sent to the local hospital and thereafter to the Central Hospital, Naisarai. He remained in the said hospital till 03.5.2008 when he was discharged.

However, it is alleged that since the husband of the petitioner retired on 30.4.2008; as such he was forcibly relieved from the hospital on 03.5.2008. Thereafter, he went to his residence. However, when his condition deteriorated he was again admitted to Nidan Nursing Home, Lohsingha, Hazaribagh where the deceased employee died during the treatment on 13.5.2008. FIR was also registered with the local police station under section 304-A of the IPC.

4. Mr. Yogendra Prasad, learned counsel for the petitioners submits that the premiums were duly deducted from the salary of the deceased employee and as such the petitioners are duly entitled for the claim amount of Rs.5,00,000/- being the sum assured as the deceased employee died as a result of the injury which he sustained while in service.

He further submits that since the deceased employee retired from service on 30.04.2008; he was discharged from the company hospital on 03.05.2008. However, when his condition deteriorated, the deceased employee got admitted in a private hospital and at the time of operation he died on 13.5.2008.

Learned counsel further submits that F.I.R. was also lodged before the local police station. Pursuant to the death of the deceased employee, the original-petitioner made a claim for the benefits which was due on account of death of her husband as he died due to an accident while on duty as per the insurance policy and MOU entered between the

employer and Insurance Company. However, for the reasons best known to the respondents; no amount was paid to the original-petitioner or to the legal heirs who are the present petitioners.

Learned counsel for the petitioners further submits that the stand of the respondents that the claim reached the insurance company beyond 90 days is non-est in the eye of law, inasmuch as, this court in various decisions has held that delay in submission of claim application would not be a hurdle in payment of the claim amount to the beneficiaries; as such, the respondents be directed to pay the insurance claim amount to the legal heirs of the deceased employee who are the present petitioners.

In support of his contention learned counsel relied upon the judgment passed in the case of Ajay Kumar Nonia Versus C.C.L. & Ors. [W.P.(S) 37 of 2013] and also in the case of C.C.L. vs. O.I.C.L. & Smt. Yashoda Devi (L.P.A. No. 347 of 2013).

5. Mr. A.K. Das, learned counsel for the respondent C.C.L. relying upon its counter affidavit submits that the documents in support of claim for insured amount was received on 27.8.2008 and the same was duly forwarded to the Oriental Insurance Company-Respondent No.5 on 30.8.2008. However, Respondent No.5 regretted the claim vide its letter dated 14.10.2008 on the ground of time/ limitation period prescribed in the memorandum of Understanding (MOU) as the death intimation of the deceased employee was not received within 90 days from the date of occurrence.

Mr. Das further submits that it is true that the deceased employee retired on 30.4.2008 but it is not a fact that he was forcibly discharged from the hospital rather he was cured and only then he was relieved on 03.5.2008. He further submits that by looking to the documents it is not proved that the death is the consequence of the accident and

even otherwise, there are no latches on the part of the employer C.C.L.

6. Mr. G.C. Jha, appearing for the insurance company submits that initially the claim of the original petitioner was rejected on the ground of limitation. However, during pendency of this case the matter was again verified and it was found that the deceased employee-Late Nageshwar Mahto died on 13.5.2008 but he superannuated from service on 30.4.2008.

He further submits that under the G.P.A.I.S policy a memorandum of understanding (MOU) was signed between C.C.L. and the Insurance company for the period from 06.5.2007 to 05.5.2008 and the deceased employee ceased to be in the employment of Respondent Company on 30.4.2008 and he died in a private hospital during the course of operation, as such it will be unfair to assume that the death occurred only due to injury sustained by him, inasmuch as, the deceased employee was relieved from the company hospital on 03.5.2008 and went to his residence and again he was admitted to a private hospital which clearly transpires from the documents and the pleadings of the original petitioner.

Moreover, the period of M.O.U. was only from 06.5.2007 to 05.05.2008, as such the deceased employee was also not covered by the insurance company at the time of his death. It is true that the policy was in existence when the employee sustained injury but in the absence of any document to prove that the said injury was the ultimate cause of death; the claim of the present petitioners should not be entertained.

7. Having heard learned counsel for the parties and after going through the documents available on record and the averments made in the respective affidavits it appears that so far as the ground of delay in rejecting the claim of the original petitioner by the insurance company is concerned; the same is not sustainable in the eye of law as it has been

held by this Court in several judgments that insurance claim cannot be rejected on the ground of late intimation. Reference in this regard may be made to the judgment passed in the case of Ajay Kumar Nonia (supra) and also in the case of C.C.L. vs. O.I.C.L. (supra).

8. However, at this stage it is pertinent to state that though the claim of the petitioners' is that the death has been caused due to the accident and injury sustained by the deceased employee but there is no document in the entire record to suggest that there is a direct nexus between the accident/injury and the death of the deceased employee. It also transpires from record that after the accident the deceased employee was admitted to the company hospital from where he was discharged on 03.5.2008. Though, it has been claimed by the learned counsel for the petitioners that the deceased employee was forcibly discharged from the company hospital on 03.5.2008; but there is no chit of paper or doctor's certificate in order to support this claim.

This assumption further gets fortified from the fact that the deceased employee did not go to other hospital rather he preferred to go to his residence after discharge and after some days he was again admitted to a private Hospital at Hazaribagh.

It further transpires from record that an F.I.R. was also lodged under Section 304-A of the I.P.C. However, there is nothing on record either in the form of Post Mortem report or the statement of the doctor who conducted operation of the deceased employee when he died. As a matter of fact, there is no chit of paper in the entire record which could suggest that there is some link or direct nexus between the injury sustained by the accident and the death of the deceased employee. Since the nexus has not been proved by way of any document; as such only on the basis of submissions; the disputed question of fact cannot be entertained by this Court. Admittedly, when the F.I.R. was lodged; the police must have done investigation and came to a conclusion and submitted

its report. Since, no such report is available on record as such the connection between the injury and the death cannot be proved in the writ court.

9. In view of the aforesaid facts and discussions, no relief can be granted to the present petitioners. However, the instant application is, hereby, disposed of by giving liberty to the present petitioners to approach the Court of competent jurisdiction in order to prove the nexus between the accident/injury and the death of the deceased employee.

10. As a result, the instant application is dismissed.

(Deepak Roshan, J.)

Jharkhand High Court Dated/07.06.2021 s.m./A.F.R.