Punjab-Haryana High Court
Sbi General Insurance Company Ltd vs Permanent Lok Adalat (Public Utility ... on 19 January, 2024
Neutral Citation No:=2024:PHHC:007537
2024:PHHC:007537
IN THE HIGH COURT OF PUNJAB & HARYANA
AT CHANDIGARH
218
CWP-23811-2021 (O&M)
Date of decision: 19.01.2024
SBI General Insurance Company Limited
...Petitioner
VERSUS
Permanent Lok Adalat (PUS) and another
...Respondents
CORAM : HON'BLE MR. JUSTICE VINOD S. BHARDWAJ
Present :- Mr. Inderjit Sigh, Advocate for the petitioner.
Mr. S.S. Sidhu, Advocate for respondent No.2.
*****
VINOD S. BHARDWAJ, J. (Oral)
1. Challenge in the present writ petition is to the order dated
26.08.2021 passed by respondent No.1-Permanent Lok Adalat (Public
Utility Services), Rupnagar whereby the application filed by respondent
No.2-applicant was allowed and the petitioner-Insurance Company had been
directed to pay an amount of Rs.20 lakhs alongwith interest @ 12% per
annum.
2. Learned counsel for the petitioner contends that insured-
Maghar Singh-husband of the applicant-respondent No.2 had obtained an
insurance policy from the petitioner with a sum of Rs.20 lakhs. On
07.08.2019, he got up around midnight for nature's call when his arm is
stated to have touched the Cooler in which current was flowing, due to short
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circuit. Maghar Singh suffered electric current and died on the spot as a
result of electrocution. On the matter being reported, an investigator was
appointed and it was reported that deceased-Maghar Singh had accidently
touched the cooler, through which the current was flowing due to a short
circuit of the wiring. The death on account of electrocution is thus also
reported by the investigator appointed by the petitioner insurance company.
The claim was, however, declined relying on an exclusion clause of the
policy and the information sent by the respondent-applicant to the effect that
the deceased had consumed alcohol on the fateful day, before going to sleep.
It was thus contended, in terms of exclusion clause incorporated in the
policy, that as the deceased was under an influence of alcohol, hence, he
would not be entitled to the benefits of the policy. The decision of the
petitioner-insurance company of not releasing the benefits of the insurance
policy was subject matter of challenge before the Permanent Lok Adalat
(Public Utility Services) under Section 22(C) of the Legal Services
Authorities Act, 1987.
3. The Permanent Lok Adalat (Public Utility Services) drafted a
memorandum of settlement, however, the conciliation proceedings failed to
reach at any result, hence, the adjudication was initiated in exercise of power
under Section 22 (C) (8) of the Legal Services Authorities Act, 1987.
4. Upon consideration of the evidence and the arguments
advanced by the respective parties, the application preferred by respondent
No.2-applicant was allowed and the petitioner was directed to pay the sum
assured to the representatives of the deceased along with interest. The
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operative part of the award reads thus:
"10. After hearing the counsel for the applicant and the
counsel for the respondent & after going through the file,
we are of the firm opinion that the application should be
allowed. Our opinion above said is based upon the
following reasons.
11. It is agreed that Maghar Singh had been insured
with the respondent and the sum assured was Rs. 20 lakh.
It is also agreed that Maghar Singh met with an accident
and died. Obviously, the respondents should pay the
assured sum of Rs. 20 lakh.
12. It is not disputed specifically that Maghar Singh
had been insured at the S.B.I. Branch Bela, District
Rupnagar. Obviously, the transaction is within the
territorial jurisdiction of this Court.
13. A perusal of the investigation file reveals that the
applicant had disclosed to the investigator that on the
day of incident Maghar Singh had consumed three small
pegs of alchohal and had gone to sleep at 10 P.M. By
relying upon the same, the ld. Counsel for the respondent
states that at the time of the accident, Maghar Singh was
under the influence of the alchohal which is the violation
of the terms and conditions of the insurance policy. We
are of the opinion that even if it is believed that on that
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night Maghar Singh had consumed three pegs of
alchohal, even then, it is inconsequential. The reason is
the respondent agrees that Maghar Singh had died on
account of an accident and not on account of
consumption of alchohal. Further more, the respondent
does not claim that the alchohal had played any role in
the accident of Maghar Singh. Hence, we are of the
opinion that the above said contention of the ld. Counsel
for the respondent is ineffective.
14. It is agreed that neither the matter was reported to
the police nor the post-mortem of Maghar Singh was got
conducted. By relying upon the same, the ld. Counsel for
the respondent states that the application is not
maintainable. However, it has not been explained that in
the given circumstances how the recording of F.I.R.
would have affected this case. Since the respondent
agrees that the death of Maghar Singh had occurred on
account of an accident, therefore, neither lodging the
F.I.R. nor the post-mortem were necessary, Hence, we
hold that the abovesaid contention of the ld. Counsel for
the respondent is inconsequential.
15. In view of the discussion made above, we direct the
respondent to pay Rs.20 lakh to the applicant as the sum
assured. The respondent is also directed to pay interest
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upon the above said amount @ 12% p.a. from the date of
institution of this application till realization of the
amount in question. The parties are left to bear their own
respective costs.".
5. Aggrieved thereof, the petitioner has approached this Court.
6. Learned counsel for the petitioner has submitted that the
deceased Maghar Singh was in breach of the terms & conditions of the
policy and as such the exclusion clause would get attracted. Since the case
of the respondent itself is that the deceased has consumed alcohol and the
said aspect is duly covered under the exclusion clause, hence, the decision of
the petitioner insurance company to repudiate the claim was in accordance
with the terms & conditions of the policy and the same cannot be faulted
with. Further, he, places reliance on the Hon'ble Supreme Court in the
matter of 'Narbada Devi and anr. Vs. H.P. State Forest Corporation and
anr.' reported as 2012 (2) RCR (Civil) 618. Paragraph 17 thereof reads thus:
"17. Be that as it may, the Provisos of insurance policy
specifically disclose that compensation will not be paid in
respect of injury of the injured if he is under the influence of
intoxicating liquor. The relevant Proviso 4 of the insurance
policy reads thus:
"PROVISOS
Provided always that the company shall not be liable under this
policy to:
4) Payment of compensation in respect of death, injury or
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disablement of the insured from (a) intentional (illegible)
suicide or attempted suicide,
(b) whilst under the influence of intoxicating liquor or drug
(c) or (illegible) by insanity, (d) arising or resulting from
the insured committing any breach of the law with
criminal intent." The aforesaid Proviso 4 makes it amply
clear that the injured is not entitled to compensation
since on facts it is proved that he was intoxicated and
that was due to intoxication."
7. Learned counsel for the respondent on the other hand contends
that the Permanent Lok Adalat (Public Utility Services) has duly taken into
consideration all the relevant aspects. He further contends that the deceased
is stated to have consumed alcohol at around 9.00 p.m. -10.00 p.m. and that
the electrocution happened at about 2.00 a.m. in the morning. Further, as
per the case three pegs had been consumed by the deceased, however, there
is no evidence on record to suggest that the deceased was under the
influence of alcohol when the incident in question took place. He further
contends that the cause of death of Maghar Singh, in the present case, is not
on account of his being under the influence of alcohol but on account of
electrocution. Since the cause of death is not relatable to the exclusion
clause, hence, the benefits admissible to the petitioner under the insurance
policy cannot be denied. It is further contended that insofar as the judgment
in the case of 'Narbada Devi and anr. (supra) relied upon by the learned
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counsel for the petitioner is concerned, the same would not be applicable to
the facts of the present case. In the said judgment a specific finding has
been recorded that the deceased was heavily drunk before his death and had
gone outside to sleep on a cold, rainy October night. The evidence in the
form of Chemical Examiner's report and expert's opinion were also adduced
before the Court wherein it was stated that cause of death was asphyxia on
account of regurgitation of food articles into larynx and trachea after
consumption of alcohol. The medical opinion taken from the Former
Professor & Head of Department of Medicine and Principal, Indira Gandhi
Medical College, Shimla was also on record according to which the alcohol
found in the blood and urine was sufficient to cause deep sleep. The Court
noticed that the cause of death in the said case was directly attributable to
the excess consumption of alcohol. Hence, when the death in question is
directly related to the violation, the exclusion would become operational in
that case. Since in the present case, the death in question occurred as a result
of electrocution and had no direct/indirect nexus with consumption of
alcohol, hence, the judgment or the clause would not come into operation
merely because a deceased may have consumed alcohol. The exclusion has
to be read in exceptional circumstances and it is incumbent upon the
petitioner-insurance company to establish that not only was the deceased
under the influence of alcohol but also that the accident/death in question
was directly attributable to acts/omissions which are in relation to the effect
of alcohol. Once the above said link is absent, the petitioner-insurance
company would not be justified to dispute its liability to disburse the insured
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amount. Further, the insurance policy is welfare oriented and unless the
breach on the part of insured is well established, the petitioner-insurance
company would not be justified in repudiating the claim.
8. No other argument has been raised by the learned counsel
appearing on behalf of the respective parties.
9. I have heard learned counsel appearing on behalf of the
petitioner and have gone through the documents appended with the present
writ petition as also the contentions raised.
10. It is undisputed that the death in question occurred on
intervening night of 07/08.08.2019, after having received an electric shock,
at about 2.00 a.m. Even though the case of the petitioner-insurance
company was to the effect that deceased-Maghar Singh, has consumed 3
pegs, however, there is no evidence that has been brought whereof it can be
said the deceased was under the influence of alcohol or he was heavily
drunk. Further, the death in question occurred on account of electrocution, as
has been reported by the investigator of the petitioner-insurance company
itself, hence, the death being in the nature of accidental death remains
undisputed and uncontroverted. The question which thus arises next is as to
whether the exclusion clause of the policy would come into play even if the
cause of death is not directly/indirectly attributable to any of the exclusions
set out therein.
11. It is well established that the contract of insurance are governed
by the principle of uberrima fides and the terms of the contract are
sacrosanct. The insurance company underwrites the rights a liability on tacit
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understanding and that any breach of the terms & conditions or material
non-disclosure would entitle the insurance company to repudiate the claim.
However, the breach of the essential terms & conditions has to be direct and
that such breach or concealment must necessarily be fundamental cause the
accident/loss which has been under-written by the insurance company. Any
remote violation, which has no bearing on the accident and/or the final
outcome, would not be sufficient for the insurance company to claim that it
is entitled to invoke its rights and repudiate a claim by invoking the
exclusions merely on account of any violation and notwithstanding whether
such violation has no bearing in the manner/nature and the circumstances in
which the accident or incident in question took place.
12. There is no evidence on the basis whereof it can be concluded
that the death in question was directly connected to the consumption of
alcohol. Rather, both the acts are independent incidents, to the exclusion of
each other. Thus, when the cause of death is not as a result of the being
render the influence of alcohol, the contention of the petitioner that the
deceased-applicant would not be entitled to the benefits would be untenable
and would defeat the very object and intent of the welfare insurance policies.
13. Further, the judgment passed in case of 'Narbada Devi and
anr. (supra), relied upon by the learned counsel for the petitioner, would not
be applicable to the facts of the present case since a specific finding based
on evidence led had been recorded by Hon'ble Supreme Court that the
deceased was heavily drunk and the death in that case was directly
attributable to the act of consumption of alcohol by the deceased. The
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asphyxiation of deceased, being a direct outcome of excessive consumption
of alcohol, was proved on record by the medical evidence and by the opinion
of the experts. The said opinion having been relied upon and having
remained controverted, the deceased therein was in direct breach of the
express condition, thus attracting the exclusions. Since the said facts are not
existent in the present case, the judgment of the Hon'ble Supreme Court in
case of 'Narbada Devi and anr. (supra) would not apply in the present
case.
14. Besides, the above said contentions of the petitioner have
already been considered by the Permanent Lok Adalat (Public Utility
Services) and has dealt with the same in Paragraph 13 of the award. Once
the said contentions have been taken into consideration and a decision has
been arrived at, based upon a possible and probable interpretation of the
evidence adduced before the Court, exercise of such a discretion would not
be ordinarily interfered with unless such exercise of discretion is illegal,
perverse or suffers from impropriety and/or the conclusions are based upon
gross misappropriation of evidence or against the settled position in the eyes
of law.
15. The Permanent Lok Adalat is guided in its decision making by
the guidelines mentioned under Section 22-D of the Legal Services
Authorities Act, 1987 which holds that Permanent Lok Adalat shall decide
on the basis of principle of natural justice, objectivity, equity, fairness &
other principles of justice. Once such a jurisdiction has been exercised and
when such exclusions are merely amongst probable and possible conclusions
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on the appreciation of the evidence, I do not find that exercise of such
discretion would suffer from a vice of illegality, procedural impropriety,
gross irregularity, perversity or mis-appreciation of evidence which may led
to a conclusion that the award would be unsustainable, on a correct
appreciation.
16. It is further evident that the Permanent Lok Adalat (Public
Utility Services), Rupnagar has taken into consideration all the relevant facts
& arguments advanced by the petitioner Insurance Company and has
exercised its discretion as per the guidelines prescribed under Section 22 -D
of the Legal Services Authorities Act, 1987.
17. The award thus does not suffer from the vice of illegality,
perversity or gross mis-appreciation of evidence. The present petition is
accordingly dismissed. The order/award dated 26.08.2021 (Annexure P-1)
passed by the Permanent Lok Adalat (Public Utility Services), Rupnagar is
hereby affirmed.
(VINOD S. BHARDWAJ)
19.01.2024 JUDGE
Mangal Singh
Whether speaking/reasoned : Yes/No
Whether reportable : Yes/No
Neutral Citation No:=2024:PHHC:007537
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