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2008(3) CPR 239
JAMMU AND KASHMIR STATE CONSUMER DISPUTES REDRESSAL COMMISSION, JAMMU
G.D. Sharma, President and Khalid Hussain, Member
Krishan Gopal (deceased) through
LRs. —Complainants
versus
M/s. Lahmeyar International Gmbh Bagliar Hydro Electric Project & Ors. —OPs.
Complaint No. 2623 of 2004
Decided on 27.3.2008
Counsel for the Parties:
For the Complainants:Mr. Ajay Singh Manhas, Advocate.
For the OP No. 4:Mr. Rajesh Kumar, Advocate.
IMPORTANT POINT
When two reasonable interpretations of the terms of the policy are possible, the interpretation which favours the insured has to be accepted.
Headnote:Consumer Protection Act, 1986—Sections 12 and 17—Insurance claim—When two reasonable interpretations of terms of policy were possible, interpretation which was favourable to insured has to be accepted—Deceased was covered under Group Personal Accident policy obtained by OP No. 2 from OP No. 4—Under the policy all project sites were insured—Deceased was on official project duty and while on the way met with road accident on National Highway and died—Claim resisted on plea that place of accident was not covered under policy it being not the project area—One clause in policy defined the ‘Project Area’ as area where permanent and temporary works was to be located in the vicinity of works —Another clause provided that works shall mean and include all permanent and temporary works to be executed, all items and things to be supplied/done and services and activities to be performed by contractor within or outside the project area—Two clauses were self contradictory—Deceased had gone on official work for obtaining report of meeting/quality control of construction material to be used in construction—Deceased was covered under the policy risk—Complainant held entitled to policy amount of Rs. 10,00,000 with interest at 6% p.a. from the date of accident. (Paras 5 to 7)
Result: Complaint allowed.
G.D. Sharma, President—The complainant herein namely, Shri Krishan Gopal was the father of the deceased Sanjeev Kumar Sharma. On 23.3.2004, said Shri Krishan Gopal made complaint herein against the OPs making inter alia averments that his son Mr. Sanjeev Kumar Sharma was employed as Assistant Civil Engineer/Site Inspector with OP No. 1 which was an associate company of the principal contractor i.e. OP No. 2. Deceased Sanjeev Kumar Sharma had the duty to maintain the quality control of the materials which were being used by OP No. 1 for the construction of the project. OP No. 2 had taken the contract from the State owned corporation known as J&K Power Development Corporation for the construction of a dam on River Chenab known as “Baglihar Hydro Electric Project, Chanderkot” hereinafter known as project. The special tests for maintaining high standards of material used in the project in normal routine works were being carried out by the other agencies like SICOP and RRL from their Jammu wings and CSMRS Laboratory which was situated in New Delhi. OP No. 1 was the agency engaged by OP No. 2 to get the works done. It is alleged that on 29.9.2002, the deceased Sanjeev Kumar Sharma was on official duty relating to the project works but unfortunately while coming back met with a road accident near Gangyal on the National Highway and died on the spot. In compliance to the relevant laws made applicable to the State of Jammu and Kashmir, the employees of the construction company (OP No. 1) were got insured by the contractor namely, OP No. 2 from OP No. 4 under Group Insurance Policy Scheme. It is pleaded that at the event of death of any permanent employee engaged in project work, his legal representative or nominee as the case may be was entitled to claim the whole amount of the Insurance Cover. The deceased Sanjeev Kumar was engaged on permanent basis by OP No.1 and was being paid Rs. 7,500 per month. Under the abovesaid insurance policy, he stood insured for a sum of Rs. 10,00,000 for the risk of his life. The complainant after the death of Mr. Sanjeev Kumar Sharma approached OPs No. 1 and 2 for the disbursement of the insured amount and in response they recommended the case for the payment of the insured risk to OP No. 4. The request had gone hay wire as there was no response. The complainant had alleged in the complaint that when he was at an advance stage of his life he unfortunately lost his only bread earning member of the family. He had to meet the expenses of marrying his young daughter and constantly bear the medical expenses of his ailing wife as well as to secure two time meals for his family. He claimed full amount in the sum of Rs. 10,00,000 which was the assured amount under the policy alongwith interest and Rs. 20,000 for inconvenience and harassment as well as Rs.15,000 towards litigation charges. It is also pleaded that the cause of action had arisen in the month of December, 2002 when the complainant had approached the OPs for the payment of insured amount and the same was denied.
2. On 30.11.2004, Mr. M.A. Bhat advocate filed the objections on behalf of OPs No. 1, 2 and 3. OP No.1 in its objections had stated that it is a consulting agency of the principal employer i.e. J&K Power Development Corporation. Respondent No. 2 got the contract of construction of Baglihar Hydro Electric Project Dam from the J&K Power Development Corporation and entered into a contract of insurance with OP No.4. Under legal obligation, OP No.2 got insured its own employees employed in the works of Baglihar Hydro Electric Project as well as the employees of OP No.1 on the terms and conditions laid down in the agreement of insurance. OP No. 2 had given the premium of the insurance policy which was a group insurance scheme. In terms of the said policy, “an employee with a pay of more than Rs. 7,500 per month had to get the insurance cover of Rs.10,00,000 in case of his death but the accident should have occurred within the project area as
