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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
Ashok Bhan, President and B.K. Taimni, Member
SUNAYANA GARG - Appellant
Versus
ICICI LOMBARD GENERAL INSURANCE CO. LTD. AND ORS. - Respondents
Revision Petition No. 4668 of 2008 from Order dated 4.9.2008 in Appeal No. 2080 of 2007 of UP State Consumer Disputes Redressal Commission
Decided on : 05-01-2010
Mr. Rakesh Kr. Gupta, Advocate, for the Appellant; Mr. Ajay Vikram Singh, Advocate, Mr. D. Vardarajan, Advocate, for the Respondent
The central legal point established is that the interpretation of insurance policy conditions must align with the spirit of the scheme and the specific language used, and that eligibility for insurance benefits is determined based on the nomination and age of partners as per the policy terms.
Headnote:
Insurance Policy - Partnership Firm - Interpretation of Condition 7
Fact of the Case:
The petitioner filed a complaint alleging deficiency in service by the respondents after her husband, a partner in a firm, died and the insurance claim was repudiated. The District Forum allowed the complaint, but the State Commission set aside the order. The petitioner filed a revision petition.
Finding of the Court:
The court interpreted condition 7 of the insurance policy, which stated that if a partnership firm did not nominate partners by a certain date, the oldest partner in age listed in Form 15 would be considered insured. The court found that the deceased partner was not the oldest and thus not eligible for the benefit.
Issues: Interpretation of condition 7 of the insurance policy, eligibility of the deceased partner for insurance benefit.
Ratio Decidendi: The court held that the spirit of the insurance scheme was to cover nominated individuals from the partnership firm, not all members. It concluded that the deceased partner was not eligible for the benefit as he was not the oldest partner listed in Form 15.
Final Decision: The court dismissed the revision petition, finding no infirmity in the State Commission's order and stating that it was in accordance with the law and terms of the policy.
ORDER
1. Petitioner was the complainant before the District Forum, where she had filed a complaint alleging deficiency in service on the part of the respondents/opposite parties.
2. Briefly stated the facts leading to filing the complaint were that Shri Sanjay Garg, late husband of the petitioner was one of the partners of M/s. Garg Automobiles in UP. Trade Tax Department of UP had obtained a policy from the first and second respondent covering the risk of life to the several categories of tax payers with them which included the partnership firm Garg Automobiles Ltd. of which late husband of the complainant, Sanjay Garg was one of the partners. In the instant case Shri Sanjay Garg died on a road accident on 21.1.2006 as a result of which a claim was preferred with the first and second respondents Insurance Company, through the Joint Commissioner Trade Tax, Moradabad, which was repudiated. It is in these circumstances, a complaint was filed before the District Forum, which was allowed and the respondents/opposite parties were directed to pay a sum of Rs. 4 lakh along with interest @ 9% p.a. from the date of the filing of the complaint till realization within a period of 2 months. A cost of Rs. 1,500 was also imposed. Aggrieved by this order, the respondent Nos. 1, 2 filed appeal before the State Commission, which was allowed and the order passed by the District Forum was set aside. Aggrieved by this order, this revision petition has been filed, before us.
3. We heard the learned Counsel for the parties. Admittedly, the parties are to be governed by condition 7 of the Policy which reads as follows:
"7. In the advertisement to be published by the Insurance Company in the month of April it will be mentioned that in case of sole proprietary firm the sole proprietor, in case of HUF the Karta and in the case of a limited companies Chief Operating Officer (CEO/MD) shall be considered as insured. As far as the insured person in the case of the partnership firm registered with the trade tax Department, UP is concerned, the published advertisement shall mention clearly that after the advertisement is published in the month of April 2005, the concerned partnership firm shall give the consent, by all the managers/partners as to which managers/partners shall be insured. Information in this regard must be submitted compulsorily by the partnership firm to Joint Commissioner (Executive) trade Tax by 15th of May 2005, if partnership firm is unable to give information by the above date then in such condition the partner who name appears in form 15 and he continues to be partner in that firm is alive till that date, shall be considered insured. However, if due to any reason the person named in form 15 does not remain partner or is not alive but his name was not changed, then the person whose name is mentioned first in form No. 14 and is alive and continues to be partner shall be considered insured and if that person is not alive or does not remain partner or Form 14/15 is not available in office of the trade tax then on the date of accident, the partner who is oldest in age and is alive shall be considered as insured."
4. It is the case of the petitioner that as per condition 7, if the names of the partners to be eligible for the benefit under the scheme are not given by 15.5.2005, then all the partners whose names appear in Form 15 shall be considered insured.
5. We are afraid we do not share this perception for the simple reason, that if we read the whole clause in a harmonious manner, then our deduction is that the spirit of the scheme is to cover not all the members of a partnership firm, a registered company or HUF, but a person nominated by the such bodies before 15.5.2005. The effect of non-nomination is also spelled out in the above para/condition 7, ".....if partnership firm is unable to give information by the above date then in such condition the partner whose name appears in form 15 and he continues to be partner in that firm is alive till
