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2021 Supreme(All) 1269

IN THE HIGH COURT OF ALLAHABAD
J.J. Munir, J.
Oriental Insurance Comp. Ltd. Thru. Div. Manager, Div.Office-2 - Petitioner
Versus
Smt. Uma Devi and others - Respondent
MISC. SINGLE No. 23973 of 2020
Decided on : 02-12-2021

Advocates:
Advocate Appeared:
For the Petitioner: Waquar Hashim
For the Respondent: C.S.C.,Ajeet Kumar,Rinku Verma

Point of Law : Plea of limitation taken up in the present case on the strength of clause 20 of the agreement read with Article 44 of the Schedule appended to the Limitation Act, would not defeat the object and purpose of the scheme so long as the claim was kept pending constituting a continuing cause, hence the plea raised deserves rejection.

Headnote:

Constitution of India, 1950 - Article 227 - Limitation Act,1963 - Article 44 (a), Article 44 - Legal Services Authority Act, 1987 - Section 22(3) - Petition are that a contract was entered into by Commissioner and Secretary, Board of Revenue, U.P., Lucknow and petitioner, Oriental Insurance Company Limited, whereby a Group Accidental Insurance Cover was provided to all farmers of Uttar Pradesh, who were recorded tenure-holders and in age group of 12 years to 70 years - Their eligibility was dependent on fact that farmer was duly recorded in Khatauni and died an unnatural death in an accident - Whether petitioner on basis of grounds taken in petition is entitled to sum assured and penalty from Insurance Company.

Findings of the court :

Court finds that there is some communication gap between petitioner-Insurance Company, District Magistrate and claimant-respondent, that has all contributed to delay in ultimate enforcement of claim before Permanent Lok Adalat - In circumstances obtaining, equity would be best adjusted if penalty imposed by Permanent Lok Adalat is reduced by 50% and determined at a figure of Rs.75,000/-, instead of Rs.1,50,000/- Court is of opinion that Simple Interest at 9% per annum ordered by Permanent Lok Adalat from date of presentation of petition, ought to be substituted by an order directing payment at rate of 9% per annum Simple Interest on substantive award of Rs.1,00,000/-from date of award till realization.

Result : Petition allowed in part.

Judgement Key Points

Key Points: - (!) (!) (!) Clause 20 of the agreement and Article 44 do not defeat the object of the scheme when a continuing cause exists; the claim remains pending. - (!) (!) (!) (!) (!) (!) Limitation analysis in PLA proceedings must consider actual communications/repudiation timelines; lack of clear communication to claimants affects when limitation runs. - (!) (!) (!) (!) (!) PLA proceedings in this case were decided in favor of respondents; petition by insurer under Article 227 was allowed in part to modify penalties and interest. - (!) (!) (!) (!) (!) Court reduced the penalty from Rs. 1,50,000 to Rs. 75,000 and ordered 9% simple interest on the substantive award from the date of order until realization. - (!) The case concerns a group accidental insurance policy for Uttar Pradesh tenure-holders, with death due to accident as eligibility; claim filed via District Magistrate, Hamirpur.

What is the legal effect of clause 20 of the insurance agreement read with Article 44 of the Limitation Act on continuing claims for a group accidental insurance scheme?

What are the proper criteria to determine limitation in a Permanent Lok Adalat proceeding for insurance claims under a group policy where denial/communication of repudiation was not clearly conveyed to claimants?

What is the appropriate quantum of penalty and simple interest on the award in cases of delay or miscommunication between insurer, district authorities, and claimants before the Permanent Lok Adalat?


JUDGMENT :

1. This petition under Article 227 of the Constitution has been filed assailing a judgment and order of the Permanent Lok Adalat, Lucknow dated 22.02.2020 passed in P.L.A. Case No.196 of 2017. By the impugned judgment and order, the Permanent Lok Adalat has granted the claim of respondent nos.1, 2 and 3 to the proceeds of a Group Insurance Policy for tenure-holder-farmers dying an accidental death. The Permanent Lok Adalat has ordered the petitioner, Insurance Company to pay the sum assured i.e. Rs.1 lakh together with penalty in the sum of Rs.1,50,000/-. Simple interest at the rate 9% per annum has been ordered on the aforesaid sum from the date of presentation of respondents' petition to the Lok Adalat. Costs in the sum of Rs.5000/- have also been awarded against the petitioner.

2. The facts giving rise to this petition are that a contract was entered into by the Commissioner and Secretary, Board of Revenue, U.P., Lucknow and the petitioner, Oriental Insurance Company Limited, whereby a Group Accidental Insurance Cover was provided to all the farmers of Uttar Pradesh, who were recorded tenure-holders and in the age group of 12 years to 70 years. Their eligibility was dependent on the fact that the farmer was duly recorded in the Khatauni and died an unnatural death in an accident. The said policy was in force from 19.11.2009 to 18.11.2010. The husband of respondent no.1-Smt. Uma Devi and father of respondent nos.2 and 3, Nishu and Bhola Singh, that is to say, the late Omkar Singh, was a resident of Village Sahurapur, Post Paunthia Buzurg, Police Station Lalpura, District Hamirpur. He died in a road accident on 08.10.2010. It is not in issue that the deceased, on the date of his demise, was in the eligibility zone according to his age group. Consequent upon Omkar Singh's death, respondent no.1 on behalf of herself and respondent nos.2 and 3, invoked the Insurance Policy and presented a claim, after completing all formalities, to the petitioner Insurance Company, routed through the District Magistrate, Hamirpur. After presentation of the claim, respondent no.1 pursued it regularly and with due diligence, visiting the office of the petitioner Insurance Company for the purpose. Despite lapse of a long period of time, she neither received the sum assured nor any communication in that regard from the Insurance Company.

3. When the first respondent did not receive any response from the Insurance Company for a considerable period of time, she presented a petition to the Permanent Lok Adalat at Lucknow. The Insurance Company filed a written statement, contesting the first respondent's claim. However, the factum of the contract of insurance was not denied. The Insurance Company, however, disputed the fact about the death of the assured in a road accident on 08.10.2010 on ground that no First Information Report had been lodged. There were other pleas raised that the post-mortem report and the panchayatnama, that was presented, related to an unknown person, which could not be read to infer the death of the assured in a road accident. It was also averred in the written statement that on receipt of the first respondent's claim through the District Magistrate, Hamirpur, the Insurance Company had appointed a surveyor, who submitted his report on 08.03.2011, wherein it was mentioned the first respondent did not produce necessary documents. It was also pleaded that on 04.04.2011, the first respondent's claim was rejected by the Competent Authority in the Insurance Company and its information was given to the District Magistrate, Hamirpur. Amongst other things, it was also pleaded that if there is any dispute between parties to the contract, the same has to be resolved by a Committee headed by the District Magistrate, whose decision would be binding on the Insurance Company. There is also a plea that the petition was presented with a delay of seven years, with no explanation about it. The territorial jurisdiction of the Permanent Lok A

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