This revision petition has been filed by the petitioner Liberty Videocon General Insurance Co. Ltd. against the order dated 03.08.2017 of the State Consumer Disputes Redressal Commission, Chhattisgarh, (in short ‘the State Commission’) passed in Appeal No.69 of 2017.

2.      Brief facts of the case are that on 30.11.2013, the petitioner herein issued a Group Personal Accident Policy in favour of the respondent no.2 and the deceased (Late Bhikham Ram) was the beneficiary of the policy.  The said policy bearing no.41122-20050-13-5000009-00-000 was valid for the period from 30.11.2013 to 29.11.2014 and the coverage and liability of the petitioner Insurance Company was strictly as per the terms and conditions of the policy.  On 12.01.2014, the respondent no.2 intimated to the petitioner that the insured died on 12.01.2014.  The said intimation was inordinately delayed and had been received by the petitioner on 21.04.2014.  The petitioner sought relevant documents from the respondent No.1.  While processing the claim, it had come to the knowledge of the petitioner that late Bhikham Ram had died due to electric shock while he was attempting to start pump on illegal electric connection.  This fact had come in the finding of the police investigation and the same was mentioned in the final report that was prepared by the concerned police officer.  On 02.06.2014, after appreciating the facts of the claims and relevant documents, it transpired that the death of the insured occurred while he indulged in an illegal act, which was specifically excluded under the policy.  Accordingly the claim of the respondent no.1 was repudiated by self-explanatory repudiation letter dated 02.06.2014.  The respondent no.1 had sent legal notice to the petitioner regarding her claim.  Aggrieved, the respondent No.1 filed a Consumer Complaint before the District Forum Bilaspur vide CC No.2015/200.  The petitioner herein vehemently contested the case and filed it’s written statement inter alia categorically taking the defense that as per the documents and the police final report, Late Bhikham Ram died due to electric shock while he was attempting to start pump on illegal electric connection.  Therefore, the act of deceased being illegal had been specifically excluded under the policy and hence, the claim of the respondent No.1 had been rightly repudiated and there was no deficiency in service on the part of the petitioner.  The respondent no.1 filed her affidavit and placed on record an alleged electricity bill in the name of the mother of the deceased.  The District Forum vide order dated 02.01.2017 allowed the complaint of the respondent No.1 and directed the petitioner to pay Rs.5,00,000/- to the respondent No.1 along with interest @9% from the date of complaint i.e. 18.08.2015 till the date of actual payment.  The District Forum further directed the petitioner to pay Rs.50,000/- and Rs.3,000/- as compensation for mental agony and litigation cost respectively. 

3.      Aggrieved by the order of the District Forum, the opposite party/petitioner preferred an appeal bearing No.2017/69 before the State Commission.  The State Commission vide its order dated 03.08.2017 dismissed the appeal.

4.      Hence the present revision petition.

5.      Heard the learned counsel for both the parties and perused the record.  Learned counsel for the petitioner stated that the case of the complainant is covered under General Exclusion No.4, which reads as under:-

“4.  Any loss or damage arising from insured person committing any breach of law with criminal intent.”

6.      Though the complainant has a legal connection for running the pump set, however, the Deceased Life Assured (DLA) was illegally connecting his pump to the power lines directly and got electrocuted in the process.  This fact is borne out from the final report of the Police.  Hence, no further proof is required, however, both the fora below have accepted the version of the complainant that the DLA was electrocuted while starting pump from his legal connection.

7.      It was further pointed out by the learned counsel for the petitioner that the policy is a contract and its terms and conditions are to be construed in the same manner in which they are expressed.  The terms and conditions of the policy are binding on both the parties and courts do not have power to amend or modify these conditions.  Accordingly, General Exclusion No.4 is fully applicable in the present case.  Both the fora below have given erroneous finding.  To support his arguments, learned counsel referred to the following cases:-

(1)     Oriental Insurance Co. Ltd. Vs. Sony Cheriyan, II, AIR 1999 SC 3252.  It has been held that:-

“16.  The insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. The insured cannot claim anything more than what is covered by the insurance policy. That being so, the insured has also to act strictly in accordance with the statutory limitations or terms of the policy expressly set out therein.”

(2)  Export Credit Guarantee Corpn. Of India Ltd. Vs. Garg Sons International, 2013 (1) SCALE 410.  It has been held that:

“10. In Vikram Greentech (I) Ltd. & Anr. v.  New India Assurance Co. Ltd. AIR 2009 SC 2493, it was held :

“An insurance contract, is a species of commercial transactions and must be construed like any other contract to its own terms and by itself…. The Endeavour of the court must always be to interpret the words in which the contract is expressed by the parties. The court while construing the terms of policy is not expected to venture into extra liberalism that may result in rewriting the contract or substituting the terms which were not intended by the parties.” (See also : Sikka Papers Limited v. National Insurance Company Ltd & Ors. AIR 2009 SC 2834).

11. Thus, it is not permissible for the court to substitute the terms of the contract itself, under the garb of construing terms incorporated in the agreement of insurance. No exceptions can be made on the ground of equity. The liberal attitude adopted by the court, by way of which it interferes in the terms of an insurance agreement, is not permitted. The same must certainly not be extended to the extent of substituting words that were never intended to form a part of the agreement.”

8.      Learned counsel for the petitioner also mentioned that there is a delay of 35 days in filing the present revision petition.  It has been mentioned in the application for condonation of delay that the petitioner is a public limited company, therefore, some time has been taken in taking the decision to file the revision petition against the impugned order.  It was prayed to condone the delay on the grounds mentioned in the application for condonation of delay.

9.      On the other hand, learned counsel for the respondent No.1/complaint stated that both the fora below have given concurrent finding of fact that the DLA had legal electricity connection and was trying to start the pump from that connection and consequently he was electrocuted.  This Commission cannot reassess the facts at the stage of revision petition against the concurrent finding given by the fora below.  There is no doubt that the policy terms and conditions should be interpreted in the form they are written and are binding on both the parties, however, in the present case, the fact is that General Exclusion No.4 is not applicable in the present case because the complainant was not involved in any act against any law as he was only starting pump in his field and got electrocuted.  It is wrong to say that he was drawing electricity from any illegal connection and in this process he was electrocuted.  The case of the complainant clearly falls within the ambit of the policy as it is a personal accident claim.  Therefore, there is no merit in the revision petition and the same may be dismissed.

10.    Learned counsel for the respondent No.2 supported the claim of the complainant and stated that the DLA was a member of the respondent No.2 and consequently was covered under the group policy for personal accident.

11.    I have carefully considered the arguments advanced by the learned counsel for the parties and have examined the material on record.  There is a concurrent finding of facts given by the fora below that the case of the complainant is not covered under the General Exclusion No.4 of the policy.  It has been held by the fora below that the complainant had a legal connection and he was electrocuted from that legal electrical connection while starting the pump.

12.    Against the concurrent finding of facts I would desist from reassessing the facts of the case in the light of the decision of the Hon’ble Supreme Court in Mrs. Rubi (Chandra) Dutta vs. United India Insurance Company, 2011 (3) Scale 654, wherein the following has been observed:-

“Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view that what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous)  interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that that the jurisdiction conferred on the National Commission under Section 21(b) of the Act has been transgressed. It was not a case where such a view could have been taken, by setting aside the concurrent finding of two fora.”

 13.   In the present revision petition, the only question involved is whether the DLA was executed from his legal connection or while starting his pump illegally from the power lines directly. This point has been decided by the fora below by giving concurrent finding as stated above.  No legal point has been raised in the revision petition to be decided in the present revision petition.  However, it is seen that the District Forum has awarded a compensation of Rs.50,000/- for mental agony apart from the policy amount of Rs.5,00,000/- along with 9% interest.  Looking at the current interest scenario, the award of 9% p.a. interest is not justified in the absence of any agreement between the parties in the policy in this regard.  In my view, an interest @6% shall be reasonable and sufficient.  Moreover, when the full policy amount along with interest has been awarded, there is no justification for awarding separate compensation for mental agony. 

14.    Based on the above discussion, the revision petition no.3839 of 2017 is partly allowed and the order of the District is upheld except for this modification that the interest allowed shall be 6% p.a. rather than 9% p.a. and the order in respect of award of Rs.50,000/- as compensation is set aside.  The order of District Forum as modified by this order be complied by the Insurance Company within a period of 45 days from the date of receipt of this order.