ORDER
(Passed on 29/04/2019)
PER SHRI.ATUL D.ALSI, PRESIDENT.
The complainant has filed this complaint U/s 12 of the Consumer Protection Act,1986 against the repudiation of insurance claim amounting to Rs.6,12,360/- and thereby claiming compensation of Rs.20,000/- towards mental torture and further Rs. 10,000/- towards cost of proceeding.
2. The facts in short giving rise to this petition are that the complainant is an employer and is engaged in the business of transportation of fly ash from the Wardha power plant] Warora and G.M.R.Emco Energy, Warora. For this purpose he has engaged employees. For the purpose of safeguarding interests of the workers the complainant had insured his employees vide policy No. 28180/141/16/8600000680 for the period from 9/2/2017 to 8/2/2018 as per provisions of Workmen Compensation Act,1923.
3. The deceased Anant Laxmikant Pimpalapure was working with the complainant as Supervisor. On 21/4/2017 while on duty, said Anant met with an accident on Nagpur Chandrapur Road near Anandwan Police Station, Warora, Distt.Chandrapur. An offence came to be registered against the offending vehicle. The intimation of the accident had been given to the OP. Unfortunately the Supervisor died on 31/5/2017.
4. The complainant filed insurance claim under the policy with the OP on behalf of beneficiary heirs of said deceased Anant alongwith requisite documents . The complainant had submitted all requisite documents with the insurance claim and he again submitted all documents on 31/10/2017 as direted by the OP, receipt of which was also acknowledged by the OP. However, the OP repudiated insurance claim for the reason of non supply of requisite documents and also alleging that at the relevant time of accident, the deceased Amol was not in the employment of the complainant.
5. The deceased was in the employment of complainant and was drawing a salary of Rs.8,000/- per month. At the time of accident said Anant was of 50 yrs of age. Therefore, according to provisions of Workman’s Compensation Act, 1923 the legal heirs of the deceased are entitled to 50% of wages multiplied by relevant factor as per compensation schedule amounting to
Rs.6,12,360/-. Repudiation of said insurance claim amounts to deficiency in service and hence, the complainant has filed this complaint.
6. The complaint is admitted and notices were served on the OPs. The OP filed its reply and thereby denied allegations against them and submitted that the in spite of repeated demand the complainant complainant failed to supply the requisite documents i.e. Muster Role filed with the claim is not signed by incharge of complainant company nor is having proper seal of the company. There is no evidence to show that on the relevant date of accident, the deceased was in the employment of the complainant. Therefore the petition deserves t o be dismissed with costs.
7. Counsel for the complainant submitted that the complainant has filed insurance policy of workers, copy of muster card, FIR, spot panchnama, PM report on record. The complainant had also submitted requisite documents with the insurance claim and subsequently on 31/10/2017 to the OP, but the OP with an intention to avoid its liability repudiated the claim under the policy mechanically and on the false ground.
8. Counsel for the OP argued that on the relevant day of accident, the deceased was not in the employment of complainant and the documents filed in this regard are false and concocted documents. The place of accident is not within the premises of complainant company. Therefore, the accident has not occurred within the period of employment and as such, the petition deserves to be dismissed.
9. We have gone through the complaint, written versions filed by OP No.1 and OP Nos.2 & 3, affidavit, documents and WNA filed by the parties. We have also heard the oral arguments advanced by parties.
Points Finding
1. Whether the complainant is a Consumer ? Yes
2. Whether there is deficiency in service on the part of
OP in repudiating the insurance claim ? Yes
3. What order ? As per final order..
As to issue No.1
10. The O.P. has not denied the insurance policy in question and as such undisputedly the complainant is the Consumer of OP insurance company.
11. The basic dispute between the parties is as to whether the deceased was in the employment of the complainant at the time of accident and whether the accident took place during the course of his employment. The complainant has filed the copy of insurance policy wherein random number of workers is shown in the policy though the specific names are not mentioned as per terms and conditions of the policy. The complainant has filed the particulars of employment of deceased at Sr.No.2 with list of documents dated 11/1/2018. The complainant has filed particulars of payment of salary to the deceased for the period October,2016 till the date of accident. The complainant has also filed the muster card showing attendance of the deceased worker. These documents are sufficient to hold that at the relevant time of accident, the deceased was in employment of the complainant.
12. As per the inquest report of S.D.M. Warora, Distt.Chandrapur the accident was caused due to rash and negligent driving of unknown vehicle which dashed to the complainant’s vehicle which was parked for changing of tyres on jack with parking indicator on. Therefore as per inquest report, there is no contributory negligence on the part of complainant or its workers in the accrual of accident.
13. The second contention of OP is that the spot of accident is not within the premises of complainant company for which the insurance policy was effected. But when the nature of duty of the worker and supervisor is such that they are required to go out of company premises for the work of the company. The deceased, who was the supervisor, was appointed by the complainant to look after the transportation of fly ash to various companies. Looking to the nature of work though the accident did not occurred within the premises of company, it needs to be deemed to have occurred within the premises and during the course of employment. There is no defense of OP that the accidental death of the worker caused due to non adherence to safety precautions as is required U/s 31 of Workmen Compensation Act or due to negligence of workers or due to they being under influence of alcohol or any other drug. Therefore, the accidental death of the deceased worker Anant Pimpalapure has occurred within the premises and during the course of his employment with the complainant. Therefore, as per the provisions of Workmen Compensation Act, the employer is liable to pay compensation equal to the 50% of monthly wages of deceased employee subject to maximum salary of Rs.8000/- per month multiplied by relevant factor or Rs.1,40,000/- whichever is higher. Therefore, as per the doctrine of in course and out of employment which connotes the actual workplace and also includes any other work connected naturally or by expressed way to the employment. Therefore, the same extends to the work place and working hours. There is a casual connection between the injury sustained in the accident while doing the work in the course of employment. Therefore, any employee who is engaged for the purpose of employer’s business, if suffers injury, permanent disability or death in any accident accrued during the course of employment, is entitled for compensation. Therefore, the complainant is entitled to compensation of Rs.6,12,360/- alongwith interest @10% p.a. from the date of accidental death i.e.31/5/2017 till realization besides compensation of Rs.25,000/- and cost of litigation Rs.15,000/-. Hence the order..
Final order
1. The Complaint No.13/2018 is partly allowed.
2. The OP shall pay to the complainant an amount of Rs.6,12,360/-
alongwith interest @10% p.a. from the date of accidental death
i.e.31/5/2017 till realization, besides compensation of Rs.25,000/- and
cost of litigation Rs.15,000/-.
3. Copy of the order be furnished to both the parties free of cost.
(Smt.Kalpana Jangade (Kute) (Smt.Kirti Vaidya (Gadgil) (Shri.Atul D.Alsi)
Member Member President
