BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BENGALURU (ADDL. BENCH)
DATED THIS THE 24th DAY OF OCTOBER 2024
PRESENT
MR. RAVISHANKAR : JUDICIAL MEMBER
MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
APPEAL NO. 252/2013 & 294/2013
Appeal No.252/2013
The Registrar, MAHE University, Manipal – 576104. Sri. G.K. Prabhu. (By. Sri. Manmohan P.N , Advo.) | ..…Appellant/s |
V/s
1. 1(a) 1(b) 1(c) | Sri. Shankara Poojary/Palan, Since dead by LRs. Smt. Rajamma, Aged 49 years, W/o. Late Shankara Poojary/Palan. Ms. Sruthi, Aged 22 years, D/o. Late Shankara Poojay/Palan. Mr. Sunil umar, Aged about 20 years, S/o. Late Shankara Poojary/Palan. All are R/a. Madhva Nagar, KMC Quarter No.201, Manipal, Udupi Taluk, Udupi District – 576113. (By Sri. K. Shasikanth Prasad, advo.) | |
2. | The Oriental Insurance Complainant. Ltd., Divisional Office, Chennai, Having its Divisional Manager, Represented by its Divisional Manager, Vishnu Prakash Building, Udupi District – 576113. (By Sri. H.C. Vrushabhendraiah, advo.) | |
3. | Sri. Balaksrishna Shettigar, H.R. Manager, MAHE University, Manipal – 576104. (By Sri. S.V. Gowramma, advo.) | …..Respondent/s |
Appeal No.294/2013
The Oriental Insurance Complainant. Ltd., Divisional Office, Chennai, Having its Divisional Manager, Represented by its Divisional Manager, Vishnu Prakash Building, Udupi District – 576113. (By Sri. H.C. Vrushabhendraiah, advo.) | ..…Appellant/s |
V/s
1. 1(a) 1(b) 1(c) | Sri. Shankara Poojary/Palan, Since dead by LRs. Smt. Rajamma, Aged 49 years, W/o. Late Shankara Poojary/Palan. Ms. Sruthi, Aged 22 years, D/o. Late Shankara Poojay/Palan. Mr. Sunil umar, Aged about 20 years, S/o. Late Shankara Poojary/Palan. All are R/a. Madhva Nagar, KMC Quarter No.201, Manipal, Udupi Taluk, Udupi District – 576113. (By Sri. K. Shasikanth Prasad, advo.) | |
2. | Sri. Balaksrishna Shettigar, H.R. Manager, MAHE University, Manipal – 576104. (By Sri. S.V. Gowramma, advo.) | …..Respondent/s |
3. | The Registrar, MAHE University, Manipal – 576104. Sri. G.K. Prabhu. (By. Sri. Manmohan P.N , Advo.) | |
O R D E R
BY SMT. SUNITA .C. BAGEWADI, MEMBER
The appeals are filed by OP No.1 and 3 aggrieved by the order dated 29/12/2012 passed in CC.No.44/2010 on the file of District Consumer Disputes Redressal Commission, Udupi and prays to set aside the order and to allow the appeal in the interest of justice and equity.
2. The brief facts of the case are as under:
The complainant was an employee of opposite party no.1 and he was employed as Lab Technician in Manipal hospital, Manipal at Nepal till 09/02/2007 and thereafter he was transferred from Nepal to Manipal hospital and joined duty on 06.03.2007. The opposite party no.1 obtained the Group Life Term Insurance Policy from M/s Met Life India Insurance Company ltd. who issued a risk coverage policy according to the request of OP No.1 and the said policy bears no.3200500000266 on 30.09.2005 to 29.09.2006 which was renewed from 30.09.2006 to 29.09.2007. According to the circular, the premium of the said policy was deducted from the employees of the opposite party no.1. The salary slip issued from opposite party no.1 to cover the risk of the employee/complainant of premium amount to the tune of Rs.205/- in the month of April 2007. As per the said circular if person dies due to natural or by accident or if he or she suffers from permanent physical disability, each employee get Rs.10,00,000/- sum issued insured. The complainant had met with road traffic accident on 24.06.2007 and he had sustained severe brain injury. After the accident, the wife of the complainant had approached opposite party no.1 and submitted all the relevant documents under group life insurance and requested for the speedy disposal of her genuine claim. The opposite party no.1 refused to provide the policy particulars to the wife of the complainant hence, she issued a lawyers notice dated 22.02.2009 to the opposite party no.1. The said notice was served to the opposite party no.1 on 23.09.2009 and even after service of notice, the OP No.1 has not given the particular of the policy to the wife of the complainant and in reply, pointed out that M/s. Met life India Insurance Company ltd. had tied up with opposite party no.3 to cover the risk of the employees of the OP No.1 and while covering the risk of the employees, the name of the complainant was excluded in the policy. The OP No.1 has deducted the premium amount from the salary of the complainant on two occasions and accepted the premium amount and adjusted the same to the policy. Since the premium amount was collected from the complainant and adjusted to the insurance policy OP No.1 to 3 are liable to pay the compensation of Rs.10,00,000/- as per the circular issued by manipal academy of higher education. Legal department of OP No.1 had not provided a clear particulars of the insurance policy inspite of sufficient requests has been made by the wife of the complainant and due to the action of OP No.1 and 2, the complainant suffered mental agony hence the complaint.
3. After service of notice, OP No.1 and 3 appeared through counsel and filed separate version. Inspite of service of notice, opposite party no.2 remained absent hence, placed exparte. Opposite party no.1 and 3 admitted the group insurance policy for the period from 30.09.2005 to 29.09.2006 and same was renewed from the period from 30.09.2006 to 29.09.2007. Further, the opposite party no.1 contended that the complaint is not maintainable under law or facts against him. Further, opposite party no.1 contended that OP No.1 neither sought for deletion of name of the complainant nor issued any instructions to the insurance company to delete the name of the complainant. The OP no.3 contended that the name of the husband of the complainant and some other employees was excluded from the list of the employees covered under the policy with effect from 23.05.2007 at the request of OP No.1 and propionate amount was refunded to the opposite party no.1. Hence, the complainant was not in the list submitted by the OP No.1 to cover the risk at the particular point of time hence, the OP No.3 is not liable to pay the compensation.
4. After trial, the District Commission has partly allowed the complaint.
5. Being aggrieved by the said order, Opposite Party 1 and 3 has preferred this appeal on various grounds.
6. Heard - Perused the appeal memo, certified copy of the order passed by the District Commission, we noticed that it is not in dispute that the complainant was employee of OP No.1 who made group life term insurance and M/s Met life India insurance company ltd., who had issued risk coverage to the employees of the
OP No.1 between 30.09.2005 to 29.09.2006 and the same was renewed from 30.09.2006 to 29.09.2007. It is also not in dispute that the complainant is one of the beneficiary of the insurance. It is also not in dispute that the complainant was transferred to the manipal and after transfer met with an road accident dated 24.06.2007 and has become 100% physical disabled .
7. Perused order of the District Commission, we noticed that the District Commission after trial directed the OP No.1 and OP No.3 to pay sum of Rs.10,00,000/- along with interest 9% per annum with compensation and litigation cost. The ground for OP No.3 for the appeal is that the name of the husband of the complainant and other employees was excluded from the list of employees covered under the policy with effect from 23.05.2007 at the request of OP No.1 and propionate amount was refunded to the OP No.1. Hence, the complainant was not in the list submitted by the OP No.1 to cover the risk at the particular point of time hence, the OP No.3 is not liable to pay the compensation, risk coverage. The ground of OP No.1 is that neither sought for deletion of name of the complainant nor issued any instructions to the insurance company to delete the name of the complainant. In present case, the OP No.1 is the employer and the complainant is employee. For non-teaching staffs, the management contributes 80% of the premium of the policy and employees contribution is 20%. According to the circular, the 20% premium amount relating to the said insurance policy deductable from the salary of the employees. It is evident that the opposite party no.1 has deducted the same for twice in a year from account of complainant. It is also evident that Ex-C-9 , as per the circular, if the person died due to natural or by accidental or if he or she suffers permanent physical disability each employee will get Rs.10,00,000/-.
8. Perused the order and documents, M/s. Met Life Insurance Company tied up with Oriental Insurance Company Chennai and the said Insurance Company informed that the name of the complainant has been deleted from the policy vide endorsement no.4117110/48/2007/2661/009 issued for the period of 23.05.2007 to 29.09.2007. However, the opposite party no.3 had not produced any authentic document to show that the name of the complainant was deleted and also there is no any document produced to show that on whom direction the opposite party no.3 has deleted the name of the complainant from the list of the policy and what is the reason for deletion. Of course there is two schedules enclosed a letter dated 14.08.2009, one is addition and other one is deletion which not bears signature of any authorized person. Such being the case, the complainant is entitled for the sum assured. Further, it is the duty of the employer to take care of the employees which would provide financial assistance to the family members of the employees in case of death or permanent physical disability.
9. Hence, considering the facts and discussion made here, we are of the opinion that the order passed by the District Commission is just and proper. No interference is required. Accordingly,
O R D E R
The appeals are dismissed.
The amount deposited in shall be transmitted to the concerned District Consumer Commission to pay the same to the complainant.
Send a copy of this order to both parties as well as concerned District Consumer Commission.
(Sunita .C. Bagewadi) (Ravishankar)
Member Judicial Member
VS*
