Smt. Bandana Roy, President
The case of the complainant, in brief, is that the complainant is the Director of Expo Project Engineering Devji Service Pvt. Ltd. Having its Head Office at Expo House, 150 Sheriff Devji Street, Greater Mumbai, Maharashtra. The said company is a construction company and its branch office is situated at Durgachak, Haldia, Purba Medinipur. Some persons are employed in the said company as Welder, Rigger, Gascutter, Grinder, Khalasi, Helper, Electrician and Supervisor. In the interest of the said company and its employees, the said company took an insurance policy from the OP being no. 031700/41/11/01/00000506 for the period on and from 03.03.2012 to 02.06.2012 for workmen compensation (group insurance) by payment of premium to the tune of Rs.21856.51/-. One employee engaged as khalasi of the company namely, Subha Pramanik, s/o Sukdev Pramanik aged about 23 years of vill. Maitimore, High Road (NH-41) P.O.-Badalchak, P.S.- Bhupatinagar of Dist.- Purba Medinipur met an accident on 10.05.2012 at Nagpur NTPC Mouda, P.O.- Mouda, Dist.- Nagpur, Maharashtra and, unfortunately, died on the same date i.e. on 10.05.2012 at 4.15 PM.
The company duly informed the said incident of death to the OP on 13.06.2012 by a letter dtd. 13.06.2012. The Ld. Labour Court, Nagpur, directed for payment of Rs.698891/- as insurance claim against the said policy which had been paid to the legal heirs of deceased Subha Pramanik. The complainant company demanded the said amount of Rs.698891/- from the OP by a letter dtd. 11.06.2015, but the OP has repudiated the said insurance claim vide letter dtd. 29.02.2016. Hence, this case.
The OP company duly contested the case by filing W/V and denied all the allegations of the complainant. The OP stated that the policy covers 14 employees including two khalasis of the complainant, but from the Muster Roll supplied by the complainant it was found that there were 262 employees engaged for work on the relevant date of occurrence i.e. on 10.05.2012. In the said policy no category of employees who are covered by the policy are mentioned. The OP also stated that the matter of accident was intimated to the OP after a delay of more than one month from the date of accident and after depositing the amount of compensation in the Ld. Labour Court at Nagpur. The compensation had been deposited suomotto in the Ld. Labour Court at Nagpur without any prior intimation to the OP Insurance Co. or with their permission. The insured i.e. the complainant obtained the policy by declaring wages of 14 employees for three months, whereas Muster Roll of May 2012 indicated 262 employees engaged in the insured project. The project tenure and size fails to justify such a selective policy and it is the condition that the insured should declare the entire total wages for the project covering the full period which is a misrepresentation on the part of the complainant to obtain the policy.
The OP claimed the complainant violated condition no. 4, 5 and 9 of the policy which are as under:
Condition no. 4
“In the event of any occurrence which may give rise to a claim under this policy, the insured shall as soon as possible give notice thereof to the Company with full particulars. Every letter claim writ summons and process shall be notified or forwarded to the company immediately on receipt. Notice shall also be given to the Company immediately the insured shall have knowledge of any impending prosecution inquest or fatal inquiry in connection with any such occurrence as aforesaid.”
Condition no. 5
“No admission offer promise or payment shall be made by or on behalf of the insured without the consent of the Company which shall be entitled if it is so desires to taken over and conduct in his name the defence or settlement of any claim or to prosecute in his name for its own benefit any claim for indemnity or damages or otherwise and shall have full discretion in the conduct of any proceedings and in the settlement of any claim and the Insured shall give all such information and assistance as the company may require.”
Condition no. 9
“The due observance and fulfillment of the terms and conditions and endorsements of this policy so far as they relate to anything to be done by the insured and the truth of the statement and answers in the Proposal shall be conditions precedents to any liability of the company to make any payment under this Policy.”
The OP demanded that claim has been rightly repudiated and prays for dismissal of the instant case.
Point for consideration:
- Whether the complainant is entitled to get relief, as prayed for?
Decision with reason:
Complainant filed copy of documents in support of his contention and OP also filed copy of documents in support of their contention. Ld. Lawyer has submitted that the Commission under Workmen Compensation Act, Nagpur has passed for disbursement. Admittedly, OP was not party in that case. OP has filed a list of employees which shows that there were 760 employees working under Expo Project Engineering Service Pvt. Ltd. Admittedly, Labour Court has already paid up Rs.698891/- to the legal heirs of the deceased. OP rightly repudiated the claim of the complainant. Complainant must go to the right Forum. We are of the view that in the fact and circumstances of the case, complainant is not entitled to get any relief, as prayed for.
Hence, it is
ORDERED
that the complaint case being no. CC/84/2016 be and the same is dismissed on contest against the OP. We make no order as to cost.
Let the copies of the judgement be supplied to all the parties free of cost.
