NARBADA DEVI . vs. H.P. STATE FOREST CORP. .

1 NON­REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION CIVIL APPEAL NO. 6379 OF 2010 NARBADA DEVI AND ORS. …APPELLANT(S)    VERSUS H.P. STATE FOREST CORPORATION  …RESPONDENT(S) & ANR. J  U  D  G  M  E  N  T MOHAN M. SHANTANAGOUDAR, J. : 1. This   appeal   arises   out   of   order   and   judgement   of   the National Consumer Disputes Redressal Commission, New Delhi (hereinafter ‘National Commission’) dated 24.04.2009 (hereinafter ‘Impugned Order’), allowing Revision Petition No. 331 of 2007 filed by the Respondent No.1 herein, Himachal Pradesh State Forest Corporation (hereinafter ‘HPSFC’), against the order dated 9.10.2006   passed   by   the   Himachal   Pradesh   State   Consumer Signature Not Verified Digitally signed by ASHWANI KUMAR Date: 2021.03.22 16:52:13 IST Reason: Disputes   Redressal   Commission,   Shimla   (hereinafter   ‘State Commission’) in Appeal No. 281/2004. 2 2. The facts leading to this appeal are as follows: Om Prakash (hereinafter   ‘deceased’)   was   an   employee   of   Respondent   No.1­ HPSFC posted as a Chowkidar (daily wages) at their Divisional Office,   Chopal.   On   the   night   of   7.10.1997,   the   deceased   was coming   from   Banal   Depot   to   Thundal   along   with   one Chandermohan, the forest guard. On the said night, there was heavy rain and storm, therefore, the deceased might have been trapped in it. On the morning of 8.10.1997, on the way to Village Thundal, the deceased was found in a hapless condition around 9:00   AM,   smelling   of   alcohol.   When   the   Chowkidar,   Mohan Singh, saw the deceased, he called the Forest Sub­Inspector, and the deceased was removed to the quarter of Chandermohan. Over there, he was given hot water bath and massaged. However, he subsequently died at about 1:00 PM on 8.10.1997. Thereafter, the forest guard, Chandermohan reached Chopal and lodged FIR on   9.10.1997   at   about   2:30   P.M.   The   Assistant   Manager   of Respondent No.1­HPSFC issued a certificate to the effect that the deceased had died on duty while he was working as a daily­rated Chowkidar. 3. The Post­Mortem Report dated 10.10.1997 stated that no injury was seen on any part of the body of the deceased. Further, 3 that the cause of death was probably asphyxia resulting from regurgitation   of   food   articles   into   larynx   and   trachea   after consumption of alcohol amounting to about 34.5 mg per 100 ml of urine, which was calculated as per the chemical examiner’s report. Expert opinion dated 6.07.1998 was obtained from one Dr.   D.J.   Das   Gupta,   M.D.   &   Former   Professor   &   Head   of Department  of   Medicine   and  Principal,  Indira  Gandhi Medical College, Shimla, which stated that the cause of death is due to alcohol ingestion and regurgitation of food into larynx. Medical opinion was also obtained from one Dr. D.S. Puri, M.D. & former Professor   &   Head   of   Department   of   Medicine,   Indira   Gandhi Medical College, Shimla. As per his opinion dated 17.08.2002, “ this level of alcohol in blood and urine is sufficient to cause deep sleep ”.  4. Under   the   Janta   Personal   Accident   Insurance   Scheme (hereinafter ‘Insurance Scheme’), Respondent No.1­HPSFC had taken   the   Janta   Personal   Accident   Insurance   Policy   dated 24.05.1996 (hereinafter ‘Insurance Policy’) for its 3008 employees from   Respondent   No.2­The   New   India   Assurance   Company Limited (hereinafter ‘Insurance Company’). Under the Insurance Scheme, there was an insurance coverage of Rs. 1 lakh for all 4 employees   who   were   willing   to   opt   for   the   said   Scheme. Respondent No.1­HPSFC had been depositing premium for its employees, including the deceased, under the Insurance Policy, which   was   effective   during   the   period   from   22.01.1997   to 21.01.1998. Consequently, the legal heirs of the deceased, i.e., the Appellants herein laid a claim before the Respondent No.2­ Insurance Company under the Insurance Policy; however, the Insurance   Company   repudiated   the   claim   vide   letter   dated 17.07.1998 and hence, the claim was not settled. 5. Aggrieved by the Insurance Company’s repudiation of their claim, the Appellants herein filed a consumer complaint under Section  12   of   the   Consumer   Protection  Act,   1986   (‘Consumer Protection Act’) before the District Consumer Disputes Redressal Forum, Shimla (‘District Forum’), alleging deficiency in service on part of the Insurance Company and claiming insurance amount of   Rs.   2   lakhs   along   with   interest   and   cost.   By   order   dated 13.09.2004, the District Forum held that the Insurance Company had   wrongly   repudiated   the   claim   and   was   liable   to   make payment and indemnification of the insured amount of  Rs. 2 lakhs to the Appellants.  5 5.1 The reasoning given by the District Forum was as follows: The   Forum   observed   that   the   only   issue   to   be   considered   is whether the death is natural or accidental. In case of the former, Respondent No.1­HPSFC would be liable for compensating the Appellants, and in case of the latter, the Insurance Company would   be   liable.   The   District   Forum   then   considered   the definition   of   asphyxia   in   the   Medicolegal   Manual   by   Dr.   K.S. Narayan Reddy which states that “ Asphyxia is a condition caused by   interference   with   respiration,   or   due   to   lack   of   oxygen   in respired due to which  the  organs  and tissues are deprived  of oxygen   (together   with   failure   to   eliminate   CO2),   causing unconsciousness   or   death. ”   The   District   Forum   therefore concluded that death by asphyxia could not be termed natural and concluded that the death of the deceased was not natural but   accidental.   The   District   Forum   further   observed   that   the quantity   of   alcohol   found   in   the   deceased’s   body   was   not sufficient   to   cause   death   in   the   normal   course   and   that   the opinion dated 6.07.1998 given by Dr. D.J. Das Gupta (supra) could not be relied on as he had not examined the body of the deceased.  6 6. Thereafter, the Respondent No.2­Insurance Company filed an   appeal   before   the   State   Commission,   which   was   listed   as Appeal No. 281/2004. The State Commission in its order dated 9.10.2006 observed that the body of the deceased did not have any external injury or mark of violence, and therefore opined that the   death   was   not   accidental.   Hence,   the   State   Commission concluded that the Insurance Company could not be held liable under   the   Insurance   Policy.   However,   the   State   Commission modified the District Forum’s order to the extent that the liability set out in the District Forum’s order would be that of Respondent No.1­HPSFC and not of the Insurance Company, relying upon the decision   of   the   National   Commission   in   The   New   India Assurance Co. Ltd. v. Smt. Jamuna Devi & Ors. , (2002) 3 CPJ 64 (NC). 7. Aggrieved,   the   Respondent   No.1­HPSFC   approached   the National   Commission   by   way   of   Revision   Petition   No.   331   of 2007,   which   was   allowed   vide   the   Impugned   Order   dated 24.04.2009. The National Commission observed that the State Commission had rightly held that the deceased’s death was not accidental   and   therefore,   the   Insurance   Company   had   no statutory liability to compensate the loss of life of the deceased as 7 per the terms of the Insurance Policy. Further, that Respondent No.1­HPSFC cannot be held liable under the Insurance Policy since it was only acting as a mediator for depositing the premium of employees with the Insurance Company. However, the National Commission  observed   that  Respondent  No.1­HPSFC  could   not avoid   liability   under   the   Workmen’s   Compensation   Act,   1923 (hereinafter,   ‘1923   Act’).   The   Appellants   herein   had   already presented   a   claim   before   the   Commissioner,   Workmen’s Compensation,   Chopal   (hereinafter   ‘Commissioner’),   seeking compensation under the 1923 Act, and the Commissioner had passed   award   dated   28.08.2003   directing   Respondent   No.1­ HPSFC to pay a sum of Rs. 1,52,887.50/­ along with interest @12% p.a. to the Appellants herein. HPSFC had appealed against the   said   award   before   the   Hon’ble   High   Court   of   Himachal Pradesh, Shimla and the Hon’ble Court had passed an interim order on 6.11.2003 directing stay of operation and execution of the Commissioner’s order dated 28.08.2003. Hence the National Commission held that the matter was already sub­judice before the Commissioner and it would not be proper for it to record its finding. The Revision Petition was accordingly allowed. Aggrieved, the Appellant has come before this Court. 8 8. Learned counsel for the Appellants has argued that that the terms   and   conditions   of   the   Insurance   Policy   were   never communicated to the insured persons nor were they supplied with a copy of the Insurance Policy. The deceased was not told that   the   Insurance   Policy   was   applicable   only   in   the   case   of accidental death and therefore, the Respondent No.1­HPSFC is liable to pay compensation to the Appellants for the death of the deceased.  8.1 The learned counsel for the Appellants further contended that   the   Insurance   Scheme   is   in   addition   to   the   Appellants’ entitlement to compensation under the 1923 Act and while all employees   of   Respondent   No.1­HPSFC   are   entitled   to compensation   under   the   1923   Act,   compensation   under   the Insurance Policy is available only to those who pay the premium. Therefore, a claim before the Commissioner under the 1923 Act cannot preclude a claim under the Insurance Policy. 8.2 Lastly, the Appellants have contended that as per the law laid down in   (supra), even if the Insurance Policy is Jamuna Devi not applicable, Respondent No.1­HPSFC may be held liable for paying   compensation   to   the   Appellants   herein.   Further,   that 9 Respondent No.1­HPSFC was acting as a mediator between the insured/deceased and the Insurance Company and hence there was a tripartite agreement which entitles the Appellants to file a case against the Respondent No.1­HPSFC. Per contra, the learned counsel for Respondent No.1­HPSFC 9. argued that under the Insurance Policy, if the insured died an accidental death, regardless of whether such death takes place within the course of employment or not, the Insurance Company would be liable. However, the Respondent No.1­HPSFC had no liability under the Insurance Policy whatsoever. If the death does not arise out of accident, neither the Insurance Company nor HPSFC would be liable. The State Commission and the National Commission rightly recorded concurrent findings that the death was   not   accidental,   however,   the   State   Commission   and   the District Forum considered the issue on the wrong premise that in case the death was accidental, the Insurance Company would be liable and otherwise, Respondent No.1­HPSFC would be liable. Further, that the deceased was an employee of Respondent No.1­ HPSFC and not a consumer since the definition of “service” under the Consumer Protection Act excludes from its ambit services 10 rendered under the contract of employment between employer and employee and hence the complaint was not maintainable under the Consumer Protection Act qua the Respondent No.1­ HPSFC. Lastly, that HPSFC could be held liable only under the provisions of the 1923 Act and not under the Insurance Scheme as   it   was   only   a   mediator   for   depositing   the   premium   of employees with the Insurance Company. 10. Learned   counsel   for   the   Respondent   No.   2­Insurance Company   contended   that   the   deceased   died   a   natural   death, which is not covered under the Insurance Policy. The Insurance Policy only covers “ bodily injury resulting solely and directly from accident caused by outward, violent and visible means (including sterilization risks )”. Since there is no evidence to show that the deceased met with any accident and the Post­Mortem Report also shows that no bodily injury was caused to the deceased, the claim is not payable under the said Policy. 10.1 It   was   additionally   pointed   out   that   Proviso   4   to   the Insurance   Policy   contains   an   exclusion   clause,   whereby   it   is clearly   provided   that   if   the   insured   dies   whilst   under   the 11 influence of intoxicating liquor or drug, claim under the Policy will not be payable.  10.2 The facts of the present case show that on the night before his death, the deceased was heavily drunk, and had gone and slept outside on a cold, rainy October night in Chopal. In case of excessive   drinking   and   cold   weather,   asphyxia   is   the   final medical   complication.   Therefore,   the   learned   counsel   for   the Insurance Company submitted that the Appellants’ claim is not maintainable under the Insurance Policy conditions, particularly Proviso 4. It was further pointed out that there is neither any direct evidence nor any bodily injury to prove the Appellants’ claim that the deceased died due to having suffered a fall during the storm at night. The learned counsel also placed reliance on the   expert   opinions   of   Dr.   D.J.   Das   Gupta   dated   6.07.1998 (supra) and Dr. D.S. Puri dated 17.08.2002 (supra) to show that the deceased was in an intoxicated state at the time of death. Hence,   the   learned   counsel   for   the   Insurance   Company submitted that the present appeal is liable to be dismissed.  11. We have heard the learned counsel for the parties at length and have considered the materials placed on record as well as the 12 findings   of   the   three   consumer   forums.   In   the   facts   and circumstances of the case, we do not find any reason to interfere with   the   impugned   order   dated   24.04.2009   passed   by   the National Commission for the reasons mentioned below. 12. From   a   bare   perusal   of   the   Insurance   Policy,   as   quoted supra, it is clear that only if the insured sustains any bodily injury   resulting   solely   and   directly   from   accident   caused   by outward,   violent   and   visible   means,   the   Insurance   Company would be liable to indemnify the insured. Therefore, as per the Insurance Policy, only accidental death of the insured shall be indemnified.   As   noted   above,   the   Post­Mortem   Report   clearly indicates that there were no injuries found on the body of the deceased. The probable cause of death as per the Final Opinion in   the   Post­Mortem   Report   is   asphyxiation   caused   by   alcohol consumption and regurgitation of food  into larynx.  As such, we find   it   difficult   to   conclude   that   the   deceased’s   death   was accidental. Further, the expert opinions of Dr. D.S. Puri and Dr. D.J. Das Gupta (supra) also show that the cause of death was due to consumption of alcohol. In light of the explicit terms of the Insurance Policy, we find that the National Commission and the 13 State Commission have rightly held that the deceased’s death was not accidental, and that the Insurance Company would not be liable to settle the Appellants’ claim.  As for the liability of the Respondent No.1­HPSFC, we are of 13. the opinion that the Respondent No.1­HPSFC was only acting as a mediator for depositing the premium of employees with the Insurance   Company   and   had   no   liability   as   such   under   the Insurance Policy. The liability of Respondent No.1­HPSFC, if any, would be under the 1923 Act, proceedings under which have already been settled by the Commissioner, as recorded in the Impugned Order.  At   this   stage,   we   consider   it   pertinent   to   deal   with   the 14. contention raised by the Appellants that Respondent No.1­HPSFC ought   to   be   directed   to   pay   compensation   in   place   of   the Insurance Company on the basis of the judgment in   Jamuna Devi   (supra).   In   the   facts   of   Jamuna   Devi ,   the   deceased employee   in   that   case   was   also   insured   under   the   same Insurance Scheme. Upon his death, a claim was raised which was repudiated by the  Insurance Company.  When the  matter came before the National Commission by way of revision petition, 14 the National Commission held that the death was not accidental and   therefore,   repudiation   of   the   claim   by   the   Insurance Company   was   correct.   However,   the   National   Commission observed from the records that the deceased therein was given to believe that the policy covered natural death as well. The National Commission also considered the fact that before the introduction of   the   Scheme,   a   communication   dated   23.01.1996   was addressed by the Financial Commissioner­cum­Secretary (PW) to all Heads of Departments under the Government of Himachal Pradesh giving details of the Insurance Scheme and the benefits arising therefrom. The said letter mentioned “death” as one of the events  covered   by   the   insurance   scheme,   however,   it   did   not specify   only   accidental   death.   Therefore,   the   National Commission held that the employer in that case was liable to make payment of compensation.  15. In   our   considered   opinion,   the   judgment   passed   by   the National Commission in   (supra) is peculiar to the Jamuna Devi facts and circumstances of that case. There is nothing on record to   show   that   the   deceased   in   the   present   case   was   given   to believe that the Insurance Policy covered natural death as well. 15 Therefore, the directions issued in   Jamuna Devi   would not be applicable to the present case. 16. At   this   juncture,   we   may   also   observe   that   in   the communication   dated   23.01.1996   addressed   by   the   Financial Commissioner­cum­Secretary   (PW)   (mentioned   supra),   it   was stated that the Insurance Scheme would cover death due to any type   of   accident   including   road,   natural   calamities   like landslides,   floods,   drowning,   tree­falling,   avalanches,   etc. However, the Appellants have not adduced any evidence to prove their contention that there was indeed a storm on the night of 7.10.1997 and that the deceased fell to his death as a result, so as to lend support to their argument that the present case may be covered in the broader terms of the Insurance Scheme as envisaged in the letter dated 23.01.1996.  17. Be   that   as   it   may,   the   Provisos   of   insurance   policy specifically disclose that compensation will not be paid in respect of injury of the injured if he is under the influence of intoxicating liquor. The relevant Proviso 4 of the insurance policy reads thus:­ “PROVISOS 16 Provided always that the company shall not be liable under this policy to: 4) Payment of compensation in respect of death, injury   or   disablement   of   the   insured   from   (a) intentional (illegible) suicide or attempted suicide, (b)   whilst   under   the   influence   of   intoxicating liquor   or   drug   (c)   or   (illegible)   by   insanity,   (d) arising or resulting from the insured committing any breach of the law with criminal intent.”   The   aforesaid   Proviso   4   makes   it   amply   clear   that   the injured is not entitled to compensation since on facts it is proved that he was intoxicated and that was due to intoxication. In light of the aforementioned observations, we decline to 18. interfere   with   the   Impugned   Order   passed   by   the   National Commission. Accordingly, the Appeal stands dismissed. No order as to costs. …..…………................................J. (MOHAN M. SHANTANAGOUDAR) .……………………………...............J.                                (VINEET SARAN)   NEW DELHI, MARCH 22, 2021