JUDGEMENT
M.THANIKACHALAM, J. -
(1.) The 2nd opposite party, in all the above complaints, is the appellant
in all the appeals.
2.This order shall dispose of the above said appeals, as agreed by the
learned counsel for the appellant.
3.Common facts, necessary for the disposal of all the appeals.
4.The parties are referred in this order as arrayed in the original
complaints.
5.The 1st opposite party (in all the cases), is having a cracker
manufacturing workshop, for which, at the instance of the 3rd opposite
party (in all the cases), the 2nd opposite party (in all the cases), had
given Group Personal Accident Insurance Scheme, assuring a sum of
Rs.50000/-, in case of accident, and under the Group Personal Accident
Insurance, the maximum workers/employees cover are 100, but unnamed. In
the said 1st opposite party fire works industries, the persons shown in
the table below, under column 1, were working as employees/ workers, and
they are also, covered by Group Personal Accident Scheme, for which
premium, was paid by the 3rd opposite party.
S.No.
Employee/ Worker
(1)
Legal heirs of the deceased employees (2)
OP.Nos.
(3)
Appeal No.
(4)
Claim amount
(5)
1.
Jakkammal
Rajamani and others
47/2007
770/2008
Rs.50000
2.
Ramalakshmi
S.Santhanam and others
34/2007
771/2008
-do-
3.
Mariselvi
P. Durairaj, and others
31/2007
772/2008
-do-
4.
Perumalsamy
P.Karuppaee and others
33/2007
778/2008
-do-
5.
Mariammal
R. Kalirajan
35/2007
779/2008
-do-
6.
Lakshmi
K. Kaleeswari
37/2007
780/2008
-do-
7.
Anthony Muthu
A. Saraswathi and others
32/2007
297/2009
-do-
8.
Sangiliammal
Mariammal
36/2007
298/2009
-do-
6.On 2.7.2005, a fire accident had taken place in the 1st opposite
party Fire works industries, in which not only the persons shown in the
above table, under column (1) died, but four others persons also died, in
addition, many sustaining injuries, for which FIR was registered. After
the accident, the Legal heirs of the deceased shown in Column No.3, were
given solacium and other benefits, but the 2nd opposite party despite the
claim made, based upon policy, failed, neglected to pay the sum of
assured under the policy, thereby they have committed deficiency in
service. The insurance company instead of honouring the policy,
repudiated the claim, on the ground that the opposite parties 1 and 3,
have committed breach of written warranty, and they have also failed to
pay the additional premium for additional number of employees, since in
the accident, according to them 167 workers were working, which is
incorrect. The workers or their legal heirs, have not committed any
violation of the terms and conditions of the policy, and therefore having
given insurance for 100, when the claim was less than that number, the
2nd opposite party should have settled the claim, and the failure should
be construed as deficiency in service. Thus alleging, all the legal heirs
of the deceased, as shown in the above table, column 3 have filed the
consumer complaints, claiming a sum of Rs.50000/-, each as well as cost
of Rs.5000/-, with interest.
7.The 1st opposite party, admitting the Group Personal Accident Insurance
Scheme, taken with the 2nd opposite party, contending that the 3rd
opposite party is the custodian of the workers, by whom premiums were
paid to the 2nd opposite party, resisted the case on the grounds, that if
the workers died during the course of employment, the family of the
deceased is entitled to get a sum of Rs.50000/- from the Group personal
Accident Insurance scheme, that has directed by the Hon?ble High Court,
for the legal heirs of the deceased, as well as for the insured they have
paid a total sum of Rs.10,65,000/-, including the claimants in all the
complaints, and therefore as such they are not liable to pay any more
compensation, further contending that only 100 labours were working, at
the time of accident, in their factory, thereby praying to dismiss the
case, as far as they are concerned.
8.The 2nd opposite party, admitting the insurance taken by the 3rd
opposite party for 100 workers of the 1st opposite party, under the Group
Personal Accident insurance claim, for the period from 30.12.2002 to
29.12.2005, resisted all the cases, contending that as per the warranty
clause, total number of employees working in the factory should not
exceed Rs.100/-, whereas there was breach of warranty clause, since at
the time of accident 149 employees working in the 1st opposite party
factory, that because of the breach of warranty clause, as well for not
following of enrolment procedure, there were violation of policies, and
they are not liable to pay the sum assured, under the Group insurance
policy, praying for the dismissal of the complaint, denying further
averments also.
9.The District Forum, in its separate orders dt.27.12.2007, recorded a
finding that the 2nd opposite party failed to prove, the breach of
employees warranty, since as per the Muster Role, only 99 workers were
working in the 1st opposite party Fire Works factory, which is within the
norms under the policy, that despite this fact, the non-settlement of the
claim should be construed as deficiency. Thus concluding, under the Group
Personal Accident Insurance Scheme, the District Forum directed in each
case, the 2nd opposite party alone should pay the sum of Rs.50000/-,
being the assured amount, with cost of Rs.5000/-, which are challenged by
the 2nd opposite party, in the above said appeals, independently.
10.The facts beyond controversy are that the 1st opposite party is
running a fire work industries at Sivakasi, which is under the control of
the 3rd opposite party. Securing the safety and welfare of the workers,
under the Group Personal Accident insurance cover, for fire works in the
factory, at the instance of the 3rd opposite party, collecting premium,
the 2nd opposite party issued a Group Personal Accident claim policy,
covering the period 30.12.2002 to 29.12.2005. Total numbers of workers,
covered under the policy are 100. In the said factory, admittedly there
was a fire accident on 2.7.2005, in which admittedly 12 workers died, and
many injured. Out of the 12 workers died, legal heirs of 8 have filed
cases, as shown in the table, and they have succeeded also, which are now
impugned.
11. The learned counsel for the appellant urged, that as per the
certificate of insurance, premium was paid Rs.4526/-, covering 100
employees, working in the factory of he 1st opposite party, and in this
case, more than 100 workers were employed, and therefore there is a
breach of warranty, inviting our attention to the conditions attached to
the Group Personal Accident insurance policy. The condition mandate,
premium should have been paid for all the workers, between the age of 14
to 70 years, working in the factory, and the number of workers working in
the factory should not exceed the actual number of workers covered in the
policy, i.e., 100 in this case. It is also an admitted fact, that only
for 100 workers, premium was paid, collected. In view of the above said
admitted facts, as per the records, it is for the appellant/2nd opposite
party to prove that either the 1st opposite party or the 3rd opposite
party, had violated the terms and conditions of the policy viz. they have
employed more than 100, thereby committed the breach of warranty.12. It
is no doubt true during the currency of the policy, fixing the total
number of employees, working in the factory, should not exceed 100, and
this can be taken as promissory warranty, as pointed out by the learned
counsel for the appellant. If such a warranty is a condition, that must
be exactly complied with, whether it is material to the risk or not, as
rightly urged by him also. For the non-compliance of the promissory
warranty is an excuse, for that there should be change of circumstances,
and it should be shown the warranty was referred unlawful in subsequent
provisions, which is not the case here. The importance of the warranty
was enlightened by the learned counsel for the appellant, inviting our
attention to a decision of the National Commission in T.S. Vivekananda
Kumar Vs. United India Insurance Co. Ltd., and another, reported in I
(2009) CPJ 288 (NC), wherein the Hon?ble National Commission has held, if
the warranty and exclusion clauses are available under the policy,
irrespective of its significance, that should be followed, failure should
make the policy void. In the policy involved, in the above decision,
there was a warranty that the stock should be secured in locked burglar
proof, safe at night. It appears, that was not complied with, though
otherwise the premises was secured. After the burglary when a claim was
made, this warranty clause was pressed into service to reject the claim,
accepted by the National Commission. If this is to be followed, insured
cannot have any claim, as said above, it is the duty of the insurance
company, to prove that the warranty was breached by employer, more than
100, employing workers, then claiming accident benefit for these employee
also.
13. In this case, total number of workers died were only 12, out of which
legal heirs of 8 alone, have filed the case. We do not have exact figure
regarding the number of persons insured, and it is not made out, even by
pleadings by the 2nd opposite party, that more than 100 persons have
claimed under the Group Personal Accident insurance cover. Thus we can
safely conclude, number of persons covered under the policy is within
100. But, the learned counsel for the appellant, would contend, that the
number of claimants are not the criterion, though it may less than 100,
but the number of workers employed in the 1st opposite party should be
taken into consideration, and irrespective number 100, since the 1st
opposite party had employed 159 workers, or exceeding 100, then it should
be construed as breach of warranty, which submission we are inclined to
accept, want of proof.
14. This submission is made to avoid unnecessary claim by 3rd parties,
being engaged by the fire work industries illegally, then in the case of
accident, covering them also, that should be prevented, which we are not
going to quarrel. Therefore, now the only question is, how many
employees, were employed by the 1st opposite party, at the time of
accident, or during the currency of the policy.
15. After the accident, as seen from Ex.A1, FIR was lodged, wherein also,
we find the number of employees insured or dead, not exceeding 100,
whereas FIR would disclose the names of some dead persons, further
informing many injured. The police have also not filed the final report,
which would disclose the number of persons dead, as well as injured,
warranting punishment against the accused. Thus, from the records
produced on behalf of the complainant, as well as on behalf of the
opposite parties 1 and 3, we are unable to say, that the 1st opposite
party would have engaged more than 100 workers, in order to say, they
have committed breach of warranty, as discussed above.
16. The enrolment procedure, or the prescribed form, not produced, cannot
be taken, as the violation of the policy, to construe the policy itself
null and void, since we find no such condition, though employment
procedure contemplates, all workers in the age group of 14 to 70 years
have to give their names of the employer, under whom they are working in
form No.1, and if at all it must be a lapse on the part of the 3rd
opposite party, for that we feel the genuine claim for the death of the
actual worker, should not be deprived of.
17. The insurance company, upon information, about the accident,
appointed one Antony Ran, for investigation, he being the insurance
surveyor, authorized, and his report is marked as Ex.B4. By going through
this report also, we find no indication, that the 1st opposite party
should have employed more than 100, though he would state, that they are
not maintaining Form No.1, as well they have submitted, Muster Roll, only
on 1.7.2006. The Muster Roll copy is marked as Ex.B13, which says, there
were only 99 workers or so. Based upon this record, the surveyor in his
final remarks, recorded, as per the Muster Roll copy, only 99 employees
present in the factory, as on the date of accident, thereby confirming
the defense of the opposite parties 1 and 3 also, instead of improving
the case of the 2nd opposite party, as if there was breach of warranty
employing more than 100, offending the certificate of insurance policy.
The District Forum, considering the surveyor?s report, as well as the
admitted fact, viz. the deceased were working in the 1st opposite party,
who are all should be covered under the policy, the policy being unnamed,
came to the just and correct conclusion, that the non-settlement of the
claim, when made by the legal heirs should be construed as deficiency,
and that is the case of the complainants also, in all the cases. For the
above said reasons, though, a sincere attempt was made by the learned
counsel for the appellant, to say that the opposite parties 1 and 3 have
committed breach of warranty, for want of evidence, we are unable accept
the same, whereas by the presence of evidence, we conclude there would
not have been more than 100 employees, and under the policy, the 2nd
opposite party, as agreed, entitled to compensate for the death, the
maximum amount of Rs.50000/-, for which alone, award was given, not even
interest, only alongwith cost, in which operative portion of the order
also, we are unable to find any error, and we refrain ourselves from
disturbing the findings and conclusion, of the District Forum, thereby
concluding all the appeals are devoid of merits, liable to be dismissed.
18. In the result, all the appeals are dismissed, confirming the order of
the District Forum in all the complaints. There will be no order as to
cost in the appeals.;