Court No. - 2
Case :- WRIT - C No. - 15430 of 2021 Petitioner :- The Oriental Insurance Company Limited Respondent :- Smt. Saroj And 2 Others Counsel for Petitioner :- Arun Kumar Shukla Counsel for Respondent :- C.S.C.,Satya Deo Ojha
Hon'ble Suneet Kumar,J.
Heard learned counsels for the parties.
This petition is being decided at the admission stage as per Rules, without calling for the counter affidavit, on the consent of learned counsels for the parties.
The first respondent (since deceased) approached the petitioner-insurance company for claim, on the death of her son, Sanjay, under the insurance scheme floated by State Government in the name and style 'Samajwadi Kisan Evam Sarvhit Bima Yojna', presently 'Mukhyamantri Kisan Evam Sarvhit Bima Yojna'. The claim came to be rejected by the insurance company, thereafter, by District Magistrate on the plea that deceased was not covered under the personal accidental insurance benefit as he was not the head of the family and/or bread earner. Aggrieved, petitioner filed a petition before Permanent Lok Adalat, Muzaffar Nagar, against the petitioner and the State claiming insurance amount. Lok Adalat by the impugned order dated 24.03.2021 allowed the PLA Case No. 2 of 2019 (Smt. Saroj and another Vs. The Oriental Insurance Company Limited and others). The order is under challenge.
It is urged by the learned counsel for the petitioner that as per the terms and conditions of the policy, the deceased, met with an accident was neither the head of the family nor bread earner, therefore, not covered under the coverage' clause of the policy. Further, attention has been drawn to the 'family composition' clause of the policy specifying the individuals who shall be considered as family members. It is provided that the dependent parents of unmarried son, where unmarried person is head of family/bread earner is covered. The relevant clauses relating to coverage and family composition are extracted:
"COVERAGE-1 Personal Accidental Insurance benefit upto a maximum INR 5 lakhs to the Head of the Family/Bread Earner (Policy holder) of the covered family."
"FAMILY COMPOSITION ESTIMATED NO. OF FAMILIES.- 3 Below individuals shall be considered as family members under the Samajwadi Kisan Sarvhit Bima Yojna Scheme:
...
d) Dependent Son
e) Dependent parents of unmarried son (where unmarried person is Head of the Family/Bread Earner)"
Relying on the terms of the policy, it is submitted that deceased was an unmarried son and depended upon his father-respondent no. 1/1, therefore, he was not eligible.
In rebuttal, learned counsel appearing for the respondent submits that deceased was sole bread earner of the family, the respondent was dependent upon him being an infirm and old person. The deceased would be covered under sub-clause (e) of the term 'family composition'.
I have heard learned counsels for the parties and perused the impugned order with the assistance of learned counsel for the parties. The submission being pressed by learned counsel for the petitioner came to be decided by Lok Adalat as issue no.-1, i.e., as to whether the deceased, Sanjay, is covered under the terms and conditions of the policy. It is noted in the impugned order that deceased was aged about 25 years, having income of less than Rs. 75,000/- per annum. Further, he was the bread earner of the family. The respondent appeared and deposed that he is an old, aged, infirm person and is unable to fend for his livelihood. He and his family was totally dependent upon the deceased son for livelihood. He further deposed that entire family was dependent upon the deceased. The statement was reiterated and supported by another witness, Pradeep. The insurance company relied upon a document/letter issued by the Lekhpal stating therein that the deceased was unmarried, he was dependent upon his father, who is the head of the family and bread earner. It is further stated that the deceased is not eligible under the scheme. It appears that on the strength of this letter, the claim of the respondent came to be rejected by the petitioner. It is further submitted by learned counsel for the petitioner that Lok Adalat has wrongly relied on a handicap certificate of Manish, brother of the deceased, to record a finding that respondent was a handicapped person. It is, therefore, urged that the finding of Lok Adalat based on the said document is per se perverse. The respondent is not a handicapped person.
In rebuttal, learned counsel for petitioner submits that Lok Adalat has committed an error in wrongly recording that father of the deceased is a handicapped person. He further submits that it was not the case of the respondent before the Lok Adalat that he is handicapped and dependent on his son, rather, it was stated that he was an old and infirm person unable to fend for his livelihood and was dependent upon his deceased son. In other words, it is urged that the basis of the claim was not being handicapped.
The error noted in the impugned order does not go to the root of the lis so as to disturb the finding based on the statement of the father of the deceased duly supported by another witness. The insurance company was unable to rebut the specific and categorical assertion of the respondent that he is infirm and unable to earn for himself and his family. It was categorically stated that deceased was the sole bread earner engaged as labourer to meet the needs of the family. The deceased was otherwise eligible under the scheme as he was aged between 18-70 years having income less than Rs. 70,000/- per annum. The petitioner company failed to produce the Lekhpal or file his affidavit before the Lok Adalat to prove the document and the averments stated therein.
On specific query, learned counsel for the petitioner failed to point out any infirmity, perversity or illegality in the impugned order so as to warrant interference.
The writ petition lacks merits. Dismissed.
Order Date :- 28.7.2021 P. Sri.