NEW INDIA ASSURANCE COMPANY LTD. v. NARAYAN DHAR SWAIN
1998-07-24
PRADIPTA RAY
body1998
DigiLaw.ai
JUDGMENT : Pradipta Ray, J. - New India Assurance Company Ltd., the insurer, has filed this appeal against the judgment and award dated December 6, 1990 passed by the Assistant Labour Commissioner-Cum-Commissioner for Workmen's Compensation, Cuttack in W.C. Case No. 68 of 1990. By the impugned award the Commissioner has awarded a compensation of Rs. 47,652.75 Paise in favour of the claimant-respondent No. 1 and held the Appellant Insurance Company liable to pay such compensation. 2. The case of the claimant in short is: The claimant was a driver of the truck bearing No. OAU 355. On June 18, 1989 at about 1.00 p. m. while he was driving the vehicle he met with an accident in course of and out of his employment and suffered fracture in both the legs. Claimant claimed that he was first removed to the nearest hospital and thereafter to Jenapur Primary Health Centre. According to him, even after plaster was removed his pain and stiffness of the injured legs subsisted and accordingly he attended the Out-door of S.C. B. Medical College & Hospital, Cuttack. He claimed that because of such injury he had become invalid and was no longer able to work as driver. 3. The owner, Respondent No. 2 submitted a written statement and also deposed as a witness (0 p.w. No. 1). The owner did not dispute the master-servant relationship and also admitted the accident. He, however, did not admit the details of the injuries as claimed by the claimant. The owner pointed out that the vehicle was duly insured with the Insurance Company under policy which was valid from December 19, 1988 to December 18, 1989 and that he was entitled to be indemnified by the Insurance Company. He also produced the original insurance policy marked as Ext. 'A'. 4. The Insurance Company, however, contested the claim filed by the claimant and denied all the material allegations made in the claim petition. 5. On the basis of the materials on record the Commissioner accepted the opinion of the Doctor and held that the claimant was disabled by 45 per cent. Commissioner also held that he was aged about 28 years at the time of accident and calculated his monthly contribution to the family at Rs. 500/-. 6. In support of the appeal Mr.
On the basis of the materials on record the Commissioner accepted the opinion of the Doctor and held that the claimant was disabled by 45 per cent. Commissioner also held that he was aged about 28 years at the time of accident and calculated his monthly contribution to the family at Rs. 500/-. 6. In support of the appeal Mr. Roy pointed out that the cheque which was submitted by the owner of the vehicle for payment of initial premium bounced and he did not pay any premium for obtaining insurance coverage. Mr. Roy has submitted that no premium having been paid no contractual relationship between the insurer and the insured existed at the time of accident, that the insurance policy was issued carelessly and that there being no contractual relationship in the absence of payment of premium the Insurance Policy exhibited by the owner was a void and inoperative document. He mainly relied upon a decision reported in 1997 (2) O.L.R 5 (Brundaban Patra v. The New India Assurance Company Ltd. Berhampur and Anr.. Besides, Mr. Roy pointed out the discrepancies and interpolations on the medical papers submitted on behalf of the claimant to show that claimant's claim regarding injury was not bona fide and believable. 7. Mr. R.N. Mohanty appearing on behalf of claimant Respondent No. 1 relied upon a decision of the Supreme Court in Oriental Insurance Co. Ltd. Vs. Inderjit Kaur and Others, to submit that non-payment of premium by the owner would not absolve the insurer of its liability to pay compensation amount after it had issued a policy of insurance covering the vehicle. Regarding the discrepancies and interpolations in the medical papers, Mr. Mohanty took the technical plea that the genuineness of those documents was never questioned before the Commissioner and such question of fact cannot be raised for the first time in an appeal under the Workmen's Compensation Act. He has referred to the limited scope of an appeal under the Workmen's Compensation Act and urged that this Court should not at all consider those allegations of fact while hearing an appeal. His further submission is that the Insurance being a matter of contract between the insurer and the insured (owner of the vehicle) the driver is in the position of a third party and the Supreme Court's decision in Indarjit Kaur's case is applicable to this case. 8.
His further submission is that the Insurance being a matter of contract between the insurer and the insured (owner of the vehicle) the driver is in the position of a third party and the Supreme Court's decision in Indarjit Kaur's case is applicable to this case. 8. To appreciate the ratio of the decision in Indarjit Kaur's case (supra) it is necessary to point out the relevant facts of that case. In that case policy of Insurance was issued by the insurer on November 30, 1989. The premium for the policy was paid by a cheque. The cheque bounced. The Appellant on January 23, 1990 duly intimated the insured about the dishonour of the cheque. It was pointed out that as the cheque was dishonoured and the premium was not paid, the Insurance Company would not be liable for any risk. Ultimately, however, the premium was vaid in cash on May 2, 1990 and was accepted by the Insurance Company. In the mean time on April 19, 1990 the bus collided with a truck and in the said accident the driver of the truck died. The truck driver's widow and minor sons filed claim petition. In the back-ground of the aforesaid facts the Supreme Court held that notwithstanding non-payment of premium at the time of accident the Insurance Company could not avoid its liability to indemnify the third party and satisfy the award of compensation. The Supreme Court observed: We have, therefore, this position. Despite the bar created by Section 64- VB of the Insurance Act, the Appellant, an authorised insurer, issued a policy of insurance to cover the bus without receiving the premium therefor. By reason of the provisions of Section 147(5) and 149(1) of the Motor Vehicles Act, the Appellant became liable to indemnify third parties in respect of the liability which that policy covered and to satisfy awards of compensation in respect thereof notwithstanding its entitlement (upon which we do not express any opinion) to avoid or cancel the policy for the reason that the cheque issued in payment of the premium thereon had not been honoured. The policy of insurance that the Appellant issued was a representation upon which the authorities and third parties were entitled to act. The Appellant was not absolved of its obligations to third parties under the policy because it did not receive the premium.
The policy of insurance that the Appellant issued was a representation upon which the authorities and third parties were entitled to act. The Appellant was not absolved of its obligations to third parties under the policy because it did not receive the premium. Its remedies in this behalf lay against the insured. xxx It must also be noted that it was the Appellant itself who was responsible for its predicament. It had issued the policy of insurance upon receipt only of a cheque towards the premium in contravention of the provisions of Section 64- VB of the Insurance Act. The public interest that a policy of insurance serves must clearly prevail over the interest of the Appellant. 9. No doubt such plea of non-payment of premium and consequential cancellation of policy was not raised before the Commissioner. The Appellant, Insurance Company, has filed an application under Order 41, Rule 27, CPC for accepting the documents annexed thereto as additional evidence. From the documents annexed to the said application it prima facie appears that by a letter dated January 3, 1989 the Insurance Company informed the owner regarding dishonour of the cheque and cancellation of the insurance policy. The same was sent to the owner by registered post with A.D. to the address given in the insurance policy, but it came back undelivered with the postal endorsement 'not found.' 10. In this Court Mr. Mohanty appearing for the claimant could not produce or show anything that any premium was paid at anytime during the validity period of the insurance policy. As already pointed out in Indrajit Kaur's case (supra) the premium was ultimately paid and accepted by the Insurance Company and the policy was not cancelled on the date of the accident. Supreme Court relied upon the provisions of Section 149(1) of the Motor Vehicles Act, 1988 (hereinafter called 'the Act') to hold Insurance Company from taking any plea that the policy, might have been cancelled or was liable to be cancelled on the date of the accident. In other words, Section 149(1) of the Act comes into play if there is no factual and formal cancellation of the insurance policy before the accident. But where there is express and specific cancellation of the policy before the date of the accident,Section 149(1) of the Act does not apply.
In other words, Section 149(1) of the Act comes into play if there is no factual and formal cancellation of the insurance policy before the accident. But where there is express and specific cancellation of the policy before the date of the accident,Section 149(1) of the Act does not apply. In the present case prima facie the policy was cancelled long before the date of accident. 11. According to the Supreme Court's decision in Indarjit Kaur's case, if insurance policy is issued without receipt of premium, the Insurance Company will remain liable to pay compensation to third party involved in accident with the concerned vehicle. Mr. Mohanty has raised a question, that the driver of the alleged insured, vehicle is to be treated as third party inasmuch as the employee is not a party to the contract of insurance. In Section 147 of the Act the word 'third party' has been used in a particular sense and it does not include a person connected or associated with the offending vehicle in the capacity of owner, passenger in the vehicle or employee of the vehicle. If the driver or conductor or employees of the vehicle was treated as "third party" then there was no necessity of having the proviso to Section 147 (1) of the Act in respect of driver or conductor or examiner of tickets, Benefit of Section 149(1) is of course available to a driver or conductor because the liability to pay such compensation remains covered by the insurance policy, but not as a third party within the meaning of Section 147(1) of the Act. I am unable to accept the submission of Mr. Mohanty that the driver is a third party within the meaning of term as used in Section 147 of the Act. Accordingly, if the Insurance Company can establish as a fact that the insurance policy was duly cancelled before the accident for non-payment of premium, and that there was no subsequent acceptance of premium and revival of the insurance policy, the Supreme Court's observation in lndrajit Kaur's case will not be applicable to the facts and circumstances of this case. 12. In the application for additional evidence documents have been annexed which prima facie indicate cancellation of the insurance policy before accident.
12. In the application for additional evidence documents have been annexed which prima facie indicate cancellation of the insurance policy before accident. As the said question was not raised before the Commissioner, the claimant or the owner is entitled to get an opportunity to dispute such claim of the Insurance Company and accordingly this case is to be re-heard by the Commissioner after giving opportunities to the parties to adduce evidence on the said question. 13. The claimant has produced the purported prescriptions issued by one Dr. Arun Kumar Biswal (Ext. 1/11) and unstamped tickets for Out-Door patients containing the alleged treatment schedule and prescription of medicines (Exts. 1/2 & 1/3). It appears that in all those sheets initially the injuries about left leg were mentioned but through interpolations 'right' has been inserted in place of 'left' Ext. 1/2 also contains clear inconsistency. Although at the top 'left' has been interpolated to put the word 'RT' but in the body "X-Ray of left leg and foot" was advised. In Exts. 1/2 & 1/3 also 'left' has been interpolated to make it'right'. Dr. Aruna Kumar Biswal was not examined. The interpolations are clearly suspicious. The Commissioner should have applied his mind and scrutinised the said purported medical papers. Although one X-Ray plate has been exhibited, no X-Ray or Radiological report has been filed. In view of such Interpolations and over-writing, the medical papers prima facie appear to be unreliable. 14. Mr. Mohanty, appearing for the claimants has submitted that the Insurance Company not having made any allegation of collection between the owner and claimant, it can not raise any question apart from those mentioned in Section 149 of the Act. He has cited some decisions, viz. 1994 (l) A.C.J. 215 (G.H.) (Koili Bewa and Ors. v. Akshaya K. Mishra and Anr.; (1986)1 A.C.J. 303 (Bom), (Sitaram v. Chief Executive Officer, Zilla Parishad, Nanded); (1992)1 A.C.J. 61 (Del), (Indian Airlines v. Arun Goel and Ors. The aforesaid submission is unacceptable.
He has cited some decisions, viz. 1994 (l) A.C.J. 215 (G.H.) (Koili Bewa and Ors. v. Akshaya K. Mishra and Anr.; (1986)1 A.C.J. 303 (Bom), (Sitaram v. Chief Executive Officer, Zilla Parishad, Nanded); (1992)1 A.C.J. 61 (Del), (Indian Airlines v. Arun Goel and Ors. The aforesaid submission is unacceptable. It is the duty of the Commissioner for Workmen's Compensation to satisfy himself about following basic facts among other before giving his verdict: (i) Employer and employee relationship; ii) Happening of the accident causing death or injury to the deceased or the injured in course and/or out of his employment; (iii) Nature of the injury and the extent of disability, if any; (iv) existence of a valid Insurance Policy covering the vehicle and the deceased or injured, in case the owner claims indemnity from Insurance Company. 15. Satisfaction about these basic requirements is a pre-requisite for any award. Manner of satisfaction, however, depends on the facts and circumstances of the case and materials on record. When attention of this Court has been drawn to the fact that no premium was paid as the cheque bounced and no document is forthcoming from the claimant or the owner to show that such plea is incorrect, it is not possible to ignore such plea on any technical ground. It is the court's duty to make all possible efforts to reach the truth and to ensure that no unscrupulous person can abuse the process of law. It is the incumbent duty of the Court to satisfy itself about existence of valid insurance policy. It is immaterial whether any allegation of collusion is pleaded or not. The decisions cited by Mr. Mohanty are not applicable to the facts and circumstances of the present case. 16. Mr. Mohanty appearing for the claimant has contended that the Appellant insurance company did not raise any question about the authenticity of the medical papers before the Commissioner and an appeal under the Workmen's Compensation Act being confined to questions of law, this Court should not delve into such questions of fact for the first time. In support of his contention Mr.
In support of his contention Mr. Mohanty has cited several decisions, on the nature of the appeal under the Workmen'sCompensation Act and the meaning of 'question of law' or 'substantial question of law' viz., 1997(1) A.C.) 461 (Oriental Insurance Company Ltd. v. Mohammed Haneef and Ors.; 1984 A.C.J 591 (Chottelal v. Dhammomal Sindhi and Ors.; Siddu Venkappa Devadiga Vs. Smt. Rangu S. Devadiga and Others, ; Shiv Balak Singh and Others Vs. Ram Kishore and Others, ; 1996 (1) A.C. J. 42 (Raveendran v. Somavally); and 1978 A.C. J. 222 (Rajinder Singh v. Malki Ram). It is not necessary to refer to those decisions as the same is a well settled proposition. But it does not mean that this Court is to shut its eyes and ignore facts or circumstances' which are apparent on the face of the records. It is the duty of a court or any adjudicating authority to carefully scrutinise the documents produced by the parties and to examine its authenticity and/or reliability. No court can overlook clearly visible interpolations and over-writings raising reasonable doubt about their authenticity or actual contents unless those ate properly explained and permit any party to reap benefit of his own fraud. Thus this Court is unable to accept the said contention of Mr. Mohanty particularly when interpolations are clearly visible and have not been explained. The documents, Exts. 1/1, 1/2 and 1/3, raise reasonable doubts about authenticity of those documents and the genuineness of the claim. 17. However, in view of the fact that no such plea was raised by the Insurance Company before the Commissioner, this Court thinks it fit and proper to give an opportunity to the claimant to get those interpolations and over-writing properly explained by examining the authors of those documents. 18. For the foregoing reasons, the appeal is allowed, the impugned judgment and award is set aside. The Workmen's Compensation Case is sent back on remand to the Commissioner for Workrnen's Compensation for re-hearing in accordance with the observations in this judgment. He will give opportunity to the parties to adduce further, evidence. All question will be decided afresh on the basis of the materials on record and further evidence, if any, adduced by the parties. The Commissioner will dispose of the case within a period of four months from the date of arrival of the records. 19. L.C. R. be sent down immediately. Appeal allowed.
All question will be decided afresh on the basis of the materials on record and further evidence, if any, adduced by the parties. The Commissioner will dispose of the case within a period of four months from the date of arrival of the records. 19. L.C. R. be sent down immediately. Appeal allowed. Final Result : Allowed