Research › Search › Judgment

Madhya Pradesh High Court · body

2008 DIGILAW 538 (MP)

VEERPAL SINGH GURJAR v. INSURANCE OMBUDSMAN FOR M P AND

2008-04-04

S.C.SHARMA

body2008
Judgment ( 1. ) THE petitioner before this Court is an agriculturist and owner of tractor bearing No. U. P. 93-K/5251, is aggrieved by an order dated 17-5-07 passed by the insurance Ombudsman for M. P. and Chhattisgarh. ( 2. ) THE grievance of the petitioner is that his tractor was registered with the Transport Department bearing No. U. P. 93- K/5251 and was insured by the respondent No. 2iffco TOKIO, General Insurance Co. Ltd. , for a period w. e. f. 7-2-06 to 6-2-07. As per averments of the petitioner the Tractor was stolen on 26-2-06 and a report was lodged with the police authorities, Insurance company and also respondent No. 3, Uttar Pradesh Sahkari Gram Vikas Bank ltd. , Lucknow as the tractor was financed by the respondent No. 3 Bank. The petitioner submitted his claim before Insurance Company respondent No. 2 and the Insurance Company appointed as investigator, Shri Upendra Vaish to investigate the case. The petitioner submitted all papers to the investigator and as his claim was not settled he was left with no other choice to approach insurance Ombudsman Madhya Pradesh and Chhattisgarh. The matter was heard at length by the Insurance Ombudsman Madhya Pradesh and chhattisgarh and the Ombudsman has held the action of the respondent insurance Company to repudiate the claim in order, and has justified the action of the Insurance Company, resultantly declined to interfere with the decision taken by the Insurance Company in rejecting the claim of the petitioner. ( 3. ) RESPONDENT No. 2 Insurance Company has filed return and it has been stated on affidavit that the award passed by the Insurance Ombudsman madhya Pradesh and Chhattisgarh is not binding upon the complainant (petitioner) and the petitioner is always having a remedy to take recourse of law before appropriate forum if he is not satisfy with the award. It has been further stated that the present matter involves various disputed questions of fact which cannot be adjudicated without appreciation of evidence and therefore, it would not be appropriate for this Court to entertain the writ petition. It has further been submitted that the petitioner can always file civil suit or can take proper steps for redressal of his grievance as he is having alternate efficacious remedy available to him, hence the present petition is not maintainable. ( 4. ) HEARD the learned Counsel for parties and perused the records. It has further been submitted that the petitioner can always file civil suit or can take proper steps for redressal of his grievance as he is having alternate efficacious remedy available to him, hence the present petition is not maintainable. ( 4. ) HEARD the learned Counsel for parties and perused the records. ( 5. ) IN the present case the petitioner who is an agriculturist and owner of tractor bearing No. U. P. 93-K/5251, took an Insurance Policy for his tractor for a period w. e. f. 7-2-06 to 6-2-07. The tractor was stolen on 26-2-06 and it has stated in the writ petition that petitioner has informed the police authorities, bank from which the tractor was financed and also Insurance Company about the theft, in time. The petitioner submitted a claim before the Insurance company and the same was denied by the Insurance Company, i. e. , respondent no. 2. The complaint made by the petitioner before the Insurance Ombudsman madhya Pradesh and Chhattisgarh was considered by the Insurance ombudsman Madhya Pradesh and Chhattisgarh and it has been observed by the insurance Ombudsman Madhya Pradesh and Chhattisgarh that the matter was inquired by the Police and the case was closed by the Police treating it to be true case but undetected case of theft. The Insurance Ombudsman Madhya Pradesh and Chhattisgarh has observed in the impugned order that the complainant has obtained insurance cover from Gwalior though the tractor was usually kept in jhanshi about 120 KM away from Gwalior. It has also been observed that the reason for bringing the tractor from Jhanshi to Gwalior only for insurance purpose was not explained by the petitioner. It has also been observed in the order, that pre-inspection report which is normally done before insuring the vehicle was done by Mr. Sudhindra Gupta, Surveyor. However, the Surveyor later on has denied the issuance of such report. The Insurance Ombudsman madhya Pradesh and Chhattisgarh on the basis of reply filed by the Insurance company given a finding that the tractor was stolen first and later on it was insured by the petitioner with the respondent No. 2 Insurance Company. ( 6. ) INSURANCE Ombudsman Madhya Pradesh and Chhattisgarh is appointed under the Redressal of Public Grievances Rules, 1998. Rules 16 and 17 of the Rules reads as under: "16. Award. ( 6. ) INSURANCE Ombudsman Madhya Pradesh and Chhattisgarh is appointed under the Redressal of Public Grievances Rules, 1998. Rules 16 and 17 of the Rules reads as under: "16. Award. (1) Where the complaint is not settled by agreement under Rule 15, the Ombudsman shall pass an award which he thinks fair in the facts and circumstances of a claim. (2) An award shall be in writing and shall state the amount awarded to the complainant : provided that Ombudsman shall not award any compensation in excess of which is necessary to cover the loss suffered by the complainant as a direct consequence of the insured peril, or for an amount not exceeding rupees twenty lakhs (including ex gratia and other expenses), whichever is lower. (3) The Ombudsman shall pass an award within a period of three months from the receipt of the complaint. (4) A copy of the award shall be sent to the complainant and the insurer, named in the complaint. (5) The complainant shall furnish to the insurer within a period of one month from the date of receipt of the award, a letter of acceptance that the award is in full and final settlement of his claim. (6) The insurer shall comply with the award within 15 days of the receipt of the acceptance letter under sub-rule (5) of Rule 16, the award may not be implemented by the Insurance Company. 17. Consequence of non-acceptance of award. If the complainant, does not intimate the acceptance under sub-rule (5) of the Rule 16, the award may not be implemented by the Insurance Company. " From bare perusal of the aforesaid provisions of law it is evident that the award passed by the Insurance Ombudsman Madhya Pradesh and Chhattisgarh is not binding on the complainant and the complainant can certainly take recourse of law before appropriate forum, if he is not satisfied that with the above. ( 7. ) RESPONDENT Company has also fairly submitted before this Court that the petitioner has a remedy of initiate Civil Suit against the respondent company for redressal of his grievance. In the present case the order passed by the Insurance Ombudsman Madhya Pradesh and Chhattisgarh as it has not been accepted, is certainly not binding upon the petitioner nor upon the Insurance company. In the present case the order passed by the Insurance Ombudsman Madhya Pradesh and Chhattisgarh as it has not been accepted, is certainly not binding upon the petitioner nor upon the Insurance company. The Insurance Ombudsman Madhya Pradesh and Chhattisgarh has given certain findings while passing the impugned order without there being any substance to support the same. From his own reasoning he has held that the tractor was stolen first and by fraudulent means Insurance cover was obtained later on. The matter was involving all the disputed questions of fact and without appreciation of evidence the finding which have been given by the Insurance ombudsman Madhya Pradesh and Chhattisgarh, in the impugned award are bad in law. The Apex Court while dealing with a case under the Banking ombudsman Scheme, 1995 in the case of Durga Hotel Complex Vs. Reserve Bank of India and others, (2007) 5 SCC 120 , has held as under: "13. Clause 16 (3) of the Scheme says, "no complaint to the banking Ombudsman shall lie". According to Blacks Law dictionary "lie" means, "to have foundation in the law; to be legally supportable, sustainable, or proper". In the context of the power conferred on the Ombudsman by the Scheme read in the light of section 35-A of the Banking Regulation Act, it would be appropriate to understand the expression as having a foundation in law in the sense that the claim must have a foundation in law. A banking Ombudsman, though might initially have jurisdiction to entertain a complaint on the basis, that it has a legal foundation, here in terms of the Scheme, he may be divested of that jurisdiction or the foundation in law might be lost on either of the parties approaching the Court, the arbitrator or the Debts Recovery tribunal in respect of the same subject-matter. Dealing with the expression "entertain" this Court held in Lakshmiratan Engg. Works Ltd. Vs. CST, AIR 1968 SC 488 : (1968) 1 SCR 505 , that it means to deal with or admit to consideration. The Court approved the views expressed by some of the High Courts that the word "entertain" meant not "receive" or "accept" but "proceed to consider on merits" or adjudicate upon. The Court also accepted the dictionary meaning of the word as "admit to consider". The Court approved the views expressed by some of the High Courts that the word "entertain" meant not "receive" or "accept" but "proceed to consider on merits" or adjudicate upon. The Court also accepted the dictionary meaning of the word as "admit to consider". This was also the view that was subsequently taken by this Court in hindusthan Commercial Bank Ltd. Vs. Punnu Sahu, (1971) 3 SCC 124. It was held therein that the expression "entertain" in Order 21 rule. 90 of the Code meant, to "adjudicate upon" or to "proceed to consider on merits" and not "initiation of proceeding" alone. Drawing an analogy, it is possible to say that the complaint must continue to have a foundation in law at the time the Ombudsman takes up the claim for his consideration and renders his decision or award. The foundation would be lost when a Court, Arbitrator, tribunal or any other Competent Forum is moved on the same subject-matter of the complaint should not be pending in any other tribunal, or Court or before an Arbitrator not merely when it is filed but also when it is taken up for consideration and disposal. " "14. There is a more fundamental aspect. The Ombudsman at best, is an Authority or Tribunal of limited jurisdiction constituted under the Scheme. It is a jurisdiction conferred by the Scheme. The exercise of jurisdiction or power by the Ombudsman would depend on his having jurisdiction not only to entertain a claim but also to bring it to an end. The continued exercise of power by him would depend on his continuing to have jurisdiction. Once he is deprived of his jurisdiction or gets derived of his jurisdiction over the subject-matter, he could no more proceed with a complaint which was earlier filed. In other words, to render an award valid in terms of the Scheme, the Ombudsman must continue to retain jurisdiction over the subject- matter of the complaint concerned. A complaint goes out of his purview when the subject-matter of it is taken to a court, Arbitrator, Tribunal or Forum. The relief that can be granted by the Ombudsman is limited and confined to the matters coming within Clause 13 of the Scheme. A complaint goes out of his purview when the subject-matter of it is taken to a court, Arbitrator, Tribunal or Forum. The relief that can be granted by the Ombudsman is limited and confined to the matters coming within Clause 13 of the Scheme. The intention behind incorporating Clause 16 (3) (d) appears to be to ensure that the relief an Ombudsman may give, may not conflict with a more comprehensive adjudication by a Court, Arbitrator, Tribunal or forum with wider powers. When there is conferment of a power on an Authority or Tribunal with limited jurisdiction, that conferred power must continue to exist, when the decision is rendered by that authority or Tribunal. Once the conferred authority or power is taken away or impeded, the Authority or Tribunal can no more exercise it. This will be the position when one of the parties in a complaint before the Ombudsman takes the subject-matter of the dispute has been taken to the Debts Recovery Tribunal or a Civil court or an Arbitrator or to any other Competent Forum, he gets divested of his jurisdiction, on a harmonious reading of Clause 16 (1) with Clause 16 (3) (d) of the Scheme. It is not, as if, a bar of jurisdiction can occur only at the stage either in view of the jurisdiction being taken away or in view of any other impediment created by the very legislation, rule or scheme that conferred the initial jurisdiction. Thus, having lost his jurisdiction over the complaint in view of Clause 16 (3) (d) of the Scheme, the ombudsman will have to decline jurisdiction to pass any order or award on the complaint. This, we think would be the proper way of understanding the bar created by Clause 16 (3) (d) of the Scheme. " "15. Conceptually, an Ombudsman is only a non-adversarial adjudicator of disputes. An Ombudsman by definition is only "an official appointed to receive, investigate, and report on private citizens complaints about the Government. A similar appointee in a non-Government organisation (such as a company or university)". (See Blacks Law Dictionary.)He serves as an alternative to the adversary system of resolving disputes, especially between citizens and Government agencies. He is an independent and non-partisan officer who deals with specific complaints from the public; against the administrative injustice and maladministration. (See 4 American Jurisprudence 2d ). (See Blacks Law Dictionary.)He serves as an alternative to the adversary system of resolving disputes, especially between citizens and Government agencies. He is an independent and non-partisan officer who deals with specific complaints from the public; against the administrative injustice and maladministration. (See 4 American Jurisprudence 2d ). Therefore, by its very nature, an Ombudsman is an alternative to an adversary system for resolution of disputes. When the subject-matter is taken away from the purview of the Ombudsman to an adjudicatory forum under an adversarial system. It is therefore, logical to understand clause 16 of the Scheme with particular reference to sub-clause (3) (d) thereof, that on one of the parties approaching an adjudicatory forum on an adversarial system, the non-adversarial adjudicator, the Ombudsman must lost his power or authority to bring about a resolution of the complaint by way of a non-adversarial adjudication. An Ombudsman is not defined in the Banking regulation Act, 1949 or in the Banking Ombudsman Scheme, 1995 constituting him as a facilitator to bring about a satisfaction of complaint, in one of the modes referred to therein. An adversarial adjudication necessarily stands on a higher plane than a settlement of a complaint at the instance of an Ombudsman. When such a forum for adversarial adjudication of dispute takes seisin of subject-matter of a complaint, it will be logical to postulate, on an interpretation of Clause 16 of the Scheme, that the Ombudsman loses his jurisdiction over the subject-matter of the complaint and consequently the complaint itself. " "17. After all, a complainant before the Ombudsman like the appellant will not be prejudiced by this interpretation. It has now been clarified in United Bank of India Vs. Abhijit Tea Co. (P) Ltd. , (2000) 7 SCC 357 : 2000 Supp. (3) SCR 153, that the expression "counter-claim" in sub-sections (8) to (11) of Section 19 of the recovery of Debts Act will take in even a claim for damages based on the same transaction and would include even an independent claim (sic : which) the respondent before the Debts Recovery tribunal may have against the claimant financial Institution. It has thus been held that a counter-claim in a wide sense will lie before the Debts Recovery Tribunal and the respondent will be entitled to raise a comprehensive counter-claim. This ratio has also been accept subsequently in State Bank of India Vs. Ranjan Chemical ltd. It has thus been held that a counter-claim in a wide sense will lie before the Debts Recovery Tribunal and the respondent will be entitled to raise a comprehensive counter-claim. This ratio has also been accept subsequently in State Bank of India Vs. Ranjan Chemical ltd. , (2007) 1 SCC 97 . It is, therefore, obvious that the appellant can make all his claims before the Debts Recovery Tribunal while defending the claim of the Bank, including the ones he has put forward before the Banking Ombudsman. " ( 8. ) THUS it is evident that the Apex Court has held that an Ombudsman is only a non-adversarial adjudicator of disputes. It has been also observed that he serves as an alternative to the adversary system for resolving disputes, especially between the citizens and Government agencies. It has also been held that respondents are free to raise claim before other forum like Debt Recovery tribunal and the jurisdiction of other forum does not stands ousted and similarly in the present case also the petitioner shall also be free to raise a claim before appropriate Forum/courts. The learned Counsel for petitioner vehemently argued that this Court can also consider the question of rejection of his claim under Article 226/227 of the Constitution of India and has relied upon a judgment of the High Court in the case of Ashok Kumar Dhingra and others Vs. Oriental Insurance Company Limited and others, AIR 2004 Delhi 161. The case referred alone before the High Court was in respect of renewal of medical claim policy wherein the Insurance Company has refused to renew the mediclaim policy but was ready to renew mediclaim policy subject to the premium being loaded by 200% and the imposition of the first loss clause to the extent of rs. 20,000/ -. The case cited by the learned Counsel for respondents was not a case involving disputed questions of fact. This is a case where the allegations and counter allegations have been made by both the parties. Claim of the petitioner is that he got his tractor insured from the respondent No. 2 Insurance Company for a period w. e. f. 7-2-06 to 6-2-07 and the allegation of the Insurance Company is that the petitioner got the insurance done after the tractor was stolen. Claim of the petitioner is that he got his tractor insured from the respondent No. 2 Insurance Company for a period w. e. f. 7-2-06 to 6-2-07 and the allegation of the Insurance Company is that the petitioner got the insurance done after the tractor was stolen. The surveyor who has done pre-inspection has also denied that any such report, i. e. , pre-inspection report was issued by him while insuring the tractor, whereas the petitioner has stated on affidavit that Mr. Sudhindra Gupta, Surveyor has conducted the survey and therefore, the insurance cover was issued to the petitioner. All these questions are certainly disputed questions of fact and has to be answered only after appreciation of evidence. The Apex Court in the case of national Highway Authority of India Vs. Ganga Enterprises and another, (2003)7 SCC 410 , has held that in respect of contractual dispute a Writ Court is not proper forum and the writ petition should be dismissed on the ground of maintainability. The Apex Court in the case of Union of India and another Vs. Ayub Ali, (2006) 7 SCC 511 , has held as under : "6. We find that a Division Bench of the High Court in Amrit Lal Vs. Union of India, CWP No. 6463 of 2001, dated 1-8-2002 by judgment dated 1-8-2002 had expressed_views which prima facie appeared to be at variance with a view expressed by the learned Single Judge. This judgment appears to have been placed before the Division bench in the Letters Patent Appeal for consideration, but the letters Patent Appeal was summarily dismissed. The manner of disposal is clearly inappropriate. It was open to the Division Bench to examine whether it was in agreement with the view expressed in the earlier writ petition where some identical issues were considered. But that has not been done. The two factors which went into the evaluation process were delay in completion of the work and the quality of work. Both these aspects normally are not to be adjudicated in the writ petition because factual adjudication is necessary. This aspect has also not been considered by the Division bench in the impugned order. " The Apex Court has therefore, held that the aspect involving factual adjudication should normally to be examined by the High Court under Article 226 of the Constitution of India. The Apex Court in the case of UP. This aspect has also not been considered by the Division bench in the impugned order. " The Apex Court has therefore, held that the aspect involving factual adjudication should normally to be examined by the High Court under Article 226 of the Constitution of India. The Apex Court in the case of UP. State Spinning Co. Ltd. Vs. RS. Pandey and another, (2005) 8 SCC 264 , has held as under: "17. Where under a statute there is an allegation of infringement of fundamental rights or when on the undisputed facts the taxing. authorities are shown to have assumed jurisdiction which they do not possess can be the grounds on which the writ petitions can be entertained. But normally, the High Court should not entertain writ petitions unless it is shown that there is something more in a case, something going to the root of the jurisdiction of the officer, something which would show that it would be a case of palpable injustice to the writ petitioner to force him to adopt the remedies provided by the statute. It was noted by this Court in L. Hirdaqy narain Vs. ITO, (1970) 2 SCC 355 : AIR 1971 SC 33 , that if the high Court had entertained a petition despite availability of alternate remedy and heard the parties on merits it would be ordinarily unjustifiable for the High Court to dismiss the same on the ground of non-exhaustion of statutory remedies, unless the high Court finds that actual disputes are involved and it would not be desirable to deal with them in a writ petition. " Once again it was held by the Apex Court in those cases where factual disputes are involved it would not be permissible to deal with them in a writ petition. In the present case also factual disputes are involved and therefore, it would not be permissible to deal with them in this present writ petition. The petitioner shall be free to take legal recourse by filing a Civil Suit or by approaching any other forum as permissible under the law. However, it is made clear that the order passed by Insurance Ombudsman Madhya Pradesh and chhattisgarh dated 17-5-07 shall not come in the way of the petitioner while agitating the matter either in Civil Suit or before any other forum. However, it is made clear that the order passed by Insurance Ombudsman Madhya Pradesh and chhattisgarh dated 17-5-07 shall not come in the way of the petitioner while agitating the matter either in Civil Suit or before any other forum. Finding given by the Insurance Ombudsman will not come in the way of the petitioner in case petitioner approaches any other forum for redressal of his grievance. The authority/court considering the grievance of the petitioner shall also not been influenced with the finding of the Insurance Ombudsman and will pass a proper order/judgment on the basis of appreciation of evidence adduced before the court/authority while dealing with the case of the petitioner. ( 9. ) WITH the aforesaid observation, present petition stands disposed of. No order as to cost.