Research › Search › Judgment

Kerala High Court · body

2016 DIGILAW 1033 (KER)

Life Insurance Corporation of India v. Amballoor Janatha Service Co-Operative Bank Ltd.

2016-11-25

ANTONY DOMINIC, SHIRCY V.

body2016
JUDGMENT : Shircy V., J. Over a span of time, the services rendered by the Life Insurance Corporation of India (hereinafter referred to as `the LIC') have improved and it attracts the public, with new policies and schemes. One such scheme introduced is `Employees Group Gratuity Life Assurance Scheme'. By this scheme the LIC offered to take over the statutory liability of the employer to pay gratuity to its employees. The 1st respondent Amballoor Janatha Service Co-Operative Bank Ltd. (hereinafter referred to as 'the Society') has accepted the offer floated by the LIC. But when an employee of the Society expired before completing his entire period of service, the liability of the employer Society for payment of gratuity to the heirs of the deceased have not been disbursed by the LIC as per the scheme and hence the Society filed W.P.(C)No. 25930 of 2010 before this Court. The learned single Judge by the judgment dated 05.11.2014 allowed the writ petition. Challenging the Judgment, this appeal has been preferred. 2. The brief facts are as follows: The LIC had offered the Employee's Group Gratuity Life Assurance Scheme for taking over the liability of various institutions under the Payment of Gratuity Act. Ext P1 is the brochure of the scheme. The Society subscribed the scheme on 28.02.1986 and it was accepted by LIC by Ext.P3. One C.B. Gopalakrishnan, an employee expired on 03.05.2009 before completing his entire period of service. The respondents 2 and 3 are the legal heirs of the deceased employee. Though, the Society paid the actual gratuity amount due to the deceased to his legal heirs and approached the LIC for reimbursement, the claim was rejected. The Society has claimed the balance amount with interest out of the total amount of Rs.3,50,000/- as per the ceiling limit of the scheme. But it was denied. Hence, the writ petition. 3. The LIC admitted that the Society had subscribed the Employee Group life Assurance Scheme on 28.02.1986, but contended that under this scheme the gratuity amount is settled according to the salary of the employees as on previous renewal date and not the salary on the date of exit subject to a maximum ceiling limit. Out of the two schemes one is with a ceiling of Rs.3,50,000/- and the other without a ceiling limit. The Society joined the scheme with ceiling limit on 28.02.1986. Out of the two schemes one is with a ceiling of Rs.3,50,000/- and the other without a ceiling limit. The Society joined the scheme with ceiling limit on 28.02.1986. As per the Scheme, the gratuity will be paid on retirement of an employee at the rate of 15 days salary for each year of service subject to a maximum of 20 months. An endorsement was issued to the policy in November 2009 placing the ceiling limit of Rs.3,50,000/-. The death of Sri. C.B. Gopalakrishnan, the employee of the Society was communicated on 25.06.2009 and as per the Scheme availed by the Society, his legal heirs are entitled to get only an amount of Rs.92,281 the premium paid and interest and the insurance coverage of Rs.1,75,000/- as per the existing norms at the time of his death. 4. We heard the learned counsel for the appellant, learned Senior Counsel for the first respondent and the learned counsel for respondents 2 and 3. 5. Ext.P1 is the brochure of LIC. By 'Group Gratuity Scheme' LIC made an attractive offer to take over the heavy burden of the employer in funding the required gratuity liability to its employees. Acting upon Ext.P2 Circular issued by the Registrar of the Society, advising societies to subscribe to the scheme, the society subscribed to the scheme for the welfare of its employees. Ext.P3 is the letter of acceptance issued by the LIC dated 01.02.1986. The relevant portion of Ext.P3 communication of the LIC reads as follows: "In the event of death of an employee while in service, a sum equal to the gratuity the deceased employee would have earned, had he completed his entire period of service, would be settled by us as gratuity. This you would agree, is a great employee welfare measure which will induce a sense of security in the minds of the employees thus boosting their morale. In the event of retirement from service on completion of the full term, the gratuity due to the employee would be paid in full. In the event of an employee leaving service before completing the normal span, such exit being beyond our control, we refund the premiums received in his behalf along with interest." 6. The conditions of the master policy attached to the policy is Ext P4. In the event of an employee leaving service before completing the normal span, such exit being beyond our control, we refund the premiums received in his behalf along with interest." 6. The conditions of the master policy attached to the policy is Ext P4. The sum assured by the policy reads as under: ''The Sum Assured under the Pure Endowment Assurance shall be an amount equal to 15 days salary of the member as on the Entry Date or the Annual Renewal Date, as the case may be for each year of service upto the Normal Retirement Date subject to the maximum of 20 months salary''. Variations in Benefits offered are stated in the policy thus: "Variations in the total benefits assured here under as on the Annual Renewal Dates shall be given effect to by endorsements over the signature of a duly authorized officer of the Corporation. The Grantees shall at the request of the Corporation produce this Policy to the Corporation whenever required for the purpose of stamping or reference." 7. Part III of the conditions of the Master Policy deals with the benefits offered to its beneficiaries as: "Part III - Benefits The benefits shall be payable to the Grantees for the benefit of the Member or the Beneficiary of the member as the case may be in accordance with the Rules of the Scheme. Upon survival of the Member to the Normal Retirement date, the Sum assured under Pure Endowment relating to him shall become payable. In the event of death of the Member before Normal Retirement Date whilst in the service of the Company, there shall become payable an amount, which shall be the total of (i) The sum assured under Term Insurance, if any, in force on the date of death of the Member and (ii) total amount of premiums paid under the Pure Endowment effected in respect of him. On cessation of service of any Member covered under this policy, the assurances granted under this Policy in respect of that Member shall terminate and the premiums in respect of that Member shall cease and the Grantees shall be paid the Cash Surrender Value for the Pure Endowment Assurance relating to the Member. No surrender value shall be payable in respect of the Term Assurance benefits. No surrender value shall be payable in respect of the Term Assurance benefits. If the Grantees discontinue payment of premiums here under for any reason whatsoever within 3 years from the Effective Date, the surrender value in respect of the Assurances effected under this Policy shall be reduced by 1% of the Sum assured under the Pure Endowment Assurance. No surrender value is payable under the Renewable Term Assurance. The liability of the Corporation in respect of the Assurance granted here under shall be restricted to the exact amount of Assurances specified in Clause (iii) of the preamble. However the liability for past Service Gratuity shall be met in full only when all the remaining installments of single premium thereof are paid in full. In the event of a Member leaving the services of the Employer before the Normal Retirement date, the withdrawal benefit will be limited to the Surrender value outlined in para 7 of Part II, Section 1 of the Master Policy. (1) The Grantee is requested to examine the policy and satisfy himself that the various provisions contained therein conform to this requirements and if any amendment or modification is found necessary, the Corporation may please be addressed in the matter immediately. He is further requested to check whether the particulars of the various Assurances effected therein are in order. In the event of any error or discrepancy being found, the Grantee is requested to communicate the same to the Corporation for rectification. (2) xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx." Thereafter an endorsement was effected to the policy on 28.11.2009 which reads as follows: "ENDORSEMENT GGPE MP No. 45836 Notwithstanding anything contained in Rules of the scheme and Master Policy to the contrary, the corporation's liability is limited to: The benefits assured under the term assurance effected are subject to a ceiling of Rs.1,75,000/- per member subject to the terms and conditions applicable to them And Benefits payable as per Gratuity Act 1972 for the past service benefits @ 15 days wages for every year of completed service with a ceiling of Rs.3,50,000/- as premiums are calculated on this basis only. And "Normal Retirement Date" shall mean in respect of each member the date on which he/she completes the age of 58 years. The premiums are calculated and benefits are paid taking this age into account. This should be pasted and kept as part of the Master policy document." 8. Sri. And "Normal Retirement Date" shall mean in respect of each member the date on which he/she completes the age of 58 years. The premiums are calculated and benefits are paid taking this age into account. This should be pasted and kept as part of the Master policy document." 8. Sri. C.B Gopalakrishan, the employee had expired before the date of endorsement. He died while he was in service. As per the terms of the policy his heirs are entitled to a sum equal to the gratuity that the deceased employee would have earned, had he completed his entire period of service and hence the LIC is not justified in denying the payment of Rs.3,50,000/- as contemplated under the scheme is the claim of the Society. The definite contention of the LIC is that as the employee expired before the endorsement, as far as his legal heirs are concerned, they are not entitled for the benefit made applicable by the endorsement. The learned counsel for LIC has argued that the word 'And' used in the endorsement has to be read as 'Or' and if that be so the payment of Rs.1,75,000/- towards life cover and Rs. 92,281/- towards premium, paid by the LIC is absolutely correct. 9. It is held in Fakir Mohd. Vs. Sitha Ram, 2002 (1) SC 741 that "The word "or" is normally disjunctive and the word "and" is normally conjunctive. But at times they are read as vice-versa to give effect to the manifest intent of the legislature as disclosed from the context. It is permissible to read "or" as "and" and vice-versa if some other part of the same statute, or the legislative intent clearly spelled out, require that to be done." Applying the principle laid down in the above decision the intention of the parties to agreement has to be gathered by taking into consideration the totality of the facts and circumstances involved. It is pertinent to note that this endorsement was forwarded with a covering letter which reads as: "We enclose herewith an endorsement under the above policy. The above endorsement forms part of the policy document, and you are requested to keep it attached to the policy. If any change is required with regard to the above conditions, please bring the same to our notice immediately. The above endorsement forms part of the policy document, and you are requested to keep it attached to the policy. If any change is required with regard to the above conditions, please bring the same to our notice immediately. If we do not receive any communication from you within 30 days, the above conditions shall be deemed to have been accepted''. It is specifically mentioned in this document that this endorsement shall be kept as part of the master policy document. So, this endorsement forms part of the master policy availed of by the Society. Having considered the submissions made, we find it difficult to agree with the interpretation attempted by the learned counsel for the LIC construing the word' And' as 'Or'. According to us, intention of the parties to the agreement is clear and specific and there appears to have no ambiguity so as to interpret 'And' as 'Or' to absolve the LIC from discharging its obligation to the Society. Therefore, we are clearly of the opinion that the word 'And' could be treated only as conjunctive and not as 'Or' which is disjunctive. 10. By Ext.P6, the Society has requested to make arrangements to sanction the amount on the death of Sri. C.B. Gopalakrishnan. The LIC has paid an amount of Rs.1,75,000/- towards life cover and Rs.91,281/- towards refund of premium. The demand for the balance amount of Rs.82,719/- by the Society limiting the claim as Rs.3,50,000/- was denied by the LIC as per Ext.P9. 11. At this juncture it is to be remembered that the scheme indicates that it is welfare measure adopted to induce a sense of security in the minds of employees thus boosting their morale. By accepting the scheme, the Society had transferred its liability to pay gratuity to its employees to the LIC and the LIC had taken over the liability of the Society. From Clause 11 of General Conditions of the Policy, obviously, it is discernible that the variations in total benefits assured shall be given by 'endorsement' of a duly authorized officer. The covering letter of LIC dated 28.11.2009 issued to the Society envisages that the endorsement annexed thereto shall form part of the policy document and it has been requested to keep it attached to the policy. 12. The covering letter of LIC dated 28.11.2009 issued to the Society envisages that the endorsement annexed thereto shall form part of the policy document and it has been requested to keep it attached to the policy. 12. The LIC has deviated from its terms and conditions and has taken a stand that the legal heirs of an employee, who expired on 03.05.2009, are not entitled to get the benefit as the endorsement altering the terms of the policy had taken effect only from 28.11.2009. But it is significant to note that no such contention had been raised by the LIC in the counter affidavit filed in the writ petition. But on the other hand it is specifically contended as follows: "There are two such schemes with a ceiling of Rs. 3,50,000/- (three lakhs fifty thousand rupees) and the other one without ceiling. The petitioner has joined the one with such ceiling with date of commencement 28.02.1986. As per the Scheme gratuity would be paid on the retirement of an employee at the rate of 15 (fifteen) days salary for each year of service, subject to a maximum of 20 months. An endorsement was issued to the policy in November, 2009 placing a ceiling limit of 3,50,000/- (three lakhs fifty thousand rupees) on the gratuity payable as per the Act. The premium is fixed taking into consideration the above aspects." 13. The learned counsel for the LIC strenuously argued that the endorsement to the effect that the ceiling limit is up to Rs.3,50,000/- is an amendment brought to the earlier benefit assured to the policy holders and here as the death of the employee was before the endorsement his legal heirs cannot claim an amount with a ceiling limit of Rs.3,50,000/-. Of-course, normally an amendment will take effect only from the date of the amendment. But, here the endorsement was issued with the specific term that the endorsement should be pasted and kept as part of the Master Policy document. No where it is mentioned that the benefit as per the endorsement dated 28.11.2009 will take effect only from the date of the endorsement. Incorporation of such a clause is to give effect to the intention of the parties, and it clearly indicates that the intention is to make the endorsement as part of the policy document itself. No where it is mentioned that the benefit as per the endorsement dated 28.11.2009 will take effect only from the date of the endorsement. Incorporation of such a clause is to give effect to the intention of the parties, and it clearly indicates that the intention is to make the endorsement as part of the policy document itself. As mentioned above no definite contention had been raised in the counter affidavit filed by the LIC that the endorsement will take effect only from the date of its incorporation to the policy conditions. The learned Single Judge while allowing the Writ Petition has held as : "The assurance of the respondent corporation through Ext.P3 communication, the Master Policy document and the subsequent endorsement have, therefore, to be read together to gather the intention of the parties. When so read, it is apparent that the endorsement was necessitated only to correct an obvious mistake in the policy document to the extent it went against the assurance contained in Ext.P3 communication. The mere fact that the endorsement was dated subsequent to the date of death of the employee, in the instant case, cannot absolve the respondent corporation from discharging its obligations to the petitioner society in terms of the understanding between them. In the instant case, while under cover of Ext.P7, the respondent Corporation paid amounts of Rs.1,75,000/- towards life cover and Rs.91,281/- towards refund of premium in respect of the deceased employee, the said payment appears to have been made in line with the Scheme that was contemplated for employees leaving service before completing their normal span. No doubt, similar conditions were made even in respect of the employees dying before the normal retirement date in Ext.P4 policy but that condition, as already noted above, stood modified by the endorsement noted above. In that view of the matter, I feel that the respondent Corporation may not be justified in denying the payments that were assured, subject to a maximum of Rs.3,50,000/- as contemplated under the payment of Gratuity Act, to the petitioner Society in respect of the deceased employee.'' 14. On a meticulous examination of the records, we find absolutely no justifiable reason to deviate from the said finding and to conclude that the endorsement dated 28.11.2009 is an amendment which would take effect only from the said date. 15. On a meticulous examination of the records, we find absolutely no justifiable reason to deviate from the said finding and to conclude that the endorsement dated 28.11.2009 is an amendment which would take effect only from the said date. 15. It is abundantly clear that the endorsement was effected for the benefit of employees to enable them to get benefits better than what they would have got as gratuity, if paid by the Society directly. Such a benefit cannot be defeated or denied by accepting the contention raised by the learned counsel for the LIC especially when there is no definite and specific contention in the counter affidavit filed in the Writ Petition that the endorsement will take effect only from 28.11.2009. It could be gathered from the records that the scheme itself was introduced as a welfare scheme to provide assistance to the employees. So to achieve the object of the scheme, we think that courts must be vigilant to see that the benefits conferred by welfare scheme shall not be defeated on technicalities. In this context it is also relevant to note that in Mathai Mathew Vs. Thampi, 1989 KHC 37 it is held by this Court that if two interpretations are possible effect should be given to that which favors the citizen and not which imposed a greater burden on him. 16. The learned counsel for LIC would also argue that writ is not the remedy for enforcing contractual obligations and it has to be agitated before the civil court. He relies on the decision reported in Bareilly Development Authority Vs. Ajay Pal Singh, AIR 1989 SC 1076 which reads as follows: "There is a line of decisions where the contract entered into between the State and the persons aggrieved is non-statutory and purely contractual and the rights are governed only by the terms of the contract, no writ or order can be issued under Article 226 of the Constitution of India so as to compel the authorities to remedy a breach of contract pure and simple." 17. Learned counsel also relied on the decisions reported in State of Bihar Vs. Jain Plastics and Chemicals Ltd., 2001 AIR SCW 4858, State of U.P. Vs. Bridge & Roof Co. (India) Ltd., AIR 1996 SC 3515 , Kerala State Electricity Board Vs. Learned counsel also relied on the decisions reported in State of Bihar Vs. Jain Plastics and Chemicals Ltd., 2001 AIR SCW 4858, State of U.P. Vs. Bridge & Roof Co. (India) Ltd., AIR 1996 SC 3515 , Kerala State Electricity Board Vs. Kurien E. Kalathil, AIR 2000 SC 2573 in support of his argument that the writ petition under Article 226 of the Constitution is not the remedy for enforcing contractual obligations and it has to be agitated before the civil court. But it is not possible to infer that there is a dispute between the parties so as to be agitated before the civil court as contended by the learned counsel for the LIC. Here the terms and conditions offered by the LIC were accepted by the Society and the omission or the mistake crept in had been rectified or modified or supplied by the further endorsement on 28.11.2009 with a specific clause to treat the same as the part of the policy from which it is clear that the terms and conditions in the policy would take effect from the date of acceptance of the scheme by the Society i.e. on 28.02.1986. Hence the decisions canvassed by the learned counsel for the LIC are not applicable to the facts of this case. 18. The brochure which has been marked as Ext.P1 itself would show that the LIC has introduced the scheme to help the employer by reducing its liability to pay the benefits to its employees. The argument of the learned counsel for LIC that its role is only as of a 'facilitator' cannot be accepted as the terms of the Master policy indicates that the aim of the LIC was to reduce the burden of the employer by introducing the new scheme and it was covering a risk by taking over the burden of discharging the statutory liability. LIC was not merely aiding or helping the society, but was taking over the burden of the employer completely. The scheme is framed as a welfare measure. The entire gratuity liability of the Society was transferred to the LIC under the scheme. In this backdrop LIC cannot be termed as a facilitator as claimed. Hence, it is absolutely not justifiable to direct the beneficiaries, who are the legal heirs of the deceased herein, to approach the civil court to redress their grievance. 19. The entire gratuity liability of the Society was transferred to the LIC under the scheme. In this backdrop LIC cannot be termed as a facilitator as claimed. Hence, it is absolutely not justifiable to direct the beneficiaries, who are the legal heirs of the deceased herein, to approach the civil court to redress their grievance. 19. In view of the aforesaid discussions, we find absolutely no justifiable or reasonable ground to interfere with the findings of the learned single Judge that the LIC is bound to pay Rs.3,50,000/- by effecting payment of the differential amount of Rs.82,719/- together with interest at the rate of 9% per annum from 07.07.2000 till the date of payment to the Society. The appeal fails. Dismissed. In Retnavalli Vs. Ambalapadu Service Co-operative Bank Ltd., 2005 (3) KLT 320 , this Court held that: "The Society with the help of the L.I.C. created a Trust Fund into which the Society pays the amount payable as gratuity to each employees as per the bye-laws of the Society in the form of the premium payable in respect of the policy. L.I.C. administers the Trust Fund for the benefit of the employees and as and when a beneficiary-employee dies or retires from service, amounts are paid out of the Trust Fund in accordance with the terms and conditions of the policy which includes the rules of the Scheme annexed to the Trust Deed, which payment absolves the Society from its liability to pay gratuity under the Payment of Gratuity Act and the bye-laws to its employees." p. 26 Part III - Benefits The benefits shall be payable to the Grantees for the benefit of the Member or the Beneficiary of the member as the case may be in accordance with the Rules of the Scheme. Upon survival of the Member to the Normal Retirement date, the Sum assured under Pure Endowment relating to him shall become payable. In the event of death of the Member before Normal Retirement Date whilst in the service of the Company, there shall become payable an amount, which shall be the total of (i) The sum assured under Term Insurance, if any, in force on the date of death of the Member and (ii) total amount of premiums paid under the Pure Endowment effected in respect of him. On occasion of service of any Member covered under this policy, the assurances granted under this Policy in respect of that Member shall terminate and the premiums in respect of that Member shall cease and the Grantees shall be paid the Cash Surrender Value for the Pure Endowment Assurance relating to the Member. No surrender value shall be payable in respect of the Term Assurance benefits. If the Grantees discontinue payment of premiums hereunder for any reason whatsoever within 3 years from the Effective Date, the surrender value in respect of the Assurances effected under this Policy shall be reduced by 1% of the Sum assured under the Pure Endowment Assurance. No surrender value is payable under the Renewable Term Assurance. The liability of the Corporation in respect of the Assurance granted hereunder shall be restricted to the exact amount of Assurances specified in Clause (iii) of the preamble. However the liability for past Service Gratuity shall be met in full only when all the remaining instalments of single premium thereof are paid in full. In the event of a Member leaving the services of the Employer before the Normal Retirement date, the withdrawal benefit will be limited to the Surrender value outlined in para 7 of Part II, Section 1 of the Master Policy. (1) The Grantee is requested to examine the policy and satisfy himself that the various provisions contained therein conform to this requirements and if any amendment or modification is found necessary, the Corporation may please be addressed in the matter immediately. He is further requested to check whether the particulars of the various Assurances effected therein are in order. In the event of any error or discrepancy being found, the Grantee is requested to communicate the same to the Corporation for rectification. (2) Until the medical reports, if any, called for are received and accepted by the Corporation, the liability on their lives will be limited to the extent of Free Cover Limit only. p. 23 Variations in the total benefits assured hereunder as on the Annual Renewal Dates shall be given effect to by endorsements over the signature of a duly authorized officer of the Corporation. The Grantees shall at the request of the Corporation produce this Policy to the Corporation whenever required for the purpose of stamping or reference. p. 18. p. 23 Variations in the total benefits assured hereunder as on the Annual Renewal Dates shall be given effect to by endorsements over the signature of a duly authorized officer of the Corporation. The Grantees shall at the request of the Corporation produce this Policy to the Corporation whenever required for the purpose of stamping or reference. p. 18. Sum Assured: The Sum Assured under the Pure Endowment Assurance shall be an amount equal to 15 days salary of the member as on the Entry Date or the Annual Renewal Date, as the case may be for each year of service upto the Normal Retirement Date subject to the maximum of 20 months salary. p. 12. Under the LIC Scheme, the gratuity payable under the Group Gratuity Scheme in the event of death of an employee before retirement is more liberal than the benefits provided by the Act. Full gratuity as though the employee has served till retirement age is provided. Judgment portion.... The assurance of the respondent corporation through Ext.P3 communication, the Master Policy document and the subsequent endorsement have, therefore, to be read together to gather the intention of the parties. When so read, it is apparent that the endorsement was necessitated only to correct an obvious mistake in the policy document to the extent it went against the assurance contained in Ext.P3 communication. The mere fact that the endorsement was dated subsequent to the date of death of the employee, in the instant case, cannot absolve the respondent corporation from discharging its obligations to the petitioner society in terms of the understanding between them. In the instant case, while under cover of Ext.P7, the respondent Corporation paid amounts of Rs.1,75,000/- towards life cover and Rs.91,281/- towards refund of premium in respect of the deceased employee, the said payment appears to have been made in line with the Scheme that was contemplated for employees leaving service before completing their normal span. No doubt, similar conditions were made even in respect of the employees dying before the normal retirement date in Ext.P4 policy but that condition, as already noted above, stood modified by the endorsement noted above. No doubt, similar conditions were made even in respect of the employees dying before the normal retirement date in Ext.P4 policy but that condition, as already noted above, stood modified by the endorsement noted above. In that view of the matter, I feel that the respondent Corporation may not be justified in denying the payments that were assured, subject to a maximum of Rs.3,50,000/- as contemplated under the payment of Gratuity Act, to the petitioner Society in respect of the deceased employee. WHARTON LAW LEXICON And, or, it is well settled that "and" is capable of being read as "or", if the context demands it to be so read. The word "or" is normally disjunctive and the word "and" is normally conjunctive. But at times they are read as vice-versa to give effect to the manifest intent of the legislature as disclosed from the context. It is permissible to read "or" as "and" and vice-versa if some other part of the same statute, or the legislative intent clearly spelled out, require that to be done. Fakir Mohd. Vs. Sita Ram, (2002) 1 SCC 741 ."