United India Insurance Co. Ltd. , Represented By Its Authorized Signatory v. Annamma Ninan, W/o. Late Mathew Ninan
2025-07-08
M.A.ABDUL HAKHIM
body2025
DigiLaw.ai
JUDGMENT : (M.A. ABDUL HAKHIM, J.) 1. The Appellant is the 3 rd Opposite Party/Insurance Company in the Application before the Employees Compensation Commissioner. Respondents 1 and 2 are the Applicants who are the dependents of the deceased workman. The Respondents 3 and 4 are the 1 st and 2 nd Opposite Parties who are impleaded as the employer. 2. The Applicants sought compensation for the death of the workman on 27.11.2015 on account of a fall from the second floor of the new apartment project of the 1 st and 2 nd respondents. The Commissioner, as per the impugned order, found that the Applicants are entitled to a compensation of Rs.4,40,560/- with interest at the rate of 12% per annum from the date of accident till the date of payment/realization and Rs.10,000/- towards funeral expenses. 3. Even though the 3 rd Opposite Party contended that they have no liability to pay interest and penalty to the Applicant as per Ext.R1 Certificate of Insurance issued to the respondents 1 and 2, the Commissioner found that the 3 rd Opposite Party is liable to pay the compensation and the 3 rd opposite party was directed to pay the compensation, interest and funeral expenses. 4. This Court admitted this Appeal on the following substantial questions of law: i. Whether the Commissioner is justified in directing the 3 rd opposite party/Insurance Company to pay the compensation, when the policy does not cover the employees employed through sub contractor? ii. Whether the Commissioner is justified in directing the 3 rd opposite party/Insurance Company to pay the compensation without considering specific contention from the part of the 3 rd opposite party that the deceased was not an employee of the 1 st opposite party and the deceased was an employee of a contractor by name Gopalakrishnan? 5. I heard the learned counsel for the Appellant, Smt.Jayasree S., and the learned counsel for Respondents 1 and 2, Sri. Gigimon Issac and the learned counsel for the Respondents 3 and 4, Sri. Ashok Shenoy. 6. The learned counsel for the Appellant contended that in the Exclusion Clause in Ext.R1 Insurance Policy, the liability of the insured for the person employed in the business under a contractor or sub-contractor of the insured is specifically excluded.
Gigimon Issac and the learned counsel for the Respondents 3 and 4, Sri. Ashok Shenoy. 6. The learned counsel for the Appellant contended that in the Exclusion Clause in Ext.R1 Insurance Policy, the liability of the insured for the person employed in the business under a contractor or sub-contractor of the insured is specifically excluded. It is revealed from the evidence that the deceased was employed through a sub- contractor and hence the 3 rd Opposite Party is not liable to pay compensation for the death of the workman. The learned counsel further contended that in the Exclusion Clause in Ext.R1 Insurance Policy, interest or penalty imposed on the insured under any law is specifically excluded. Hence, the Appellant/3 rd Opposite Party is not liable to pay interest for the compensation awarded. The learned counsel relied on the decision of the Hon’ble Supreme Court in Kunnel Engineers and Contractors Private Limited v. New India Assurance Company Limited and Another [ (2023) 15 SCC 776 ] and the decision of this Court in National Insurance Co. Ltd. v. Usha [2023 KHC 9219] in support of her contentions. 7. On the other hand, the learned counsel for the Respondents contended that on account of the indemnification clause provided in Ext.R1 Policy, it is for the insurer to pay the compensation directly to the employee or to the dependents of the employee and it is not a question of payment by the employer and reimbursement. The learned counsel for respondents 3 and 4 invited my attention to Exts.R4 & R5 sent by the 1 st Opposite Party to the 3 rd Opposite Party promptly intimating the accident and submitting the relevant documents for processing the claim for compensation. The contention is that the Appellant/3 rd Opposite Party neither replied nor processed the claim and it is the 3 rd Opposite Party who committed the default which invited the interest on the compensation. The learned counsel for the respondents 3 & 4 relied on the decisions of the Hon’ble Supreme Court in Canara Bank v. United India Insurance Company Limited and Others [(2020) 3 SCC 455] and Municipal Committee Katra v. Ashwani Kumar [2024 KHC 8219] and the decision of this Court in Branch Manager, New India Assurance Co. Ltd. v. Kaleeswari and Another [ 2017(5) KHC 844 ] in support of his contentions. 8. I have considered the rival contentions. 9.
Ltd. v. Kaleeswari and Another [ 2017(5) KHC 844 ] in support of his contentions. 8. I have considered the rival contentions. 9. The first question to be considered is whether the worker under a sub-contractor is excluded from the Ext.R1 Policy. The Exclusion Clause in Ext.R1 policy excludes the liability of the insured for persons employed in the business under a contractor or sub-contractor of the insured unless specifically covered in the Schedule. The said clause makes it abundantly clear that if the persons employed in the business of the insured are covered in the Schedule, they are covered even if they are employed under a contractor or sub-contractor. In the Schedule of Ext.R1 Policy, skilled workers are included, declaring their wages. Admittedly, the deceased was an electrician and hence a skilled worker. Since the deceased was a skilled worker included in the Schedule, he is not excluded by the aforesaid Exclusion Clause in Ext.R1 Policy, even if he was employed through a contractor or sub-contractor. Hence, I find that the Appellant/ 3 rd Opposite Party is liable to pay compensation for the death of the workman. The substantial questions of law are answered in the affirmative and against the Appellant. 10. The next contention of the counsel for the Appellant is that the Appellant/3 rd Opposite Party is not liable to pay interest for the compensation awarded, as the same is specifically excluded in the Exclusion Clause in Ext.R1 Policy. 11. In Kunnel Engineers (supra) , the Hon’ble Supreme Court dealt with the exclusion clause in the Policy that “the Insurance granted hereunder is not extended to include any interest and/or penalty imposed on the insured on account his/their failure to comply with the requirements laid down under the WC Act, 1923….”. On facts, the Hon’ble Supreme Court found that the employer did not tender compensation to the employee even on provisional basis, and therefore, under the exception clause, the liability towards interest cannot be fastened on the Insurance Company.
On facts, the Hon’ble Supreme Court found that the employer did not tender compensation to the employee even on provisional basis, and therefore, under the exception clause, the liability towards interest cannot be fastened on the Insurance Company. It is further held that the liability of the Insurance Company does not fall under the Act and the same is governed only by the terms of contract; that when parties have agreed upon the terms of the insurance contract, the Court cannot interpret the clauses in the contract, by adverting to equity principles; and that it is because in commercial transactions, the question of lack of bargaining power does not arise. On these findings, the Hon’ble Supreme Court upheld the view taken by the High Court in declaring that the insurer is not liable to satisfy the interest component payable by the employer in terms of the award of the Commissioner. 12. In Usha (supra) , the learned Single Judge of this Court held that, the Insurance Company had specifically pleaded that they have no liability to pay the interest referring to the exclusion clause with regard to liability for interest; that admittedly the employer has not paid the compensation; that the reliance placed on the decision in Kaleeswari (supra) is of no avail; that as noticed supra, the Apex Court and this Court has consistently upheld the exclusion clause in the insurance policy, on interest and that therefore, the Insurance Company cannot be made liable for the interest awarded. 13. In Kaleeswari (supra) , the Division Bench of this Court dealt with an exclusion clause that "the Insurance Company is not liable to pay interest or penalty imposed on the insurer on account of his/ their failure to comply with the requirements under the Workmen's Compensation Act, 1923".
13. In Kaleeswari (supra) , the Division Bench of this Court dealt with an exclusion clause that "the Insurance Company is not liable to pay interest or penalty imposed on the insurer on account of his/ their failure to comply with the requirements under the Workmen's Compensation Act, 1923". It is held that the exclusion of interest is not an absolute one and it is a conditional exclusion only; that in order to invoke the exclusion clause, the Insurance Company ought to have stated in their Written Statement that the Applicant or the 1 st Opposite Party has failed to comply with the requirements laid down under the Act; that the Insurance Company should have specified the particulars of the requirement which the Applicant had failed to comply under the Act; that the Insurance Company should have proved the said contention also in evidence; that the Insurance Company has not disclosed the particulars of the requirement, which the applicant had failed to comply under the Act and the Insurance Company has no such case; that the Insurance Company has failed to prove the failure from the part of the Applicant or the 1 st opposite party to comply with the requirement under the Act and that in such circumstances, the Insurance Company cannot escape from the liability to pay interest for the compensation amount. 14. In view of the aforesaid clause in the Insurance Policy, if the Insurance Company proves the failure on the part of the employer to comply with the requirement under the Act, the Insurance Company can avoid payment of Interest. 15. Sub Clause (1) of Section 4A of the Employee’s Compensation Act, 1923 mandates that compensation under Section 4 shall be paid as soon as it falls due. Sub Clause (2) provides that in cases where the employer does not accept the liability for compensation to the extent claimed, he shall be bound to make provisional payment based on the extent of liability which he accepts.
Sub Clause (2) provides that in cases where the employer does not accept the liability for compensation to the extent claimed, he shall be bound to make provisional payment based on the extent of liability which he accepts. Sub Clause (3) provides that where any employer is in default in paying the compensation due under this Act within one month from the date it fell due, he is liable to pay interest @ 12% per annum or at such higher rate not exceeding the maximum of the lending rates of any scheduled bank as may be specified on the amount due; and if there is no justification for the delay, to pay a further sum not exceeding 50% of such amount by way of penalty. In view of the aforesaid exclusion clause of the Policy, if the employer violates this provision by defaulting payment of compensation or provisional compensation within one month, the Insurance Company is definitely entitled to avoid payment of interest and penalty. Going by the wording in the said clause, it is for the employer to pay the compensation within one month and thereafter get reimbursement of the same from the Insurance Company. 16. The aforesaid decisions are clearly distinguishable on the facts of the present case as interest/penalty exclusion clause is differently worded in the present case. The principal clause in Ext.R1 reads as follows: “NOW THIS POLICY WITNESSETH, subject to the terms exceptions and conditions contained herein or endorsed hereon, that if at any time during the Period of Insurance any Employee or Employees of the Insured shall sustain Injury by accident arising out of and in the course of his employment in the Business , for which the Insured is liable to pay compensation under any Law(s) specified in the Schedule , then the Company shall indemnify the Insured upto the Limit of Indemnity against all sums for which the Insured shall be so liable, including costs and expenses for defending any such claim incurred with the Company's consent.” 17. The interest exclusion clause reads as follows: “EXCLUSIONS This Policy shall not cover liability of the Insured ….. d) For interest and/or penalty imposed on the Insured under any law or otherwise. …..”. 18. It is useful to refer to Paragraph 22 of Canara Bank (supra) rendered by the Hon’ble Supreme Court. “22.
The interest exclusion clause reads as follows: “EXCLUSIONS This Policy shall not cover liability of the Insured ….. d) For interest and/or penalty imposed on the Insured under any law or otherwise. …..”. 18. It is useful to refer to Paragraph 22 of Canara Bank (supra) rendered by the Hon’ble Supreme Court. “22. The principles relating to interpretation of insurance policies are well settled and not in dispute. At the same time, the provisions of the policy must be read and interpreted in such a manner so as to give effect to the reasonable expectations of all the parties including the insured and the beneficiaries. It is also well settled that coverage provisions should be interpreted broadly and if there is any ambiguity, the same should be resolved in favour of the insured. On the other hand, the exclusion clauses must be read narrowly. The policy and its components must be read as a whole and given a meaning which furthers the expectations of the parties and also the business realities. According to us, the entire policy should be understood and examined in such a manner and when that is done, the interpretation becomes a commercially sensible interpretation.” 19. Bearing in mind the aforesaid legal proposition, let me examine the aforesaid clauses in Ext.R1 Policy. The aforesaid principal clause in Ext.R1 provides for payment of compensation by the Insurance Company directly to the workmen or dependents. In other words, as per Ext.R1 Policy, the Insurance Company has taken over the liability to pay the compensation payable by the employer under the Employee’s Compensation Act, 1923 . In such a case, there is no liability on the employer to make the payment as per Section 4A of the Employee’s Compensation Act, 1923 and hence there could not be any default from his part. The interest exclusion clause does not contain or deal with the failure of the employer to comply with the requirements under the Employee’s Compensation Act, 1923 . Hence, I am of the view that if there is a default in payment of compensation or provisional compensation as required under Section 4A , the interest or penalty has to be met by the Insurance Company alone and not the employer.
Hence, I am of the view that if there is a default in payment of compensation or provisional compensation as required under Section 4A , the interest or penalty has to be met by the Insurance Company alone and not the employer. In the case on hand, the 1 st Opposite Party duly intimated the accident and forwarded the relevant records as per Exts.R4 and R5 to the 3 rd Opposite Party/Insurance Company to process the claim. The 3 rd Opposite Party neither processed the claim nor responded to Exts.R4 and R5. The default is clearly on the part of the 3 rd Opposite Party. The interest or penalty could not be imposed on the employer who is the insured in the Ext.R1 Policy to attract the exclusion clause in Ext.R1. 20. In Municipal Committee Katra (supra) , the Hon’ble Supreme Court has held that it is beyond cavil of doubt that no one can be permitted to take undue and unfair advantage of his own wrong to gain favourable interpretation of law; that that he who prevents a thing from being done shall not avail himself of the non- performance he has occasioned and that to put it differently, 'a wrong doer ought not to be permitted to make profit out of his own wrong'. Since the default is on the part of the 3 rd Opposite Party, the 3 rd Opposite Party shall not be allowed to avoid payment of interest which was occasioned on account of its fault. 21. I am of the view that the Employees Compensation Commissioner correctly ordered the 3 rd Opposite Party to pay the interest. No substantial question of law arises in this regard. Accordingly, this Appeal is dismissed. 22. The learned counsel for the respondents 1 & 2 pointed out that the Bank has initiated coercive proceedings against his clients on account of the loan taken by them and they are in urgent need of money. In view of this submission, the Employees Compensation Commissioner is directed to disburse the deposited amount to the respondents 1 & 2 expeditiously, at any rate, within a period of two months from the date of receipt of a copy of this judgment.