Neutral Citation No. - 2025:AHC-LKO:12750 Court No. - 19 Case :- WRIT - C No. - 1001826 of 2015 Petitioner :- The Oriental Insurance Company Ltd. Thru Divisional Manager Respondent :- Smt. Somvati And 7 Others Counsel for Petitioner :- Waquar Hashim Counsel for Respondent :- C.S.C.,Naresh Singh Hon'ble Manish Mathur,J. 1. Heard Mr. Waquar Hashim, learned counsel for petitioner, learned State Counsel for opposite parties no.7 & 8 and Mr. Naresh Singh Chauhan, learned counsel for opposite parties no.1 to 6. 2. Petition has been filed challenging judgment and order dated 23.01.2015 passed by Permanent Lok Adalat, Lucknow in PLA Case No.97 of 2014, Smt. Somvati And 7 Others versus Oriental Insurance Company Ltd. & Ors. 3. It has been submitted that an agreement dated 19.11.2009 had been entered into between petitioner company and the State of U.P. to cover risk of accidental death of registered farmers owing agricultural land and being in the age group of 12 year's to 70 year's. The said policy was effected for one year from 19.11.2009. 4. It is submitted that in pursuance of the said agreement, the opposite parties filed their claim seeking compensation on account of death of the farmer, who is the predecessor-in-interest of the claimants/ opposite parties. 5. It is submitted that the said claim was rejected on the ground that since cause of death could not be ascertained, death would not be covered in terms of the agreement dated 19.11.2009. 6. The Permanent Lok Adalat framed five issues with issues no.1 & 2 pertaining to jurisdiction and issue no.3 pertaining to limitation. Issue no.4 pertained to validity of rejection of claim on the ground that cause of death as per postmortem report could not be ascertained. Issue no.5 pertained to relief which could be granted. 7. On the basis of instructions, learned counsel for petitioner does not press the findings recorded in impugned judgment pertaining to jurisdiction of Permanent Lok Adalat of the issue of delay and submits that the dispute in question has already been adjudicated upon by Coordinate Bench of this Court in the case of Oriental Insurance Company Ltd. Versus Abhishek Kumar & Ors.; Writ C No.1000840 of 2015 & other connected matters, which may be followed in the present case. 8. Learned counsel for opposite parties also on the basis of instructions admits that the present petition is squarely covered by the aforesaid judgment and order dated 29.07.2022 in the case of Abhishek Kumar (supra). 9. A perusal of the impugned judgment has referred to Clauses 4, 17 and 24 of the Agreement dated 19.11.2009 alongwith that to indicate that in case of any deficiency of documents, it was open to the Insurance Company to have ascertained the claim on its own and since it was not done, burden of Insurance Company has not been discharged. It also indicates refers to Clause 17 to record a finding that the claim was not excluded in terms thereof. 10. A Coordinate Bench of this Court in the case of Abhishek Kumar (supra) has already considered the said aspect in the following manner: "4. It is further submitted that the petitioner-Insurance Company had acted on the basis of Clause 4 of the Agreement which is quoted hereunder for ready reference:- "Scope of Cover:- Oriental Insurance Company Limited hereby agrees, subject to the terms, conditions and exclusions contained or otherwise expressed in the policy document, to pay to the insured a sum not exceeding the sum insured during the tenure of the policy, if any of the insured Person dies due to or suffers disability as mentioned in the benefit table due to sustaining any bodily injury resulting from accident, caused by external, violent and visible means, to the extent and in the manner hereinafter provided. The accident will included death due to snake bite, drowning in River, Tank, Pond or well, collapse of roof or falling of tree, falling from roof or tree, vehicle (including tractor/trolley and tempo) accident, dacoity, riot, scuffle. Enmity, violence, terrorist activities, fire, flood, lightning thunder & electric shock etc. Necessary documents will be required to establish the cause of death. The following documents will be required to be produced to Oriental Insurance Company Limited for claim processing. (1) Fully complete claim Form (2) Computerized Khatauni (3) Age proof in following order of priority- (a) Matriculation Certificate/High School Certificate (b)Parivar Register (c) Ration Card (d) Voter ID card/Voter List (e) Any other age proof (4) Post Mortem Report (5) Copy of FIR/GD (in case of death due to snake bite) (6) Death Certificate (7) Police panchnama (8) CMO Certificate in cases of disability Postmortem report will not be insisted upon where body is irrecoverable, say due to flood or body is in such a shape after accident the post mortem is not possible. Also in case of drowning and snakebite, FSL/CA report will not be insisted upon to establish the cause of death. Disablement, to the extent mentioned in the benefit table, caused due to an accident defined above, shall be covered. The Policy covers accidental death and disability/arising out of an accident only as elaborated in the policy document." 11. After hearing learned counsel for the respective parties and going through the record, the position which emerges out is that the Agreement has been entered into between the State of UP and the petitioner-Insurance Company on 19.11.2009 with an object to insure the farmers of Uttar Pradesh for Rs. 1 lakh aged between 12 to 70 years whose names were in the revenue records of the State of Uttar Pradesh as the owner of the agricultural land under the Janta Personal Accident Policy. 12. Undisputedly, Clause 4 of the Agreement deals with scope of cover and it has been provided therein that the documents mentioned in the said clause are required to be produced to the petitioner-Insurance Company for claim processing including the computerized khatauni. Clause 4 is to be read in totality with other clauses of the Agreement like Clause 2 of the Agreement which talks about the farmers whose names were in the Khatauni records of the State of Uttar Pradesh as the owner of the agricultural land shall be covered by the agreement. For convenience, the Clause 2 of the Agreement is quoted hereunder:- "This is an unnamed policy and all farmers in the age group of 12 to 70 years, both inclusive, whose names appear in the Khatauni records of the state of Uttar Pradesh as the owner of agricultural land in the State of Uttar Pradesh shall be covered under this policy, without any selection, If a farmer attains 12 years of age on any date during the currency of policy period, he/she will be deemed to be covered from such date. But if a farmer crosses 70 years of age during the tenure of this policy, he/she will also remain covered till the end of the policy period." 13. Similarly, Clause 17 of the Agreement deals with exclusion, where the petitioner-Insurance Company shall not be liable under this policy. The Clause 17 is reproduced hereunder for ready reference:- "17. Exclusions: Oriental Insurance Company Limited shall not be liable under this Policy for:- (i) Compensation under more than one of the categories specified in the Basis of Assessment of the JPA Policy document in respect of the same period of disablement of the Insured Person under this Policy. (ii) Any other payment to the same person under this policy after a claim under one of the categories I & II as specified in the Basis of Assessment of the JPA policy document of claims he has been admitted and become payable. However, this exclusion shall apply only to this policy and shall in no way affect benefits derived by the Insured Person or his/her legal heir(s) under any other Insurance Policy or Scheme. (iii) Any payment in case if more than one claim in respect of such Insured person, under this policy during any one period of insurance by which the sum payable as per the Basis of Assessment of Claims of this Policy to such insured person exceeds the maximum liability of Oriental Insurance Company Limited as applicable to such insured person. (iv) Payment of compensation in respect of death, injury or disablement of insured person. (a) From intentional self-injury, suicide or attempted suicide. (b) Whilst under the influence of intoxication of liquor or psychotropic drugs. (c) Whilst engaging in aviation or ballooning or whilst mounting into, or dismounting form or traveling in any balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world. Standard type of aircraft means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft is privately owned or chartered or operated by a regular airline or whether such a aircraft has a single engine or multi engine. (v) Payment of compensation in respect of death, injury of disablement of the Insured Person due to, or arising but of, or directly or indirectly connected with or traceable to war, invasion, act of foreign enemy, hostilities (where war be declared or not) civil war, rebellion, revolution, insurrection, mutiny military or usurped power, seizure, capture arrests, restrains and detainment of all kinds. Payment of compensation in respect of death or bodily injury on any disease or illness to the Insured Persons:- (a) Directly or indirectly caused by or contributed to by or arising from ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste or from the combustion of nuclear fuel. For the purpose of this exception, combustion shall include any self sustaining process of nuclear fission. (b) Directly or indirectly caused by or contributed to by or arising from nuclear weapon materials. (vi) Death or disablement directly or indirectly caused by an/or contributed to and/or aggravated or prolonged by child birth or pregnancy or in consequence thereof. (vii) Payment of compensation in respect of injury or disablement directly or indirectly arising out of or contributed by or traceable to any disability existing on the date of issue of this policy." 14. Clause 24 of the Agreement provides that, the claim shall not be rejected or repudiated on mere technicalities. The said clause 24 of the agreement is quoted hereunder:- "This Agreement shall be implemented by following a procedure so that the claims are accepted as a rule and are rejected as an exception, in case the farmer dies of accidental death and when this fact comes in the knowledge of Oriental Insurance Company Limited as per this Agreement, and if there is nay shortcoming or deficiency in the documents filed, the Oriental Insurance Company Limited would itself make an inspection for confirming the cause of death and shall make the payment accordingly. The claims shall not be rejected or repudiated on mere technicalities." 11. A perusal of the aforesaid judgment and order dated 29.07.2022 passed by Coordinate Bench of this Court in the case that the dispute raised therein also pertained to rejection of claim of the claimants therein on the ground of their not furnishing a computerized khatauni as required under Clause 4 of the agreement. The judgment thereafter adverts to Clause 4 of the said agreement as well as exclusions indicated under Clauses 17 & 24 of the agreement and records a finding that in terms of Clause 24 of the agreement, the agreement is required to be implemented so that the claims are accepted as a rule and are rejected as an exception in case the farmer dies of accidental death and if there is any short coming or deficiency in the documents filed, the Insurance Company itself would make an inspection for conforming the cause of death and shall make the payment accordingly. It is also indicated that the claims shall not be rejected or repudiated on mere technicalities. 12. A perusal of Clauses 4, 17 and 24 of the agreement clearly indicate the fact that even in case cause of death could not be ascertained, it would not come within exception clause so as to deprive the claimants to which they are entitled as per agreement. 13. After recorded a finding with regard to the aforesaid clauses, the compensation awarded has thereafter been reduced on the following proposition: "18. In view of the discussions made above, it is found that there is no illegality and perversity in the impugned judgments passed by the Permanent Lok Adalat as far as accepting the insurance claims of the private respondents and hence, no interference is called for in the judgments impugned. 19. From the above discussion made hereinabove, the position with regard to the applicability of Clause 22(b) of the Agreement which emerges out is that as per Clause 4 of the agreement, the computerized khatauni was required for the purpose of the claim and hence it cannot be said that rejection of claim on the said ground is wholly illegal. As the judgments relied by the learned counsel for the petitioner with regard to the quantifying the penalty by this Court in Writ Petition Nos.20736 of (M/S) 2018 and 5324 of (M/S) 2015, this Court has held that the penalty imposed as per Clause 22(b) of the Agreement is exorbitant and quantified the amount of penalty as Rs.50,000/- and 75,000/- respectively. 20. This Court having regard to the facts and circumstances of the case as well as the resultant delay would quantify the amount of penalty at Rs. 75,000/- and to this extent, the impugned judgments are modified. The amount of Rs.1 Lakh along with interest @9% per annum from the date of the order of the Permanent Lok Adalat as well as the amount of penalty of Rs.75,000/- to be deposited before the Permanent Lok Adalat within a period of six weeks and shall be released in favour of the opposite parties forthwith after due verification of their identities. If any amount was deposited earlier that shall be adjusted against the total amount to be paid by the petitioner- Insurance company in pursuance of the order passed today." 14. This Court does not find any occasion to take a view divergent from that already recorded in the case of Abhishek Kumar (supra). 15. Considering aforesaid discussion, the impugned judgment and order is modified in terms of paragraph 20 of the judgment and order dated 29.07.2022 passed in the case of Abhishek Kumar (supra). 16. Opposite parties are directed to ensure payment to claimants within a period of four weeks from the date a certified copy of this order is served upon concerned authority. 17. The petition is therefore disposed of in the manner indicated hereinabove. Order Date :- 3.3.2025 Subodh/- Digitally signed by :- SUBODH KUMAR SINGH High Court of Judicature at Allahabad, Lucknow Bench Digitally signed by :- SUBODH KUMAR SINGH High Court of Judicature at Allahabad, Lucknow Bench