LIFE INSURANCE CORPORATION OF INDIA AND ANR. - Opp.Party(s)
AMIT SHARMA
02 Feb 2010
ORDER
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSIONNEW DELHIREVISION PETITION NO. 1068 OF 2006
(Against the Order dated 02/07/2006 in Appeal No. 1158/2005 of the State Commission Punjab)
1. LACHMAN RAMRESIDENT OF VILLAGE & POST OFFICE RATHRIAN VIA TAPPA KHERA TEH MALOUT DISTT. MUKTSAR
...........Petitioner(s)
Versus
1. LIFE INSURANCE CORPORATION OF INDIA AND ANR.NEAR CHOWK G.T.ROAD MALOUT DISTT. MUKTSAR
...........Respondent(s)
BEFORE:
HON'BLE MR. JUSTICE B.N.P. SINGH ,PRESIDING MEMBERHON'BLE MR. S.K. NAIK ,MEMBER
For the Petitioner :
NEMO
For the Respondent :
NEMO
Dated : 02 Feb 2010
ORDER
Factual matrix are that petitioner who took life insurance policy for a sum of Rs. 1,25,000/-, known as Endowment Assurance Policy with profit plus accident benefit, from respondent Corporation, met with an accident while cutting fodder on fodder clipper on 23.08.2004 followed by amputation of his left arm. After respondent Corporation was approached by petitioner insured for settlement of claim, claim was repudiated holding that as contemplated by clause 10 of policy, petitioner did not qualify for receipt of assured sum under Accident Benefit Clause. Eventually, a complaint case came to be filed with District Forum, which holding, with mistaken perception, that amputation of arm was a permanent disability, ruled out contentions raised on behalf of respondent Corporation and directed them to honour claim of petitioner for value of Rs. 1,25,000/-. Award of compensation of Rs. 10,000/- for mental harassment and litigation expenses was also awarded. When finding was challenged by petitioner before State Commission, State Commission having noticed niceties of provisions of Act and interpreting clauses of section 10, while reversing finding of District Forum, unsuited petitioner, dismissing complaint. Even noticing plethora of decisions which interprets first part and second part of clause 10 of the Act, and, second part being a deemed provision, judicial consistency is not the highest state of legal bliss as law must grow and it cannot afford to be static and precedents must be a stepping stone and not a haulting place. Though strenuous efforts were made by learned counsel for petitioner to impress us that petitioner being an illiterate and a labourer, who after amputation of one arm was neither able to do labour work any more nor would be in a position to get any other alternate employment, was fully covered under clause 10 of insurance policy and also that as amputation of his left arm had incapacitated him for all times to come in his profession or occupation as a labourer and cannot adopt any such profession or occupation to earn his livelihood, we are afraid that the provisions of the Act can be stretched so liberally to suit the individual status of the petitioner even when his case was not covered by either of two parts of provisions of clause 10 of the Act. We may, profitably put on record relevant part of clause 10 of Act which gives benefit to the assured on account of disability, as under :- 10. Accident Benefit If at any time when this Policy is in force for full sum assured, the life assured, before the expiry of the period for which the premium is payable or before the policy anniversary on which the age nearer birthday of the life assured is 65 (whichever is earlier), is involved in an accident resulting in either permanent disability as hereinafter defined or death and the same is proved to the satisfaction of the Corporation, the Corporation agrees in the case of a) Disability to the life assured (i) to pay in monthly installments spread over 10 years an additional sum equal to the sum assured under this policy. If the policy becomes a claim before the expiry of the said period of 10 years, the disability benefit installments which have not fallen due will be paid along with the claim; (ii) to waive the payment of future premiums. The disability above referred to must be disability which the result of an accident and must be total and permanent and such that there is neither then nor at any time thereafter any work, occupation or profession that the life assured can ever sufficiently do or follow to earn or obtain any wages, compensation or profit. Accidental injuries which independently of all other causes and within ninety days from the happening of such accident result in the irrecoverable loss of the entire sight of both eyes or in the amputation of both hands at or above the wrists, or in the amputation of both feet at or above ankles, or in the amputation of one hand at or above the wrist and one foot at or above the ankle, shall also be deemed to constitute such disability. Manifestly, while first part relates to disability which should not only be total and permanent but should also be such as to render the insured incapable to do any work, occupation or profession for whole of his life, second part of the Act provides that in case of accidental injuries resulting in irrecoverable loss of entire sight of both the eyes or in amputation of both the hands at or above wrist, or in amputation of both feet at or above both the ankles or in amputation of one hand at or above wrist and one foot at or above ankle shall also be deemed to constitute permanent disability. It is a deeming provision where capacity to earn is not required to be considered and also making it explicitly clear that independent of the injuries which may be total and permanent for any other cause, the loss of limbs, as stated therein, would by itself be deemed to be permanent disability by legal fiction. That apart, inspiration can be had from judgment of National Commission in LIC of India Vs. Ramesh Chandra 1997 (2) CPR 8 (NC). Learned counsel for petitioner, however, brought to our notice two citations which are of the National Commission. In case of LIC of India Vs. Devi Das Sirsode 2006 (1) CPC 397, even there being amputation of both the legs incapacitating the insured to be gainfully employed for a profession or occupation, the claim was repudiated by insurance company. In this back drop, the National Commission held repudiation of claim of the assured, to be invalid and unjustified. In case of LIC of India Vs. Ram Singh Tanwar 2007 (1) CPC 278, decided on 28.11.2006 by National Commission, even though assured who was driver had lost his one leg, National Commission upholding the finding of State Commission, directed insurance company to honour claim of the assured. We may, however, profitably refer to a decision of the National Commission rendered on 15.05.2008 in the matter of LIC of India Vs. Satpal Kashyap (RP No. 3122 of 2003) where, in case of loss of sight of one eye, repudiation of claim of the assured was held to be valid on interpretation of second part of clause 10 of the Endowment Policy. The finding so recorded therein are in conformity of the decision of the National Commission in LIC of India Vs. Ramesh Chandra 1997 (2) CPR 8 (NC). We do not find flaw with the finding recorded by State Commission which are based on meticulous appreciation of the issues. There being no merit, revision petition is accordingly dismissed, but without order as to cost.
......................JB.N.P. SINGHPRESIDING MEMBER ......................S.K. NAIKMEMBER
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