NCDRC

NCDRC

RP/596/2010

LIC OF INDIA & ANR. - Complainant(s)

Versus

SANJAY SUDHAKAR POOJARY - Opp.Party(s)

M/S. MOHAN LAW CO.

18 Mar 2010

ORDER


NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSIONNEW DELHIREVISION PETITION NO. 596 OF 2010
(Against the Order dated 08/09/2009 in Appeal No. 2593/1998 of the State Commission Maharastra)
1. LIC OF INDIA & ANR.Nashik City Branch No. 2, Gole Colony, Sahyadri BldgNashik2. LIC OF INDIAWestern Zonal Office, Yogakshemam Jeevan Bima MargMumbai - 400021 ...........Petitioner(s)
Versus
1. SANJAY SUDHAKAR POOJARYR/o. 4266-A, Kalaram Mandir,Uttar Darwaja (North Door),Panchavati, Nashik-3. ...........Respondent(s)

BEFORE:
HON'BLE MR. JUSTICE R.C. JAIN ,PRESIDING MEMBERHON'BLE MR. ANUPAM DASGUPTA ,MEMBER
For the Petitioner :NEMO
For the Respondent :NEMO

Dated : 18 Mar 2010
ORDER

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40 days delay in filing the present revision petition is condoned subject to payment of costs of Rs.25,000/- by the petitioner to the respondent.
 
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2.          Aggrieved by the order dated 08.09.09 passed by the Maharasthra State Consumer Disputes Redressal Commission, Mumbai (in short, ‘the State Commission’) in first appeal no. 2593/08, the Life Insurance Corporation of India (in short, ‘LIC’) has filed this revision petition. By the impugned order, the State Commission has dismissed the appeal filed by the LIC against the order dated 30.09.98 passed by the District Consumer Disputes Redrssal Forum, Nasik, along with cost of Rs.5,000/-
 
3.      We have heard the learned counsel for the parties and having done so, we are of the view that the revision petition can be disposed of at this stage itself because only a short question about interpretation of clause 10(b) of the terms and conditions of the policy is involved and it will decide the fate of the revision petition and in turn that of the complaint. Learned counsel for the petitioner would assail the impugned order as legally unsustainable on the contention that the orders passed by the District Forum and the State Commission are based on a total misreading and mis-interpretation of the clause 10(b) of the terms and conditions of the policy which reads as under:-
 
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“ The disability above referred to must be disability which is the result on an accident and must be total and permanent and such that there is neither then not 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 writ, 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. “
 
4.          Learned counsel for the respondent/complainant submits that the respondent has suffered a permanent disability to the extent that his middle, ring and little fingers had to be amputated on account of the accident with which he met while working in the factory and even the index finger and thumb have also become motionless and, therefore, respondent has incurred permanent disability of his entire right hand. There is no dispute in regard to this factual position but the question is as to whether despite that being the position the case of the complainant would be covered by clause 10 (b) (supra) of the policy. On a bare reading of the said clause, we have no hesitation to hold that the kind of disability which the respondent has suffered due    to the alleged
 
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accident, is not covered under the said clause. Therefore, with heavy heart, we have to hold that the complainant was not entitled to any insurable claim as sought by him and which has been allowed by the District Forum and the State Commission. The reasoning giving by the State Commission in regard to the interpretation of clause 10 (b) to say the least is not at all tenable.
 
5.      In the result, the revision petition is allowed and the impugned order is hereby set aside. Consequently, the complaint will be deemed to have been dismissed. We call upon the petitioner LIC to remit the amount of cost of Rs.25,000/- to the respondent by means of bank draft within a period of four weeks from today failing which it shall carry interest @ 12% p.a.
 


......................JR.C. JAINPRESIDING MEMBER
......................ANUPAM DASGUPTAMEMBER