Life Insurance Corporation of India and two others have filed this revision petition against the order dated 9.5.2007 passed by the Karnataka Consumer Disputes Redressal Commission (for short, “the State Commission”) and the order dated 30.6.2006 passed by District Consumer Disputes Redressal Forum, Hassan (for short, the District Forum). By the impugned order the District Forum had directed the petitioner to pay disability accidental benefit to the complainant respondent as per the terms of the policy and also awarded a sum of Rs.20,000/- as compensation within a period of one month, failing which the awarded amount was to carry interest @ 12% p.a. till date of realization. Rs.100/- were awarded by way of cost.

          Briefly sated the facts of the case are that respondent filed a complaint before the District Forum alleging that he had purchased four policies bearing Nos.721806793, 721570307 & 721758105 all being endowment policies and policy No.721518060 being Jeevan Mitra Policy (double cover endowment plan with profits) from the petitioner Corporation for a total sum of Rs.2,90,000/-. It was further alleged that on the intervening night of 5/3/2001 and 6/3/2001, he met with an accident in which he sustained grievous to his right leg and he was shifted to Bangalore for the treatment. He was treated as an inpatient for about one year and ultimately his left leg was amputated.

          Respondent filed a claim with the petitioner which was repudiated on 20.7.2001 that the disability suffered by the respondent did not amount to permanently disability as defined in the policy and, therefore, he was not entitled to any compensation.  Another ground for repudiation was that even after accident he was still gainfully employed.

          Respondent being aggrieved filed complaint before the District Forum. District Forum allowed the complaint and directed the petitioner to pay disability accidental benefit to the respondent as per terms of the policy alongwith compensation of Rs.20,000/- within a month failing which awarded amount was to carry interest @ 12% p.a. Rs.100/- were awarded by way of cost.

          Petitioner being aggrieved filed an appeal before the State Commission, which has been dismissed.

          Respondent is not present despite notice. Order to be proceeded ex parte.

          Counsel for the petitioner contends that disability accidental benefit could not be extended to the respondent as the same was not covered as per terms and conditions of the policy. We find substance in the submission. Clause 10.4 of the policy reads as under: -

“The disability above referred to must be a disability which is a result of an accident and must be total and permanent and such that there is neither then or at any time thereafter any work, occupation or profession that the life assured can ever sufficiently do or follow to earn or obtain wages, compensation or profit. Accidental injuries which independently of all other causes and within 120 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 be also deemed to constitute such disability.”

          A perusal of clause 10.4 would show that the life assured can be paid the amount only if the disability suffered by him is total and permanent and as a result of accident which renders him unfit thereafter to work, occupy or do any profession to earn his livelihood. The injuries suffered independently of other causes must result in irrecoverable loss of the entire sight of both eyes or in the amputation of both hands at or above wrists or in the amputation of feet at or above ankles, or in the amputation of one hand at or above the wrist and one foot at or above wrist within 120 days of the happening of the accident. Only such injuries are deemed to constitute permanent disability under Clause 10.4.

          Admittedly, the respondent did not suffer any such permanent disability in the present case.  Clause 10.4 came for interpretation before this Commission in LIC of India vs. Ramesh Chandra reported in II (1997) CPJ 45 (NC) and LIC of India vs. Sh. Satpal Kashyap, in Revision Petition No.3122 of 2003 (dated 15.5.2008). In Ramesh Chandra’s case, four Members Bench of this Commission after taking into consideration a similar clause, held as under: -

“The question is whether the amputation of right hand suffered by the complainant is a specified event and constitute disability entitled to an accident benefit under Clause 10 (a) of the policy bond. The accident benefit is available to the assured only if he is involved in an accident resulting in total and permanent disability as defined in Clause 10. The disability referred in the said clause must be disability which is the result of accident and must be total and permanent. The accidental injure is which independently of all other causes and within 120 days from 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 wrists or in the amputation of feet at or above ankles, or in the amputation of one hand at or above the wrist and one foot at or above the wrist only constitute such disability. The case of the complainant is not of the amputation of both the hands at or above the wrist or in the amputation of feet at or above ankles. The cause of the complainant is the amputation of one hand at or above the wrist but that is not independently deemed to be a disability as is covered since the coverage in the clause is only in cases of amputation of one hand at or above the wrist and one foot at or above ankle. It bears repetition that the deeming clause consisting the disability will get attracted only if there was the amputation of one hand at or above the wrist and one foot at or above the ankle. If it is the amputation of one hand at or above wrist or amputation of one foot or above the ankle, then it does not by the fiction of the clause 10 (a) constitute disability. The constitution of the policy bond which is the basis of the contract of insurance, is a question of law and its true and correct interpretation would give justification to the Fora to pronounce upon the deficiency in service, if any. The District Forum as well as the State Commission had no jurisdiction to go beyond the terms and conditions of the policy bond and could only order the payment of disability benefit if it was specified event covered under Clause 10 of the conditions of policy. The amputation of only one hand does not fall within the deeming definition constituting disability in terms of Clause 10 (a) of the policy bond and thus the impugned orders suffer from serious illegalities.”

[Emphasis supplied]

To the similar effect is the judgment of this Commission in S.K. Mittal’s case (supra) wherein after taking into consideration the same clause as in the present case, it was held as under: -

“Bare reading of the above clause would show that on the life assured’s suffering from permanent disability as a result of an accident, the Insurance Company subject to a ceiling of Rs.1,00,000/- will pay additional sum equal to the sum assured under a policy in monthly instalments spread over 10 years and if the policy becomes a claim before the expiry of this period the benefit instalments which have not fallen due will be paid alongwith the claim and future payment of premiums will be waived. Permanent disability consists of loss of entire sight of both the eyes or amputation of both the hands at or above the wrists or amputation of both feet at or above the ankles, or amputation of one hand at or above the wrist and one foot at or above the ankle. Policy is a contract and conditions thereof are binding on both the parties. Obviously, loss of sight of one eye suffered by Sat Pal Kashyap-life assured cannot be treated as a permanent disability within the meaning of the said clause. Assuming that it is a permanent disability Shri Kashyap was entitled to the additional amount of disability benefit of Rs.1,00,000/- and not Rs.1,25,000/-. Decision in Ramesh Chandra”s case (supra), which was rendered with reference to similar Clause 10(a) of the policy applied on all fours to this case. Order of District Forum as affirmed by the State Commission, thus, deserves to be set aside being legally erroneous.”

We agree with the view taken in the aforesaid decision of this Commission and respectfully following the same holding that the respondent did not suffer permanent disability as defined in the terms of the policy entitling him to claim the amount under the policy. Foras below erred in taking view contrary to this Commission.

Revision petition accepted. Orders of Fora below are set aside and complaint dismissed with no order as to costs.