Life Insurance Corporation of India vs CHANDAN SINGH

LIFE Insurance Corporation of India (hereinafter referred as the Corporation) has come up in appeal against the order of the District Forum, Rewari dated 20.10.1997 vide which the complaint filed by Chandan Singh was allowed by holding that the Corporation was liable to pay a sum of Rs. 50,000/- and other benefits under the policy in question with 12% interest from the date of filing of the complaint.

THE challenge to the impugned order is that the complainant had not suffered total disability. As per Clause 10 of the policy, insurance claim is payable only in the cases of amputation of one hand at or above wrist and one foot at or above ankle. Amputation of only one hand does not constitute disability. Notice of the appeal was issued, but the respondent has not put in appearance, despite service. The Commission has considered the submissions of the Counsel for the appellant and has perused the impugned order. The only proposition canvassed before the Commission is whether the complainant is entitled to compensation as per Clause 10 of the policy or not ? This very much proposition came up before the Hon''ble National Commission in the case of L.I.C. of India v. Ramesh Chandra, reported as II (1997) CPJ 45 (NC)=1997 (2) CPC 126. The question before the Hon''ble National Commission was whether the amputation of right hand suffered by the complainant was a specified event and constitute disability entitled to an accident benefit under Clause 10(a) of the policy. 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. As per terms of the insurance policy, the accident injuries, which resulted 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 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 only constitute such disability.

In view of the above discussions, this Commission is of the considered view that claim of the complainant is not covered under Clause 10 of the policy as amputation of only one hand does not constitute disability. The order of the District Forum suffers from irregularity and can not be sustained. It appears that the District Forum did not go through the terms and conditions of the policy. Consequently, we allow the appeal, quash the impugned order and dismiss the complaint. However, in case, the complainant is a workman within the meaning of the Workmen Compensation Act, it will be open to him to file a claim under the Workmen Compensation Act. The plea of limitation won''t be raised by any of the parties, i.e. the employer or the Life Insurance Corporation. Appeal allowed.