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2011 Supreme(SC) 1468

SUPREME COURT OF INDIA
G.S. Singhvi, H.L. Dattu, JJ.
Life Insurance Corporation of India and another - Petitioners
Versus
Hira Lal - Respondent
SLP (c) No. 28693 of 2009
Decided On : 23-08-2011

Advocates:
Advocate Appeared:
For the Petitioner:P.S. Patwalia, Senior Advocate and S. Rajappa, Advocate.
For the Respondent:Vikash Singh, Advocate and Charu Mathur, AOR.

Headnote:

Consumer Protection Act - Section 12 - Respondents claim for insurance amount was dismissed - Suffered permanent blindness due to accident - Pay the amount to the Respondent - Petition is directed against order passed by National Consumer Disputes Redressal Commission revision preferred by the Petitioners against order State Consumer Disputes Redressal Commission had upheld Respondents claim for insurance - Complaint filed by the Respondent under Section 12 of Consumer Protection Act for directing Petitioners to pay the amount in accordance with the insurance policy on premise that he had suffered permanent blindness due to accident was dismissed - District Consumer Forum - State Commission, - expression accident is used in the policy in ordinary sense of the word as noted an unlocked mishap or untoward event is not expected or designed – Held, Circumstances of case is accepted, our approach would be too pedantic and narrow besides being contrary to meaning of word accident as noted in preceding paras - Faced with this situation again persisted with vehemence circumstances of case by no stretch of imagination blindness of deceased can be termed to be due to accident within the meaning of terms of the policy. This submission is being noted simply to be rejected - It has no basis either in law or in facts of this case - Commission independently examined the matter and agreed with State Commission that the Respondent had suffered blindness due to accident and he was entitled to the insurance amount - Special leave petition is accordingly dismissed - Petitioner No. 1 is allowed 6

ORDER :

G.S. Singhvi, H.L. Dattu, JJ.

This petition is directed against the order passed by the National Consumer Disputes Redressal Commission (for short, "the National Commission") whereby the revision preferred by the Petitioners against the order of the Himachal Pradesh State Consumer Disputes Redressal Commission, Shimla (for short, "the State Commission"), which had upheld the Respondent's claim for insurance amount was dismissed.

2. We have heard Mr. P.S. Patwalia, learned Senior Counsel appearing for the Petitioners and Mr. Vikash Singh, Learned Counsel appearing for the Respondent and carefully perused the record.

3. The complaint filed by the Respondent under Section 12 of the Consumer Protection Act for directing the Petitioners to pay the amount in accordance with the insurance policy on the premise that he had suffered permanent blindness due to accident was dismissed by the District Consumer Forum. The State Commission, after threadbare examination of the matter allowed the appeal filed by the Respondent.

4. Paras 21 to 27 of the order passed by the State Commission which contained detailed reasons for granting relief to the Respondent read as under:

    "21. The expression 'accident' is used in the policy in ordinary sense of the word as noted hereinabove, an unlocked mishap or untoward event which is not expected or designed. As per Dictionary of Insurance Law, by E.R. Hardy, 1981 Edition, "accident means, a term involving the idea of something fortuitous and unexpected. It is difficult to define the term 'accident' as used in a policy of this nature, so as to draw with perfect accuracy a boundary line between injury or death from accident, and injury or death from natural causes; such as shall be of universal application. At the same time, we may safely assume that, in the term 'accident' as so used, some violence, casualty or vis major, is necessarily involved. We cannot think disease produced by the action of a known cause can be considered as accidental. Sinclair v. Maritime Passengers Assurance Company, (1861) 3 E and E 478 at 485 : 121 ER 521 (per Cockburn CJ).

    "22. An injury is caused by accident where it is the natural result of a fortuitous and unexpected cause e.g. where the insured is run over by a train (Lawrence v. Accidental Insurance Company Ltd., (1881) 7 QBD 216 (DC), or is thrown from his horse while hunting (Re: Etherington and Lancashire and Yorkshire Accident Insurance Company, (1909) 1 KB 591 : (1908-10) AII ER Rep 581 (CA), drinks poison by mistake (Cole v. Accident Insurance Company Ltd., (1889) 5 TLR 736 : (1889) 61 T 227 (CA), is suffocated by an escape of gas (Re United London and Scottish Insurance Company Ltd., Brown's Claim, (1915) 2 Ch 167 (CA), or is drowned whilst bathing (Trew v. Railway Passengers' Assurance Company, (1861) 6 H&N 839 : 158 ER 346)

    23. As per Mozley and Whiteley Law Dictionary, Eighth Edition 1970, 'accident' is defined as follows:

    'Accident - As a ground for seeking the assistance of a Court of equity, accident means not merely inevitable casualty, or the act of God, or, as it is called, Vis major, but also such unforeseen events, misfortunes, losses, acts, or omissions as are not the result of negligence or misconduct.'

    24. At the risk of repetition, we may observe that Dr. Chaudhary has, in his cross examination on behalf of the Insurance Company, admitted that blindness in the present case is not the result of an injury or accident. Whereas on the other hand, defence of the Respondents while contesting the complaint was that since the disease was hereditary, therefore, it cannot be termed as an accident within the meaning of policy of insurance, as such, they are not liable to indemnify the Appellant. In our opinion, the meaning of word 'accident' is being interpreted by the Respondents to mean that the blindness in case of the Appellant was due to something which was expected and/or was due to any cause attributable to the Appellant himself. There is nothing on the reco

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