2003 Supreme(Pat) 1012
PATNA HIGH COURT
Aftab Alam, J.
Raju Vishwakarma
Versus
Union Of India And Others
Civil Writ Jurisdiction Case No. 1917 of 2003 ;
Decided On : SEPTEMBER 15, 2003
The definition of disability must be understood in the context of the person assured's life and circumstances
Headnote:
The petitioner, a male aged 35, lost a limb in a motorcycle accident and his claim for accident benefit was rejected by the Life Insurance Corporation of India. The dispute revolved around the interpretation of disability under clause 10 of the policy. The Corporation contended that the loss of one leg did not meet the definition of disability, while the petitioner argued for a more flexible interpretation. The court held that disability must be understood in the context of the person assured's life and circumstances, and remitted the matter for further enquiry by the Corporation.
Fact of the Case:
The petitioner lost a limb in a motorcycle accident and his claim for accident benefit was rejected by the Life Insurance Corporation of India.
Finding of the Court:
The court found that the definition of disability must be understood in the context of the person assured's life and circumstances, and remitted the matter for further enquiry by the Corporation.
Issues: Interpretation of disability under clause 10 of the policy
Ratio Decidendi: Disability must be understood in the context of the person assured's life and circumstances
Final Decision: The writ petition was allowed, and the matter was remitted for further enquiry by the Corporation. The Corporation was directed to pay Rs. 10,000 as the cost of litigation to the petitioner.
1. The petitioner is a male aged about 35 years. He lost one of his limbs in motor cycle accident. His claim of accident benefit was rejected by the Life Insurance Corporation of India (hereinafter referred to as the Corporation) on the ground that the loss suffered by him was not covered by the policy.
2. The petitioner is evidently a poor person without means or resources. He gave his brief to a lawyer who is so simple that in the writ petition, instead of enclosing the policy document of the petitioner he enclosed his own Insurance Policy taken from some other Insurance Company. This was to show to the court that the other Insurance Company gave to the assured a better deal and the Corporation should also pay compensation to the petitioner as the other company, under some other Insurance Scheme. The writ petition was also drafted very poorly and it contained very little facts of any relevance. In those circumstances the court asked Mr. Naveen Sinha, Advocate to appear in this case as amicus curiae. Mr. Chansi Roy, Advocate who is the counsel for the petitioner was advised to assist Mr. Sinha in bringing on record the relevant facts. I am happy to record that Mr. Naveen Sinha gave valuable assistance to the court in this case and with his help an amendment petition (IA No. 2177 of 2003) was filed on behalf of the petitioner, bringing on record some relevant facts and also the policy document of the petitioner (Annexure 9). On behalf of the Corporation a counter affidavit and a supplementary counter affidavit have been filed. Though the record of the case cannot yet be said to be comprehensive, sufficient materials have come before the court for a proper adjudication on the issue in dispute.
3. The petitioner took a twenty years money back policy (bearing no. 511123168) for a sum of Rs. 75,000/- with accident benefit. The policy was effective from 28.1.1997 and it was to remain valid till 28.2.2017. On 5.10.1999 while the petitioner was going on motor cycle he was hit by a truck bearing registration no. BR-1F-2909 as a result of which he received grievous injuries. He was admitted to the Patna Medical College Hospital where his left leg had to be amputated. A report, dated 28.4.2003 of the Medical Board for Handicapped from the office of the Civil Surgeon-cum-Chief Medical Officer, Patna is produced before the court which has a photograph of the petitioner affixed to it. In the photograph the petitioner is shown sitting on an armless chair; he is wearing a sleeveless vest and under-pants. From the photograph it appears that his left leg was amputated about 6" above the knee. According to the petitioner, his loss of limb was directly the result of the accident that took place on 5.10.1999 and the amputation was done within a few days of the accident. In regard to the accident his fardebayan (Annexure 2) was recorded by the Officer Incharge, Bihta P.S. at 8 P.M. on 5.10.1999 at referal hospital, Bihta where he was taken immediately after the accident. In the fardebeyan he stated that the accident was caused due to over-speeding and rash and negligent driving by the driver of the truck. On the basis of the fardebayan a formal F.I.R. was drawn up (Annexure 10) giving rise to Bihta P.S. Case No. 244 of 1999 against the driver (unknown) of truck no. BR-1G-2909. It is stated by the petitioner that at the time of the accident he had a valid driving licence (Annexure 11). It is also not in dispute that on 5.10.1999 when the accident took place and when a few days later the leg of the petitioner was amputated, the policy was subsisting and the premium had been paid upto-date.
4. The petitioner made a claim for accident benefit in terms of clause 10 of the Policy but the Corporation rejected it on the ground that loss of one leg was not covered by the terms of the policy. Before this court also the Corporation has taken the stand that loss of one leg was not covered by the definition of disability and hence, the petitioner was n