Permanent disability leading to loss of functionality can qualify for insurance compensation under a Group Personal Accident Policy if it meets defined criteria.

JUDGMENT

Manmohan, J.:--Present writ petition has been filed seeking a direction to the respondents to pay to the petitioner insurance compensation of Rs. 10 lakhs along with interest @ 12% per annum from the date of accident of the petitioner, till its realisation.

2. The relevant facts of the present case are that on 11th May, 2008 at about 1740 hours while carrying out vehicle patrolling by the troops of `C' Coy of Ex-39 Bn BSF, deployed under NB-II Bn BSF, Commanded by Shri N.K. Singh, Comdt., in connection with Panchayat Election duty West Bengal (WB) in general area of Village Ganga Manna, PS Bandwan, Distt.-Purulia (WB), the Tata-407 vehicle carrying the troops was blown due to a powerful Improvised Explosive Device (IED) blast activated by extremists in which Constable Ali Akbar Sheikh of 39 Bn BSF sacrificed his life on the spot, Constable B Ramayanyulu succumbed to his injuries on 15th May, 2008 at 2230 hrs, while under treatment at ICU, Steel Authority of India Hospital, Bokaro and six other individuals of 39 Bn BSF, including the petitioner, sustained serious injuries.

3. Learned counsel for the petitioner stated that compensation of amount of Rs. 10 lakhs each had been paid by the Insurance Company to the next of kin of both deceased BSF personnel, namely, late Constable Akbar Seikh and late B Ramayanyulu, but the other BSF personnel including the petitioner who were injured in the IED blast were not paid any claim/compensation by the Insurance Company for the injury/disability sustained by them.

4. He further stated that though the petitioner was declared unfit for further service in BSF due to loss of two fingers in the hand and his disability was assessed at 59%, yet the respondent-Insurance Company did not pay any compensation. He, however, clarified that the petitioner had been paid SPBY disability compensation amounting to Rs. 2,95,000/- and disability pension of Rs. 11,940/- per month to be revised from time to time.

5. Learned counsel for the BSF stated that BSF had approached West Bengal Police authorities on a number of occasions for obtaining the Insurance claim from the Insurance Company for the injury/disability sustained by the BSF personnel due to IED blast during the Panchayat elections. He, however, stated that neither any reply nor any payment had been received from the National Insurance Company, Kolkata.

6. Learned counsel for the National Insurance Company, with utmost respect to the petitioner, stated that going by the Medical Board Report relied upon by the petitioner which describes the disability suffered by the petitioner as 59%, the same did not fall within the definition of `Permanent Total Disability' (PTD) within the contemplation of the subject policy and hence no compensation is payable to the claimant in terms of the GPA policy.

7. Having heard learned counsel for the parties and having perused the paper book, this Court finds that the Director General, West Bengal Police had taken a `tailor made' Group Personal Accident Policy' for coverage of its personnel deployed in extremist affected areas of West Bengal from National Insurance Company Limited from time to time. The premium and the extent of coverage under these policies were negotiated and the clarifications with respect to various aspects, respective rights and obligations, emanating from the said GPA Policy had formed the basis of the terms agreed between the parties.

8. The National Insurance Company vide letter dated 31st August, 2004 had defined Permanent Total Disability "if such injury shall as a direct consequence thereof immediately permanently totally and absolutely di