NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
C. Viswanath, Presiding Member
National Insurance Co. Ltd. —Petitioner
versus
Kuldeep Singh —Respondent
Revision Petition No.2793 of 2016
(Against the Order dated 03/06/2016 in Appeal No. 1015/2013 of the State Commission Delhi)
Decided on 12.4.2019
Held, in construing the terms of a contract of insurance, the words used therein must be given paramount importance, and it is not open for the Court to add, delete or substitute any words. It is also well settled that since upon issuance of an insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risks covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavour of the court should always be to interpret the words in which the contract is expressed by the parties.
Further held, the insured lost his 100% earning capacity is driver. Hence, he is entitled for the full insured claim.
The Petitioner was directed to pay Rs.4 lakhs i.e. full insured amount with interest @12% from the date of denial to till the payment. The Petitioner was further directed to pay Rs.1 lakhs as compensation for harassment and litigation expenses. It was made clear that the order had to be complied within 30 days of the receipt of the copy of the order; otherwise action could be taken under Section 25/27 of the Consumer Protection Act, 1986. (Para 4)
Result: Revision dismissed.
C. Viswanath, Presiding Member—The present Revision Petition is filed by the Petitioner under Section21(b) of the Consumer Protection Act, 1986 against Order passed by the State Consumer Disputes Redressal Commission, Delhi (hereinafter referred to as the “State Commission”) in Appeal No. 1015/2013 dated 03.06.2016.
2. According to the Respondent/Complainant, he was living at Sundergarh, Orissa and was insured with National Insurance Co. Ltd./Petitioner under a Group Janta Personal Accident Insurance Policy, vide Policy No. 100300/47/01/9600022/03/96/30343 for Rs. 4 Lakhs.The period covered under the policy was from 08.01.2004 to 07.01.2006. Unfortunately on 11.02.2005, while the Respondent was on duty, truck No. OG-04-G-6857, suddenly met with an accident due to which he sustained injuries.The Respondent was admitted in Cuttack, Orissa in the I.G.H. RourkelaHospital upto 14.02.2005.Thereafter, he was admitted in Government Hospital, S.C.B. Medical College Hospital, Cuttack from 15.02.2005 to 28.02.2005 and finally in General Nursing Home, Road No. 133/01, Manglabag, Cuttack from 01.03.2005 to 13.03.2005 wherein the left leg of the Respondent was amputated. He had spent Rs.1,25,000/- in total on his treatment. The Respondent has further deposited the necessary papers with the Petitioner for clearance of the insured amount of Rs.4 lakhs but the same was not paid to him. Thus, the Complaint was filed.
3. The Petitioner filed the Written Statement in which he did not dispute the fact that the Policy of Rs.4 lakhs was issued by the Petitioner but the only question raised was about the jurisdiction, though it has Head Office in Delhi. No other dispute was filed in the Written Statement. The Petitioner mentioned the claim in respect for injury within six months of the policy to be 50% of the sum insured.
4. District Forum, vide order dated 10.07.2013, allowed the Complaint on the ground that there was no merit in the preliminary objections regarding the territorial jurisdiction as the principal office of the Insurance Company was in Delhi and Respondent had also shifted to Delhi after the aforesaid event.The contention that the Respondent was only entitled to 50% of the claim was also not tenable in view of the clause (b) and (d) on cover-note which allowed full insured amount in case of permanent disability.In this case the leg was amputated.The District Forum, therefore, held that the Respondent was entitled to the full insured amount. The Petitioner was directed to pay Rs.4 lakhs i.e. full insured amount with interest @12% from the date of denial to till the payment. The Petitioner was further directed to pay Rs.1 lakhs as compensation for harassment and litigation expenses. It was made clear that the order had to be complied within 30 days of the receipt of the copy of the order; otherwise action could be taken under Section 25/27 of the Consumer Protection Act, 1986.
5. Being aggrieved by the order of the District Forum, the Petitioner filed an Appeal before the State Commission. The State Commission vide order dated 03.06.2016 dismissed the Appeal of the Petitioner. The State Commission further observed that they find no error in the order passed by the District Forum.
6. Being aggrieved by the order passed by the State Commission, the Petitioner filed the present Revision Petition before this Commission.
7. Heard the Learned Counsel for the Petitioner as well as the Respondent. They reiterated their respective contentions as stated above.Also carefully perused the record.
8. Both the parties filed certain judgements in support of their contentions which are stated as below:
9. The Petitioner placed the following judgements on record:—
In National Insurance Co. Ltd. Vs. A.S. Mooosani & Co., this Commission held that in General Assurance Society Ltd. (supra), a Constitution Bench of this Court has observed that:—
“11. ......In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the wo
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