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IN THE HIGH COURT OF ALLAHABAD
VIVEK CHAUDHARY, MANISH KUMAR, JJ.
Anuj Kudesia - Petitioner
Versus
Life Insurance Corp and Ors. - Respondents
Writ - C No. 9686 of 2007
Decided On : 14-12-2023
Disability Benefits - Insurance Policy - Clause 10.2, Clause 10.4 - [10.2, 10.4] - The court discussed the interpretation of clause 10.4 of the insurance policy, emphasizing the impact of disability on the assured individual's earning capacity and the expansive scope of disabilities covered under the policy. The court also highlighted the liberal and purposive interpretation of beneficial clauses and the relevance of the term 'any wages, compensation or profit' in determining disability benefits.
Fact of the Case:
The petitioner, a practicing advocate, purchased insurance policies with disability benefits. After an accident resulting in the amputation of his right arm, he claimed disability benefits, which were rejected by the respondents. The petitioner challenged the rejection in the present writ petition.
Finding of the Court:
The court found that the petitioner's earning capacity was significantly impacted by the disability, rendering him entitled to disability benefits under the insurance policies. The impugned orders were quashed, and the Insurance Corporation was directed to pay disability benefits to the petitioner with interest.
Issues: Interpretation of disability benefits under the insurance policy, impact of disability on the petitioner's earning capacity, and entitlement to disability benefits.
Ratio Decidendi: The court held that the first part of clause 10.4 defined total and permanent disability in terms of adverse impact on the earning of the assured due to a disability resulting from an accident. The expansive scope of disabilities covered under the policy, the liberal and purposive interpretation of beneficial clauses, and the relevance of the term 'any wages, compensation or profit' were crucial in determining the petitioner's entitlement to disability benefits.
Final Decision: The petition was allowed, and the impugned orders were quashed. The Insurance Corporation was directed to pay disability benefits to the petitioner along with an interest of 8% p.a. from the due date, within 30 days of the order.
JUDGMENT :
1. Heard Sri Apoorva Tewari, learned counsel for the petitioner, Sri Mahendra Pratap Singh, learned counsel for respondents nos. 1 to 4 and Sri Tarun Chaudhary, Advocate, holding brief of Sri Mohd. Altaf Mansoor, learned counsel for respondents nos. 5 and 6.
2. Present petition has been filed challenging the order dated 27.07.2006 passed by respondent No. 4 and order dated 17.08.2006 passed by respondent No. 3, whereby petitioner's claims for the insured amount and disability benefits have been rejected.
3. Brief facts of the case are that the petitioner, a practising advocate, purchased four insurance policies with same terms and conditions on various dates for an assured sum totalling Rs. 4,10,000 from opposite party No. 1, Life Insurance Corporation of India (for brevity hereinafter referred to as ‘Corporation’). Clause 10.2 (a) of the terms of which stipulates waiver of future premiums and payment of monthly installments as disability benefits to the assured, in addition to the assured sum, in case, the insured person is involved in an accident and suffers from a permanent disability as defined under clause 10.4 of the terms and conditions of the policy. On 14.06.2006, petitioner unfortunately met with an accident while driving his car resulting in amputation of his right arm from above his elbow. On 07.07.2006, Chief Medical Officer, Lucknow certified that the petitioner is suffering from 80% disability as defined under the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. Thereafter petitioner moved claim applications under clause 10.2(a) for disability benefits before the respective Branch Managers of the Corporation. By the impugned orders, petitioner’s claim for disability benefits have been rejected. Petitioner is challenging the said orders in the present writ petition.
4. Sri Apoorva Tewari, learned counsel for the petitioner challenges the impugned orders on the ground that the amputation of the right hand of the petitioner from above the elbow is a permanent disability affecting earnings of the petitioner and therefore the petitioner is entitled to permanent disability claims as per clause 10.2 and defined under clause 10.4 of the terms of the insurance policies. The disabilities enumerated in second part of clause 10.4 as well as in the impugned orders are only examples and not an exhaustive list of disabilities for entitlement to disability benefits. He further submits that his case is covered under the first part of clause 10.4 of the policy. He submits Clause 10.4 entitles disability benefits to such policyholders who as a result of an accident suffer from a total and permanent disability and are unable to sufficiently perform their occupation or earn wages, compensation and profit. Petitioner being a practising advocate suffered a financially disadvantageous position due to his physical disability and has to make an extraordinary effort to attend Court proceedings and is unable to sufficiently perform his profession as earlier, hampering his professional commitment to his clients thereby affecting his earnings. Without his right hand, he is unable to hold and carry his files, handle books and briefs effectively and even requires constant help on dias of Court. He also needs to keep a typist to prepare his petitions and other applications. Thus, in totality he is unable to conduct himself as sufficiently as his able-bodied peers on the dias while arguing a case. In support of his submission learned counsel relies upon the judgment of Supreme Court in the case of Abhimanyu Pratap Singh vs. Namita Sekhon and Another; (2022) 8 SCC 489. Counsel for the petitioner further submits that the clause relating to disability benefits is beneficial and therefore should be given a liberal and purposive interpretation. In support of his submission counsel for the petitioner places reliance upon a Division Bench Judgment of this Court in the case of Udai Shankar Si
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