ORDER Dr. P.D. Shenoy, Member—Heard the learned counsel for the petitioner. There is a delay of 34 days in filing this revision petition, for which a condonation application has been filed. For the reasons mentioned in the same, the delay is hereby condoned. 2. The facts of this case in brief are that Shri Jyotindra R Bhavsar had obtained an insurance policy on 18.9.1997 for Rs.1,00,000 from the Life Insurance Corporation (in short the LIC). The complainant/insured was admitted to Sterling Hospital, Ahmedabad on 28.9.2004. After Coronary Angiography was performed, he was advised two valves of the heart of the complainant had to be operated and replaced with new ones. After the surgery the complainant was discharged from the Hospital on 10.10.2004. The complainant requested the LIC, through a letter, dated 26.10.2004, to reimburse the expenditure incurred for the surgery. The complainant informed that in terms of the policy condition 50% of the sum assured i.e.Rs.50,000 be paid immediately and the complainant may be relieved from paying further premium. The complainant also requested the LIC to give him any further benefits applicable under the policy. The LIC repudiated the claim on 1.11.2004, with the following endorsement: “As per policy condition valve replacement operation is not covered under benefit (b) under this policy.” 3. LIC requested the complainant to continue to pay the premium under the said policy. Further correspondence and pleadings with the LIC did not yield any positive result. Hence, the complainant filed a complaint before the District Forum. In the District Forum the Insurance Company contended that the complainant had not undergone the above heart surgery and replacement of the valve is not covered under the Benefit ‘B’, therefore, he is not entitled for the claim, Rs.50,000 being the 50% of the assured sum. The District Forum after elaborate examination of the case, partly allowed the complaint and directed the LIC to give benefits stipulated in the policy, apart from refund of the premium with 6% interest from 1.10.2004 till its realization. In addition to the above Rs.5,000 was awarded as compensation towards mental agony and Rs.5,000 as cost. 4. Dissatisfied by the order of the District Forum, the LIC filed an appeal before the State Commission. The State Commission relying upon the judgment of this Commission in LIC of India and Anr. v. Medishetty Rajashekharam1 dismissed the appeal. 5. In addition to the above Rs.5,000 was awarded as compensation towards mental agony and Rs.5,000 as cost. 4. Dissatisfied by the order of the District Forum, the LIC filed an appeal before the State Commission. The State Commission relying upon the judgment of this Commission in LIC of India and Anr. v. Medishetty Rajashekharam1 dismissed the appeal. 5. Aggrieved by the order of the State Commission, the LIC has filed this revision petition. Learned counsel for the petitioner drew our attention to a medical certificate issued by the Sterling Hospital on 9.10.2004, wherein it is mentioned that the insured was operated for coronary angiography and double valve replacement. 6. Learned counsel for the petitioner brought to our notice an extract of the judgment of the Apex Court in United India Insurance Co. Ltd. v. M/s Harchand Rai Chandan Lal.2 “Further it is possible that an insurer may sustain loss is technical terms of the criminal law but no relief can be given to him unless his case is covered by the terms of the policy. It is not open to interpret the expression appearing in the policy in terms of criminal law; but it has to give meaning to the expression as defined in the policy. The act that causes the loss must fall within the definition in the policy and it cannot take the cover and contents of the definition as laid down in the criminal law. Therefore, when the definition of the word ‘burglary’ has been defined in the policy then the case should fall within that definition. Once a party has agreed to a particular definition, he is bound by it and the definition of criminal law will be of no avail. The terms of the contract has to be strictly read and natural meaning is given to it. No outside aid should be sought unless the meaning is ambiguous.” “Court however, directs the Insurance Companies to amend their policies so as to make them more meaningful to the public at large. The definition of word burglary should be given meaning which is closer to the realities of life. The common man understands that he has taken out the policy against theft. He hardly understands whether it should precede violence or force. The definition of word burglary should be given meaning which is closer to the realities of life. The common man understands that he has taken out the policy against theft. He hardly understands whether it should precede violence or force. It should have the meaning which a common man can easily understand rather than become more technical so as to defeat the cause of public at large”. Findings: 7. The case quoted in support by the revision petitioner AIR 2004 Supreme Court 4794—Firstly it relates to general insurance case and not of Life Insurance Corporation and secondly, in this case it has held that as follows: “It is not open to interpret the expression appearing in the policy in terms of criminal law, but it has to give meaning to the expression as defined in the policy. No outside aid should be sought unless the meaning is ambiguous. It should have the meaning which a common man can easily understand rather than become more technical so as to defeat the cause of public at large.” 8. No attempt was made by the State Commission, or this Commission to give meaning of expression as defined under the policy in the terms of criminal law. 9. The Hon’ble Apex Court has also observed that no outside aid to be provided unless the meaning is ambiguous. Let us look at any picture the transverse section of the heart given in any text book it contains not only arteries and ventricles but also the valves. The valves are the integral and internal parts of the heart. Valves cannot be replaced without opening the heart. 10. It is a settled law that wherever there is an ambiguity in terms of the Insurance policy, the benefit of interpretation should go to the insured and not to the insurer. 11. In the above judgment (supra) cited by the petitioner’s counsel the Hon’ble Apex Court has also directed the Insurance Companies to amend the policy so as to meaning of public at large. In case after case we are finding that le Insurance Companies are issuing the same policies with complicated sentences in tiny letters making it difficult for even the literate person to understand the meaning of various clauses. In case after case we are finding that le Insurance Companies are issuing the same policies with complicated sentences in tiny letters making it difficult for even the literate person to understand the meaning of various clauses. The agents of the Insurance Company are not in the habit of explaining the meaning of the clauses of the Insurance Policy especially the exclusion clauses to the prospective clients. 12. Looking from each and every angle this relates to the insurance against burglary and pertaining to the facts of that case and is therefore distinguishable. 13. The Benefit of clause (B) of the policy schedule shall be available on the occurrence of any of the following contingencies. The Life assured undergoes open heart by-pass surgery performed on significantly narrowed/occludes coronary arteries to restore adequate blood supply to heart and the surgery must have been proven to be necessary by means of coronary angiography. All other operations (e.g. angioplasty and thromobodysis bycoronary Artery Cathetrization) are specifically excluded. Let us carefully look at each segment of the clause. (i) The need for surgery to be proved by means of coronary anigography. In this case coronary angiography was conducted after which the surgery was proved necessary. (ii) Angioplasty and Thromobodysis bycoronary Artery Cathetrization are excluded. This exclusion clause does not apply as the insured had not undergone these procedures. (iii) Life assured undergoes an open heart by-pass surgery performed on significantly narrowed/occluded coronary arteries to restore adequate blood supply to the heart. In this case also blood supply to the heart was in-adequate, hence, the open-heart surgery was performed for double valve replacement and valve is a part of the heart. 14. In LIC of India v. Madisetty Rajashekaram (supra}, it was observed as follows: “Learned counsel for the petitioner placed reliance on medical opinion of Dr Pradeep Mathur. The question is whether the operation in question was open heart by-pass surgery performed on significantly narrowed/occluded coronary arteries to restore adequate blood supply to heart. The clause as mentioned herein above supports the case of the complainant respondent. Mr Mangat Ram Chawla was operated at Indraprastha Apollo Hospital on 27.3.2002 for severe aortic regurgitation secondary to bicuspid aortic valve. He had symptoms of breathlessness on exertion and occasional palpitation for 5-10 days. However, he also mentioned in the certificate/opinion that “Bicuspid aortic valve is a congenital abnormality of heart present right from birth”. Mr Mangat Ram Chawla was operated at Indraprastha Apollo Hospital on 27.3.2002 for severe aortic regurgitation secondary to bicuspid aortic valve. He had symptoms of breathlessness on exertion and occasional palpitation for 5-10 days. However, he also mentioned in the certificate/opinion that “Bicuspid aortic valve is a congenital abnormality of heart present right from birth”. Surgery is an open heart surgery and requires valve replacement of original aortic valve by prosthetic value 270N-X. This surgery does not involve bypassing of coronary arteries and hence it is different from coronary bypass surgery. Dr Pradeep Mathur has not filed any affidavit. He had not treated the patient in Apollo Hospital as per discharge summary. He was not made available for cross-examination. For these reasons, we cannot act upon his opinion. No doubt, it is also mentioned that this surgery did not involve bypassing of coronary arteries, yet it was an open heart surgery but it would not make difference in view of the main purpose rule of interpretation. In case, main purpose rule of interpretation of policies like the present one is applied, the policy would cover the risk. Consequently, we are not inclined to accept this contention.” 15. Accordingly, we hold that the ratio of the citation given in Medishetty case (supra) is squarely applicable to the case on hand. 16. With these observations, the revision petition is dismissed. There shall be no order as to cost. Revision petition dismissed. ********