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2016 DIGILAW 909 (PNJ)

LIFE INSURANCE CORPORATION OF INDIA v. PERMANENT LOK ADALAT

2016-03-15

LISA GILL, MAHESH GROVER

body2016
JUDGMENT : Mahesh Grover, J. CM No. 861-LPA of 2016 Delay condoned. C.M. stands allowed. CM No. 862-LPA of 2016 Allowed as prayed for. LPA No. 404 of 2016 1. The appellant-Life Insurance Corporation of India has filed the instant appeal against the judgment of learned Single Judge dated 14.12.2005. 2. They are contesting the claim of the insured to the benefits of policy by relying on Clause 10(4) of the policy which can be extracted here below :- “10(4). The disability above referred to must be disability which is the result of an accident and must be total and permanent and such that there is neither then nor at any time thereafter any work, occupation, or profession that the Life Assured can every sufficiently do or follow to earn or obtain any wages, compensation or profit. Accidental injuries which independently of all other causes and within 180 days from the happening of such accident, result in irrecoverable loss, of the entire sight of both eyes or in the amputation of both hands at or above the wrist, or in the amputation of both the feet at or above the ankle or in the amputation of one hand at or above the wrist and one foot at or above the ankle, shall also be deemed to constitute such disability.” 3. It is not disputed that the insured suffered an accident leading to amputation of one of his legs and if the policy had been honoured the injured would have been entitled to a claim of Rs. 1 lakh (the insured amount) coupled with another one lakh rupees on account of the disability staggered over a period of time. 4. Learned counsel for the appellant contends that a perusal of clause 10(4) would not entitle the insured to any amount as only one leg had been amputated and he would have been entitled to the compensation if both his legs had been amputated in view of the afore extracted clause where claim is to be given only in case of total and permanent disability. 5. 5. Considering the permanent disability which has been determined at about 65 per cent by the Medical Board this would clearly disentitle the insured to any benefit of the policy in view of partial disability and since nothing more can be read into the policy except the terms which have been agreed upon by the contracting parties, the claim necessarily has to be repudiated. 6. We have heard the learned counsel for the appellant and find that the argument raised before this Court is absurd to say the least. The insured was a labourer and if his one leg has been amputated he would resultantly have been sufficiently disabled from pursuing even his livelihood. The argument is hollow and even otherwise no such interpretation can be placed on clause 10(4) that an insured would be entitled to get the compensation if he suffered only 100 per cent disability and not otherwise. The opening words of clause 10(4) reveal that a disability referred to must be disability which is the result of an accident and must be 'total' and 'permanent' which have to be read and assigned a separate meaning and not to be construed conjunctively. 7. It would certainly entitle the claimant to a claim in terms of the policy since undisputedly, amputation of a leg falls in the category of a permanent disability. 8. We are further of the opinion that the entire litigation initiated by the insurance company to thwart a valid claim smacks of a deliberate attempt to frustrate the legitimate claim of a person who took out the policy with a firm hope that his interest would be taken care of in the eventuality of an unfortunate accident or death. The insurance companies cannot be permitted to defeat such valid claims by raising frivolous objections which apart from defeating the claim and the purpose of the insurance altogether always result in wastage of time of the courts unnecessarily and heap further misery on persons already in distress. 9. The appellant is therefore burdened with costs of RS. 1 lakh which shall be compensatory to respondent No.2. 10. The appellant is directed to pay the total amount of claim with costs to the respondent No.2 within one week from today. 11. Appeal dismissed.