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Judgment
THIS appeal has been filed by the Life Insurance Corporation of India against the order of the District Forum, Udaipur dated 19.4.93.
THE only question for determination in this appeal is as to whether the complainant-respondent was entitled to disability benefit arising from accident. THE complainant was under a Life Insurance Policy dated 25.1.91 insured for Rs. 35,000/- with the Life Insurance Corporation of India. On 10.2.91 when he was going on bicycle he struck against the cow got injury in left feet. His left leg was amputed and he claimed disability benefit. In this regard Clause 10 of the policy is relevant which inter alia provides that if any time when the policy is in force for the full sum assured, the life assured, before the expiry of the period for which the premium is payable or before the policy anniversary on which the age nearer birthday of the life assured is 65, (whichever is earlier) is involved in an accident resulting in either permanent disability as hereinafter defined or death and the same is proved to the satisfaction of the Corporation, the Corporation agreed to pay the disability benefit. It is then provided in Clause 10 that the disability referred to above 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 ever sufficiently do or follow to earn or obtain his wages, compensation or profit. It is clear from the above wordings in the clause that there must be total and permanent disability. It is true that the left leg of the complainant-respondent has been amputed, but in case of such disability all that can be said is that the complainant became physically handicapped. There was not a total disability. The complainant, could very well walk with the help of baisakhi or any other support and carry on his profession as an Advocate. It is worthy to be noted that this very clause by a fiction has included certain type of disability as constituting disability within the meaning of the said clause. It is provided that accidental injuries which independently of all other causes and within ninety days from the happening of such accident, result in the irrecoverable loss of the entire sight of both eyes or in the amputation of both hands at or above the wrists, or in the amputation of both feet at or above ankles 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. It is clear from this fictional clause part that amputation of one hand at or above the wrist and one foot at or above the ankle, have been made to constitute disability. The word ''and'' is important in the above clause. In order to constitute disability, there should have been amputation of one hand and one foot. That is not so in the present case as there was amputation of one foot only at or above the ankle. It is, therefore, clear that the complainant did not suffer from a total and permanent disability. He was, therefore, not entitled to the accident benefit claimed by him. The District Forum was wrong in allowing the complaint filed by the complainant and in directing the payment of Rs. 35,000/- and awarding accident benefit of Rs. 5,000/- under Clause 10(2)(ka) of the policy.
We, therefore, allow this appeal, set aside the order of the District Forum dated 19.4.93 and dismiss the complaint filed by the complainant-respondent. In the circumstances of the case, parties will bear their own costs. Appeal allowed.