Any form of disability which prevents a person from performing his duty as he used to do prior would be treated as 100% disability in his/her vocational capacity. This requires insurance companies to follow their clauses accordingly. This was decreed by Hon’ble Shri Justice Goutam Bhaduri in the case of Yaduvir Singh Bisht Vs. National Insurance Company Limited and Ors. [WPC No. 1647 of 2013] on the 02nd of July 2021 at the Hon’ble High Court of Chhattisgarh, Bilaspur.
The brief facts of the case are, the petitioner who is a sub-inspector was discharging his duties in the coming operation at the forest and at that time of incident he stepped over a pressure bomb and as a result he sustained grievous injuries on his right leg and elbow. He was hospitalised and treated and disability to the extent of 45% was assessed by the medical officers. The state government to protect and encourage its employees had entered into a memorandum of understanding with the insurance company. as per the policy in case of loss of limb, eye or ear he was to be given an assured sum of Rs.5 Lakhs in which the petitioner falls. It was submitted that the insurance company did not release the said amount even after repeated letters by the director general of police. A legal notice was sent as well but remained unresponded. Thus, in hope of remedy, the petitioners have filed the present petition.
The counsel for the insurance company submitted that the, petitioner was not entitled for any relief to get a claim of Rs.5 Lakhs instead he was entitled for Rs.1 Lakh as according to the MoU the nature of injury which the petitioner had sustained would fall within the ambit of permanent loss/damage of part or body. Therefore, the petitioner is entitled to receive Rs. 1 Lakh. He would further submit that the medical certificate only says about 45% disability. Consequently, the claim of the petitioner to the extent of Rs.5 Lakh as has been recommended by the State Government cannot sustain. However, the counsel for the petitioner said that, the loss of a body part is relate to the occupation of the injured and the loss of limb herein in this case has rendered the petitioner incapable to perform the same job in future up till he retired besides the mental and physical agony. Therefore, the National Insurance Company be directed to release the amount of Rs.5 Lakhs as per the terms and conditions of the policy.
The court heard the submissions of both the counsels. It decreed that the objective behind the MoU was to provide the protective umbrella to its employees so as to assure the financial support who takes up such hazardous and risky job. The court relied on the judgement by the supreme court in Chanappa Nagappa Muchalagoda V. Divisional Manager, New India Insurance Company Limited {AIR 2020 SC 166} wherein it was decreed that, “when an injury rendered a person incapable to do a particular job considering the avocation, it would deemed to be 100% loss of earning capacity”. In the present case, the loss of limb of the petitioner would disable him from performing his duties. The court said that, “It is obvious that in the like nature of incident if a person is exposed to any bomb he would not embrace it get his bodily part amputated to come under definition of loss of limb to get a higher claim. Therefore, the incapacity to perform the vocation to the fullest by petitioner for cause of 45% permanent disability of leg would mean that permanent disability sustained in naxallite operation rendering one unfit to do same job would amount to loss of limb as per MoU. The benevolent object of MoU cannot be seen in narrow lens only to avoid liability by insurance company.” Thus, the court allowed this writ petition by directing the insurance company to pay Rs. 5 lakh to the petitioner within a period of 45 days.
