Bhag Chand Jain                               - Petitioner 
Vs. 
LIC of India & Anr.                          - Respondents

Before: Hon'ble Mr.Justice C.L.Chaudhry, Presiding Member, Dr.(Mrs.) R.Thamarajakshi, Member
Mr. S.P. Bagla, Member, Hon'ble Mr. Justice J.K.Mehra, Member

C.L.Chaudhry, J. Member

This Revision Petition is directed against the order dated 18th April, 1996 passed by the State Consumer Disputes Redressal Commission, Rajasthan at Jaipur. The facts giving rise to this Revision Petition may be summarised as under: The Petitioner in this Revision Petition was the Complainant before the District Forum. The Petitioner had taken a policy on 28th May, 1987. The duration of the Insurance Policy was for 20 years with personal accident benefit. The sum assured was Rs. 75,000/-. The case of the Complainant was that on 19th April, 1988, he was going with his wife in a bus from Nathdwara to Bombay. In the morning of 20th April, 1988 at 5.30 AM when the bus reached near village Lakodra, a truck came from the opposite side with a fast speed and hit the bus from wrong side and as a result the bus was damaged and the passengers travelling in it received injuries. In the accident, the Petitioner also sustained serious injuries on both his legs but one leg became permanently disabled. He got his treatment from Baroda Hospital and SMS Hospital, Jaipur. He submitted his claim with the LIC of India and furnished supporting documents. The Life Insurance Corporation of India on 6th August, 1992 repudiated the claim of the Petitioner on the ground that the disability was not total and permanent.

In these premises, the Petitioner approached the District Forum, Jaipur by filing a complaint. The Life Insurance Corporation of India filed written version before the District Forum wherein it was admitted that the complainant was insured with the LIC with personal accident benefit. It was denied that the Petitioner had become total and permanently disabled. The permanent disability was defined in condition no. 10 of the Insurance Policy and the injuries sustained by the complainant did not fulfil the requirement of total and permanent disability.

The parties were given opportunity to produce the relevant evidence. During the course of proceedings before the District Forum, the Petitioner moved an application for constituting a Medical Board for his examination. The District Forum allowed the application and constituted a Medical Board of the Doctors of SMS Hospital, Jaipur. The opinion given by the Medical Board is reproduced below for the sake of reference and convenience:

"The Members of the Board examined Shri Bhag Chand Jain, S/o Mohan Lal, aged 37 years, R/o Jaipur, along withall relevant documents. The Members of the Board are of the opinion that Shri Bhag Chand Jain sustained multiple fractures on both lower extremities. There is no possibility to improve and he has developed permanent disability in totality."

The Petitioner also produced on the record two medical certificates dated 13-11-90 and 12-5-92 issued by Dr. Madhav Upadhyay, Professor and Head of Department of Orthopedic Surgery, SMS Medical College Hospital, Jaipur. In the certificate dated 13-11-90, it was mentioned that the Petitioner was under his treatment and care for multiple fractures of both lower extremities. On examination conducted on 12-11-90, it revealed that he had a permanent partial disability of 55%. In the other certificate dated 12-5-92, it was disclosed that the Petitioner was under his treatment and care for multiple fractures of both lower extremities in the SMS Medical College Hospital, Jaipur from 24th April, 1988 to 31st January, 1990. After the Petitioner was discharged from the Hospital, he had been examining him from time to time. His condition was not improving and thus there was no possibility of disability which was of a permanent and total to recover.

Needless to say that the Life Insurance Corporation of India did not produce any evidence before the District Forum. On the basis of material placed by the Petitioner, the District Forum returned the finding that the Petitioner had developed permanent disability and his case was covered under the terms of Insurance Policy. As a result, the complaint was allowed and LIC was directed to pay an amount of Rs. 75,000/- in terms of the Insurance Policy.

The Life Insurance Corporation of India, being aggrieved by the order of the District Forum, approached the State Commission, Jaipur by filing an Appeal. After hearing the counsel for the parties, the State Commission allowed the Appeal and set aside the order of the District Forum resulting in dismissal of the complaint. The State Commission returned the finding that in none of the certificates, it was mentioned that due to the injuries sustained by the complainant, he was not in a position to do any work or carry on any profession or occupation. In the absence of that proof, the condition of total and permanent disability as defined in Clause 10 of the Insurance Policy was not satisfied. Mere disability is not enough unless it is of such nature that the complainant was disabled for doing any work.We have heard the learned Counsel for the parties. The main contention raised on behalf of the Petitioner is that the order of the State Commission suffers from legal infirmity as the State Commission failed to consider very material and important evidence in arriving at a conclusion. The State Commission completely ignored the opinion of the Medical Board. In the order passed by the State Commission, there is no reference to the opinion of the Board at all. It has resulted into miscarriage of justice. On the other hand, Counsel for the LIC contended that the order of the State Commission is correct and suffers from no legal infirmity.

We have given our thoughtful consideration to the entire controversy. In our opinion, the contention raised on behalf of the Petitioner has merit. The District Forum had relied upon the certificates issued by Dr. Madhav Upadhayay and the opinion of the Medical Board of the SMS Medical College Hospital, Jaipur. The State Commission failed to consider the opinion of the Board wherein it was specifically mentioned that the Petitioner sustained multiple fractures of both lower extremities and there was no possibility to improve and he had developed permanent disability in totality. Petitioner had also filed an affidavit before the District Forum stating therein that he was permanently disabled to do any work after the accident. The case of the Petitioner stood fully established from the opinion of the Medical Board, certificates of Dr. Madhav Upadhayay and his own affidavit. In our opinion, the State Commission committed a grave legal error by ignoring very material evidence placed on record, i.e., opinion of the Medical Board. The State Commission also committed a legal error by rejecting the two certificates issued by Dr. Madhav Upadhyay on insufficient and untenable grounds. The order of the State Commission suffers from legal infirmity and is unsustainable in law. As a result thereof, we allow this Revision Petition and set aside the order passed by the State Commission and restore the order of the District Forum. However, we leave the parties to bear their own costs. The Revision Petition stands disposed of as above.