If the nature of injury renders a person 100% disable of his vocational capacity, then in such case it would be considered as a permanent disability: Chhattisgarh High Court.
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.
1AFRHIGH COURT OF CHHATTISGARH BILASPUR WPC No. 16413Ex.S.I.(GD) Yaduvir Singh BishtS o Late Balwant Singh Bisht AgedAbout 63 Years No. 710240216 BN 55 CRPF R o RZ C 2 134 D MahabirEnclave Part 1 Street No.4 New Delhi 110045 Petitioner Versus 1.National Insurance Company Limited Through Divisional Manager DivisionalOffice 14 Sterling Cinema Building 2nd Floor 65 Murzban Street Mumbai 4000012.State Of Chhattisgarh Through Secretary Home Department Bilaspur C.G.3.The Director General Of Police Police Headquarter Raipur C.G.4.The Superintendent Of Police South Buster Dantewada C.G. RespondentsFor Petitioner:Ms. Trishna Das Advocate For Respondent No.1:Shri Dashrath Gupta Advocate For Respondents State:Ms. Astha Shukla PLHon ble Shri Justice Goutam BhaduriOrder02 07 20 211.Heard.2.The instant petition is for release of the amount of Rs.5 Lakhs against theinsurance claim in lieu of the compensation to the petitioner on account of thefact that the petitioner while performing his duties in Bomb Detection & DisposalSquad suffered injuries because of land mine blast on 15.02.2007. Therefore 2as per the Memorandum of Understandingof the State Government withthe National Insurance Company Limited the petitioner since has suffered thepermanent disability to the extent of 45% of his leg resulting into completeinability to perform the vocation was entitled to get the claim of Rs.5 Lakhs.3.Learned counsel for the petitioner would submit that the petitioner wasdischarging his duties in the combing operation at forest and at that time ofincident he stepped over a pressure bomb at Dantewada as a result hesustained grievous injuries on his right leg and elbow and becameunconscious. She would further submit that subsequently he was hospitalizedand was treated at the end of recovery disability to the extent of 45% wasassessed by the medical officers. She would further submit that since the jobwas hazardous as such the State Government to protect and encourage theemployee in the like situation entered into a Memorandum of Understanding(MoU) with the insurance company. The said MoU was effective in the State ofChhattisgarh for naxallite related violence and as per the policy in case of lossof limb eye or ear he was to be given an assured sum of Rs.5 Lakhs in whichthe petitioner falls. It is stated that the Director General of Police and theauthorities recommended for release of the said amount of Rs.5 Lakhs byrepeated letters but eventually the said amount was not paid by the insurancecompany. The legal notice by the counsel was also sent but it wasunresponded therefore eventually this petition has been filed. Reference isalso made to the law laid down by the Supreme Court in the case of ChanappaNagappa Muchalagoda V. Divisional Manager New India InsuranceCompany Limited {AIR 2020 SC 166} to draw an analogy that the loss of body 3part would have a nexus with the vocation and the loss of limb herein in thiscase has rendered the petitioner incapable to perform the same job in futureuptill he retired besides the mental and physical agony. Therefore the NationalInsurance Company be directed to release the amount of Rs.5 Lakhs as per theterms and conditions of the policy. 4.According to the State the petitioner was an ex service man before beingsuperannuated and worked as Sub Inspector in CRPF and while he was postedin District Dantewada Camp Aranpur which is a Naxallite area of districtDantewada. On 15.02.2007 a patrolling party proceeded for area dominationand searching and when they were returning back to the camp Aranpur apressure bomb exploded and the petitioner who was working under the BombDisposal Squad was injured and the pressure bomb was dug out after searchand a report to this effect was registered as F.I.R. No.0 2007 dated 05.02.2007at P.S. Camp Aranpur District Dantewada. As per the State in order to boostthe moral of the employees officers deployed in naxallite area a policy decisionwas taken and therefore a MoU was entered in between the State ofChhattisgarh and National Insurance Company and while the incidenthappened in view of the MoU which was in operation and clause 8 thereofpurports that after submission of the relevant claim documents the claim wouldbe settled as early as possible within one month.5.It is further submitted by the State that upon the injured petitioner making aclaim before the State authorities the letter was first sent to the DivisionalManager on 02.04.2011 along with all relevant documents i.e. the claim of theinjured petitioner copy of the F.I.R. copies of the medical certificates etc. but 4nothing happened as such it was followed by another letter dated 24.06.20211followed by letter dated 01.11.2011 and 08.02.2013 and lastly on 21.08.2013 however the amount was not released for which the petitioner is entitled. 6.Learned counsel for the National Insurance Company would submit that thepetitioner was not entitled for any relief to get a claim of Rs.5 Lakhs instead hewas entitled for Rs.1 Lakh as according to the MoU the nature of injury whichthe petitioner had sustained would fall within the ambit of permanentloss 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 about45% disability. Consequently the claim of the petitioner to the extent of Rs.5Lakh as has been recommended by the State Government cannot sustain. 7.I have heard learned counsel for the parties and perused the documents. 8.Admitted facts of this case are that the petitioner while performing his duty inthe naxallite combing operation sustained injury by a pressure bomb. Thepetitioner was working in bomb disposal squad. By such injury he sustained45% permanent disability. State Government in order to boost the moral of theemployee who are engaged in the naxallite operation had entered into an MoUwith National Insurance Company. The entire object to provide the protectiveumbrella to its employees so as to assure the financial support who takes upsuch hazardous and risky job. It is obvious that because of the people likepetitioner are at field discharging their duty under such life threateningcondition the general people in urban area takes pleasant sleep including theofficers of National Insurance Company. It is because of people like the 5petitioner who are performing their duty the naxallite operations are fenced toparticular area and not allowed to spread over State. The State Governmenttherefore to encourage and boost the moral of its force had entered into anMoU with Insurance Company to strike a balance of human loss & bodily injuryand to mitigate it by other way of support. 9.The MoU for the particular subject which is on record between the StateGovernment and the National Insurance Company the relevant clause thereof isreproduced hereinunder: “1 The insurance policy will cover the police personnel engaged in theNaxal affected area of the State of Chhattisgarh.2 This policy will be effective any where in the State of Chhattisgarh for Naxalrelated violence.4 All claim amount will be similar for all irrespective of rank.6 Benefits under the policy are as under:1Death 100% of Sum InsuredRs. 10 00 000.00 2Permanent Disability 100% of Sum InsuredRs. 10 00 000.003Loss of Two Limbs or Two Eyesor Two Ears. 100% of Sum InsuredRs. 10 00 000.004Loss of one Limb or one eye orone ear. 50% of Sum Insured Rs. 5 00 000.00 5Permanent Loss damage of anypart of the body. 10% of Sum Insured Rs. 1 00 000.00 6In case of hospitalization due toinjury Lump sum payment of Rs.10 000 per week subject to amaximum of Rs. 20 000 Rs. 20 000.00 7Children EducationCompensation on death of thepolice person. Rs. 25 000.008 After submission of relevant claim documents as specified above claimshall be settled as early as possible within one month. 610.The petitioner who now stands superannuated sustained permanent bodilyinjury. His medical certificate disability certificate is reproduced hereinunder: “DISABILITY CERTIFICATEDistrict Medical Board: JagdalpurCertificate No. 240 Date: 17 09 07(Recent attested photograph showing thedisability affixed here) CERTIFICATE FOR THE PERSONS WITH DISABILITIESThis is to certify that Shri Y. S. Bisht Son of Shri Balwant SingghBisht Age: 56 years old male Registration No. 55BN CRPF JD CrossRestriction of in case of Maluniled Fracture CaladiumpermanentSouth Bastar Dantewada (C.G.)”11.The return of the State shows that after the examination of the documents theState recommended by its letters dated 02.04.2011 24.06.2011 and01.11.2011 08.02.2013 & 21.08.2013 repeatedly asked the Divisional Manager National Insurance Company to release the amount of Rs.5 Lakhs consideringthe nature of injury.12.As has been laid down by the Supreme Court that the percentage of injury willhave a bearing to the vocational disability if the nature of injury renders a 7person 100% disable of his vocational capacity then in such case it would beconsidered as a permanent disability. The Supreme Court in the case ofChanappa Nagappa Muchalagoda V. Divisional Manager New IndiaInsurance Company Limited {AIR 2020 SC 166} specifically laid down thatwhen an injury rendered a person incapable to do a particular job consideringthe avocation it would deemed to be 100% loss of earning capacity. In theinstant case since the petitioner was working as Sub Inspector under theCRPF in Bomb Detection & Disposal Squad and after he sustained injury afterthe accident the injury would not had allowed him to go for a combing operationwhich requires a particular type of specialized acts during duty. Therefore unless and until the petitioner is fit to the extent of 100% he could not havedischarged the nature of duty which the petitioner was performing.Consequently the injury which caused disablement to the part of the right leg tothe extent of 45% and would render the petitioner not to perform his duty to theextent of aggression as was earlier one it would be deemed to be consideredto be loss of limb. The meaning of loss of limb cannot be given a narrowinterpretation or a definition that computation only would be considered only forloss of limb. It is obvious that in the like nature of incident if a person isexposed to any bomb he would not embrace it get his bodily part amputated tocome under definition of loss of limb to get a higher claim. Therefore theincapacity to perform the vocation to the fullest by petitioner for cause of 45%permanent disability of leg would mean that permanent disability sustained innaxallite operation rendering one unfit to do same job would amount to loss oflimb as per MoU. The benevolent object of MoU cannot be seen in narrowlence only to avoid liability by insurance company. The denial of the claim by 8insurance company will defeat the trust in the system & will impress upon thepeople working in naxallite operation that sword is dangling over them withoutany sense of security. 13.Therefore I am of considered opinion that as per the MoU the petitioner wouldbe entitled to get a sum of Rs.5 Lakhs as insurance claim. The documentswould show that despite the State persuaded the insurance company to releasethe amount to the tune of Rs.5 Lakhs considering the injury sustained by thepetitioner and various letters having written however the insurance companyremained dormant. There is no denial in the reply of the insurance companyalso that the letters written by the State were not received from 2011.Accordingly it is directed that the insurance company shall pay an amount ofRs.5 Lakhs to the petitioner within a period of 45 days from the date of receiptof the copy of this order which shall carry an interest @ 6 % p.a. from January2008.14.Accordingly the writ petition stands allowed. SD Sd Goutam Bhaduri JudgeAshu 