NARASIMHULU Vs. UNITED INDIA INSURANCE CO CUDDAPAH

JUDGEMENT

(1.) THE petitioner is an officer in Rayalaseema Gram Panchayat. In 1996, he bought Janata Personal Accident Policy (policy) of first respondent. He met with an accident on 24. 2. 1999. He allegedly suffered injuries and resultant 50% disability in the right leg. He, therefore, claimed an amount of Rs. 2,50,000/- and first respondent rejected the same by an order 30. 3. 2000. He, therefore, sought redressal before the insurance Ombudsman, Hyderabad, second respondent herein, as per redresal of Public grievance Rules, 1998, and the same was dismissed by an order dated 22. 1. 2001. Yet again the petitioner approached the District forum, Cuddapah, by way of complaint under section 12 of the Consumer Protection Act, 1986. By an order dated 11. 2. 2004, the learned District Forum dismissed the complaint. While doing so, in Para 26 of said order, the District Forum observed that the petitioner has remedy by way of a suit or writ. Therefore, he filed instant writ petition. Second respondent filed a counter-affidavit and none appears for first respondent. Therefore, this Court requested sri Kota Subba Rao, learned standing counsel for various insurance companies, to assist the Court as amicus curiae. He appeared and made submissions, for which this Court is grateful to him.

(2.) LEARNED Counsel for the petitioner submits that rejection of the claim on the ground that 50% disablement cannot be considered as total loss is erroneous in view of the binding clauses in policy. He placed reliance on clause (c) of policy, which obligates the insurer to pay 50% of the sum insured even if the disablement is not associated with loss or physical separation of the limbs. He also relied on observations made by the District Forum that a writ would lie in such a matter. Per contra, the learned amicus curiae submits that for claiming policy amount a writ would not lie. He also submits that it is clause (d)of policy which applies in this case and as the petitioner was not absolutely disabled from being occupied with or giving attention to any employment or occupation, he is not entitled to any claim even though he suffered 50% disablement.

(3.) IF the rejection of insurance claim by the insurer can be justiciable issue in a writ petition, the other question would fall for consideration. However, having regard to the binding precedents referred to hereinafter this Court is of the considered opinion that a writ petition for claiming insurance amount, as it involves disputed questions of fact, would not lie.