w w w . L a w y e r S e r v i c e s . i n



Regional Manager, Bajaj Allianz General Ins. Co. Ltd., New Delhi & Another v/s Capt. Bibhuti Mohan Jha


Company & Directors' Information:- TO THE NEW PRIVATE LIMITED [Active] CIN = U72900DL2006PTC235208

Company & Directors' Information:- BAJAJ AND COMPANY PVT LTD [Active] CIN = U00000DL1990PTC041995

Company & Directors' Information:- MOHAN INDIA PRIVATE LIMITED [Active] CIN = U70101DL2010PTC207186

Company & Directors' Information:- MOHAN MOHAN & CO PRIVATE LIMITED [Active] CIN = U60200BR1951PTC000497

Company & Directors' Information:- R AND R MOHAN INDIA PVT LTD [Active] CIN = U74899DL1961PTC003426

Company & Directors' Information:- BAJAJ (INDIA) PVT LTD [Strike Off] CIN = U51109WB1986PTC040285

Company & Directors' Information:- K MOHAN (INDIA ) PRIVATE LIMITED [Strike Off] CIN = U63090DL1987PTC027404

Company & Directors' Information:- B L AND CO NEW DELHI PRIVATE LIMITED [Active] CIN = U74899DL1968PTC004910

Company & Directors' Information:- S F S ALLIANZ PRIVATE LIMITED [Active] CIN = U74120MH2012PTC227999

Company & Directors' Information:- BAJAJ INDIA PVT LTD [Strike Off] CIN = U74899DL1976PTC008210

Company & Directors' Information:- NEW INDIA CORPORATION PRIVATE LIMITED [Strike Off] CIN = U36999TN1940PTC001776

    First Appeal No. 119 of 2015

    Decided On, 04 August 2020

    At, National Consumer Disputes Redressal Commission NCDRC

    By, THE HONOURABLE MR. PREM NARAIN
    By, PRESIDING MEMBER

    For the Appellant: Pradeep Gaur, Advocate. For the Respondent: Mohinder Singh, Lovekesh Aggarwal, Advocates.



Judgment Text


This first appeal has been filed by the appellant Regional Manager, Bajaj Allianz General Insurance Co. Ltd. against the order dated 17.11.2014 of the State Consumer Disputes Redressal Commission, Maharashtra (in short ‘the State Commission’) passed in Complaint No.CC/12/254.

2. Brief facts of the case are that the respondent/complainant was a licensed pilot working with Air India. The respondent availed an insurance policy for loss of licence and personal accident (Aviation Plan) to secure himself in case of loss of pilot licence due to contingencies mentioned in the policy. He retired from Air India from his regular employment on 30.6.2009. He was later employed on contract basis. The respondent was reemployed on contract basis on year to year basis by the Air India. His first contract was from 17.07.2009 to 16.07.2010. The contract was renewed for another year from 19.7.2010 to 18.07.2011. During this contract period, the respondent was declared temporarily unfit for flying on 21.06.2011 and declared permanently unfit for flying on 05.07.2011. The respondent filed claim for the insurance amount under the policy (Rs.50,00,000/-) with the opposite party. The opposite party vide its letter dated 25.11.2011 denied the claim for total insurance amount, however, they offered one month salary of Rs.6,35,000/- as settlement of the claim. The respondent then filed a consumer complaint bearing no. CC/12/254 before the State Commission. The complaint was resisted by the opposite party by filing the written statement. It was stated that as per condition no.3 of the policy, the Insurance Company was required to pay only one month’s salary and this sum was offered to the complainant but the same was declined by the complainant. It was requested to dismiss the complaint. However, the State Commission allowed the complaint and passed the following order on 17.11.2014:-

“1. Complaint is partly allowed.

2. Opponent Insurance Company is directed to pay Rs.50,00,000/- [sum assured under the policy] along with Rs.7,50,000/- (as bonus of Rs.2,50,000/- @5% p.a. on the sum assured effective from the year 2008 to 2011) with interest @6% p.a. effective from the date of filing of complaint i.e. 25/09/2012 within period of 45 days from the date of the order, failing which the rate of interest will be enhanced to 9% p.a. from 25/09/2012 till its realization.

3. Opponents are further directed to bear their own costs and to pay costs of Rs.25,000/- to the complainant.”

3. Hence the present appeal.

4. Heard the learned counsel for both the parties and perused the record. The learned counsel for the appellant stated that the condition no.3 of the policy states as under:-

“3. It is declared and agreed that the maximum sum insured to be granted under the Policy is restricted as per annexure attached. The maximum limit of sum insured for unemployed pilots is restricted to Rs.10,00,000/-. It is however, further agreed that the compensation under both Temporary Medical Unfitness (TMU) and Permanent medical Unfitness (PMU) in no case shall exceed the sum insured or the sum of the salary including allowances a pilot would have earned from his employer till date of his retirement, whichever is lower. For this purpose retirement would include service on contract basis or any other extension granted by the employer.”

5. It was argued that from the above condition, it is clear that the Insurance Company has to pay insured amount or salary of the remaining months till retirement, whichever is less. In the case of the complainant, regular retirement has already happened on 30.06.2009 and therefore, the retirement would mean the end of the contract of the complainant. The current contract was from 19.7.2010 to 18.7.2011. The complainant was declared permanently unfit for flying on 05.07.2011 and therefore, the complainant was entitled only for salary to be paid upto 18.07.2011, however, full one month’s salary has been offered to the complainant. The State Commission has also based its judgment and order on the basis of this very condition, however, the State Commission has wrongly interpreted the provision of this condition. There is no ambiguity in this condition and its straight meaning has to be considered for settlement of the claim. Thus, the order of the State Commission is totally illegal and against the contract of the policy. The parties are bound by the contract of the policy and no court can interpret the contract differently than that expressed in terms of the policy.

6. On the other hand, learned counsel for the respondent stated that the complainant was originally appointed as a Commander Pilot for a period of three years effective from 06.07.2009. However, this was modified and was made effective for one year for the period 17.07.2009 to 16.07.2010 and was to be renewed on yearly basis. It was further stated that the pilots are allowed to work upto 65 years of age subject to medical fitness and therefore, effective age of retirement would be 65 years. It was also argued that had the complainant not become permanently unfit for flying, Air India would have renewed his contract for further one year. Thus, the date of effective retirement in the case of the complainant should be taken to be 18.07.2012 and not 18.07.2011. Thus, the complainant is entitled to get full insurance amount of Rs.50,00,000/- and the accrued bonus as ordered by the State Commission.

7. I have carefully considered the arguments advanced by the learned counsel for the parties and have examined the material on record. Some of the undisputed facts are that complainant has taken the policy, which was effective when the complainant was declared unfit for flying on 05.07.2011. The complainant had actually retired from regular employment of Air India on 30.6.2009 though he was appointed on three years contract initially, but the same was converted to year to year appointment on contract basis. The current contract was from 19.07.2010 to 18.7.2011. Meanwhile, the complainant became permanently unfit for flying on 05.07.2011 and his employment contract was not extended by Air India. Thus, his employment with Air India even on contract basis ended on 18.07.2011, therefore, the date of retirement will definitely be the date of end of the contract i.e. 18.07.2011. Thus, as per the condition no.3 of the policy, the liability of the Insurance Company is to pay insured amount or salary of number of months remaining for retirement of the insured whichever is less. On the basis of this condition, the liability of the Insurance Company seems to be only the salary for about a month which has already been offered by the Insurance Company. Thus, I do not find any illegality in the offer given by the Insurance Company. Though the State Commission has based its decision on the same condition, but has not clarified the reason for allowing the total insurance amo

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unt. Clearly, the interpretation of the State Commission in respect of condition no.3 is not correct and the order of the State Commission cannot be sustained. 8. Based on the above discussion, the First Appeal no.119 of 2015 is allowed and the order of the State Commission dated 17.11.2014 passed in consumer complaint no. CC/12/254 is set aside, however, the Insurance Company will pay the amount of Rs.6,35,000/- as already offered along with interest @9% p.a. from the date of filing of the complaint before the State Commission till actual payment. The Insurance Company shall also pay the accrued bonus as per the terms of the policy. The payments should be ensured within a period of 30 days from the date of receipt of this order by the Insurance Company.
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