Government of Rajasthan vs KISHORE KUMAR

THIS appeal by the opposite party to Complaint No. 163 of 2001 is directed against the order dated 17.10.2002 whereby District Forum, Barmer decreed respondent''s claim to the extent of Rs. one lakh against them.

RELEVANT facts are these: Shri Kishore Kumar, the respondent-complainant (the respondent), while going to attend to his duties as a lower Division Clerk in the office of the Executive Engineer, P.H.E.D., Barmer on 19.2.2000 in an autorickshaw, sustained multiple injuries as a result of overturning of the autorickshaw. He was covered under the group (Personal Accident) Insurance Scheme of the Government of Rajasthan (appellant No. 1). He, therefore, submitted his claim for compensation under the said scheme. His claim was, however, repudiated by appellant No. 1 on 8.8.2001 on the ground that the same was not admissible under Instruction (Rule) No. 7(3) of the Instruction Booklet about the said scheme. The District Forum, vide its impugned order, however, allowed his claim and directed the appellant to pay a sum of Rs. 1 lakh with interest at the rate of 7 per cent per annum from 8.8.2001 to him. Hence this appeal by the O.Ps. Heard the learned Counsel for the parties and examined the material on the record of the District Forum.

It is not in dispute that the provisions of the Group (Personal Accident) Insurance of the appellants are applicable to the case of the respondent and that if his case falls within the beneficial provisions of such scheme, no interference with the impugned order by us would be required. On going through the medical examination report and other like reports about the nature of the injuries caused and damage done to the respondent, we find that as a result of the overturning of the autorickshaw, the respondent had sustained multiple injuries on his forehead, left cheek, lower hip and left hip joint, left leg, on both sides of back, left little finger, right knee, right wrist and fingers. On x-ray examination, fracture of fibula bone at its upper half, fracture of 12th and 9th ribs of right side and 4th and 5th of left side and fracture of left femur bone at its trochecutic region were detected. Dr. Ateet B. Sharma, in his certificate issued on 24.2.2001, certified 15 per cent permanent partial disability to the respondent caused by the fracture of left hip bone. On examining him on 10.2.2002 Dr. H.K. Singhal, M.S. (Surgeon) at the Government Hospital certified that there were closed fractures of left hip joint and mid-shaft fibula, multiple lacerated wounds on forehead and left lower hip, black eye with edema and sub-congeal haemorrhage on left side with element of head injury and multiple abrasious on face left side. Dr. Singhal recorded the history of treatment of the complainant and of his undergoing surgical operation at Gandhi Lincon Hospital and at Satellite Orthopaedic and Research Centre, Ahmedabad and noticed that the complainant could not run fast and walk with help crutches and that his left lower limb had become 2" shorter than that on the right side and had permanent disability in that region and aspect. The question for consideration, however, is whether the above mentioned injuries to the respondent are covered by the Scheme under consideration.

INSTRUCTION No. 6 of the INSTRUCTION Book says that: "(Hindi matter omitted): 1. (Hindi matter omitted) 2. xxxxxxx 3. xxxxxxx 4. xxxxxxx 5. to 9. xxxxxxxxxxxxxxxxxxxx"

It may be noted that what is required for obtaining the benefits of and under the Scheme is that the injury should have been sustained by the insured in an accident and that such injury should be the direct cause of the physical loss sustained by him. In the instant case, the provisions of Instruction No. 6(1) are fully applicable to the case of the respondent.

COMING now to Instruction No. 7(3), under which the appellant repudiated the claim of the respondent, we note that it reads as under: "7. (Hindi matter omitted) 1. (Hindi matter omitted) 2. (Hindi matter omitted) 3. Hindi matter omitted"

[Emphasis supplied] It is on the basis of the underlined statement in Instruction No. 7(3) that it was vehemently urged that no benefit under the scheme is admissible on the basis of fracture of the bones of the hands or legs and, for that matter, any other bone of the body, of the injured. In our opinion, such a restricted application of the scheme would negate the very purpose and object of such a beneficial scheme. It has been seen above that as per Instructions 6(1) an injured who had sustained injuries in an accident and which injuries directly resulted in causing loss or partial loss to any of his organ, limb or a part of his body, which has substantially diminished his capacity and capability to perform his routine duties or to do his normal work, would also be entitled to the benefits of the Scheme. This view gets support from the example given under Instruction No. 8 in the following words: ("Hindi matter omitted") N.B. : The maximum amount payable under the Scheme is Rs. 2 lakhs in the event of accidental death of the insured.

IT may thus be seen that the scope of Instruction No. 6(1) is wide enough to embrace within its fold such losses to other parts, organs or limbs of the injured also which have not been specifically defined and explained in the Scheme. For example, whereas in Instruction No. 9, it has been explained that "loss of hand" would mean "computation of hand at or above the wrist" and "loss of foot" would mean "amputation of foot" at or above the ankle, no such attributes have been attached to "loss of one or both eyes", though all the three i.e., the hands, the feet and the eyes have been mentioned in Instruction Nos. 11(2) and 11(3) and in the case of loss of both hands or both feet or both eyes the sum assured payable as per Instruction No. 11(2) would be Rs. 2 lakhs each and in the case of loss of one hand or one foot or one eye. Rs. 1 lakh each as per Instruction No. 11(3). IT may further be noted that in the category of partial loss, loss of hearing, loss to the fingers and thumbs of hands, loss of big toes and other toes of the foot have although been included in Instruction No. 11(5) but there is no mention therein of partial loss of eye or eyes caused as a result of injuries sustained in an accident. IT means that injury to eye or eyes in the accident would certainly result in loss (Hindi matter omitted) but the extent of such injury has not been, like the injuries (loss) to hands and feet, defined in Instruction No. 9.

ON the same analogy and looking to the aims and objects of the Scheme, it should follow that injuries caused to head, heart, lungs, kidneys, ears etc. of the insured in an accident and which injuries have resulted in diminishing the non-ability of these organs cannot altogether be ignored while awarding compensation or the sum assured under the Scheme. The various clauses of the scheme, as reflected in the Instruction Booklet are required to be given liberal and purposeful interpretation while applying to the cases of Government servants who sustain injuries in accidents in the course of discharge of their official duties. In this behalf, we seek support from the decisions of Karnataka High Court in the case of Mysore Sugar Co. Ltd. v. B.T. Krishna Murthy, II (1997) SCC 233, Allahabad High Court, decisions in Raghu Raj Singh v. Divisional Superintendent, Northern Railways, 1968 All. L.J. 109, and Obra Thermal Power Station, U.P. State Electricity Board v. Workmen''s Compensation Commissioner, 1997 All. L.J. 747, and our own decision in the case of L.I.C. v. Sharvan Kumar Sharma, Appeal No. 884 of 2002, decided by our order of the even date.

Applying the aforementioned principles to the facts of the case on hand, we are of the opinion that the District Forum did not err in awarding a compensation of Rs. 1 lakh to the respondent-insured. In this behalf, we would like to refer to the medical examination reports, the X-ray examination report and the certification of loss of various organs/parts of the respondent, caused as a result of injuries sustained by him in the accident and particularly taking note of the loss caused to his eye and head and shortening of his left lower limb by 2", we are inclined to uphold the impugned order. We do accordingly.

IN the result, this appeal fails and is dismissed accordingly with cost on parties. Appeal dismissed.