High CourtsSingle Bench(2016) 08 J&K CK 0008

Mohan Lal vs Oriental Insurance Co. Ltd.

Jammu And Kashmir High Court · Decided on 10 August 2016 · Citation: (2017) 1 TAC 103

HON’BLE JUDGES
Mr. Ramalingam Sudhakar, J.
RESULT
Disposed Off
CASE NUMBER
CIMA No. 199 to 203 of 2007, 205 to 226 of 2007, S-28 of 2006 and 494 of 2013

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Judgment

202 paragraphs · 2,523 words

1,Cost of treatment,"Rs.2,500/-

2,Special Diet and Transport charges,"Rs.2,500/-

3,Pain and Suffering,"Rs.5,000/-

4,Loss of amenities of life,"Rs.15,000/-

,Total,"Rs.25,000/-

1,Cost of medicines,"Rs.5,000/-

2,Boarding and lodging expenses,"Rs.7,500/-

3,Transport charges,"Rs.3,000/-

4,Special Diet,"Rs.2,500/-

4,Pain and suffering,"Rs.15,000/-

5,Loss of amenities of life,"Rs.10,000/-

,Total,"Rs.43,000/-

1,Cost of treatment,"Rs.10,000/-

2,Transport Charges,"Rs.5,000/-

3,Pain and suffering,"Rs.10,000/-

4,Loss of amenities of life,"Rs.15,000/-

,Total,"Rs.40,000/-

1,Cost of medicines,Rs.3000/-

2,Special diet,"Rs.5,000/-

3,Pain and suffering,"Rs.10,000/-

4,"Attendant, travelling & Boarding & Lodging

charges","Rs.5,000/-

,Total,"Rs.23,000/-

1,Cost of treatment/special diet,"Rs.10,000/-

2,Boarding and lodging,"Rs.5,000/-

3,Travelling expenses,"Rs.5,000/-

4,Pain and suffering,"Rs.10,000/-

5,Loss of amenities of life,"Rs.20,000/-

,Total,"Rs.50,000/-

1,Future loss of income,"Rs.25,000/-

2,Cost of treatment,"Rs.10,000/-

3,Cost of extra nutrition,"Rs.5,000/-

3,Expenses on boarding/lodging,"Rs.5,000/-

4,Pain and suffering,"Rs.10,000/-

5,Loss of amenities of life,"Rs.5,000/-

,Total,"Rs.60,000/-

1,Cost of medicines,"Rs.7,000/-

2,Special diet,"Rs.5,000/-

3,Attendance/transport charges,"Rs.8,000/-

4,Pain and suffering,"Rs.10,000/-

5,Loss of amenities of life,"Rs.10,000/-

,Total,"Rs.40,000/-

1,Cost of treatment,"Rs.5,000/-

2,Transport Charges,"Rs.5,000/-

3,Attendant charges,"Rs.2,500/-

4,Cost of extra nutrition,"Rs.2,500/-

3,Pain and suffering,"Rs.7,500/-

,Total,"Rs.22,500/-

CIMA No. 215/2007,,

73.

The claim of the claimant/appellant before the Tribunal was that she was of the age of 9 years on the date of accident and in the accident she,,

received multiple grievous injuries. Her head, right ear and arm were badly crushed, which have crippled her and she is unable to perform her day",,

to day routine job. It was stated that firstly she was admitted in Sunderbani Hospital and on the same day was referred to GMC Hospital, Jammu",,

where she remained under treatment upto 23.09.1996. Appellant claimed total compensation of Rs.8.30 lacs on various grounds mentioned in the,,

claim petition. The appellant placed on record of the Tribunal a disability certificate, however, this certificate makes mention of only pain and",,

stiffness of lumber spine and it does not make mention of any injury as mentioned in the claim petition.,,

74.

The Tribunal found that the OPD Card produced by the appellant does not tally with the date of accident or the date when the petitioner was,,

examined in the GMC by the doctor, who issued disability certificate. Even the father through whom claim petition was filed had not appeared in",,

the witness box. The Tribunal further noticed that name of the appellant does not figure in the list of injured person or list of prosecution witnesses,,

issued by the SHO Police Station concerned. Accordingly, the Tribunal held that the appellant had failed to prove that she suffered any injury in the",,

accident and dismissed the claim petition.,,

75.

Aggrieved by dismissal of the claim petition, the appellant has filed this appeal for setting aside the order of the Tribunal and for grant of",,

reasonable, just and appropriate award in her favour stating that the Tribunal had awarded Rs.25,000/- as interim award under 'no fault liability'",,

but had dismissed the claim petition, ignoring the fact that the appellant sustained 5% disablement in her right ear, head injury and right arm was",,

badly crushed due to which the appellant has become a disabled woman.,,

76.

After hearing learned counsel for the parties and perusing the award it is found that the date of the OPD card placed before the Tribunal did,,

not tally with the date of the accident or the date when the petitioner was examined in GMC by Dr. Rakesh Sharma. The Tribunal was justified in,,

dismissing the claim petition because appellant has neither examined her father through whom claim petition was filed nor any witness, except the",,

doctor who issued the disability certificate. Mere filing of the claim petition is not sufficient for grant of compensation. This appeal is accordingly,,

dismissed.,,

CIMA No. 216/2007,,

77.

The claimant/appellant was of the age of 10 years on the date of accident and had filed her claim petition through her father Mr. Satvir. The,,

claim before the Tribunal was that she received multiple injuries to whole of her body in the accident. Injury to her head and stomach was,,

described to be very serious because it resulted in continuous bleeding. According to the appellant, she remained admitted in Hospital at",,

Sunderbani from 19.10.1996 to 23.10.1996 but she has not placed on record any medical evidence in this regard nor was such record,,

summoned. The appellant examined Dr. Rakesh Sharma who issued the disability certificate but the father, who filed the claim petition, has not",,

appeared in the witness box. Appellant's name also does not figure in the list of injured persons issued by the SHO Police Station concerned. The,,

Tribunal has further noticed that the witnesses examined in connected claim petitions have not disclosed that the appellant was travelling in the,,

offending vehicle and sustained injuries. It was only Kamla Devi W/o Hari Dev Singh, who was also one of the claimants stated that one Nirmal",,

Kumari was also traveling in the offending bus but her parentage has not been disclosed and there were two other women namely Nirmal Kumari,,

and Nirmla Devi, who have also filed claim petition. It was also noticed by the Tribunal that the statement of Dr. Rakesh Sharma was not signed by",,

the then Presiding Officer.,,

78.

After considering the above facts, the Tribunal has dismissed the claim petition.",,

79.

Aggrieved by the dismissal of the claim petition, the appellant has filed this appeal seeking setting aside of the dismissal order and for grant of",,

reasonable, just and appropriate award in her favour by stating that the Tribunal had awarded Rs.25,000/- as interim award under 'no fault liability'",,

but had dismissed the claim petition, ignoring the fact that the appellant sustained 10% permanent disablement in her stomach and head injury due",,

to which the appellant has become a disabled woman.,,

80.

After hearing learned counsel for the parties and perusing the award it is found that the Tribunal was justified in dismissing the claim petition,,

because neither any medical was placed on record (except the disability certificate to prove the injuries) nor the father of the appellant, through",,

whom claim petition was filed, has appeared in the witness box. Mere filing of the claim petition is not sufficient for grant of compensation.",,

81.

This appeal is accordingly dismissed.,,

CIMA No. 217/2007,,

82.

The claim of the claimant/appellant before the Tribunal was that he was a bandmaster and was of the age of 25 years at the time of accident.,,

The monthly income was pleaded as Rs.2000/- per month. It was alleged that both side ribs of the appellant were badly pressed in the accident,,

due to which he is unable to breathe properly. According to the appellant, he was treated in Sunderbani Hospital and was discharged on",,

21.09.1996. The appellant also placed on record of the Tribunal a disability certificate issued by Dr. Rakesh Sharma of GMC Hospital, Jammu,",,

which indicates that appellant suffered stiffness of lumber spine due to the injury to spine. While appearing in the witness box, the appellant claimed",,

that his ribs were badly damaged in the accident. The doctor was also examined in order to prove the disability certificate.,,

83.

The Tribunal observed that appellant claims that his ribs were badly pressed but he failed to explain as to how Dr. Rakesh Sharma issued,,

certificate in respect of stiffness of lumber spine and the doctor has not mentioned the nature of the injuries and also had not disclosed the age of,,

the injury. Accordingly, the Tribunal held that no amount of compensation can be granted on account of any loss of future earning and after",,

considering that appellant injured in the accident and might have spent some amount on the treatment, awarded compensation as under :-",,

1,Cost of treatment,"Rs.4,000/-

2,Cost of extra nutrition,"Rs.2,500

2,For boarding and lodging,"Rs.1,500/-

3,For traveling expenses,"Rs.5,000/-

4,For pain and suffering,"Rs.10,000/-

,Total,"Rs.23,500/-

91.

The claim of the claimant/appellant before the Tribunal was that she was student and was of the age of 16 years at the time of accident.,,

According to her, besides studies she used to help her parents in household and agricultural affairs after school hours and has assessed Rs.5,000/-",,

per month as cost of the services she rendered. It was alleged that in the accident the appellant received multiple grievous and soft tissue injuries,,

and the wounds received by her have caused permanent disfiguration. However, the appellant has not placed on record of the tribunal any medical",,

record. At the time of filing of the claim petition, the permanent disability certificate was not placed on record by stating that same has not been",,

issued by the doctor attending her. This plea of the appellant was found to be false by the Tribunal because the permanent disability certificate,,

which was produced later on was issued on 13.05.1997 whereas the claim petition was filed on 26.05.1997 i.e. after 13 days from the date of,,

issuance of disability certificate. While appearing in the witness box, the appellant claimed that she sustained fracture of left leg and injuries to knee",,

but has failed to prove that she sustained such injuries in the accident. Even in the list of the injured persons issued by the Police Station concerned,",,

the name of the appellant does not figure. Thus, the Tribunal observed that claimant/appellant has failed to prove that she suffered injuries of the",,

nature mentioned in the permanent disability certificate in the accident in question. The doctor who issued the disability certificate while appearing in,,

the witness box has stated that no treatment record was shown to him. Therefore, the Tribunal held that the disability certificate is doubtful and",,

cannot be relied upon and dismissed the claim petition.,,

92.

The appellant has filed this appeal seeking enhancement of the award of the Tribunal. According to the appellant, the Tribunal has granted",,

Rs.5,000/- only as compensation and he seeks modification of the award by passing a reasonable, just and appropriate order.",,

93.

Learned counsel appearing for the Insurance Company justifying the order of the tribunal has contended that the disability certificate issued by,,

a doctor who has never treated the patient cannot be relied upon and placed reliance on the following judgments of Hon'ble the Supreme Court,",,

viz., (i) Raj Kumar v. Ajay Kumar and anr. 2011 ACJ 1; and (ii) Rajesh Kumar alias Raju v. Yudhvir Singh, 2008(7) SCC 305, and a",,

judgment of Karnataka High Court rendered in National Insurance Co. Ltd. Banglore v. Rangappa and anr. 2012 AAC 133 (Kar).,,

94.

The Apex Court in Raj Kumar v. Ajay Kumar and another (supra), while dealing with disability certificates, held as follows:-",,

2.

The Tribunal should also act with caution, if it proposed to accept the expert evidence of doctors who did not treat the injured but who give",,

'ready to use' disability certificates, without proper medical assessment. There are several instances of unscrupulous doctors who without treating",,

the injured, readily giving liberal disability certificates to help the claimants. But where the disability certificates are given by duly constituted",,

Medical Boards, they may be accepted subject to evidence regarding the genuineness of such certificates. The Tribunal may invariably make it a",,

point to require the evidence of the Doctor who treated the injured or who assessed the permanent disability. Mere production of a disability,,

certificate or Discharge Certificate will not be proof of the extent of disability stated therein unless the Doctor who treated the claimant or who,,

medically examined and assessed the extent of disability of claimant, is tendered for cross-examination with reference to the certificate. If the",,

Tribunal is not satisfied with the medical evidence produced by the claimant, it can constitute a Medical Board (from a panel maintained by it in",,

consultation with reputed local Hospitals/Medical Colleges) and refer the claimant to such Medical Board for assessment of the disability.""",,

(Emphasis supplied),,

95.

The Apex Court in Rajesh Kumar alias Raju v. Yudhvir Singh (supra) observed as follows:-,,

11.

The certificate in question in this case was obtained after two years. It is not known as to whether the civil surgeon of the hospital treated the",,

appellant. On what basis, such a certificate was issued two years after the accident took place is not known. The author of the said certificate had",,

not been examined. Unless the author of the certificate examined himself, it was not admissible in evidence. Whether the disability at 60% was",,

calculated on the basis of the provisions of the Workmen's Compensation Act or other wise is not known. It is also not known as to whether he,,

was competent to issue such a certificate. It even does not appear that the contentions raised before us had either been raised before the Tribunal,,

or the High Court. The Tribunal as also the High Court, therefore, proceeded on the materials brought on record by the parties. In absence of any",,

contention having been raised in regard to the applicability of the Workmen's Compensation Act which, in our opinion, ex facie has no application,",,

the same, in our opinion, cannot be permitted to be raised for the first time.""",,

(Emphasis supplied),,

96.

In National Insurance Co. Ltd. Bangalore v. Rangappa and anr. (supra), High Court of Karnataka observed as under:-",,

14.

In addition to this claimant and commissioner also takes assistance of one Dr. Sridhar who has neither treated claimant nor knows anything",,

about the alleged injury suffered by him. He gives a false medical certificate to the effect that claimant has suffered injuries in the accident which is,,

caused due to use of tractor belonging to Subbegowda and said injury has caused 40% disability to his left leg. He does not give any opinion as,,

contemplated under Section 4(1)(c)(ii) of Workmen's Compensation Act which require the doctor to give opinion regarding what would be loss of,,

earning capacity the said injury has caused. In the absence of same Commissioner takes up responsibility on his broad shoulders and again comes,,

to assistance of claimant in fixing loss of earning capacity generously at 40% without there being acceptable evidence in support thereof and,,

proceeded to award compensation in favour of claimant.""",,

97.

The Tribunal was justified in dismissing the claim petition because the appellant had failed to prove the injuries alleged to have been suffered in,,

the accident. Moreover the doctor who issued the disability certificate while appearing before the Tribunal stated he never treated the appellant,,

and no treatment record was shown to him.,,

98.

In such view of the matter, the appeal is dismissed.",,

CIMA No. 220/2007,,

99.

In this case the Tribunal found that the claimant/appellant did not suffer any injury in the accident and his name does not figure in the list of,,

1,"Cost of treatment, special diet and transport

charges","Rs.10,000/-

2,Cost of extra nutrition,"Rs.5,000/-

2,Pain and suffering,"Rs.10,000/-

3,Loss of amenities and pleasure of life,"Rs.10,000/-

,Total,"Rs.35,000/-

1,Medical expenses,"Rs.7,500/-

2,Special diet/extra nutrition,"Rs.5,000/-

3,Attendant/Boarding and lodging charges,"Rs.5,000/-

4,Pain and suffering,"Rs.15,000/-

5,Loss of amenities of life,"Rs.10,000/-

,Total,"Rs.42,500/-

1,Loss of future income,"Rs.20,000/-

2,Cost of treatment,"Rs.5,000/-

3,Extra nutrition/special diet,"Rs.5,000/-

4,Attendant expenses,"Rs.2,500/-

3,Transport charges,"Rs.4,000/-

4,Pain and suffering,"Rs.15,000/-

,Total,"Rs.51,500/-

1,Cost of medicines,"Rs.5,000/-

2,Special diet,"Rs.5,000/-

3,Attendant charges,"Rs.2,500/-

4,Transportation charges,"Rs.5,000/-

5,Pain and suffering,"Rs.15,000/-

6,Loss of amenities of life,"Rs.10,000/-

,,

1,Cost of treatment,"Rs.8,000/-

2,For special diet,"Rs.2,000/-

3,For boarding and lodging,"Rs.5,000/-

4,For traveling expenses,"Rs.3,000/-

5,For pain and suffering,"Rs.10,000/-

6,For loss of amenities of life,"Rs.10,000/-

,Total,"Rs.38,000/-

1,Loss of future income,"Rs.2,60,000/-

2,Cost of treatment,"Rs.10,000/-

3,Special diet,"Rs.5,000/-

4,Transport and attendance charges,"Rs.5,000/-

5,Loss of marriage prospects,"Rs.15,000/-

6,Pain and sufferings,"Rs.20,000/-

7,Loss of amenities and pleasures of life,"Rs.20,000/-

,Total,"Rs.3,35,000/-