UNITED INDIA INSURANCE CO. LTD. vs RAJESH SHARMA

ALL the four appeals arise out of an accident which took place on 6.12.1991.

RAJESH Sharma, appellant in First Appeal No. 226 of 1998, while returning from his factory at Baddi to his residence, driving his Fiat car, collided with a tanker coming from the opposite side. Serious injuries were caused to Rajesh Sharma, and also to his father A.P. Sharma who was travelling by the same car. Both were under insurance cover for accident issued by the United India Insurance Co. Ltd. There is also no dispute that both Rajesh Sharma and A.P. Sharma have suffered permanent disability for which compensation will have to be paid by the Insurance Company. The dispute is about the quantum of compensation payable by the Insurance Company. Both Rajesh Sharma and A.P. Sharma have relied on the medical certificates granted by Dr. B.R. Verma, retired Director of Health Services. Dr. Verma has certified that A.P. Sharma had suffered 75% disability and Rajesh Sharma''s disability was to the extent of 56%. The Insurance Company was prepared to give compensation on the basis of Dr. Saluja''s opinion. According to Dr. Sanjay Saluja the disability in case of A.P. Sharma was 27% and in case of Rajesh Sharma 26%. The Insurance Company relied on a medical certificate given by Dr. Sanjay Saluja. The State Commission has preferred the medical certificate given by Dr. Verma who was a retired Director of Health Services. It has been contended on behalf of the Insurance Company that Dr. Saluja was an Orthopaedic Surgeon and his medical certificate should not have been rejected by the State Commission on the basis of die medical opinion given by Dr. Verma who was not a Orthopaedic Surgeon, but only a Physician.

HAVING heard the parties we feel that the case of the two complainants, Rajesh Sharma and A.P. Sharma should be examined by an independent Medical Board. We appoint the Head of the Department of Orthopaedic and the Head of the Department of Opthalmology of P.G.I. Hospital, Chandigarh to examine A.P. Sharma and Rajesh Sharma to constitute the Medical Board. The Board will consider the conflicting medical opinions given by Dr. B.R. Verma and Dr. Sanjay Saluja and give an independent opinion on the quantum of physical disability suffered by the two complainants after a medical check-up.

AN eye test will also be done to ascertain the damage, if any, caused to the eyes of the complainants. On behalf of the complainants it has been argued that the complainants had made claims under six heads. The State Commission had over-looked one of the claims altogether and he has preferred independent appeals in this regard.

WE shall examine this contention of the complainants when this case is finally taken up for hearing.

BOTH the Insurance Company and the complainants will approach the two doctors for finding out a date when it will be convenient for the doctors to examine the complainants. Post the case for hearing in the first week of January, 1999. The Board must convey its finding to this Commission within eight weeks from the date of receipt of a copy of this order. The two doctors constituting the Board will be paid a sum of Rs. 2,000/- each. The amount will be paid by the United India Insurance Company in the first instance. The Insurance Company, however, in the meantime must pay the admitted amount of liability to the complainants. The Insurance Company agreed to pay a sum of Rs. 2,81,000/-to A.P. Sharma and a sum of Rs. 1,62,500/- to Rajesh Sharma on the basis of reports submitted by Dr. Saluja. These amounts must be paid within a period of one month from today. The amount should be accepted by A.P. Sharma and Rajesh Sharma without prejudice to their rights and contentions.

COPIES of this order will also be sent directly to the Heads of the Opthalmology Department and Orthopaedic Department, P.G.I., Chandigarh.