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Himachal Pradesh High Court · body

2016 DIGILAW 2386 (HP)

National Insurance Company Ltd. v. Mukta Sharma

2016-11-11

MANSOOR AHMAD MIR

body2016
JUDGMENT : Mansoor Ahmad Mir, J. 1. Both these appeals are the outcome of common award, dated 7th October, 2010, passed by the Motor Accident Claims Tribunal (I), Kangra at Dharamshala, H.P. (for short, the Tribunal), whereby compensation to the tune of Rs.12,60,050/, alongwith interest at the rate of 9% per annum, came to be granted in favour of the claimant and the insurer was saddled with the liability, (for short, the impugned award). 2. Feeling aggrieved, the claimant questioned the impugned award by the medium of FAO No. 181 of 2011 on the ground of adequacy of compensation, while the insurer has assailed the impugned award in FAO No. 1 of 2011 on the ground that the Tribunal has fallen into an error in saddling it with the liability. 3. Facts, as pleaded in the claim petition, are that the claimant, on 24th April, 2005, was traveling in Maruti Car No. HP-19-7000, being driven by respondent no. 2, namely, L.R. Sharma. When the said car reached near Banikhet, it rolled down the road and fell into a rivulet, resulting into injuries to the claimant, was taken to Public Health Center Banikhet, Tehsil Dalhousie, from-where was taken to Dr. Anil Singh Nursing Home, Pathankot, whereafter to Dr. Kalra’s Hospital at Pathankot, underwent medical tests, was referred to Dayanand Medical College and Hospital Ludhiana remained under treatment upto 12th May, 2005 and thereafter from 12th May, 2005 to 19th May, 2005 at IGMC, Shimla. It was also claimed that the claimant sustained permanent injury, was a practicing lawyer and was earning Rs.20,000/- per month. Thus, the claim petition was filed for compensation to the tune of Rs.32,50,000/- as per the break-ups given in the claim petition. 4. Respondent No. 1 resisted the claim petition by filing reply. Respondent No. 2 (husband of the claimant) also filed reply wherein it has been admitted that the claimant sustained injuries in the accident in question and that he was holding a valid and effective driving licence at the time of accident. 5. On the pleadings of the parties, the following issues were framed: “1. Whether the petitioner suffered injuries due to the rash and negligent driven of Maruti Car No. HP-19-7000 by respondent No. 2? OPP 2. If issue No. 1 is proved in affirmative to what amount of compensation the petitioner is entitled to and from whom? OPP 3. 5. On the pleadings of the parties, the following issues were framed: “1. Whether the petitioner suffered injuries due to the rash and negligent driven of Maruti Car No. HP-19-7000 by respondent No. 2? OPP 2. If issue No. 1 is proved in affirmative to what amount of compensation the petitioner is entitled to and from whom? OPP 3. Whether the petition is not maintainable? OPR-1 4. Relief.” 6. The statement of the claimant as PW-1 was got recorded through Local Commissioner. In addition, the claimant examined Dr. Sandeep Puri as PW-2, HHC Prittam Chand as PW-3, Dr. J.S. Chandel as PW-4, Dr. Viyom Parkash Bhardwaj as PW-5. On the other hand, the insurer examined Ashok Kumar as RW-1. 7. The Tribunal after scanning the pleadings as well as the entire evidence held the claimant entitled to Rs.12,60,050/- as compensation alongwith interest at the rate of 9% per annum, and saddled the insurer with the liability. 8. Feeling aggrieved, the insurer has challenged the impugned award by the medium of FAO No. 1 of 2011 on the ground that the compensation awarded by the Tribunal is excessive and that the Tribunal has wrongly fastened the liability on the insurer inasmuch as the insured has committed willful breach. 9. The claimant has challenged the impugned award by way of FAO No. 181 of 2011 and prayed for enhancement of compensation. 10. Following questions arise for determination in the instant appeals: (i) Whether the Tribunal has rightly saddled the insurer with the liability? (ii) Whether the amount awarded by the Tribunal is adequate or otherwise? 11. The factum of insurance is not in dispute. The claimant-injured is a third party, therefore, her claim cannot be defeated on flimsy grounds. 12. It is beaten law of the land that the insurer has to plead and prove that the owner of the offending vehicle has committed willful breach of the terms and conditions contained in the policy and mere plea here and there cannot be a ground for seeking exoneration. 13. The Apex Court in case titled as National Insurance Co. Ltd. vs. Swaran Singh & Others, reported in AIR 2004 SC 1531 , has taken the similar view. It is apt to reproduce relevant portion of para 105 of the judgment herein-below: “105...................... (i)......................... (ii)........................ 13. The Apex Court in case titled as National Insurance Co. Ltd. vs. Swaran Singh & Others, reported in AIR 2004 SC 1531 , has taken the similar view. It is apt to reproduce relevant portion of para 105 of the judgment herein-below: “105...................... (i)......................... (ii)........................ (iii) The breach of policy condition e.g. disqualification of driver or invalid driving licence of the driver, as contained in sub-section (2) (a) (ii) of Section 149, have to be proved to have been committed by the insured for avoiding liability by the insurer. Mere absence, fake or invalid driving licence or disqualification of the driver for driving at the relevant time, are not in themselves defences available to the insurer against either the insured or the third parties. To avoid its liability towards insured, the insurer has to prove that the insured was guilty of negligence and failed to exercise reasonable care in the matter of fulfilling the condition of the policy regarding use of vehicles by duly licensed driver or one who was not disqualified to drive at the relevant time. (iv) The insurance companies are, however, with a view to avoid their liability, must not only establish the available defences raised in the said proceedings; but must also establish 'breach' on the part of the owner of the vehicle; the burden of proof wherefore would be on them. (v)......................... (vi) Even where the insurer is able to prove breach on the part of the insured concerning the policy condition regarding holding of a valid licence by the driver or his qualification to drive during the relevant period, the insurer would not be allowed to avoid its liability towards insured unless the said breach or breaches on the condition of driving licence is/are so fundamental as are found to have contributed to the cause of the accident. The Tribunals in interpreting the policy conditions would apply “the rule of main purpose” and the concept of “fundamental breach” to allow defences available to the insured under Section 149 (2) of the Act.” 14. It is also profitable to reproduce para 10 of the latest judgment of the Apex Court in the case of Pepsu Road Transport Corporation vs. National Insurance Company, reported in (2013) 10 SCC 217 herein-below: “10. It is also profitable to reproduce para 10 of the latest judgment of the Apex Court in the case of Pepsu Road Transport Corporation vs. National Insurance Company, reported in (2013) 10 SCC 217 herein-below: “10. In a claim for compensation, it is certainly open to the insurer under Section 149(2)(a)(ii) to take a defence that the driver of the vehicle involved in the accident was not duly licensed. Once such a defence is taken, the onus is on the insurer. But even after it is proved that the licence possessed by the driver was a fake one, whether there is liability on the insurer is the moot question. As far as the owner of the vehicle is concerned, when he hires a driver, he has to check whether the driver has a valid driving licence. Thereafter he has to satisfy himself as to the competence of the driver. If satisfied in that regard also, it can be said that the owner had taken reasonable care in employing a person who is qualified and competent to drive the vehicle. The owner cannot be expected to go beyond that, to the extent of verifying the genuineness of the driving licence with the licensing authority before hiring the services of the driver. However, the situation would be different if at the time of insurance of the vehicle or thereafter the insurance company requires the owner of the vehicle to have the licence duly verified from the licensing authority or if the attention of the owner of the vehicle is otherwise invited to the allegation that the licence issued to the driver employed by him is a fake one and yet the owner does not take appropriate action for verification of the matter regarding the genuineness of the licence from the licensing authority. That is what is explained in Swaran ingh case. If despite such information with the owner that the licence possessed by his driver is fake, no action is taken by the insured for appropriate verification, then the insured will be at fault and, in such circumstances, the Insurance Company is not liable for the compensation.” 15. Thus, it was for the insurer to plead and prove that the offending vehicle was being driven in violation of the terms and conditions contained in the insurance policy, has not led any evidence to that effect, has failed to discharge the onus. 16. Thus, it was for the insurer to plead and prove that the offending vehicle was being driven in violation of the terms and conditions contained in the insurance policy, has not led any evidence to that effect, has failed to discharge the onus. 16. Having said so, question no. (i) is answered accordingly and it is held that the Tribunal has rightly saddled the insurer with the liability. Accordingly, the appeal filed by the insurer, being FAO No. 1 of 2011, is dismissed. 17. PW-2 Dr. Sandeep Puri has stated that the condition of the claimant-injured was critical and she has to carry this injury throughout her life, and that the injury has affected her brain. It has also come on the record that at the first instance, the disability certificate was issued wherein it was mentioned that the claimant suffered 20% permanent disability. Thereafter, the condition of the claimant deteriorated and the claimant was again examined by the Medical Board, which issued the disability certificate whereby the disability was assessed at 51%. The said disability certificate has been proved on record as Ext.PW-1/A. Accordingly, it is held that the Tribunal has rightly relied upon the disability certificate Ext.PW-1/A and held that the claimant suffered 51% permanent disability. 18. Insurer had moved application under Section 170 of the Act before the Tribunal for contesting the claim petition on all grounds, which was granted. Thus, the insurer can question the impugned award on the ground of adequacy of compensation. 19. The learned counsel for the appellant/claimant argued that the compensation awarded by the Tribunal is meager and is required to be enhanced accordingly. It was submitted that the Tribunal has not properly assessed the income of the claimant-injured and also awarded paltry amount under the heads pain and suffering, medical expenses and transportation charges. It was further submitted that the Tribunal has also not taken into account the effect of the disability suffered by the claimant. 20. It appears that the Tribunal has not assessed the compensation properly and rightly. Thus, in the facts of the case, question arises as to what is adequate compensation. In order to determine the said issue, the evidence of the claimant is required to be appreciated. 21. PW-2 Dr. 20. It appears that the Tribunal has not assessed the compensation properly and rightly. Thus, in the facts of the case, question arises as to what is adequate compensation. In order to determine the said issue, the evidence of the claimant is required to be appreciated. 21. PW-2 Dr. Sandeep Puri, DMC Hospital, Ludhiana, has stated that the claimant remained admitted in the hospital for 25 days, has to undergo medical treatment throughout her life and has to lead her life below normal. 22. PW-4 Dr. J.S. Chandel stated that the disability certificate dated 6th January, 2007 bears the signatures of Dr. Viyom Bhardwaj, examined as PW-5, who stated that Ext.PW-1/A (disability certificate) dated 6th January, 2007 bears his signatures. 23. The disability certificate, dated 6th January, 2007, Ext.PW-1/A, proved on record by the claimant shows that she suffered 51% permanent disability. The said fact has been proved by the claimant through her statement as well as from the statements of PW-4 and PW-5, though it has been pleaded in the claim petition that the claimant suffered 20% permanent disability. Another disability certificate, dated 31st December, 2005, has been proved on record as Ext.RX, which does disclose that the claimant suffered 20% permanent disability. The first disability certificate issued on 31st December, 2005 and the second disability was issued on 6th January, 2007. It appears that after the issuance of the first disability certificate, the percentage of the disability has increased which has affected her physical frame, for which reason the Medical Board examined the claimant afresh and the second disability certificate dated 6th January, 2007 was issued, whereby the disability has been shown to be 51%, which stands proved by the claimant by leading evidence. 24. Having said so, the compensation is to be assessed keeping in view the disability suffered by the claimant i.e. 51%. 25. The Apex Court in R.D. Hattangadi vs. M/s. Pest Control (India) Pvt. Ltd. & Others, reported in AIR 1995 SC 755 , Arvind Kumar Mishra vs. New India Assurance Co. Ltd. & Another, 2010 AIR SCW 6085, Ramchandrappa vs. The Manager, Royal Sundaram Aliance Insurance Company Limited, 2011 AIR SCW 4787 and Kavita vs. Deepak and Others, 2012 AIR SCW 4771, has clearly laid down the principles as to how compensation has to be awarded in cases where the claimants have suffered permanent disability and how the assessment is to be made. 26. The Apex Court in its latest decision in Jakir Hussein vs. Sabir and Others, (2015) 7 SCC 252 , while discussing its earlier pronouncements, observed that in injury cases, the compensation would include not only the actual expenses incurred, but the compensation has to be assessed keeping in view the struggle which the injured has to face throughout his/her life due to the permanent disability and the amount likely to be incurred for future medical treatment, loss of amenities of life, pain and suffering to undergo for the whole life etc. It is apt to reproduce paragraphs 11 and 18 of the said decision hereunder: “11. With regard to the pain, suffering and trauma which have been caused to the appellant due to his crushed hand, it is contended that the compensation awarded by the Tribunal was meagre and insufficient. It is not in dispute that the appellant had remained in the hospital for a period of over three months. It is not possible for the courts to make a precise assessment of the pain and trauma suffered by a person whose arm got crushed and has suffered permanent disability due to the accident that occurred. The appellant will have to struggle and face different challenges as being handicapped permanently. Therefore, in all such cases, the Tribunals and the courts should make a broad estimate for the purpose of determining the amount of just and reasonable compensation under pecuniary loss. Admittedly, at the time of accident, the appellant was a young man of 33 years. For the rest of his life, the appellant will suffer from the trauma of not being able to do his normal work of his job as a driver. Therefore, it is submitted that to meet the ends of justice it would be just and proper to award him a sum of Rs.1,50,000/- towards pain, suffering and trauma caused to him and a further amount of Rs.1,50,000/- for the loss of amenities and enjoyment of life. …………. …………… …………… 18. Further, we refer to the case of Rekha Jain & Another vs. National Insurance Co. Ltd. 2013 8 SCC 389 wherein this Court examined catena of cases and principles to be borne in mind while granting compensation under the heads of (i) pain, suffering and (ii) loss of amenities and so on. …………. …………… …………… 18. Further, we refer to the case of Rekha Jain & Another vs. National Insurance Co. Ltd. 2013 8 SCC 389 wherein this Court examined catena of cases and principles to be borne in mind while granting compensation under the heads of (i) pain, suffering and (ii) loss of amenities and so on. Therefore, as per the principles laid down in the case of Rekha Jain & Another and considering the suffering undergone by the appellant herein, and it will persist in future also and therefore, we are of the view to grant Rs.1,50,000/- towards the pain, suffering and trauma which will be undergone by the appellant throughout his life. Further, as he is not in a position to move freely, we additionally award Rs.1,50,000/- towards loss of amenities and enjoyment of life and happiness.” 27. The claimant-injured was an Advocate by profession. The disability suffered by the claimant has shattered her physical frame and, in all probabilities, she would not be in a position to do the job of an Advocate, as she would have been doing prior to the accident. 28. It has been pleaded by the claimant in the Claim Petition that she, at the time of accident, was earning Rs.20,000/- per month. No evidence has been led by the claimant in support of her assertion that she was earning Rs.20,000/- by practicing as an Advocate. However, by guess work, it can be said that the claimant-injured was earning not less than Rs.10,000/- per month. 29. The accident had taken place on 24th April, 2005, whereafter, as pleaded in the claim petition, the petitioner remained admitted till 19th May, 2005 in different hospitals, which fact is borne out from the material available on the record. After discharge from the hospital, the claimant would have also remained out of profession for a considerable period, say, for, six months. 30. The discussion in the preceding paragraph shows that the claimant, after sustaining the injury, remained admitted in the hospital for about one month and also would have remained out of profession for about six months, for treatment. The income of the claimant, as has been held above, was Rs.10,000/- per month. The Tribunal has gone astray in not awarding anything for the period during which the claimant remained under treatment. The income of the claimant, as has been held above, was Rs.10,000/- per month. The Tribunal has gone astray in not awarding anything for the period during which the claimant remained under treatment. The Tribunal must have appreciated the fact that the claimant was forced to remain out of practice because of the injuries sustained by her and not as per her own choice. Thus, the claimant was to be awarded compensation under the head loss of earning during treatment. Accordingly, the claimant is held entitled to Rs.10,000/- x 7 = Rs.70,000/- under the head loss of earning during treatment. 31. From the above discussion, it can safely be held that the claimant lost earning capacity to the extent of 50%. Thus, after making deduction, future loss of income, per month, to the claimant can be said to be Rs.5,000/-. 32. The claimant was 50 years of age at the time of accident. Having regard to the judgment of the Apex Court in Smt. Sarla Verma and Others vs. Delhi Transport Corporation and Another, (2009) 6 SCC 121 , which decision was also upheld by the larger Bench of the Apex Court in Reshma Kumari and Others vs. Madan Mohan and Another, 2013 AIR (SCW) 3120 read with the 2nd Schedule attached with the Act, it is held that multiplier of ‘11’ is just and appropriate, and is applied accordingly. 33. Having said so, the claimant is held entitled to Rs.5,000 x 12 x 11 = Rs. 6,60,000/- under the head loss of future income. 34. The Tribunal has also lost sight of the fact that the claimant suffered a lot, which fact is evident from the statement of Dr. Sandeep Puri (PW-2). Not only this, because of the disability suffered by the claimant, she has to struggle throughout her life. In the given circumstances, read with the law laid down by the Apex Court, the claimant is held entitled to Rs.1,00,000/- under the head ‘pain and sufferings’. 35. The claimant is also deprived of all comforts and amenities of life. The Tribunal has not awarded anything under the head loss of amenities of life. Keeping in view the facts and the law laid down by the Apex Court, the claimant is held entitled to Rs.1,00,000/- under the head loss of amenities of life. 36. 35. The claimant is also deprived of all comforts and amenities of life. The Tribunal has not awarded anything under the head loss of amenities of life. Keeping in view the facts and the law laid down by the Apex Court, the claimant is held entitled to Rs.1,00,000/- under the head loss of amenities of life. 36. The claimant would have also spent at least 100/- per day i.e. Rs.3,000/- per month on account of special diet during the period of treatment. Accordingly, the claimant is held entitled to Rs.3,000/- x 7 = Rs.21,000/- under the head special diet. 37. Keeping in view the expert evidence, the claimant has to undergo medical check-ups/treatment, at intervals, throughout her life and I deem it proper to award Rs.20,000/- under the head ‘future medical treatment’. 38. Compensation awarded by the Tribunal under the heads ‘medical expenses, ‘transportation charges’ and ‘attendant charges’ is maintained. 39. Having glance of the above discussion, the claimant is awarded Rs.11,40,150/- under different heads as under:- S. No. Heads Amount 1. Loss of earning during treatment Rs.70,000/- 2. Loss of future income Rs.6,60,000/- 3. Pain and sufferings Rs.1,00,000/- 4. Loss of amenities of life Rs.1,00,000/- 5. Attendant charges Rs.25,000/- 6. Special diet Rs.21,000/- 7. Future medical treatment Rs.20,000/- 8. Medical expenses incurred Rs.1,34,150/- 9. Transportation charges Rs.10,000/- Total Rs.11,40,150/- 40. The Tribunal has also wrongly awarded interest at the rate of 9%, which is on the higher side. It is beaten law of the land that the rate of interest should be awarded as per the prevailing rates, in view of the judgments rendered by the Apex Court in cases titled as United India Insurance Co. Ltd. and Others vs. Patricia Jean Mahajan and Others, reported in (2002) 6 SCC 281 ; Santosh Devi vs. National Insurance Company Ltd. and Others, reported in 2012 AIR SCW 2892; Amrit Bhanu Shali and Others vs. National Insurance Company Limited and Others, reported in (2012) 11 SCC 738 ; Smt. Savita vs. Binder Singh & Others, reported in 2014 AIR SCW 2053; Kalpanaraj & Others vs. Tamil Nadu State Transport Corporation, reported in 2014 AIR SCW 2982; Amresh Kumari vs. Niranjan Lal Jagdish Pd. Jain and Others, reported in (2015) 4 SCC 433 and Mohinder Kaur and Others vs. Hira Nand Sindhi (Ghoriwala) and Another, reported in (2015) 4 SCC 434 and discussed by this Court in a batch of FAOs, FAO No. 256 of 2010, titled as Oriental Insurance Company vs. Smt. Indiro and Others, being the lead case, decided on 19.06.2015. 41. Accordingly, it is held that the amount of compensation shall carry interest at the rate of 7.5% per annum from the date of filing of the claim petition till realization. 42. In view of the above discussion, the impugned award is modified. The Registry is directed to release the amount, alongwith interest, in favour of the claimant, forthwith, through her bank account, and the excess amount, if any, be released in favour of the insurer through payee’s account cheque. 43. Both the appeals stand disposed of accordingly.