National Insurance Company Ltd. v. Bivash Saha alias Bivash Chandra Saha, Son of Shri Tapan Ch. Saha
2016-11-16
T.VAIPHEI
body2016
DigiLaw.ai
JUDGMENT & ORDER : 1. Heard Mr. S Lodh, the learned counsel for the appellant insurance company. Also heard Mr. R Datta, the learned counsel for the claimant-respondent. 2. This appeal is directed against the judgment & award, dated 06-10-2012, passed by a learned Member, Motor Accident Claims Tribunal, Sonamura, West Tripura (as it then was), in TS(MAC) No.21/2011 awarding a sum of Rs.4,62,270/- to the claimant-respondent as compensation for the injuries sustained by him in a vehicular accident. 3. The case of the claimant respondent is that in the morning of 16-9-2010, when he was riding with other passengers in a vehicle bearing registration No.TR-03-A-1983(Auto Rickshaw) towards Rajarbag Motor Stand from Brahmabari, the vehicle suddenly turned turtle on the left side of the road, which caused grievous injuries on various parts of his body. According to the claimant-respondent, the accident was caused due to the rash and negligent driving of the offending vehicle by its driver. He was immediately taken to TSD Hospital, Udaipur and was treated there as an indoor patient w.e.f. 16-09-2010 to 22-09-2010. The multiple injuries suffered by the claimant-respondent were fracture injuries on left clavicle, left distal end of radius, spinal cord and also suffered injuries on right & left leg, left hand, back side of waist, left shoulder, left elbow and right ankle. When his condition could not be improved, he was admitted to TMC & Dr. BRAM Hospital, Agartala for better treatment and was treated there as an indoor patient from 21-10-2010 to 27-10-2010, again from 10-11-2010 to 27-11-2010 and then finally from 02-01-2011 to 04-03-2011. According to the claimant respondent, even after his discharge from the hospital, he continued to receive treatment by attending the private chambers of doctors. He, therefore, claimed a compensation of Rs.15,30,000/-. The police registered a regular case vide R K Pur, P.S Case No.363/2010 under Sections 279/338 IPC over the vehicular accident and investigated the case. 4. According to the certificate issued by the District Disability Cell, South Tripura, Udaipur, the claimant-respondent is stated to be suffering from 70% disability. However, on perusal of the certificate so issued, it is not legible as to what was the nature of the disability suffered by the claimant-respondent as the description of the injuries mentioned therein turned out to be illegible. It also does not indicate as to whether the disability is about locomotor/visual/speech and hearing disability.
However, on perusal of the certificate so issued, it is not legible as to what was the nature of the disability suffered by the claimant-respondent as the description of the injuries mentioned therein turned out to be illegible. It also does not indicate as to whether the disability is about locomotor/visual/speech and hearing disability. It is incomprehensible to me as to how the Tribunal could simply award compensation without properly understanding the nature of the disability not to speak of the functional disability of the claimant respondent sustained by him. It is also not indicated in the said Certificate as to whether the disability is a permanent or temporary in nature. On the other hand, without ascertaining all these materials the Tribunal proceeded to award a sum of Rs.4,62,270/- to the claimant-respondent together with an interest @ 9% per annum. 5. In a case of injury, the Tribunal has the duty to ascertain the functional disability actually sustained by claimant, if necessary, by taking the assistance of a competent medical expert to enable him to arrive at just compensation. After all, the compensation awarded must be just and reasonable i.e. proportionate to the damage in the real sense. It should neither be a bonanza nor a source of profit. So the award of compensation is to be quantified by taking into consideration the facts and circumstance and attending peculiar or special features, if any, which requires judicious and rational approach. Of course, there will no precise mathematical calculations.- See State of Haryana v. Jasbir Kaur, (2003) 7 SCC 484 . In the view that I have taken, the impugned judgment dated 06-10-2012 cannot be sustained and is liable to be set aside. However, the case shall have to be remanded to the learned Member, Motor Accident Claims Tribunal, Sonamura, West Tripura for further trial. Needless to say, both the parties shall adduce more evidence to substantiate their respective cases. While conducting further trial, the Tribunal shall keep in mind the principles laid down by the Apex Court in paras 10, 11, 12, 13, 14, 15, 16, 17 and 18 of their judgment in Raj Kumar v. Ajay Kumar, (2011) 1 SCC 343 : “10.
Needless to say, both the parties shall adduce more evidence to substantiate their respective cases. While conducting further trial, the Tribunal shall keep in mind the principles laid down by the Apex Court in paras 10, 11, 12, 13, 14, 15, 16, 17 and 18 of their judgment in Raj Kumar v. Ajay Kumar, (2011) 1 SCC 343 : “10. Where the claimant suffers a permanent disability as a result of injuries, the assessment of compensation under the head of loss of future earnings would depend upon the effect and impact of such permanent disability on his earning capacity. The Tribunal should not mechanically apply the percentage of permanent disability as the percentage of economic loss or loss of earning capacity. In most of the cases, the percentage of economic loss, that is, the percentage of loss of earning capacity, arising from a permanent disability will be different from the percentage of permanent disability. Some Tribunals wrongly assume that in all cases, a particular extent (percentage) of permanent disability would result in a corresponding loss of earning capacity, and consequently, if the evidence produced show 45% as the permanent disability, will hold that there is 45% loss of future earning capacity. In most of the cases, equating the extent (percentage) of loss of earning capacity to the extent (percentage) of permanent disability will result in award of either too low or too high a compensation. 11. What requires to be assessed by the Tribunal is the effect of the permanent disability on the earning capacity of the injured; and after assessing the loss of earning capacity in terms of a percentage of the income, it has to be quantified in terms of money, to arrive at the future loss of earnings (by applying the standard multiplier method used to determine loss of dependency). We may however note that in some cases, on appreciation of evidence and assessment, the Tribunal may find that the percentage of loss of earning capacity as a result of the permanent disability, is approximately the same as the percentage of permanent disability in which case, of course, the Tribunal will adopt the said percentage for determination of compensation. (See for example, the decisions of this Court in Arvind Kumar Mishra v. New India Assurance Co. Ltd., (2010) 10 SCC 254 And Yadava Kumar v. National Insurance Co. Ltd., (2010) 10 SCC 341 12.
(See for example, the decisions of this Court in Arvind Kumar Mishra v. New India Assurance Co. Ltd., (2010) 10 SCC 254 And Yadava Kumar v. National Insurance Co. Ltd., (2010) 10 SCC 341 12. Therefore, the Tribunal has to first decide whether there is any permanent disability and, if so, the extent of such permanent disability. This means that the Tribunal should consider and decide with reference to the evidence: (i) whether the disablement is permanent or temporary; (ii) if the disablement is permanent, whether it is permanent total disablement or permanent partial disablement; (iii) if the disablement percentage is expressed with reference to any specific limb, then the effect of such disablement of the limb on the functioning of the entire body, that is, the permanent disability suffered by the person. If the Tribunal concludes that there is no permanent disability then there is no question of proceeding further and determining the loss of future earning capacity. But if the Tribunal concludes that there is permanent disability then it will proceed to ascertain its extent. After the Tribunal ascertains the actual extent of permanent disability of the claimant based on the medical evidence, it has to determine whether such permanent disability has affected or will affect his earning capacity. 13. Ascertainment of the effect of the permanent disability on the actual earning capacity involves three steps. The Tribunal has to first ascertain what activities the claimant could carry on in spite of the permanent disability and what he could not do as a result of the permanent disability (this is also relevant for awarding compensation under the head of loss of amenities of life). The second step is to ascertain his avocation, profession and nature of work before the accident, as also his age. The third step is to find out whether (i) the claimant is totally disabled from earning any kind of livelihood, or (ii) whether in spite of the permanent disability, the claimant could still effectively carry on the activities and functions, which he was earlier carrying on, or (iii) whether he was prevented or restricted from discharging his previous activities and functions, but could carry on some other or lesser scale of activities and functions so that he continues to earn or can continue to earn his livelihood. 14.
14. For example, if the left hand of a claimant is amputated, the permanent physical or functional disablement may be assessed around 60%. If the claimant was a driver or a carpenter, the actual loss of earning capacity may virtually be hundred per cent, if he is neither able to drive or do carpentry. On the other hand, if the claimant was a clerk in government service, the loss of his left hand may not result in loss of employment and he may still be continued as a clerk as he could perform his clerical functions; and in that event the loss of earning capacity will not be 100% as in the case of a driver or carpenter, nor 60% which is the actual physical disability, but far less. In fact, there may not be any need to award any compensation under the head of “loss of future earnings”, if the claimant continues in government service, though he may be awarded compensation under the head of loss of amenities as a consequence of losing his hand. Sometimes the injured claimant may be continued in service, but may not be found suitable for discharging the duties attached to the post or job which he was earlier holding, on account of his disability, and may therefore be shifted to some other suitable but lesser post with lesser emoluments, in which case there should be a limited award under the head of loss of future earning capacity, taking note of the reduced earning capacity. 16. The Tribunal should not be a silent spectator when medical evidence is tendered in regard to the injuries and their effect, in particular, the extent of permanent disability. Sections 168 and 169 of the Act make it evident that the Tribunal does not function as a neutral umpire as in a civil suit, but as an active explorer and seeker of truth who is required to “hold an enquiry into the claim” for determining the “just compensation”. The Tribunal should therefore take an active role to ascertain the true and correct position so that it can assess the “just compensation”.
The Tribunal should therefore take an active role to ascertain the true and correct position so that it can assess the “just compensation”. While dealing with personal injury cases, the Tribunal should preferably equip itself with a medical dictionary and a handbook for evaluation of permanent physical impairment (for example, Manual for Evaluation of Permanent Physical Impairment for Orthopaedic Surgeons, prepared by American Academy of Orthopaedic Surgeons or its Indian equivalent or other authorised texts) for understanding the medical evidence and assessing the physical and functional disability. The Tribunal may also keep in view the First Schedule to the Workmen’s Compensation Act, 1923 which gives some indication about the extent of permanent disability in different types of injuries, in the case of workmen. 17. If a doctor giving evidence uses technical medical terms, the Tribunal should instruct him to state in addition, in simple non-medical terms, the nature and the effect of the injury. If a doctor gives evidence about the percentage of permanent disability, the Tribunal has to seek clarification as to whether such percentage of disability is the functional disability with reference to the whole body or whether it is only with reference to a limb. If the percentage of permanent disability is stated with reference to a limb, the Tribunal will have to seek the doctor’s opinion as to whether it is possible to deduce the corresponding functional permanent disability with reference to the whole body and, if so, the percentage. 18. 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 give 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 the claimant, is tendered for cross-examination with reference to the certificate.
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 the 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.” Though the extracts are quite lengthy, their importance cannot be over-emphasized since proper determination of the just compensation payable to the claimant-respondent hinges upon due application of mind by the Tribunal on the aforesaid principles. 6. For what has been stated in the foregoing, this appeal is disposed of by remanding the case to the Tribunal for further trial in accordance with law. The impugned judgment is, therefore, set aside. Since the accident took place as early as 2010, an attempt will be made by the Tribunal to conclude the trial and dispose of the case within a period of 6(six) months from today. Both the parties are directed to appear before the Tribunal on 28-11-2016 for further proceedings. Transmit the L.C. record forthwith. 7. Before parting, I am constrained to observe that the manner in which the Motor Accident Claim Cases are conducted by the Tribunal, the counsel appearing for the claimant, the insurer and the owner of the offending vehicle left much to be desired. The Tribunal should take more pro-active role in the course of taking the evidence of the parties. The examination-in-chief these days are prepared by lawyers, yet seldom the averments made therein hit the bull’s eye with respect to the occupation, source of income, the income of the claimant/deceased or how the income was earned or nature of the disability sustained (for example as in this case) by the claimant and its impact of his/her earning capacity thereby leaving these vital issues to the imagination of the tribunal/appellate court to decide.
A typical example of cross-examination of the claimant by the counsel for the insurer is found in this appeal, which may be reproduced below: “Cross by O.P. Insurance Co.:- It is not a fact that I did not sustained any injuries followed by road traffic accident involved in the vehicle bearing registration No. TR-03A-1983. I is not a fact that my monthly income was Rs. 6,000/-. It is not a fact that I did not incur Rs. 2,26,350/- towards the cost of medicine. It is not a fact that my disablement certificate does not relied (related?) to the traffic accident. It is not a fact that my claim is excessive. It is not a fact that I am not entitled to have any compensation from the Insurance Company”. 8. What is the object of cross-examination? After a party examines his witness-in-chief, his opponent has the right to cross-examine him. The cross-examination follows immediately upon the examination-in-chief, unless the court for some reason, postpones it. The main object of cross-examination is to bring out the falsity and to find out the truth. Cross-examination is an art. It is to enable to the Court to assess the relative merits of the case projected by the parties. In the instant case, the appellant would like to establish that the claim petition was based on falsehood. The cross-examination of the claimant-respondent extracted above clearly demonstrates that no serious attempt was made by the counsel for the insurer to bring out the falsity, if there be any, in the case of the claimant-respondent or find out the truth from the cross-examination. Mere denial of the statement of the claimant-respondent in the so-called cross-examination does not help the case of the insurer. Under the circumstances, the parties are advised to instruct their respective counsels to prosecute their cases more competently and earnestly. Nothing stated in the foregoing, however, shall be construed to be an observation on the merit of the case, which is yet to be decided by the Tribunal after allowing the parties to adduce more evidence.