Sunil Barbaruah v. Regional Manager Oriental Insurance Company Ltd. And Others, Assam
2019-09-10
MICHAEL ZOTHANKHUMA
body2019
DigiLaw.ai
JUDGMENT : Michael Zothankhuma, J. Heard Mr. N. Sharma, learned counsel for the appellant. Also heard Mr. A. Dutta, learned counsel for the respondent No.1 and Mr. S.C. Biswas, learned counsel for respondent Nos. 2 and 3. 2. This is an appeal for enhancement of the compensation amount of Rs. 50,000/- awarded by the learned Member, MACT No. 2, Kamrup-M, in MAC Case No. 1048/2016 vide judgment dated 08.03.2017. 3. The facts of the case in brief is that the appellant, while walking by the side of the road on 15.12.2015, was knocked down by a motor cycle bearing Registration No. AS12J/9273 as a result of which, he sustained injuries on his person. 4. Accident claim petition was filed by the appellant under Section 166 of the M.V. Act,1988 claiming compensation in respect of the medical expenses incurred by him. The learned Tribunal vide the impugned judgment dated 08.03.2017 passed in MAC Case No. 1048/2016, awarded Rs. 50,000/- to the appellant as medical expenses. 5. The learned counsel for the appellant submits that while the appellant had submitted a claim of approximately Rs. 7.5 Lakhs as medical expenses for the treatment incurred in treating the appellant's injuries, the learned Tribunal had awarded only Rs. 50,000/-, without examining the relevant medical records. He submits that as there is no dispute with regard to the medical bills submitted by the appellant, the learned Tribunal should have awarded the amount as provided in the medical bills. He also submits that on being knocked down by the motor cycle, the appellant sustained fracture injuries on his ankle and knee of the right leg and on the left arm and also after 6 or 7 days the appellant suffered brain haemorrhage. 6. The appellant's counsel submits that if the learned Tribunal had doubts with regard to the medical bills submitted by the appellant, the learned Tribunal should have examined the same by calling witnesses. In this regard he has relied upon the judgment of the Madras High Court in Shanmugham v. The Managing Director, Tamil Nadu State Transport Corporation, (2006) 4 MadLJ 257.
In this regard he has relied upon the judgment of the Madras High Court in Shanmugham v. The Managing Director, Tamil Nadu State Transport Corporation, (2006) 4 MadLJ 257. The appellant's counsel has also relied upon the judgment of the Calcutta High Court in the case of Traders Syndicate v. Union of India, (1983) AIR Calcutta 337, in support of his submission that in the absence of any cross-examination or suggestion with regard to the genuiness of the medical bills submitted by the appellant, the respondents are deemed to have accepted the medical expenses, as reflected in the medical bills. 7. Mr. A. Dutta, learned counsel for the respondent No. 1/Insurance Company, on the other hand, submits that no doctor or representative of the hospitals was examined to prove the genuiness of the medical bills submitted by the appellant. He, thus, submits that without there being any proof of the genuineness of the medical bills submitted by the appellant and keeping in view the nature of injuries sustained by the appellant, there is no infirmity in the decision of the learned Tribunal in awarding Rs. 50,000/- only. He also submits that there is no proof of the alleged brain haemorrhage suffered by the appellant being related to the accident. 8. I have heard the learned counsels for the parties. On perusing the medical bills submitted by the appellant, it appears that the appellant was first admitted to EMM Hospital & Research Centre, Tezpur on 15.12.2015 and discharged on 16.12.2015. In the medical report of EMM Hospital, Tezpur, the injuries of the appellant is shown as right leg and left shoulder following RTA. Thereafter, he was admitted to Pratiksha Hospital, Guwahati on 16.12.2015 and discharged on 22.12.2015. The final bills of Pratiksha Hospital shows that the injury of the appellant to be “leg AP/LAT.” Thereafter, he was admitted to International Hospital, Guwahati and discharged on 06.01.2016. The discharge report dated 06.01.2016 shows the final diagnosis of the appellant as follows:- “1. Right Tibia Fracture (Lower End) with Fracture Left Neck of Humerus 2. Type 2 Diabetes Mellitus 3. Hypertension” 9. None of the medical bills and documents submitted by the appellant show that any examination has been done with regard to the alleged brain haemorrhage suffered by the appellant, though the appellant in his cross- examination has stated that he suffered brain haemorrhage, 6 or 7 days after the accident.
Type 2 Diabetes Mellitus 3. Hypertension” 9. None of the medical bills and documents submitted by the appellant show that any examination has been done with regard to the alleged brain haemorrhage suffered by the appellant, though the appellant in his cross- examination has stated that he suffered brain haemorrhage, 6 or 7 days after the accident. Further, the appellant has also admitted in his cross- examination that he does not know whether the brain haemorrhage occurred due to the injuries sustained by him in the accident. The evidence given by the appellant in his cross-examination is reproduced below:- “I know about the contents of my affidavit. While I was trying to cross the road, the offending motorcycle knocked me down. I sustained fracture wounds on the ankle and knee of the right leg and on the left arm. After the accident for some time I lost my consciousness. After six/seven days, I suffered brain haemorrhage. I don't know whether the brain haemorrhage occurred due to the injuries sustained in the said accident or not. Still I cannot bend the right ankle. It is not a fact that I have prayed for granting excessive compensation.” 10. The evidence adduced in the cross-examination of the appellant and the medical reports submitted by the appellant goes to show that the stand of the appellant that he had suffered brain haemorrhage seems to be a fabricated after thought. It is unbelievable that the appellant would not have been examined for brain haemorrhage during the time he was in the various hospitals or even afterwards, if he had apparently suffered brain haemorrhage within 6 or 7 days of the accident. This is due to the fact that the appellant was in various hospitals continuously from the date of the accident, i, e.,15.12.2015 till 06.01.2016. There is no document made between 15.12.2015 and 05.05.2016, i.e., the date of filing the claim petition or even till date, showing that the appellant has been medically examined for his alleged brain haemorrhage. The above casts a doubt on the reliability of the appellant as a fair witness. 11. The Madras High Court has held in Para 12 and 13 in Shanmugham v. The Managing Director, Tamil Nadu State Transport Corporation, (2006) 4 MadLJ 257 as follows:- “12.
The above casts a doubt on the reliability of the appellant as a fair witness. 11. The Madras High Court has held in Para 12 and 13 in Shanmugham v. The Managing Director, Tamil Nadu State Transport Corporation, (2006) 4 MadLJ 257 as follows:- “12. An injured-claimant is entitled to sufficient medical treatment so as to restore himself to the original position as he would be but for the accident. In this case, the claimant had first approached the Government Hospital for firstaid and thereafter approached specialist Doctors in various hospitals for further treatment in respect of the injuries suffered on 12.6.1994. The Tribunal should have examined the relevant medical records and Bills if there was any doubt or called for details. 13. The Tribunal apparently passed the order rejecting a portion of the claim, on the ground that there is no evidence of a Doctor to support the medical bills of the claimant. The claim on medical bills should have been accepted in its entirety or rejected in full. The medical records clearly establish that treatment was given to the appellant-claimant only in respect of the injuries suffered by the claimant due to the accident caused by the negligence on the part of the driver of the bus belonging to the Transport Corporation on 12.6.1994. The proceedings before the Tribunal are summary in nature and based on records and documents. Strict rules of evidence cannot be made applicable to the proceedings before the Tribunal. The Tribunal has got power to device its own method of conducting the proceedings and while appreciating the claims, it has got the power to look into the documents and satisfy itself about the bona-fides of the claim.” In the case of Traders Syndicate v. Union of India, (1983) AIR Calcutta 337, the Calcutta High Court has held that in the absence of cross-examination and suggestions with respect to an issue, it has to be held that the defendant had accepted the appellants case on the said issue. 12. In the present case, the appellant has apparently claimed approximately Rs. 7.5 lakhs, for the expenses incurred by him in treating the fracture of his ankle and knee of the right leg and on the left arm.
12. In the present case, the appellant has apparently claimed approximately Rs. 7.5 lakhs, for the expenses incurred by him in treating the fracture of his ankle and knee of the right leg and on the left arm. However, a perusal of the medical bills, etc., which have been submitted by the appellant shows that the medicines he purchased for his injury relates to stomach ulcers, gastroesophageal reflux disease (GERD), vaginal fungal infection, infection caused by bacteria, hypertension, blood sugar, cholesterol and triglycerides, to name a few. The medicine Pantocid 40 is a medicine for stomach ulcer and GERD, etc. The tablet Cetil 500 is to treat infection of the ears, lungs, urinary tract caused by bacteria and lyme disease. The tablet Zerodol-P is for treating osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. The injection Apidra and injection Lantus are basically insulin for treating blood-sugar. The tablet Domstal 10mg is for treating stomach disorders. The tablet Forcan 150mg is for treating vaginal fungual infection. The tablet Telma is for treating hypertension. These medicines have been reflected in the bills submitted by the appellant and shows that they have got nothing to do with fracture of the appellant's leg and hand. In fact, the appellant being a male, it is a blatant attempt in trying to play a fraud on this Court, when he makes a bills for reimbursement of a tablet, which is used for treating vaginal fungal infection. These medicines are reflected in the discharge report dated 06.01.2016 issued by the International Hospital and which have been exhibited in evidence. In the above background, this Court is of the view that all the medical bills, medical reports, etc, submitted by the appellant cannot be taken at its face value and the appellant had to prove the Bills/Reports, by examining by way of evidence, the authors of the Bills/Reports. 13. The claimant has also submitted various hand-written bills issued by some consultant physiotherapist, who has apparently treated the appellant by giving him physiotherapy sessions continuously from 08.01.2016 till 31.08.2016. The physiotherapy bills amounting to Rs. 1,87,600/- also show that the appellant had been charged Rs. 500/- for two physiotherapy sessions for a day, while in some cases he has been charged Rs. 400/- for one physiotherapy session per day. This Consultant Physiotherapist, who has issued the said receipts has not been called to give evidence to prove the receipts. 14.
1,87,600/- also show that the appellant had been charged Rs. 500/- for two physiotherapy sessions for a day, while in some cases he has been charged Rs. 400/- for one physiotherapy session per day. This Consultant Physiotherapist, who has issued the said receipts has not been called to give evidence to prove the receipts. 14. The bills submitted by the appellant also shows that approximately Rs. 1,20,000/- had been given as medical expenses vide Exhibit No. 68,89,125, etc., on lumpsum basis, while he was in International Hospital. However, no reason for payment of the same is reflected in the Exhibit-No. 68,89,125, etc., or in the final hospital bills, made by the International Hospital, i.e., Exhibit-142. 15. The various medical bills submitted by the appellant also show that he has taken a many similar blood tests on several occasions, which has nothing to do with fractures. Also, he has consulted several Doctors per day, while in International Hospital, including Doctors from the “Cardio group” and consultation fees have purportedly been paid by him to those several Doctors. The appellant having suffered fractures, this Court is unable to understand as to why Doctors from the “Cardio group” have to be consulted. As stated earlier, the appellant has clearly tried to hoodwink this Court by claiming that he suffered brain hemorrhage. The medical certificates also clearly show that all the contents therein are not related to the injury of fractures suffered by him in the accident. As this Court is of the view that the bills submitted by the appellant required to be proved and the same not having been done, this Court does not find any infirmity with the decision of the learned Tribunal in awarding Rs. 50,000/- to the appellant. 16. In Ramchandrappa v. Royal Sundaram Alliance Insurance Co. Ltd., (2011) 13 SCC 236 , the Apex Court has held that “in all cases and in all circumstances, the Tribunal need not accept the claim of the claimant in the absence of supporting material. It depends on the facts of each case.
50,000/- to the appellant. 16. In Ramchandrappa v. Royal Sundaram Alliance Insurance Co. Ltd., (2011) 13 SCC 236 , the Apex Court has held that “in all cases and in all circumstances, the Tribunal need not accept the claim of the claimant in the absence of supporting material. It depends on the facts of each case. In a given case, if the claim made is so exorbitant or if the claim made is contrary to ground realities, the Tribunal may not accept the claim and may proceed to determine the possible income by resorting to some guesswork, which may include the ground realities prevailing at the relevant point of time.” In the present case, the appellant claimant has submitted medical bills/reports in support of his claim for re-imbursement, which have no relation to fractures. The same cannot be accepted by this Court for the reasons stated in the fore-going paragraphs. 17. Having stated as above, it is expected that some expenses would have been incurred by the appellant for the injuries of fractures sustained by him. As Rs. 50,000/- has been awarded by the learned Tribunal, this Court does not find any ground to interfere with the impugned judgment passed by the learned Tribunal. The appeal is accordingly dismissed.