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2020 DIGILAW 1000 (KAR)

Divisional Manager, National Insurance Co , Ltd. v. Savita Maruti Rane

2020-06-08

S.G.PANDIT, V.SRISHANANDA

body2020
JUDGMENT V. Srishananda, J. - Though these appeals are listed for admission, with the consent of parties, the matter is finally heard and disposed of by this order. 2. The appeal in MFA No.24444/2013 is preferred by the Insurance company who was the second respondent in MVC No.2145/2011 on the file of the Presiding Officer, FTC I, Chikodi, being aggrieved by the judgment and award dated 11.02.2013 whereby granting compensation of Rs.10,60,000/- with cost and interest @ 6% p.a. from the date of petition till realization to the claimants and MFA No.100255/2014 is preferred by the claimant against the same judgment and award seeking enhancement of compensation. 3. The brief facts which are necessary for the disposal of these appeals are as under : 4. The first respondent claimant filed the petition under Section 166 of Motor Vehicles Act claiming compensation to the tune of Rs.50,00,000/- with interest at 18% alleging that on 02.07.2011 at about 3.00 p.m. when claimant was proceeding in a Maruti car bearing No.GA-08 A-7692 from Shiradi to Goa, the driver of the said car drove the same in rash and negligent manner and as such, the claimant sustained grievous injuries. It is further contended that the claimant was carrying on the business and private service, had monthly income of Rs.25,000/-. On account of injuries sustained in the accident, she is unable to carry on her day today work. 5. On issuance of notice before the tribunal, the owner of the vehicle bearing No.GA-08 A-7692 remained absent and placed exparte. Respondent No.2- the Insurance company appeared and filed its written statement denying the allegations made in the claim petition. The Insurance company specifically contended that the driver of the car bearing No.GA-08 A-7692 did not possess the valid driving license and therefore, there was breach in the conditions of the policy and hence, the Insurance company is not liable to pay the compensation. 6. In order to substantiate the contentions urged in the claim petition, the first respondent claimant examined herself as PW1 and got examined the Doctors as PW2 to 4. She also examined one Prashant Digambar Pawar as witness on her behalf. On behalf of claimant, 24 documents were relied upon as documentary evidence which are marked as Ex.P1 to 24. On behalf of respondents none was examined, nor any documentary evidence placed on record. 7. She also examined one Prashant Digambar Pawar as witness on her behalf. On behalf of claimant, 24 documents were relied upon as documentary evidence which are marked as Ex.P1 to 24. On behalf of respondents none was examined, nor any documentary evidence placed on record. 7. The tribunal on cumulative consideration of the entire material on record, allowed the claim petition in part and granted the compensation in a sum of Rs.7,02000/- as under: 1 Loss of future income 7,02,000/- 2 Medical expenses 2,37,752/- 3 Pain and suffering 75,000/- 4 Loss of amenities 25,000/- 5 Loss of income of petitioner during treatment period 10,000/- 6 Loss of dependency 10,000/- 7 Conveyance 10,200/- Total 10,59,951/- Rounded off 10,60,000/- 8. The learned counsel for the appellant- Insurance company vehemently contended that the compensation awarded by the tribunal is exorbitant. It is the specific contention of the counsel that the Doctors who did not treat the injured have assessed the disability at 78% & 67% on particular limb and the tribunal has considered the disability to the whole body at 50%, which is contrary to well established principles of law. Therefore, he sought for reduction of the award of compensation on the head of loss of future earnings. 9. It is further contended that the tribunal has assessed the income of the claimant at Rs.9,000/- per month, which is on the higher side especially when the claim petition itself mentions occupation of the claimant as house wife. He further contended that the award of compensation at Rs.75,000/- on the head of pain and suffering is on the higher side and sought for reduction of the compensation awarded by the tribunal. 10. Per contra, it is the argument of learned counsel for the first respondent-claimant that the award of compensation by the tribunal is just and proper. Due to the accident, the claimant is unable to carry daytoday work and therefore, assessing the disability at 50% by the tribunal is proper. He further argued that the tribunal has taken into consideration the salary certificate which is marked at Ex.P11 and therefore, assessing the income at Rs.9,000/- by the tribunal is justified. 11. He drew the attention of this court with regard to the photo which is marked as Ex.P13 and disability which is marked at Ex.P18 and 23 and sought for dismissal of the appeal. 12. 11. He drew the attention of this court with regard to the photo which is marked as Ex.P13 and disability which is marked at Ex.P18 and 23 and sought for dismissal of the appeal. 12. In view of the rival contentions urged by the parties, the sole point would arise for considers is : 1. Whether the appellant-insurance company has made out the case for reduction of the compensation. 13. Answer to the above point is affirmative for the following: REASONS: 14. In the present case, the factum of the first respondent suffering grievous injuries on account of accident that occurred on 02.07.2011 at about 3.00 p.m. while the claimant was moving in a car bearing No.GA-08 A-7692 from Shiradi to Goa is not in dispute. 15. The medical records especially wound certificate marked at Ex.P4 and discharge summary marked vide Ex.P6 and the medical bills produced vide Ex.P14 to 16 and X-ray at Ex.P17 would clearly establish that the first respondent suffered grievous injuries. She was treated in KLE Hospital, Belagavi. 16. The doctors who gave the disability certificate vide Ex.P18 and 23 are examined as PW2 and 4 respectively. 17. Pw2-Dr. Pawar stated that he treated the claimant and issued Ex.P12 certificate, Ex.P18 disability certificate. According to him, the claimant sustained disability of left upper hand component to the extent of 78%. 18. Pw4 -Dr. Charate stated that he examined the records produced by the claimant and thereafter assessed the disability factor only on the basis of records produced before him and issued disability certificate as per Ex.P23 indicating the disability to the extent of 67% to left upper limb only. 19. Based on Ex.P18 and P23, the tribunal has assessed the disability to the extent of 50% as found in the para No.10 of the impugned judgment. 20. The main contention of the Insurance company in the present appeal is that PW2 and PW4 have not treated the injured and as such, they were incompetent to assess the disability and therefore, there cannot be any probative value attached to Ex.P18 and P23. 21. It is not in dispute that PW2 and 4 are not the doctors, who treated the injured. 22. Insofar as Ex.P18 is concerned, PW2 has assessed the disability of left upper hand component to the extent of 78%. 23. 21. It is not in dispute that PW2 and 4 are not the doctors, who treated the injured. 22. Insofar as Ex.P18 is concerned, PW2 has assessed the disability of left upper hand component to the extent of 78%. 23. Likewise, Ex.P23 is the disability certificate issued by PW4 after considering the medical records produced by the injured has assessed disability in respect of left upper limb to the extent of 67%. 24. It is pertinent to note neither PW2 nor PW4 have not assessed the whole body disability while issuing Ex.P18 and Ex.P23. But, the tribunal assessed the disability factor at 50% to the whole body and computed the compensation amount. 25. On perusal of the impugned judgment, it is seen that the tribunal did not assign any specific reasons for assessing the disability at 50%. No cogent evidence is placed on record by the claimant either to assess the disability at 50%. 26. Whenever, a court records a finding, it has to be supported by proper reasoning. It is well established principle of law and requires no emphasis that reasoning is the heartbeat of every finding. 27. In this regard, this court places its reliance on the judgment of the Hon'ble Apex Court, in the case of Sec.& Curator Victoria Memorial Hall V/s. Howrah Ganatantrik Nagrik Samity and others, (2010) 3 SCC 732 held as under: 41. Reason is the heartbeat of every conclusion. It introduces clarity in an order and without the same, it becomes lifeless. Reasons substitute subjectivity by objectivity. Absence of reasons renders the order indefensible/unsustainable particularly when the order is subject to further challenge before a higher forum .. 42. Thus, it is evident that recording of reasons is a principle of natural justice and every judicial order must be supported by reasons recorded in writing. It ensures transparency and fairness in decision making. The person who is adversely affected by may know as to why his application has been rejected. 28. Applying the legal principles enunciated in the above decision to the facts of the case on hand, tribunal ought to have recorded reasons for assessing the disability factor at 50% especially Ex.P18 and P23 mentions disability factor as 78% and 67% to upper left limb only. 29. 28. Applying the legal principles enunciated in the above decision to the facts of the case on hand, tribunal ought to have recorded reasons for assessing the disability factor at 50% especially Ex.P18 and P23 mentions disability factor as 78% and 67% to upper left limb only. 29. Even in the oral evidence PW2 and 4, hardly any material is found so as to arrive at a finding that injured suffered disability to the extent of 50% to the whole body. 30. When a treating doctor is not examined, based on the disability certificate issued by an expert, what is the method by which courts are required to assess the disability factor is no longer res integra. 31. In this regard, this court gainfully places its reliance on the judgment rendered by Hon'ble Apex Court in the case of Sandeep Khanuja v. Atul Dande, (2017) 3 SCC 351 , it is held at para Nos.13 and 14 as under: 13. In the last few years, law in this aspect has been straightened by this Court by removing certain cobwebs that had been created because of some divergent views on certain aspects. It is not even necessary to refer to all these cases. We find that the principle of determination of compensation in the case of permanent/partial disablement has been exhaustively dealt with after referring to the relevant case law on the subject in Raj Kumar V.Ajay Kumar in the following words : (SCC pp.348-50. paras 8-11) "Assessment of future loss of earnings due to permanent disability. 8. Disability refers to any restriction or lack of ability to perform an activity in the manner considered normal for a human being. Permanent disability refers to the residuary incapacity or loss of use of some part of the body, found existing at the end of the period of treatment and recuperation, after achieving the maximum bodily improvement or recovery which is likely to remain for the remainder life of the injured. Temporary disability refers to the incapacity or loss of use of some part of the body on account of the injury, which will cease to exist at the end of the period of treatment and recuperation. Permanent disability can be either partial or total. Temporary disability refers to the incapacity or loss of use of some part of the body on account of the injury, which will cease to exist at the end of the period of treatment and recuperation. Permanent disability can be either partial or total. Partial permanent disability refers to a person's inability to perform all the duties and bodily functions that he could perform before the accident, though he is able to perform some of them and is still able to engage in some gainful activity. Total permanent disability refers to a person's inability to perform any avocation or employment related activities as a result of the accident. The permanent disabilities that may arise from motor accident injuries, are of a much wider range when compared to the physical disabilities which are enumerated in the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 (the Disabilities Act, for short). But if any of the disabilities enumerated in Section 2(i) of the Disabilities Act are the result of injuries sustained in a motor accident, they can be permanent disabilities for the purpose of claiming compensation. 9. The percentage of permanent disability is expressed by the doctors with reference to the whole body, or more often than not, with reference to a particular limb. When a disability certificate states that the injured has suffered permanent disability to an extent of 45% of the left lower limb, it is not the same as 45% permanent disability with reference to the whole body. The extent of disability of a limb (or part of the body) expressed in terms of a percentage of the total functions of that limb, obviously cannot be assumed to be the extent of disability of the whole body. If there is 60% permanent disability of the right hand and 80% permanent disability of left leg, it does not mean that the extent of permanent disability with reference to the whole body is 140% (that is 80% plus 60%). If different parts of the body have suffered different percentages of disabilities, the sum total thereof expressed in terms of the permanent disability with reference to the whole body cannot obviously exceed 100%. 10. If different parts of the body have suffered different percentages of disabilities, the sum total thereof expressed in terms of the permanent disability with reference to the whole body cannot obviously exceed 100%. 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. 14. The crucial factor which has to be taken into consideration, thus, is to assess as to whether the permanent disability has any adverse effect on the earning capacity of the injured. . 32. 14. The crucial factor which has to be taken into consideration, thus, is to assess as to whether the permanent disability has any adverse effect on the earning capacity of the injured. . 32. It is also necessary for this court for refer to the judgment of Hon'ble High Court of Delhi in the case of Rajesh Thyagi and others V/s. Jaibir Singh, (2019) ACJ 1245 reported in 2018 SCC Online Del 13316: . The relevant paragraphs in the decision is culled out hereunder for ready reference. "26.5. Ascertainment of the effect of the percentage of permanent disability on the actual earning capacity (percentage of loss of earning capacity) involves three steps: (i) 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 or life). (ii) The second step is to ascertain is avocation, profession and nature of work before the accident, as also his age. (iii) The third step is to find out whether: (a) The claimant is totally disabled from earning any kind of livelihood, or (b) 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 (c) 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." 33. Applying the legal principles enunciated in the aforesaid decisions to the facts of case on hand, it is pertinent to note that even thought PW2 and PW4 have assessed the disability caused to the injured at 78% and 67% to the left upper limb, there is no independent assessment of disability by the tribunal. Oral evidence of doctors as well as claimant would not improve the case of the injured in assessing permanent disability to the whole body or reduction as to her earning capacity and carrying on the day today life. 34. In the absence of any cogent evidence placed on record in this regard, the tribunal without assigning any plausible reasons, has assessed the disability at 50%. 34. In the absence of any cogent evidence placed on record in this regard, the tribunal without assigning any plausible reasons, has assessed the disability at 50%. Mere mentioning of the reported cases without discussing the factual matrix of those cases and assessing disability at 50% by the tribunal in our considered opinion cannot be countenanced in law. 35. This finding of the tribunal of assessing the disability at 50% in the considered opinion of this court is thus perverse in nature. 36. The insurance company in its appeal contended that the income of the injured-claimant assessed by the Tribunal at Rs.9,000/- per month is on the higher side and, on the other hand, the claimant, relying on Ex.P.11, has contended that the income assessed by the Tribunal ignoring Ex.P.11 is on the lower side. It is very interesting to note that in the claim petition as well as in the examination-in-chief, by way of affidavit, the claimant has stated that she was doing private service and business by which she was earning monthly income of Rs.25,000/-. But, nowhere either in the claim petition or in the evidence, the claimant has stated the type of private service and the nature of business carried on by her. Strangely, in the crossexamination, she deposes that she is working as a clerk in Pai Khot Builders and placed on record Ex.P.11- certificate to say that she was working as clerk drawing salary of Rs.18,000/- per month. In support of Ex.P.11, the claimant examined P.W.3, claiming to be the Chief Accountant in Pai Khot Builders, where the claimant is stated to be working as clerk. In his chief-examination, by way of affidavit, P.W.3 states that he has been authorised by the company/firm to depose on behalf of the company/firm. However, no authorization letter is placed on record. In his evidence, P.W.3 sates that the claimant is working as clerk in Pai Khot Builders earning Rs.18,000/- per month. There is inconsistency in the evidence of the claimant as well as P.W.3. As such, evidence of P.W.3 cannot be believed. Ex.P.11 is not proved as the author of the said certificate is not examined. The accident is of the year 2011 and the notional income for the said year was Rs.6,000/- per month taken by this Court as well as the Lok Adalats while settling the accidental claims. As such, evidence of P.W.3 cannot be believed. Ex.P.11 is not proved as the author of the said certificate is not examined. The accident is of the year 2011 and the notional income for the said year was Rs.6,000/- per month taken by this Court as well as the Lok Adalats while settling the accidental claims. But, the Tribunal taking an overall view of the evidence on record, has assessed the notional income of the claimant at Rs.9,000/- per month which needs no interference. 37. P.Ws.2 and 4 are the doctors examined on behalf of the claimant to prove her disability. Ex.P.18 is the disability certificate which indicates that the claimant suffers from 78% disability to the right upper limb, whereas Ex.P.23 the disability certificate issued by the doctor P.W.4 indicates that the claimant has suffered 67% permanent physical disability in respect of left upper limb. The tribunal assessed the disability at 50% to the whole body which, according to us is on the higher side. 38. While assessing the disability or determining the disability criteria what is to be looked into is avocation, profession and nature of work carried on by the claimant as is held in the case of Sandeep Khanuja and Rajesh Tyagi supra. 39. In the instant case, in the claim petition as well as in the examination-in-chief, the claimant states that she was doing private service and business by which she states that she was earning Rs.25,000/- per month, but, in the cross-examination, she states that she was working in Pai Khot Builders and she is not able to do the same work which she was doing prior to the accident. Ex.P.11-certificate is placed on record that too in the further examination of P.W.1 after her crossexamination. In her evidence, she has not stated that the accidental injury or the disability suffered by her would come in the way of her employment as a clerk or she has not stated the functional disability to function as a clerk. She has not placed on record any document to say that subsequent to the accident she has been removed from the company as a clerk. On the other hand, Ex.P.11 would indicate that she is continued in service. Therefore, it would be appropriate to asses the disability of the claimant at 1/3rd of the disability stated by P.W.4 and it can be taken at 22%. 40. On the other hand, Ex.P.11 would indicate that she is continued in service. Therefore, it would be appropriate to asses the disability of the claimant at 1/3rd of the disability stated by P.W.4 and it can be taken at 22%. 40. Accordingly, we find sufficient force in the submissions made by the counsel for the appellant- Insurance company and it is appropriate to assess the disability by taking 1/3rd of the disability mentioned in the disability certificate marked vide Ex.P18 and 23. Consequently, the income i.e., assessed on the head of loss of future income needs to be reduced. 41. The learned counsel for the claimantrespondent however submitted that the claimant has already withdrawn the compensation amount and at this stage, they are unable to repay the same. 42. It is pertinent to note that the accident is of the year 2011 and at this distance of time, if the compensation amount is to be re-fixed by reducing disability factor to 1/3rd as against 50% taken by the Tribunal in assessing the loss of future income, the claimant would necessarily be ordered to repay the amount if already withdrawn by her. 43. In the peculiar facts and circumstances of the case, and the disability assessed by the Doctor vide Ex.P18 and 23, and the disability being reduced from 50% to 1/3rd of the total disability, we deem it appropriate to order a fixed sum of Rs.3,50,000/- to be reduced from the total compensation, instead of reassessing the compensation, which would be much more than the amount now ordered to be reduced. 44. Having regard to the material placed on record and in the facts and circumstances of the case, we deem it appropriate to order for reduction of a fixed sum to Rs.3,50,000/- from the adjudged compensation in the impugned judgment and award. Accordingly, the point is answered in affirmative. Hence, we pass the following : ORDER The appeal filed by the Insurance company in MFA No.24444/2013 is allowed in part. The appeal filed by the Insurance company in MFA No.100255/2014 is dismissed. A sum of Rs.3,50,000/- is reduced in the adjudged compensation of the tribunal to a sum of Rs.10,60,000/- The reduced sum of Rs.3,50,000/- is ordered to be refunded to Insurance company by the claimants within two months from today, failing which, the said sum shall carry interest @ 6%, till it is repaid.