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2021 DIGILAW 2162 (RAJ)

Reliance General Insurance Company Limited v. Suresh Parjapati

2021-11-17

SANJEEV PRAKASH SHARMA

body2021
ORDER 1. These appeals are preferred against the award dated 06.11.2019 passed by the Commissioner, Employees' Compensation Act, Bundi, Headquarter, Kota whereby the amount of Rs.11,89,800/- was awarded as compensation to the injured- respondent who suffered amputation resulting in 65% permanent disability while working at the mines and doing work on the loader vehicle which was duly insured under the Reliance Miscellaneous and Special Types of Vehicles Package Policy Certificate cum Policy Schedule issued by the appellant-company namely Reliance General Insurance. 2. Learned counsel appearing for the appellant submits that there is a gross perversity in the order passed by the Commissioner, Employees' Compensation while passing of the award. Learned counsel firstly submits that the income and compensation calculated is erroneous and does not go in confirmity with the Employees' Compensation Act, 1923. 3. Learned counsel further submits that the policy does not cover person who has suffered injuries while working on the loader and it is only the driver alone who can claim compensation under the Employees' Compensation Act and if at all claim could have been filed the same could be as a third party claim to be set up under the Motor Vehicles Act before the Motor Accident Claims Tribunal and the Employees' Compensation Commissioner has acted beyond his jurisdiction to hear the petition and pass an award. Learned counsel further submits that the injured claimant was not working as a driver on the vehicle and was shown to have been caused injuries while he was screwing the bolts of the loader when the driver of the vehicle without information started the vehicle resulting in causing severe injury to his hand which was amputated. Therefore he submits that the claimant cannot be said to be actually working as a driver on the vehicle. 4. Learned counsel has relied on the judgment passed by the Supreme Court dated 10.11.2006 in the case of Shakuntala Chandrakant Shreshti vs Prabhakar Maruti Garvali & Anr. : Appeal(civil) 4778 of 2006. 5. Per contra, learned counsel appearing for the claimants submits that admittedly a policy Exhibit-11 was issued after receiving a huge premium of sum of Rs.5,789/- known as a Reliance miscellaneous special type of vehicle package policy. : Appeal(civil) 4778 of 2006. 5. Per contra, learned counsel appearing for the claimants submits that admittedly a policy Exhibit-11 was issued after receiving a huge premium of sum of Rs.5,789/- known as a Reliance miscellaneous special type of vehicle package policy. The conditions of the said policy not only covered the driver but also under the limits of liability it covered death of or bodily injury to any person so far as it is necessary to meet the requirements of Motor Accidents Act. Learned counsel submits that apart from premium for driver and legal liability premium the actual total liability premium company also charged package premium of Rs.5,248/-. Thus it covers even an employee who was severely injured while working on the loader(vehicle) if the vehicle is insured as above and the Insurance Company cannot absolve itself from the liability of payment. The respondent had rightly approached the Employees' Compensation Commissioner as he was admittedly an employee working in the mines and would be covered under the Employees Compensation Act, 1923 for the payment of compensation. 6. I have considered the submissions and find that the appellants had exhibited the policy certificate which was issued for the vehicle by the name of Reliance Miscellaneous Special Types of Vehicles Package Policy Certificate cum Policy Schedule. As per the said policy following conditions were laid down:- Limitation as to use The policy covers use for any purpose other than a. Organized racing b. Pace making c. speed testing, d. Reliability trials e. Use for carriage of passengers for hire or reward Person/Classes of Persons entitled to drive: Any person including the insured provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license provided also that the person holding an effective learner's license may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989 Limits of Liability a. Under Section 11-1(i) of the Policy-death of or bodily injury to any person so far as it is necessary to meet the requirements of the Motor Vehicle Act, 1989 b. Under Section 11(1)(ii) of the Policy-Damage to property other than property belonging to the insured or held in trust or in the custody of control of the insured up to the limits specified Rs.7.5 lakhs. Deductible under Section- (i) Compulsory deductable Rs.2859.3/-(ii) Additional compulsory deductable Rs.0/-(iii) voluntary deductable Rs.0/- PA Cover for owner-driver under section IV CSI Rs.200000/- Special conditions: INSURANCE BY THIS POLICY COVERNOTE IS SUBJECT TO RECOMMENDATIONS IN PRE INSPECTION REPORT WHEREVER APPLICABLE consolidated Stamp Duty paid vide Receipt No. 48545 dated 25-March-2010.' 7. Thus, a premium of Rs.5,789/- was collected as for basic liability premium, legal liability LLP paid on one person, legal liability premium, total liability premium and package premium. Keeping in view, thereto, this Court is satisfied that the Insurance Policy takes into its ambit even those person who may suffer death or bodily injury while working on the vehicle or gets injured by the vehicle. 8. Keeping in view above, admittedly as per the evidence which has come on record, the claimant had suffered injuries while working on the vehicle and his hand was amputated hence the submission of learned counsel for the appellant that the Insurance Company was not liable for the injuries caused to the respondent is held to be misconceived and is accordingly rejected. 9. So far as the claim amount of compensation is concerned, it shall be governed as per Section 4 of the Employees' Compensation Act, 1923 which lays down the amount of compensation which is required to be paid and for the calculation required to be conducted for the purpose Section 4(i)(b)b and Section 4(i)(c) of the Act of 1923 need to be noticed and are quoted as under:- (b) where permanent total disablement results from of the injury an amount equal to sixty per cent of the monthly wages injured employee multiplied by the relevant factor; or an amount of one lakh and forty thousand rupees, whichever is more; Provided that the Central Government may, by notification in the Official Gazette, from time to time, enhance the amount of compensation mentioned in clauses (a) and (b); Explanation I.-For the purposes of clause (a) and clause (b), 'relevant factor', in relation to a employee means the factor specified in the second column of Schedule IV against the entry in the first column of that Schedule specifying the number of years which are the same as the completed years of the age of the 1 [employee] on his last birthday immediately preceding the date on which the compensation fell due. (c) where permanent partial disablement result from the injury (i) in the case of an injury specified in Part II of Schedule I, such percentage of the compensation which would have been payable in the case of permanent total disablement as is specified therein as being the percentage of the loss of earning capacity caused by that injury; and (ii) in the case of an injury not specified in Schedule I, such percentage of the compensation station payable in the case of permanent total disablement as is proportionate to the loss of earning capacity (as assessed by the qualified medical practitioner) permanently caused by the injury; Explanation I.-Where more injuries than one are caused by the same accident, the amount of compensation payable under this head shall be aggregated but not so in any case as to exceed the amount which would have been payable if permanent total disablement had resulted from the injuries. Explanation II.-In assessing the loss of earning capacity for the purposes of sub-clause (ii), the qualified medical practitioner shall have due regard to the percentages of loss of earning capacity in relation to different injuries specified in Schedule I;' 10. As per aforesaid explanation I appended to 4(1)(b) it is apparent that the relevant factor has to be taken to count as per the 2nd column of Schedule 4 the respondent was of age of 20 years and the relevant factor as per the Schedule would be 224. Monthly income of the injured has been assessed as Rs.8000/-. Accordingly as per joint reading of Section 4(1)(b) & a(1)(c)(i) it is apparent that the income calculation has to be done for a person suffering 65% permanent partial disability is same as for total disablement. Hence, the calculation is to be done as per Section 4(1)(b) i.e. an amount equal to 60% of the monthly wages of the injured to be multiplied by the relevant factor. Accordingly following calculation is made out; (8000 X 60)/100=4,800/-) i.e. 60% of the amount of monthly wages. Rs.4800X224=Rs.10,75,200 plus medical expenses =Rs.25,000 (Total Rs.11,00,200/-) 11. Relevant factor is 224 accordingly the compensation which shall be available is 10,75,200/- along with aforesaid compensation as a sum of Rs.25,000/- has been released for medical expenses. Accordingly a total sum of Rs.11,00,200/- is found to be payable to the claimant. This amount was liable to be paid from the date of accident that is 21.01.2011. Relevant factor is 224 accordingly the compensation which shall be available is 10,75,200/- along with aforesaid compensation as a sum of Rs.25,000/- has been released for medical expenses. Accordingly a total sum of Rs.11,00,200/- is found to be payable to the claimant. This amount was liable to be paid from the date of accident that is 21.01.2011. 12. It is noticed that the amount has not been released even till date. Keeping in view, it is now directed that the aforesaid amount of Rs.11,00,200/- shall be paid in terms of Section 4A(3)(b). The submission of learned counsel for the appellant is that the interest is payable by the employer and not by the Insurance Company is also wholly misconceived. The Insurance company acts for the insured and therefore, on default of the insured the Insurance Company has to pay and hence the amount of interest is also required to be paid by the Insurance Company. 13. That apart, this Court finds that there was no reasonable justification for delay in payment and this present appeal does not raise any question of law and accordingly this Court, considering that the injured has been waiting for his compensation since 2011 and 10 years have passed, deem it appropriate to also direct the Insurance Company to pay a cost of Rs.2.5 lacs, in addition to the aforesaid compensation and interest. The appellant-company shall release the amount positively in favour of the claimant within a period of three months. 14. These appeals are accordingly stand disposed of. All pending application, if any, stand disposed of.