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2026 DIGILAW 281 (MAD)

Reliance General Insurance Company Limited v. Sundararaj S/o Ramasamy

2026-01-28

N.SATHISH KUMAR, R.SAKTHIVEL

body2026
JUDGMENT : R. SAKTHIVEL, J. 1. Feeling aggrieved by the Award dated December 23, 2021 passed by 'the Motor Accidents Claims Tribunal (Special Court) Tiruppur' ['Tribunal' for short] in M.C.O.P. No.1736 of 2015, the second respondent therein/insurance company has preferred C.M.A. No.2113 of 2022 praying to set aside the Award, while the petitioner therein has preferred Cross Obj. No. 102 of 2022 praying to enhance the compensation. 2. This Common Judgment will now decide both, the Civil Miscellaneous Appeal and the Cross Objection. 3. For the sake of convenience, hereinafter, the parties will be referred to as per their array in the Original Petition. PETITIONER'S CASE 4. On March 11, 2015, at about 08.00 a.m., the petitioner was travelling as a pillion rider on a two-wheeler bearing Registration No.TN-41-AL-3233. The said vehicle was ridden in a rash and negligent manner and dashed against another two-wheeler bearing Registration No. TN-05-AE-2784, as a result of which the petitioner sustained grievous injuries. Immediately after the accident, the petitioner was taken to the Government Hospital, Udumalpet, for first aid and thereafter shifted to KMCH Hospital, Coimbatore for further treatment. In connection with the said accident, a First Information Report (F.I.R.) in Crime No.114 of 2015 was registered on the file of the Madathukulam Police Station, Tiruppur District, for the offences punishable under Sections 279 and 337 of the Indian Penal Code, 1860 , against the first respondent. At the time of the accident, the petitioner was aged 29 years and was practising as a Chartered Accountant, earning a sum of Rs.50,000/- per month. According to the petitioner, the accident occurred solely due to the rash and negligence of the first respondent, who is the owner-cum-driver of the two- wheeler bearing Registration No. TN-41-AL-3233 in which the petitioner was riding pillion. The second respondent is the insurer of the said offending vehicle. Hence, both the respondents are jointly and severally liable to compensate the petitioner. Accordingly, the petitioner filed the Claim Petition seeking a compensation of Rs.2,50,00,000/- (Rupees Two Crores Fifty Lakhs only). FIRST RESPONDENT'S CASE 5. First respondent remained absent and was set ex-parte by the Tribunal. SECOND RESPONDENT'S CASE 6. The second respondent filed a counter statement disputing the manner of the accident and the alleged negligence on the part of the first respondent. It is contended that there was no negligence on the part of the first respondent. FIRST RESPONDENT'S CASE 5. First respondent remained absent and was set ex-parte by the Tribunal. SECOND RESPONDENT'S CASE 6. The second respondent filed a counter statement disputing the manner of the accident and the alleged negligence on the part of the first respondent. It is contended that there was no negligence on the part of the first respondent. Further, the second respondent denied the petition averments and contended that the petitioner shall be put to strict proof of same. On these grounds, the second respondent prayed for dismissal of the claim petition. TRIBUNAL 7. At trial, on the side of the petitioner, the father of the petitioner namely Mr.Ramasamy was examined as P.W.1; Dr.A.Sivakumar, one of the member of the Medical Board constituted to assess the petitioner's disability, was examined as P.W.2; and Ex-P.1 to Ex-P.16 were marked. On the side of the second respondent, first respondent - Vijayakumar was examined as R.W.1 and Ex-R.1 and Ex-R.2 were marked. Disability Certificate issued by the Medical Board was marked as Ex-X.1. 8. The Tribunal, upon a careful consideration of the oral and documentary evidence available on record, found that the accident occurred due to the rash and negligent act of the first respondent, who is the owner-cum-driver of the offending two-wheeler. The Tribunal further found that the second respondent / insurance company did not dispute the policy coverage and hence, the Tribunal presumed that the policy is a comprehensive policy covering the pillion rider as well and that the policy was in force at the material point of time. Accordingly, the Tribunal held the second respondent is liable to pay compensation to the petitioner and awarded a sum of Rs.90,14,312/- (Rupees Ninety Lakhs Fourteen Thousand Three Hundred and Twelve only) as compensation, as tabulated hereunder: APPEAL 9. Feeling aggrieved by the Award, the second respondent /insurance company has preferred C.M.A. No.2113 of 2022. Seeking enhancement of the compensation, the petitioner has preferred Cross Obj. No.102 of 2022. 10. During the pendency of the matter before this Court, the petitioner filed an Application under Order XLI Rule 27 of CPC in Civil Miscellaneous Petition No.1849 of 2026 in the Appeal, praying to receive two documents, namely (i) Discharge Summary and (ii) Medical Bill Series, and mark the same as additional evidence as Ex-P.17 and Ex-P.18 respectively. ARGUMENTS: 11. 10. During the pendency of the matter before this Court, the petitioner filed an Application under Order XLI Rule 27 of CPC in Civil Miscellaneous Petition No.1849 of 2026 in the Appeal, praying to receive two documents, namely (i) Discharge Summary and (ii) Medical Bill Series, and mark the same as additional evidence as Ex-P.17 and Ex-P.18 respectively. ARGUMENTS: 11. Heard Mr.P.Suresh Srinivasan, learned Counsel appearing for the appellant in C.M.A. No.2113 of 2022 / first respondent in Cross Obj. No.102 of 2022 / second respondent / insurance company, and Mr.MA.P.Thangavel, learned Counsel appearing for the Cross Objector in Cross Obj. No.102 of 2022 / first respondent in C.M.A. No.2113 of 2022 /petitioner. 12. Mr.P.Suresh Srinivasan, learned Counsel would restrict the challenge in the Appeal to quantum of compensation and submit that the Tribunal failed to appreciate the evidence on record in proper manner. The Tribunal has taken a sum of Rs.2,57,451/- as annual income of the petitioner without any basis. Further, the Tribunal has not properly deducted income-tax. The compensation awarded under various heads are exorbitant and not based on any evidence. As regards the Order XLI Rule 27 Application, he would contend that the petitioner has already claimed the amount from Star Health Insurance Company and hence, he would strongly object in allowing the Civil Miscellaneous Petition. Accordingly, he prays to allow the Appeal while dismissing the Civil Miscellaneous Petition, dismiss the Cross Objection and reduce the award amount. 13. Per contra, Mr.MA.P.Thangavel, learned Counsel would submit that the petitioner suffered 100% functional disability and he cannot move on his own and he is still undergoing treatment. The Tribunal failed to award future medical expenses. He would further submit that after claim petition, the petitioner incurred medical expenses to the tune of Rs.3,87,624/-, and the relevant bills and medical records have been sought to be received and marked as additional evidence vide the Order XLI Rule 27 Application. He would pray to allow the same and consider the same to award further compensation under the head of medical expenses. He would also contend that the documents sought to be marked also show that the petitioner requires continuous treatment and therefore, the Tribunal erred in not awarding compensation towards future medical expenses. Accordingly, he prays to dismiss the Appeal, allow the Cross Objection and the Civil Miscellaneous Petition and enhance the Award amount. DISCUSSION: 14. He would also contend that the documents sought to be marked also show that the petitioner requires continuous treatment and therefore, the Tribunal erred in not awarding compensation towards future medical expenses. Accordingly, he prays to dismiss the Appeal, allow the Cross Objection and the Civil Miscellaneous Petition and enhance the Award amount. DISCUSSION: 14. This Court has considered both sides' submissions and perused the evidence available on record. The main point that arises for consideration in both the Civil Miscellaneous Appeal and the Cross Objection is whether the quantum of compensation awarded by the Tribunal is just, fair and reasonable, and supported by evidence. 15. Case of the petitioner / injured is that he was riding pillion in a motorcycle bearing Registration No.TN-41-AL-3233 which was driven by the first respondent at the material point of time. Owing to the rash and negligence of the first respondent, the first respondent dashed against another motorcycle bearing Registration No. TN-05-AE-2784 leading to an accident. Hence, the first respondent is responsible for the accident. 15.1. Respondent No.1-Vijaya Kumar was set ex parte before Tribunal. Considering the facts and circumstances of the case, this Court is of the view that notice to Respondent No.1 is not necessary. Therefore, notice to Respondent No.1 is dispensed with by this Court. 16. The contention of second respondent is that the accident occurred when a motorcycle proceeding in front of the first respondent's motorcycle, suddenly swerved right and the first respondent is not responsible for the accident. 17. In this case, Ex-P.1 - F.I.R. has been filed against the first respondent, based on the complaint given by the rider of the another motorcycle bearing Registration No. TN-05-AE-2784. P.W.1, the father of petitioner, deposed on behalf of the petitioner as the petitioner went into a vegetative state due to the injuries sustained in the accident. He deposed in line with the Claim Petition averments that the accident occurred due to the rash and negligence of first respondent. Further, the first respondent examined by the second respondent as R.W.1, deposed in his cross- examination that he admitted the criminal charges in respect of the accident before the Criminal Court and paid fine. He has also deposed that the petitioner was wearing helmet at the time of accident. Further, the first respondent examined by the second respondent as R.W.1, deposed in his cross- examination that he admitted the criminal charges in respect of the accident before the Criminal Court and paid fine. He has also deposed that the petitioner was wearing helmet at the time of accident. In view of his own admission, as well as the evidence of P.W.1 and Ex-P.1 - F.I.R., this Court is of the view that the accident happened due to the rash and negligence of the first respondent. 18. As regards the liability of the second respondent/insurance company, it is apposite to mention here that the petitioner has mentioned the insurance policy number as well as its validity period in the Claim Petition's long cause title. The policy number has been mentioned as 1202552312013570' and the validity period has been mentioned as from February 3, 2015 to February 2, 2016. The insurance company did not deny the policy coverage for the pillion rider specifically in the counter. The first respondent being the owner-cum-driver of the offending vehicle was examined as R.W.1. Neither the petitioner's side nor the second respondent's side cross examined him with regard to the coverage or nature of the insurance policy. When there is no denial that the vehicle involved is insured with the insurance company, it ought to have produced a copy of the insurance policy with all relevant information as to the nature of policy and its coverage. But the second respondent / insurance company in this case failed to do so. Under such circumstances, the Tribunal presumed that the policy is a comprehensive policy covering the pillion rider as well. The approach of the Tribunal is justifiable. Further, when this Court posed the learned Counsel for the appellant / insurance company with a question as to whether the insurance policy is a comprehensive / package policy, he submitted that it is a comprehensive policy. On a lighter note, out of curiosity, this Court checked the second respondent's website [www.reliancegeneral.co.in] for policy claim details by entering the policy number and the date of accident. In the claim details mentioned therein, apart from the first respondent's name and the offending vehicle's registration number, the insurance product was mentioned as 'Motor Cycle / Scooter Comprehensive Policy'. Moreover, there is no dispute qua manner of accident or liability in the Appeal. In the claim details mentioned therein, apart from the first respondent's name and the offending vehicle's registration number, the insurance product was mentioned as 'Motor Cycle / Scooter Comprehensive Policy'. Moreover, there is no dispute qua manner of accident or liability in the Appeal. As stated supra, the appeal is restricted to quantum of compensation alone. In these circumstances, this Court confirms the Tribunal's finding that the second respondent is liable to pay compensation to the petitioner. 19. Coming to quantum of compensation, this Court would first like to deal with the Order XLI Rule 27 Application. This Court has perused the two documents sought to be received and marked as Ex-P.17 and Ex- P.18 viz., (i) Discharge Summaries and (ii) Medical Bill Series, and also perused the affidavit filed in support of the Application. In the affidavit, it is stated that even after passing of the Award, the petitioner is continuously taking treatments till date and has spent a huge sum of Rs.3,87,624/- towards medical expenses. Due to the unfortunate accident, the petitioner suffered grievous injuries, social stigma, pain and sufferings. This Court is of the view that the documents sought to be received and marked are necessary to award a fair, just and reasonable compensation in this case. Moreover, no prejudice would be caused to the second respondent if the documents are marked. Accordingly, this Court is inclined to allow the Civil Miscellaneous Petition No.1849 of 2026. The 2 additional documents are marked as Ex-P.17 and Ex-P.18 , as tabulated hereunder: 20. As regards disability, the Regional Medical Board, Office of the Joint Director of Health Services, Tiruppur District, has assessed the disability of the petitioner on January 8, 2019 as 88% partial permanent disability. The said Report has been marked as Ex-X.1. In Ex-X.1 - Report, the Medical Board has made the following observations: "He was diagnosed with RTA bilateral post decompressive craniectomy calvarial defect with hydrocephalus. He has undergone following Procedure bilateral custom made titanium plate carnioplasty with programmable up shunt insertion under GA. His Disability is Partial Permanent and assessed as Eight Eight Percentage (88%)." 21. In Ex-X.1 - Report, the Medical Board has made the following observations: "He was diagnosed with RTA bilateral post decompressive craniectomy calvarial defect with hydrocephalus. He has undergone following Procedure bilateral custom made titanium plate carnioplasty with programmable up shunt insertion under GA. His Disability is Partial Permanent and assessed as Eight Eight Percentage (88%)." 21. From the evidence of P.W.2 - Doctor Sivakumar, who is a member of the Medical Board that assessed the petitioner, captured in Paragraph No.13 of the Tribunal’s Order, it is clear that the partial permanent disability has directly affected his day-to-day activities in all aspects including earning capacity, marital prospects, etc., and thus, caused functional disability. P.W.2 / Doctor has deposed that petitioner suffered severe head injury in the accident and some medical special device has been implanted in his brain, which needs replacement over time to time. Further that, the excess brain fluid secreted has to be removed from brain periodically. Further that, the petitioner was brought before the Medical Board in a stretcher in a completely vegetative state, with no leg and arm movements and a full time attender is necessary to look after the petitioner and take care of his day-to-day needs. He further deposed that petitioner's urine, stools and food intake are all managed through tubes and that the petitioner would not be unable to lead a normal marital life or engage in sexual activity. The evidence of P.W.2 would clearly establish that the petitioner is suffering from 100% functional disability. The fact that the accident occurred in March 2015 and the petitioner at the time of assessment by Medical Board in January 2019, was still suffering from 100% functional disability clearly indicates the severity of the injuries sustained and the permanent nature of the disability. The Tribunal has rightly assessed functional disability at 100% and employed multiplier method in line with the decision of the Hon'ble Supreme Court in Sarla Verma vs. Delhi Transport Corporation, (2009) 6 SCC 121 . 22. As per the pleadings and the evidence of P.W.1, the petitioner was working as a Chartered Accountant. As per Ex-P.14 - Income Tax Return of the petitioner for the assessment year 2014-2015, shows that his annual income for the corresponding period is Rs.2,57,451/-, which comes to Rs.21,454/- per month. The Tribunal is justifiable in taking the same as the monthly income of the petitioner. As per Ex-P.14 - Income Tax Return of the petitioner for the assessment year 2014-2015, shows that his annual income for the corresponding period is Rs.2,57,451/-, which comes to Rs.21,454/- per month. The Tribunal is justifiable in taking the same as the monthly income of the petitioner. Further, the Tribunal based on Ex- P.12 - Petitioner's PAN Card, found that he was born on January 8, 1987 and that he was aged 28 Years at the time of accident. As per National Insurance Company Limited vs. Pranay Sethi , (2017) 16 SCC 680 , the Tribunal added 40% future prospects and applied the multiplier of 17 as per Sarla Verma's Case . However, the Tribunal failed to deduct the applicable professional tax of Rs.2,500/-. Further, the Tribunal failed to deduct income-tax in proper manner; the Tribunal ought to have deducted Rs.11,117/- instead of Rs.5,522/- towards Income Tax and Cess. For ease of reference, the relevant tax slabs for the assessment year [2015 - 2016] are tabulated hereunder: 23. Accordingly, this Court is inclined to re-work / re-quantify the compensation under the head of loss of income / dependency as tabulated hereunder: 24. As regards the medical bills in Ex-P.18 presented through the Order XLI Rule 27 Application, when read along with the two discharge summaries in Ex-P.17 issued by NG Hospital Private Limited, Coimbatore, it could be seen that the petitioner incurred a sum of Rs.3,87,624/- towards medical expenses after filing of the Claim Petition. It is to be noted that Ex-P.18 contains two acknowledgements from Star Health Insurance Company for Final Approval for cashless medical claim, from which it could be seen that, out of the incurred sum of Rs.3,87,624/-, the petitioner has claimed a sum of Rs.64,871/- and Rs.1,56,916/- from Star Health Insurance Company. In other words, the acknowledgement shows that the petitioner has already claimed a total sum of Rs.2,21,787/- out of the totally incurred medical expense of Rs.3,87,624/- (after claim petition). Hence, the petitioner is entitled to only the remaining amount of Rs.1,65,837/- which could not be claimed by him, as otherwise it would amount to dual compensation. 25. Further, the Tribunal upon considering the evidence of P.W.2 - Doctor and Ex-X.1 - Disability Report, ought to have acknowledged the future medical needs of the petitioner and awarded compensation therefor. Hence, the petitioner is entitled to only the remaining amount of Rs.1,65,837/- which could not be claimed by him, as otherwise it would amount to dual compensation. 25. Further, the Tribunal upon considering the evidence of P.W.2 - Doctor and Ex-X.1 - Disability Report, ought to have acknowledged the future medical needs of the petitioner and awarded compensation therefor. Considering the evidence of P.W.2 set out in Paragraph No.21 hereinabove coupled with the evidence of Ex-X.1, this Court is of the view that Rs.2,50,000/- towards future medical expenses would be just, fair and reasonable. 26. As regards the compensation awarded by the Tribunal under other heads, namely under Serial Nos.2 to 8 in the table below, upon giving due regard and weightage to the medical evidence, especially the evidence of P.W.2, Ex-X.1, Ex-P.2 - Wound Certificate, Ex-P.3 to Ex-P.5 - Discharge Summaries & Ex-P.6 - Medical Bills, as well as the facts and circumstance of the case, this Court comes to the conclusion that there is no need to interfere with them. CONCLUSION: 27. In view of the foregoing narrative, the Cross Objector / petitioner is entitled to a modified compensation of Rs.92,92,551/- [Rupees Ninety Two Lakhs Ninety Two Thousand Five Hundred and Fifty One only] as tabulated below: 27.1. To be noted, interest cannot be granted on the compensation awarded towards future medical expenses, since such expenses are prospective in nature and have not yet been incurred by the petitioner. After excluding the compensation of Rs.2,50,000/- awarded towards future medical expenses, the total compensation comes to Rs.90,42,551/-. Hence, the Cross Objector / petitioner is entitled to 7.5% interest per annum on Rs.90,42,551/- from the date of Claim Petition till realisation. It is hereby clarified that the exclusion of future medical expenses amount is solely for the purpose of interest, and the total compensation payable to the petitioner remains Rs.92,92,551/-. 27.2. The appellant / insurance company is directed to deposit the total compensation of Rs.92,92,551/-, along with 7.5% annual interest on Rs.90,42,551/- from the date of Claim Petition till realisation, to the credit of M.C.O.P. No.1736 of 2015 on the file of Motor Accidents Claims Tribunal (Special Court), Tiruppur, less the amount if any already deposited, within a period of two months from the date of receipt of a copy of this Judgment. 27.3. 27.3. Upon such deposit, the Tribunal shall deposit 50% of the total amount in a high interest bearing fixed deposit in a nationalised bank. The petitioner's guardian namely his father - Ramasamy, shall be permitted to withdraw the interest accruing thereon every six months and utilise the same for the needs and welfare of the petitioner. 27.4. If there is any medical emergency requiring heavy funds, amount required shall be released from the 50% amount so deposited by the Tribunal subject to the satisfaction of the Tribunal qua the need of funds. 27.5. The petitioner's guardian namely his father - Ramasamy is permitted to withdraw the remaining 50% Award amount along with accrued interest thereon, subject to the satisfaction of the Tribunal that the petitioner is duly taken care of by his guardian. 27.6. In all other aspects including 'costs before Tribunal' the Award of the Tribunal holds good. 28. In fine: (i) The Civil Miscellaneous Petition in C.M.P. No.1849 of 2026 in C.M.A. No.2113 of 2022 is allowed. Additional documents are received and marked as Ex-P.17 and Ex-P.18. (ii) The Civil Miscellaneous Appeal filed by the insurance company in C.M.A. No.2113 of 2022 is dismissed. (iii) The Cross Objection filed by the claimant in Cross Obj. No.102 of 2022 is allowed in part with proportionate costs and Advocate fees as per Rules. (iv) Considering the facts and circumstances of the case, there shall be no order as to costs in C.M.A. No.2113 of 2022. (v) Consequently, connected C.M.P. No.16392 of 2022 in C.M.A. No.2113 of 2022 is closed.