BEFORE THE MOTOR ACCIDENTS CLAIMS TRIBUNAL CUM II
ADDITIONAL CHIEF JUDGE: CITY CIVIL COURT :AT HYDERABAD
THURSDAY THIS THE 14TH DAY OF FEBRUARY, 2019
PRESENT : SRI B.PAPI REDDY
II ADDL. CHIEF JUDGE, HYDERABAD
MVOP No. 1392 of 2010
Between : Fatima Hasan D/o Syed Aminul Hasan Jafri, aged : 12 yrs, Occ : student (Being minor rep. by her father as Natural Guardian, Syed Aminul Hasaj Jafri S/o Syed Ahmed Hussain, aged ; 55 yrs, Occ : Journalist,) R/o H No.171210/2/L, I.S. Sadan X Roads, Santosh Nagar, Hyderabad 500
059.... Petitioner.
Vs.
1. K. Maddileti S/o K. Giddaiah, aged : Major, Occ : Business, R/o H No.1521, Ashok Nagar, Gadwal, Mahabubnagar District, Andhra Pradesh.
2. United India Insurance Company Ltd., Off : at 142/10, Near Krishnaveni Chowk, Bheem Nagar, Gadwal, Mahabubnagar District 509 125. (Policy No.051104/31/08/02/00000290 Valid from 26.06.2008 to
25.06.2009)... Respondents.
This OP is coming on this day before me for final hearing in the presence of Sri M.Sudhakar Reddy, Advocate for the Petitioner and of Sri B. Peddiraju, Advocate for second respondent first respondent remained exparte and the matter having stood over for consideration, this court delivered the following :
O R D E R
This is a claim petition filed under Section 166 of Motor Vehicles
Act,1988 (for short 'the M.V.Act') claiming a compensation of Rs.20,00,000/ with future interest at 12% per annum for the injuries alleged to have been sustained by the minor petitioner on 11.05.2009 at Kothur bypass road on
N.H.No.7 near Vinayaka Steel Factory, Kothur Mandal, Mahaboobnagar
District in the motor vehicle accident.
2) The averments of the petition, in brief, are as follows :
The case of the petitioner as per the claim petition is that on 11.05.2009 at about 12.00 noon the petitioner along with her family 2OP 1392-10 members were proceeding from Hyderabad towards Jahangeer Peer Darga,
Kothur in a vehicle Swaraj Mazda bearing No. AP12 V 2419, when the said vehicle reached bypass road Kothur on N.H.7, while crossing from Kothur to
Jahangeer Peer Dargah a lorry bearing No.AP 21 U 9705 came in a high speed from Shadnagar thereby dashed the vehicle in which the petitioner and her family members were proceeding, due to which the petitioner along with her family members received grievous injuries due to the reason that the driver of the offending vehicle not taken proper precautions lost control over speed thereby caused injuries.
3)The petitioner stated that she sustained injuries on her head and chest, immediately she was shifted to Care Hospital, Banjara Hills,
Hyderabad where she underwent inpatient treatment for 37 days from 11.05.2009 to 16.06.2009 and spent a sum of Rs.6,80,000/ towards hospital expenses, thereafter also continued treatment as inpatient by incurring expenditure amounting to Rs.3,20,000/. Thus the petitioner spent total expenditure of Rs.10,00,000/ and still undergoing treatment and suffered total disability, the petitioner having sustained head injury not able to do her daily work and affected her right eye resulting in disfiguration on account of upper eyelid not functioning.
4)The petitioner is aged about 11 years as on the date of accident and she was quite hale and healthy, she is a student of 7th class in
Gowtham Model School, Santosh Nagar, Hyderabad, due to the accident finding difficult to move, as such the petitioner lost her present academic year 200910. Thus the petitioner is claiming total compensation of
Rs.20,00,000/ under all heads. Hence the claim petition.
3OP 1392-10
5)The first respondent remained exparte.
The second respondent filed counter by denying each and every averment of the claim petition stating that the petitioner already benefited a sum of Rs.2,50,000/ towards mediclaim by TTK Health Care Private
Limited vide bill dt. 15.06.2009 and concession given amount of
Rs.30,000/, thus, the total amount of Rs.2,80,000/ is benefited, the respondent denied involvement of the offending vehicle and driving of the same in a rash and negligent manner, the said offending vehicle driver is not having valid licence at the time of accident, the second respondent also denied the injuries on the petitioner, treatment and expenditure as stated by the petitioner. Hence prayed to dismiss the claim petition.
6)Basing on the above pleadings, the following issues have been settled for trial.
1. Whether the accident took place due to the rash and negligent
driving of the Swaraj Mazda bearing No. AP 21.U.9705 causing
injuries to the petitioner?
2. Whether the petitioner is entitled to compensation? If so, to what extent and against whom?
3. To what relief?
7)During the course of trial, on behalf of the petitioner Pws. 1 to
Pw.4 were examined, Exs A.1 to A.16 documents were marked. The 2nd respondent examined Rw.1 & Rw.2 and marked Exs B.1 & B.2. Heard both sides and gone through the entire evidence.
8) ISSUE NO.1 :
The learned counsel for the petitioner argued that the petitioner lost eye sight, still she has been undergoing treatment, as such the disability 4OP 1392-10 cannot be assessed, the medical record and bills which are supported by the doctors evidence Pws 3 & 4 clearly goes to show that there is no hope of getting eye vision of the petitioner, per contra the learned counsel for the second respondent argued that the petitioner availed medical expenses under mediclaim facility, hence that part amount has to be deducted.
9)Thatas seen from the counter second respondent formally denied the accident and injuries on the petitioner but the petitioner to substantiate her case examined the father of the petitioner as Pw.1, he reiterated the contents of the petition in his chief affidavit and testified the same before the court by deposing that the above said accident occurred on the sole negligence of R1 vehicle, Ex A.1 F.I.R copy in crime No. 106 of 2009 dt. 11.05.2009 was marked, the same discloses that one of the family member of the petitioner statement was recorded in the hospital while under going treatment immediately after the accident, basing on which the FIR was registered, the
FIR clearly discloses that on 11.05.2009 when the petitioner along with her family members were proceeding in a vehicle bearing No. AP 12 V 2419 the offending lorry bearing No.AP 21 U 9705 came in a high speed in a rash and negligent manner dashed against the vehicle in which the petitioner was proceeding, the said earliest information clearly goes to show that it is the first respondent vehicle which caused the accident, the police after thorough investigation after examination of 15 witnesses came to the conclusion that the first respondent being the owner cum driver caused the accident, chargesheet filed for the offences under Section 337 and 338 IPC, Ex A.3 is
Medico Legal Patient Record of the petitioner by which it is evident that the petitioner immediately after the accident on 11.05.2009 admitted in the hospital, Ex A.4 is the crime details form but as admitted by Pw.1 he was not 5OP 1392-10 the eye witness to the accident but the documents marked through him are undisputed and unchallenged. The minor petitioner also examined as Pw.2, she being the injured in the accident clearly and categorically deposed that the above said accident occurred only because of the rash and negligent driving of the first respondent vehicle and except denying the suggestion with regard to the manner of accident nothing is elicited in her cross examination. The second respondent examined it's Administrative Officer as
Rw.1, he deposed that first respondent lorry bearing No.AP 21 U 9705 was insured with them, the same was valid from 26.06.2008 to 25.06.2009 and the said policy was issued under certain terms and conditions as mentioned in the policy Ex B.1, this witness also not denied the manner of accident as stated by the petitioner, who deposed merely with regard to the quantum of compensation as they have already deposited some amounts before the court, second respondent also failed to examine any eye witness to the accident including first respondent, as such except unchallenged evidence of
Pws.1 & 2 which is supported by Exs A.1 to A.3 there is nothing contrary to the case of the petitioner as such the petitioner clearly proved their case on preponderance of possibility, it is clearly held that the above said accident occurred only on the negligence of the driver of the first respondent vehicle.
Hence this issue is answered accordingly in favour of petitioner.
10) ISSUE No.2 :
The petitioner claimed total compensation of Rs.20,00,000/, that coming to the injuries, medical expenditure and treatment the petitioner marked Ex A.3 Wound Certificate, Ex A.5 is the discharge summary issued by Care Hospital for the treatment for the period from the date of accident on 11.05.2009 to 16.06.2009, Ex A.6 is the discharge summary issued by 6OP 1392-10
Siddhaatha Eye Center dt.15.10.2010, Ex A.7 also discharge summary dt.
23.05.2011, Ex A.8 discharge summary of Deccan Hospital dt. 27.04.2013,
Ex A.9 are the OP Cards for the different dates, Ex A.10 is case summary of the petitioner issued by Siddhaatha Eye Center, Ex A.11 are the medical bills (14 in number), Ex A.12 are the bunch of medical bills for
Rs.4,90,875/, Ex A.13 are the medical prescriptions, Exs A.14 to A.16 are the Xray, C.T.Scan films.
11)The learned counsel for the second respondent argued that the petitioner was reimbursed about Rs.2,50,000/ under mediclaim policy, that has to be deducted from the medical expenses of the petitioner, RW1 stated that Rs 2,50,000/ paid by TTK helath care but during the cross examination he stated that he had no knowledge whether TTK Health care paid to Care Hospital, R2 also examined billing manager of care Hospital as
RW2, he deposed that the total bill of the hospital was of Rs 6,55,935/, out of which Rs 2,50,000/ was paid by TTK Health care but the petitioner paid only Rs 3,79,813/, it is also elicited in his cross examination that the pharmacy bills will not be included in the Care hospital Bill,ExA12 bills are issued by the care pharmacy, the learned counsel also placed reliance on the following decisions of Hon’ble Delhi High court by stating that as per these decisions the mediclaim reimbursement amount was deducted:
1. National Insurance Co.Ltd Vs RK Jain dated 02072012 2013 ACJ 2609
2. National Insurance Co.Ltd Vs Shiela Avinash dated 27012012 2014 ACJ 320
3. Bajaj Allianze General Insurance Co.Ltd Vs Ganpat Rai Sehgal dated 03012003 2013 ACJ 2366
12)But the same Hon’ble High Court of Delhi in subsequent decision on 3rd December, 2013 in MAC.A. No.693/2006 between NATIONAL 7OP 1392-10
INSURANCE CO. LTD Vs SH. AMAN KAPUR & ORS it is held that the reimbursement amount from mediclaim policy cannot be deducted and held elaborately as under “So far as the question of deduction of Rs.1,38,000/ received by the respondent No.1 from the other insurer under the Mediclaim Policy is concerned, the same has rightly not been deducted by the learned
Tribunal inview of the law laid down by this Court in the case of Dr.
A.C. Mehra Vs. Behari Lal & Anr., I (1997) ACC 657, wherein this
Court has held that the reimbursement of medical expenses under
Mediclaim Policy and Personal Accident Policy can always be claimed against the tort feasor, as the victim had paid the premium for getting the said policies. The relevant portion of the same reads as under: “After hearing the Counsel for the parties and perusing the authorities relied by the Counsel, I am of the opinion that the reasoning given by the Tribunal cannot be sustained. The learned Counsel for the appellant has correctly stated that the amount paid by his Insurance
Company to M/s. Saran Motors cannot be adjusted or deducted. That was paid under a separate contract entered into by the appellant with a third party. In this regard reference can be made to Chapter 10 of "The Quantum of Damages" by Kemp & Kemp1986 Edition, where reference has been made to various English decisions holding that completely collateral matters cannot be invoked by a tortfeasor to reduce the damages payable to the victim of his tort. The following passage from para 10002 which refers to case law can be reproduced for our advantage:
In an action for injuries caused by defendant's negligence a sum received by the plaintiff on an accidental insurance policy cannot be taken into account in reduction of damages". This is the headnote to
Bradburn v. Great Western Ry. and in our view correctly summarizes the effect of this case. Two passages from the judgments in this case contain the ratio decidendi Bramwell B. said:
In Dalby v. India and London Life Assurance Company it was decided that one who pays premiums for the purpose of insuring himself, pays on the footing that his right to be compensated when the event insured 8OP 1392-10 against happens is an equivalent for the premiums he has paid; it is a quid pro qua, larger if he gets it, on the chance that he will never get it at all. That decision is an authority bearing on the present case, for the principle laid down in it applies, and shows that the plaintiff is entitled to retain the benefit which he has paid for in addition to the damages which he recovers on account of the defendants 'negligence .
And Pigott B. said:
The plaintiff is entitled to recover the damages caused to him by the negligence of the defendants and there is no reason or justice in setting off what the plaintiff has entitled himself to under a contract with third persons, by which he has bargained for the payment of a sum of money in the event of an accident happening to him. He does not receive that sum of money because of the accident, but because he has made a contract providing for the contingency; an accident must occur to entitle him to it, but it is not the accident, but his contract; which is the cause of his receiving it. (Emphasis supplied)
6. The reading of this para clearly establish, that there is no distinctions so far as the law relating to injury is concerned. The point in issue is, whether the amount received by the injured on account of his contract with third person can be deducted ?The answer is definitely "No".
13)The mediclaim policy amount will be reimbursed only on the payment of the premium for the reason that if the petitioner suffered any treatment because of injuries the insurance company has to indemnify the petitioner but for the said reason the second respondent cannot exempted in payment of such amount in view of the above latest decision,, during the cross examination also Pw.1 clearly denied the suggestion made by the second respondent counsel with regard to reimbursement under mediclaim, the nature of injuries and the amounts paid by the petitioner.
9OP 1392-10
14)The petitioner also examined Pws.3 and 4, Pw.3 by reiterating the medical records deposed that on the date of accident on 11.05.2009 he examined the petitioner with the history of road traffic accident at 12.15
P.M. she was found following injuries.
1) Severe Head injury with compound depressed fracture right TP Bone with underlying SDH.
2) Multiple Frontal Temporal and basal Ganglion contusion with I.V.
Bleed.
3) Severe chest injury with right pneumothorax
4) Right optic nerve injury with orbital bone fracture,
5) Frontal bone fracture and Ethimoral bone fracture.
15)According to Pw.3 because of all those injuries the petitioner was unconscious with difficulty in breathing. She was introbated immediately and examined by the doctors concerned specialists like orthopedic surgeon, plastic surgeon, C.T. Surgeon and Optholmologist, the petitioner was also taken up for emergency surgery for elevation of depressed fracture and evaluation of underlying Hematoma, she was treated for pneumothorax with
I.C.D. On 16.05.2009 she underwent Trachostomy as she required continuous ventilatory support, the same was removed on 19.05.2009, he further deposed about the continuous regular inpatient treatment in the hospital, the petitioner also undergone treatment for associated tooth problems, even at the time of discharge on 16.06.2009 she advised aggressive physiotherapy long term medication to minimize the effects of brain damage and to undergo corrective procedure for the eye and tooth.
Pw.3 deposed that Ex A.5 discharge summary, Ex A.9 OP Cards, Exs A.6 to
A.8 and A.10 are taken by the petitioner on their advice. Ex A.11 hospital bills are issued under the course of treatment for Rs.6,55,935/ apart from that also the patient incurred expenditure towards out patient under Ex 10OP 1392-10
A.12, when he was examined the petitioner, she was having persistent residual deficit in the right eye even after several correction surgeries and still she is under regular followup, further treatment for the injuries to the brain, right eye and lungs definitely affected her day today life, studies and the development and there was also almost more than 90% risk to life at the time of injury.
16)The petitioner to prove the treatment and eye injury condition examined Pw.4 (doctor), he deposed that he was practicing as
Ophthalmologist since 15 years and running hospital i.e Siddharth Eye
Center, he clearly deposed that the petitioner was admitted in his hospital on 15.10.2010 with squint and ptosis eye problem, secondary to Trauma, due to the injury she developed problem to right eye and he gave treatment for Squint correction surgery on 15.10.2010 discharged on the same day under Ex A.6, but again the petitioner was admitted in their hospital on 23.05.2011 for the same problem and the said injury was already existing since prior to Ex A.6, he conducted Ptosis surgery on the patient and discharged on the same day under Ex A.7. This witness deposed that the injuries sustained by the patient cannot be treated and corrected in a single sitting which takes many more surgeries for correction of squint and ptosts.
the said problem arises when the nerve to the eye is damaged and the problem of controlling the eye lid will develop, due to such injury the petitioner sustained disfiguration of her right eye under Ex A.6. The petitioner incurred a sum of Rs.26,000/ under Ex A.7 and Rs.27,500/, he further testified that for further surgeries and treatment the petitioner requires Rs.70,000/ per sitting but there is no guarantee that even after the surgeries her disfiguration can become normal, she has to suffer the same 11OP 1392-10 for her life time and during the cross examination also nothing is elicited except denying the suggestions.
17)The above evidence clearly goes to show that the petitioner suffered five grievous injuries and she lost right eye, there is no hope whether the eye sight will restore even after so many surgeries as such it is clear that the petitioner lost her one eye sight which required so many surgeries and there is no conformity as to when she will get normal vision, there is no complete treatment and there is no clarity as to when the petitioner will come to normal condition hence by considering the loss of one eye sight the disability has to be assessed, that as per the Workmens Compensation Act schedule I the Loss of sight to such an extent as to render the claimant unable to perform any work for which eye sight is essential or Very severe facial disfigurement is mentioned as 100% disability and the same is taken for awarding just compensation.
18)That according to the claimant she was aged about 11 years at the time of accident and she was a student, PW1 reiterated the contents of claim petition in his chief about the age and avocation of the claimant, admittedly the claimant have not filed any proof for the education, Exs.A.5 first medical record discloses that the age of the claimant as 11 years only and apart from the medical record there is no evidence with regard to the age of the claimant, respondents also not disputed the age of the claimant as such the claimant age is taken as 11 years.
12OP 1392-10
19)In a case between BAJAJ ALLIANZ GENERAL INSURANCE CO LTD
V/S GUJJALA RAMULAMMA AND OTHERS reported in 2016 ACJ 230 it is held as under “compensation has to be assessed as per Second Schedule to know whether the same is below or above the minimum limit as prescribed in Puttammas case (2 supra). Since the boy is 5 years old, a suitable multiplier has to be selected. The Apex Court in the case of Reshma
Kumari and others v. Madan Mohan and another, 2013 ACJ 1253 held as follows:
In cases where the age of the deceased is upto 15 years, irrespective of the Section 166 or Section 163A under which the claim for compensation has been made, multiplier of 15 and the assessment as indicated in the Second Schedule subject to correction as pointed out in Column (6) of the table in Sarla Verma vs. Delhi Transport
Corporation {(2009)6 SCC 121} should be followed.
b) Following the above, multiplier 15 and notional income of
Rs.15,000/ p.a. are to be taken”
20)The claimant suffered dis figuration and eye sight as such by relying upon the decision the compensation has to be awarded for permanent disability, the multiplier 15 and notional income of Rs 15,000/ p.a is taken the compensation comes to Rs 2,25,000/, the claimant filed and proved medical bills of Rs 7,03,813/ as such the same is awarded, Rs 10,000/ is awarded for transport, for pain and suffering for five grievous injuries
Rs,1,50,000/ is awarded as such the claimant is entitled for a total compensation amount of Rs.10,88,813/.
21)That as stated above under issue No.1 it is held that the claimant sustained injuries in the accident caused by the rash and negligent driving of R1 being the owner cum driver, Ex.B1 policy discloses that R1 is the 13OP 1392-10 owner of the offending vehicle bearing no AP21U9705, the policy issued by
R.2 was in force from 26062008 to 25062009 and the above accident occurred on 11052009 as such R.1,R.2 are jointly and severally liable to pay the compensation, admittedly there are no violations of policy conditions. hence this issue is answered in favour of the claimant accordingly.
22) ISSUE NO.3 :
In the result, the petition is partly allowed, awarding a compensation of Rs.10,88,813/ (Rupees Ten Lakhs and Eighty Eight Thousand Eight
Hundred thirteen only) with proportionate costs with future interest at 7.5% per annum on Rs.10,88,813/ from the date of petition till the date of deposit against the respondent Nos.1 and 2 jointly and severally. The respondent Nos. 1 and 2 shall deposit the entire compensation within one month from today. The rest of the claim is dismissed without costs.
The amount shall be kept in fixed deposit in any nationalized bank till the petitioner attains majority.
The advocate fee is fixed at Rs.5,000/,
Dictated to the Stenographer, transcribed and typed by him,
corrected and pronounced by me in the open court, on this the 14th day of February, 2019.
Sd/ (B. Papi Reddy) Chairman (MACT) cum II Additional Chief Judge, City Civil Court, Hyderabad
Appendix of Evidence Witnesses examined
For the Petitioner : For the Respondents :
Pw.1 : Syed Aminul Hassan Jafri Rw.1 : S.Chandra Shekar
Pw.2 : Fatima Hassan Rw.2 : L Ramesh
Pw.3 : Dy.Syed Ameer Basha
Pw.4 : Dr. Siddharth Karan 14OP 1392-10
Documents Marked
For the Petitioner :
Ex A.1Certified copy of the FIR. Ex A.2Certified copy of the Charge Sheet. Ex A.3Certified copy of Wound Certificate. Ex A.4Certified copy of Crime Details form with rough sketch. Ex A.5Discharge Summary issued from Care Hospital. Ex A.6Discharge summary dt. 15.10.2010 of M/s Siddarth Eye Centre. Ex A.7Discharge summary of dt.23.05.2011. Ex A.8Discharge summaryk of Deccan Hospital dt. 27.04.2013. Ex A.9Out Patient Cards. Ex A.10Case summary issued by M/s Siddarth Eye Centre. Ex A.11Bills numbering 14 issued by Care Hospital. Ex A.12Bunch of Medical Bills. Ex A.13Medical Prescriptions. Ex A.14Xray films. Ex A.15CT Scan Films. Ex A.16Xray reports.
For the respondents :
Ex B.1Attested copy of Policy. Ex B.2Final Bill Summary of Fathima Hasan issued by Care Hospital.
Sd/ (B. Papi Reddy) Chairman (MACT) cum II Additional Chief Judge, City Civil Court, Hyderabad