MOTORACCIDENTCLAIM
PETITIONREFERENCE
MANUALPrepared by Hanif. S. Mulia.
1 MACP Reference Manual
CONTENTSSr. No.
Particulars Page No.
1Re Requirement for the police to forward to the Claims Tribunal
AccidentInformationReport(AIR)whichtheTribunalhastotreat
asanapplicationforcompensation.
6
2 HowtodecideaclaimpetitionwhereinFatalInjuriesweresustainedbythedeceased
12
3 How to decide a claim petition wherein claimant has sustained
Injuries
19
4 Howtodeterminemonthlyincomeofthedeceasedorinjuredwhen
nodocumentinsupportthereofisproduced
42
5 Howtodetermineincomeofthedeceasedorinjuredclaimantwhen
thereisdocumentaryevidenceonrecordtoshowthatthedeceased
or injured claimant was earning in foreign currency and not in
IndianRupee
44
6 HowtodecideaclaimpetitionwheredefenceofInvalid,Learners
Licence&FakeDrivingLicenceandDefenseofQualification/Badge
istaken
46
7 InwhichcircumstancesInsurerisliabletopaycompensationwhen
injuredclaimantordeceasedwastravellinginthegoodsvehicle
55
8 Liability of insurer to compensation in the cases where injured
claimantordeceasedwastravellingintheprivatecarasoccupants
Ortravellingontwowheeleraspillionrider
59
9 Howtodecideaclaimpetitionpreferredundersection163Aofthe
Act
60
2 MACP Reference Manual
10 What if the cheque given for payment of premiumof insurance
policyisdishonoured
64
11 WhatisthemeaningofArisingoutofuseofMotorVehicle 6512 WhetherFinanceCompany,whichhasadvancedloanforthepurpose
ofpurchaseofvehicleunderthe'HirePurchaseAgreement'canbe
saidtobetheowneroftheVehicle
67
13 Whendriveroftheunknownvehiclespedawayaftertheaccident,
whetherinsuchsituationclaimpetitionismaintainableinviewof
theprovisionscontainedunderSections161&163oftheAct
68
14 Whetherallthejointtortfeasorsarerequiredtobejoinedasparty
opponentsintheclaimpetition
70
15 Whetherthepointofnegligenceandliabilityofinsurer,decidedby
thecoordinateTribunalisbindingontheothercoordinateTribunal,
iftheclaimpetitionhasarisenfromthesameaccident
72
16Whetheraclaimpetitionpreferredbytheaclaimant(alsotheownerof
the offending vehicle, without involving another vehicle) alleging
therein that accident occurred because of the rash and negligent
drivingofthevehicleownedbyhimismaintainable
73
17 WhatisthemeaningofPublicPlace,asdefinedu/s2(34)ofthe
Act
75
18 What if, thevehiclewhichmetwithanaccident is soldof by its
ownerbeforethedateofaccidentandnameofthetransfereeowner
(purchaser)isnotenteredintotheR.C.Book
78
19 Whetheraclaimpetitioncanbedismissedforwantofprosecutionor
nonappearanceoftheclaimantand/orhisAdvocate
83
20 Whetheraclaimpetitioncanbe dismissed for nonproductionof
documentsmentionedunderRule211oftheGujaratMotorVehicles
84
3 MACP Reference Manual
Rules,198821 Howtodecideaclaimpetition,whereinsurerhastakenadefenceof
violationof'Permit'
85
22WWhetheranawardpassedbytheTribunalcanbereviewed: 8823 DetailsofProposalFormsforPrivateCars/MotorisedTwoWheelers
PackagePolicyandLiabilityOnly/ActPolicy:90
24 Standard wordings in respect of the Policy including Premium
computationtable,certificateofInsuranceandCoverNote
90
25CeCertainminorpoints/issueswhichcreatelittletroubleforLd.Judges
todecidesuchtrickypoints/issues.Suchpoints/issues,withcitations
andreadyreckoner.
91
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1. Whiledecidingaclaimpetition,preferredundertheMotorVehiclesAct,
1988(hereinafterreferredas'theAct'),moreoftenthennot,Ld.Judgesof
theTribunalsarevexedwithsuchquestionsthatitbecomesdifficultfor
themtocometoacertainconclusion,mainreasonsforsuchvexationare:
a)Nonavailabilityofjudgmentsoncertainpoints,
b)If judgments are available on some points, they run in
differentdirections,
c) Lackofknowledgetodecide,astowhethertheinsurance
policyis 'ActPolicy'(StatutoryPolicy)or 'Comprehensive
Policy'(PackagePolicy).
2. Bywayof this Article, an attempt is made to help Judicial Officers to
decideclaimpetitionseasily,andmoreparticularly,inaccordancewiththe
law. Hon'ble Apex Court and Hon'ble High Courts have laid down
principles/guidelines to decide claim petitions, which will be discussed
hereinbelow.
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3.RequirementforthepolicetoforwardtotheClaimsTribunalAccident
InformationReport(AIR)whichtheTribunalhastotreatasanapplication
forcompensation:
3.1 TheBenchcomprisingofThreeHon'bleLordshipsofHon'bleApex
Court in the case of Jai Prakash v/s National Insurance Com. Ltd,
reportedin2010(2)GLR(SC)hasgivenfollowingdirectionstoPolice
andTribunals.
A)DirectionstothePoliceAuthorities:
TheDirectorGeneralofPoliceofeachStateisdirectedtoinstruct
allpolicestationsinhisStatetocomplywiththeprovisionsofSec.
158(6)oftheAct.Forthispurpose,thefollowingstepswillhave
to be taken by the Station House Officers of the jurisdictional
policestations:
(i)AccidentInformationReport('AIR',forshort)inFormNo.
54 of the Central Motor Vehicles Rules, 1989 shall be
submitted by the police (Station House Officer) to the
jurisdictionalMotorAccidentsClaimsTribunal,within30days
oftheregistrationoftheF.I.R.Inadditiontotheparticulars
requiredtobefurnishedinFormNo.54,thepoliceshouldalso
collectandfurnishthefollowingadditionalparticularsinthe
AIRtotheTribunal:
(i)Theageofthevictimsatthetimeofaccident;
(ii)Theincomeofthevictim;
(iii)Thenamesandagesofthedependentfamilymembers.
(ii)TheAIRshallbeaccompaniedbytheattestedcopiesofthe
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F.I.R., site sketch/mahazar/photographs of the place of
occurrence,drivinglicenceofthedriver,insurancepolicy(and
ifnecessary,fitnesscertificate)ofthevehicleandpostmortem
report(incaseofdeath)ortheinjuredordependentfamily
members of the deceased should also be furnished to the
Tribunal.
(iii)Simultaneously,acopyoftheAIRwithannexuresthereto
shall be furnished to the Insurance Companyconcerned to
enabletheinsurertoprocesstheclaim.
(iv) Thepoliceshallnotifythefirstdateofhearingfixedby
theTribunaltothevictim(injured)orthefamilyofthevictim
(incaseof death) and the driver, ownerand insurer. If so
directedbytheTribunal,thepolicemaysecuretheirpresence
onthefirstdateofhearing.
B)DirectionstotheClaimsTribunals:
The Registrar General of each High Court is directed to
instructallClaimsTribunalsinhisStatetoregisterthereports
of accidents received under Sec. 158(6) of the Act as
applicationsforcompensationunderSec.166(4)oftheAct
anddeal with themwithout waiting for the filingof claim
applicationsbytheinjuredorbythefamilyofthedeceased.
TheRegistrar General shall ensure that necessary registers,
formsandothersupportisextendedtotheTribunaltogive
effecttoSec.166(4)oftheAct.
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ForcomplyingwithSec.166(4)oftheAct,thejurisdictional
MotorAccidentsClaimsTribunalsshallinitiatethefollowing
steps:
(a) The Tribunal shall maintain an institution register for
recordingtheAIRs.whicharereceivedfromtheStationHouse
Officersofthepolicestationsandregisterthemasmiscellaneous
petitions. If any private claim petitions are directly filed with
referencetoanAIR,theyshouldalsoberecordedintheregister.
(b)TheTribunalshalllisttheAIRs.asmiscellaneouspetitions.It
shallfixadateforpreliminaryhearingsoastoenablethepolice
tonotifysuchdatetothevictim(familyofthevictimintheevent
ofdeath)andtheowner,driverandinsurerofthevehicleinvolved
intheaccident.Once,theclaimant(s)appear,themiscellaneous
application shall be converted to claim petition. Where a
claimant(s)filetheclaimpetitionevenbeforethereceiptofthe
AIRbytheTribunal,theAIRmaybetaggedtotheclaimpetition.
(c) The Tribunal shall enquire and satisfy itself that the AIR
relatestoarealaccidentandisnottheresultofanycollusionand
fabricationofanaccident(byany"policeofficerAdvocatedoctor"
nexus,whichhascometolightinseveralcases).
(d) The Tribunal shall by a summary enquiry ascertain the
dependentfamilymembers/legalheirs. Thejurisdictionalpolice
shallalsoenquireandsubmitthenamesofthedependentlegal
heirs.
(e)TheTribunalshallcategorisetheclaimcasesregistered,into
those where the insurer disputes liability and those where the
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insurerdoesnotdisputetheliability.
(f)Wherevertheinsurerdoesnotdisputetheliabilityunderthe
policy, theTribunal shall makeanendeavour to determinethe
compensationamountbyasummaryenquiryorreferthematter
totheLokAdalat for settlement, soastodisposeoftheclaim
petitionitself,withinatimeframenotexceedingsixmonthsfrom
thedateofregistrationoftheclaimpetition.
(g) The Insurance Companies shall be directed to deposit the
admitted amount or the amount determined, with the Claims
Tribunalswithin30daysofdetermination.TheTribunalsshould
ensurethatthecompensationamountiskeptinafixeddeposit
anddisbursedasperthedirectionscontainedinKeralaS.R.T.C.v.
SusammaThomas,1994(2)SCC176.
(h)AstheproceedinginitiatedinpursuanceofSecs.158(6)and
166(4)oftheActaredifferentinnaturefromanapplicationby
the victims(s) under Sec. 166(1)of theAct, Sec. 170will not
apply.TheinsurerswillthereforebeentitledtoassisttheTribunal
(eitherindependentlyorwiththeownersofthevehicles)toverify
thecorrectnessinregardtotheaccident,injuries,age,incomeand
dependants of the deceased victim and in determining the
quantumofcompensation.
C)Directionwithrespecttoinvestment:
InparaNo.28&29ofJaiPrakash'scase(supra)ithasbeenheldas
under:
28.Toprotectandpreservethecompensationamountawardedto
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the families of the deceased victim special schemes may be
considered by the Insurance Companies in consultationwith Life
InsuranceCorporationofIndia,StateBankofIndiaoranyother
NationalisedBanks.Oneproposalisforformulationofaschemein
consultation with the Nationalised Banks under which the
compensationiskeptinafixeddepositforanappropriateperiod
andinterestispaidbytheBankmonthlytotheclaimantswithout
anyneedfortheclaimantshavingtoapproacheithertheCourtor
their Counsel or the Bank for that purpose. The scheme should
ensure that the amount of compensation is utilised only for the
benefitoftheinjuredclaimantsorincaseofdeath,forthebenefitof
thedependentfamily.
29.Weextractbelowtheparticularsofaspecialschemeofferedbya
NationalisedBankattheinstanceoftheDelhiHighCourt:
(i)Thefixeddepositshallbeautomaticallyrenewedtilltheperiod
prescribedbytheCourt.
(ii)Theinterestonthefixeddepositshallbepaidmonthly.
(iii)Themonthlyinterestshallbecreditedautomaticallyinthesavings
accountoftheclaimant.
(iv)OriginalfixeddepositreceiptshallberetainedbytheBankinsafe
custody. However, the original passbook shall be given to the
claimantalongwiththephotocopyoftheF.D.R.
(v) The original fixed deposit receipt shall be handed over to the
claimantattheendofthefixeddepositperiod.
(vi) Photo identity card shall be issued to the claimant and the
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withdrawal shall be permitted only after due verification by the
Bankoftheidentitycardoftheclaimant.
(vii) No cheque book shall be issued to the claimant without the
permissionoftheCourt.
(viii)Noloan,advanceorwithdrawalshallbeallowedonthefixed
depositwithoutthepermissionoftheCourt.
(ix) The claimant can operate the Savings Bank account from the
nearestbranchofU.CO.Bankandontherequestoftheclaimant,
theBankshallprovidethesaidfacility.
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4.HowtodecideaclaimpetitionwhereinFatalInjuriesweresustainedbythedeceased:
4.1 InSarlaVermav/sDelhiTransportCorporation,reportedin2009
ACJ1298(SC)=AIR2009SC3104guidelinesfordeterminationof
multiplier,futureprospectsofthedeceased,deductiontowardspersonal
andlivingexpendituresareissued.Theratiolaiddowninthecaseof
SarlaVerma(supra)wasconsideredbytheThreeHon'bleJudgesofthe
Hon'bleApexCourt inthecaseofReshmaKumariv/sMadanMohan,
reportedin2013ACJ1253(SC)anditisheldthatratiolaiddowninthe
caseofSaralVerma(supra)shouldbefollowedbythealltheTribunals.
TheprincipleslaiddowninthecaseofSralaVeramandReshmaKumari
(supra) qua determination of multiplier, future prospects of the
deceased, deduction towards personal and living expenditures are as
under:
a)ChoiceofMultiplier:
Age of the Deceased MultiplierUpto 15 years 1515 to 20 years 1821 to 25 years 1826 to 30 years 1731 to 35 years 1636 to 40 years 1541 to 45 years 1446 to 50 years 1351 to 55 years 1156 to 60 years 961 to 65 years 7Above 65 years 5
12 MACP Reference Manual
b)WhatshouldbethemultiplierinthecaseofFatalinjurycase,wheredeceasedwasunmarriedson/daughter:
Therearedifferenceofopinionastowhatshouldbethemultiplierin
the case of fatal injury case, where deceased was unmarried
son/daughter.InShyamSingh,reportedin2011(7)SCC65=2011
ACJ1990(SC),ithasbeenheldthatMultiplierinthecaseofdeathof
unmarried son/daughter, proper multiplier should be arrived at by
assessingaverageageofparentsofthedeceased.Butdifferentviews
aretakenbyHon'bleApexCourtinthecasesofP.S.Somnathanv/s
Dist.InsuranceOfficer, reportedin2011ACJ737(SC), AmritBhanu
Shaliv/sNICom.,reportedin2012ACJ2002(SC),Saktideviv/sNI
Com,reportedin2010(14)SCC575andReshmaKumariv/sMadan
Mohan,reportedin2013ACJ1253(SC).Intheabovereferredcasesit
hasbeenheld that in thecaseof deathof unmarriedson/daughter,
multipliershouldbeaappliedonthebasisofageofthedeceasedand
notonthebasisofaverageageoftheparentsofthedeceased.
c)FutureProspectofDeceased:
In para No.11of the Srala Verama's (supra) judgment it is held as
under:
Inviewof imponderables anduncertainties, wearein favourof
adoptingasaruleofthumb,anadditionof50%ofactualsalaryto
theactualsalaryincomeofthedeceasedtowardsfutureprospects.
wherethedeceasedhadapermanentjobandwasbelow40years.
[Wheretheannualincomeisinthetaxablerange,thewords'actual
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salary' should be read as 'actual salary less tax']. The addition
shouldbeonly30%iftheageofthedeceasedwas40to50years.
Thereshouldbenoaddition,wheretheageofdeceasedismorethan
50years.Thoughtheevidencemayindicateadifferentpercentageof
increase,itisnecessarytostandardizetheadditiontoavoiddifferent
yardsticksbeingappliedordifferentmethodsofcalculationsbeing
adopted.Wherethedeceasedwasselfemployedorwasonafixed
salary(withoutprovisionforannualincrementsetc.),thecourtswill
usuallytakeonlytheactualincomeatthetimeofdeath.Adeparture
therefrom should be made only in rare and exceptional cases
involvingspecialcircumstances.
4.2 From the above referred observations, it becomes clear that
where the deceased hada permanent job and was below40 years
(wheretheannualincomeis inthetaxablerange,thewords 'actual
salary'shouldbereadas 'actualsalary,lesstax'),additionshouldbe
50%and if the age of the deceased was between 40 to 50 years,
additionshouldbeonly30%andthereshouldbenoaddition,where
the age of deceased is more than50years. In the cases where the
deceasedwasselfemployedorwasonafixedsalary,withoutprovision
forannualincrementsetc.,theTribunalcanusuallytakeonlytheactual
incomeatthetimeofdeath.
4.3 It is also required to be born in mind that House Rent
Allowance, Medical Allowance, Dearness Allowance, Dearness Pay,
Employees Provident Fund, Government Insurance Scheme, General
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ProvidentFund,C.C.A.etcshouldbetreatedaspartandparcelofthe
incomeofthedeceased,whilecalculatingincomeofthedeceasedfor
thepurposeofcomputingcompensation.Referencemaybemadeto
ratiolaiddownbyHon'bleApexCourtinthecaseofSunilSharmav/s
BachitarSingh,reportedin2011ACJ1441(SC)alsoseeVimalKanwar
v/sKishoreDan,reportedin2013ACJ1441.
4.4 Now,thequestionis,whenadeparturefromtheabovereferred
guidelineshouldbemade?Inthisregards,referenceisrequiredtobe
madetotheratiolaiddowninthecaseof K.R.Madhusudhanv/s
AdministrativeOfficer,reportedinAIR2011SC979.Inthesaidcase
deceasedwasaged53yearsandwasworkingasSeniorAssistantin
KarnatakaElectricityBoard.AsperBoardAgreement,aftercompletion
offiveyears,payrevisionwascompulsoryandevidencewasproduced
bytheclaimantsshowingthatifdeceasedwouldhavebeenalivehe
would have reached gross salary of Rs. 20,000/ p.m. Hence, even
thoughdeceasedwasabove50yearsofage,itisheldthatclaimants
areentitledtocompensationcalculatedonthebasisofsuchincreased
income.
d)DeductiontowardsPersonalandLivingExpenditures:
4.5InParaNo.14ofSarlaVeram'scase(supra)itisheldasunder:
Havingconsideredseveralsubsequentdecisionsofthiscourt,weare
of the view that where the deceased was married, the deduction
towardspersonalandlivingexpensesofthedeceased,shouldbeone
15 MACP Reference Manual
third(1/3rd)wherethenumberofdependentfamilymembersis2to
3,onefourth(1/4th)wherethenumberofdependantfamilymembers
is4to6,andonefifth(1/5th)wherethenumberofdependantfamily
membersexceedsix.
4.6InParaNo.14ofSarlaVeram'scase(supra)itisheldasunder:
Wherethedeceasedwasabachelorandtheclaimantsaretheparents,
the deduction follows a different principle. In regard to bachelors,
normally,50%isdeductedaspersonalandlivingexpenses,becauseit
isassumedthatabachelorwouldtendtospendmoreonhimself.Even
otherwise,thereisalsothepossibilityofhisgettingmarriedinashort
time,inwhicheventthecontributiontotheparentsandsiblingsis
likelytobecutdrastically.
4.7 Meaningthereby,thedeductiontowardspersonalandlivingexpenses
of the deceased, should be onethird (1/3rd) where the number of
dependantfamilymembersislessthan3,onefourth(1/4th)wherethe
numberof dependant family members is 4 to 6, andonefifth (1/5th)
wherethenumberofdependantfamilymembersexceedsix.Andinthe
cases where deceased was unmarried son/daughter, the deduction
towardspersonalandlivingexpensesofthedeceased,shouldbeonehalf.
4.7.1.IthasbeenfurtherheldinParaNo.15ofSarlaVerma'scase(supra)
that:
Further,subjecttoevidencetothecontrary,thefatherislikelytohave
hisownincomeandwillnotbeconsideredasadependantandthe
mother alone will be consideredas a dependent. In the absence of
16 MACP Reference Manual
evidencetothecontrary,brothersandsisterswillnotbeconsideredas
dependents,becausetheywilleitherbeindependentandearning,or
married,orbedependantonthefather.Thusevenifthedeceasedis
survivedbyparentsandsiblings,onlythemotherwouldbeconsidered
tobeadependant,and50%wouldbetreatedasthepersonaland
livingexpensesofthebachelorand50%asthecontributiontothe
family.However,wherefamilyofthebachelorislargeanddependant
ontheincomeofthedeceased,asinacasewherehehasawidowed
motherandlargenumberofyoungernonearningsistersorbrothers,
hispersonalandlivingexpensesmayberestrictedtoonethirdand
contributiontothefamilywillbetakenastwothird.
4.8 Plainreadingofabovereferredobservations,makesitclearthat,
unless, it is proved that father of the deceased was not having
independent income, father of the deceased cannot be treated as
dependant.Sameanalogyappliesinthecasesofwhereclaimpetitionis
preferred by the sibling/s of deceased who was/were unmarried
brother/sister of such deceased. But if, it is proved that father of the
deceasedwasnothavingindependentincome,fatherofthedeceasedcan
betreatedasdependant.Inthecaseswhereclaimpetitionispreferredby
themother,sibling/swhoweresolelydependantontheincomeoftheof
deceased, in such cases, onethird (1/3rd) may be deducted towards
personalandlivingexpensesofdeceased.
4.9InSralaVeram(supra)ithasbeenheldinpar26that:
Inaddition,theclaimantswillbeentitledtoasumofRs.5,000/
17 MACP Reference Manual
under the headof 'loss of estate' andRs. 5,000/ towards funeral
expenses. The widow will be entitled to Rs. 10,000/ as loss of
consortium'.
4.10 ButabenchofThreeHon'bleJudgesoftheHon'bleApexCourtin
thecaseofRajeshv/sRajbirSingh,reportedin2013ACJ1403hasheld
thatclaimantswillbeentitledtoasumofRs.1,00,000/undertheheadof
lossofcareandguidanceforminorchildren,Rs.25,000/towardsfuneral
expenses and the widow will be entitled to Rs. 1,00,000/ as loss of
consortium.
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5.HowtodecideaclaimpetitionwhereinclaimanthassustainedInjuries:
5.1Iftheclaimpetitionispreferredu/s166oftheAct,ininjurycases,
choiceofmultiplierremainsthesame,asinthecaseoffatalinjuries
cases. Deductions towards personal and living expenditures are not
madeininjuriescase.Todeterminethefuturelossofincome,ratiolaid
downinthecaseofRajKumarv/sAjayKumar,reportedin2012ACJ1
=2011(1)SCC343isrequiredtobefollowed.Inparagraph6ofthe
saiddecision,thevariouselementsofcompensationareenumeratedas
under:
"Pecuniarydamages(Specialdamages)
(i) Expenses relating to treatment, hospitalization, medicines,
transportation,nourishingfoodandmiscellaneousexpenditure.
(ii)Lossofearnings(andothergains)whichtheinjuredwould
havemadehadhenotbeeninjured,comprising:
(a)Lossofearningduringtheperiodoftreatment;
(b)Lossoffutureearningsonaccountofpermanentdisability.
(iii)Futuremedicalexpenses.
Nonpecuniarydamages(Generaldamages)
(iv)Damagesforpain,sufferingandtraumaasaconsequenceof
theinjuries.
(v)Lossofamenities(and/orlossofprospectsofmarriage).
(vi) Loss of expectation of life (shortening of normal
longevity)".
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5.2 Compensation in the case, where an injured victim is Government
Servant/Salariedperson,whosesalaryhasincreasedaftertheaccidentand
hasnotsustainedanyfinancialloss:
5.2.1 Theconceptofawardingcompensationis:thatnoamountof
compensationcanrestorethephysicalframeoftheappellant.Thatis
whyithasbeensaidbycourtsthatwheneveranyamountisdetermined
asthecompensationpayableforanyinjurysufferedduringanaccident,
the object is to compensate such injury" so far as money can
compensate" because it is impossible to equate the moneywith the
human sufferings or personal deprivations. Money cannot renew a
brokenandshatteredphysicalframe.
5.2.2 Hon'bleApexCourtinthecaseofRajKumarv/sAjayKumar,
reportedin2011ACJ1=2011(1)SCC343,hasheldinparaNo.10as
under:
Ontheotherhand,iftheclaimantwasaclerkingovernment
service, the loss of his left hand may not result in loss of
employmentandhemaystillbecontinuedasaclerkashecould
performhisclericalfunctions;andinthateventthelossofearning
capacitywillnotbe100%asinthecaseofadriverorcarpenter,
nor60%whichistheactualphysicaldisability,butfarless.Infact,
theremaynotbeanyneedtoawardanycompensationunderthe
head of `loss of future earnings', if the claimant continues in
government service, though he may be awarded compensation
undertheheadoflossofamenitiesasaconsequenceoflosinghis
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hand...
5.2.3 Reference is also required tobe made to ratio laid downby
Hon'bleGujaratHighCourtinthecaseofGurdipsinhs/oBisensingh
Sadhuvs.ChauhanBhupendrakumarUdesing,reportedin1980GLR
221.Inthesaidjudgment,itisheldthattheCourtcanmakerough
estimateabout loss of earningcapacity in the light of thefacts and
circumstancesandtheavailabledataofmedicalevidenceonrecord.In
thesaidcase, Hon'bleHighCourthadestimatedthe loss of earning
capacityat25%ofactualincomeandclaimantwasawardedRs.45,000,
thoughtherewasnoimmediatereductioninhissalaryasaTechnical
AssistantinO.N.G.C.Relyinguponthesaiddecision,Hon'bleDivision
bench of Gujarat High Court has held in the case of Mohanbhai
Gemabhaivs.BalubhaiSavjibhai,reportedin1993(1)GLR249(para
20)that:
Nodoubt,itisimperativefortheTribunaltoconsiderthefacts
andcircumstances,andthemedicalevidence,showingtheextentof
physicalimpairment.Ifnopreciseanddirectevidenceshowingthe
percentageorextentofthedisablementisspeltout,theTribunal
canmakeroughandreasonableestimateoflossofearningcapacity
soastodeterminethejustamountofcompensationunderthehead
of'prospectiveeconomicloss'.
5.2.4 EventheobservationsofHouseofLords,reportedin1912AC
496 are very relevant and same can be taken into consideration.
Referencerequiredtobemadetotheratiolaiddownin2013ACJ79
21 MACP Reference Manual
para20.
5.2.5 From the above referred ratios of Hon'ble Apex Court and
Hon'bleGujaratHighCourt,itbecomesclearthatTribunalcangrant
compensation to those injured persons who have not suffered any
financiallossorwhosesalaryincomehaveactuallyincreasedafterthe
dateofaccidentandsuchcompensationshouldnotbeunderthehead
of'lossofFutureEarnings'butundertheheadof'LossoffAmenities'
Such claimants are entitled for such amount of compensation,
calculatedonthebasisof1/4th ofthenetsalaryincome,whichthey
weregettingatthetimeofaccident.
5.3DeterminationofpermanentPartialDisablementoftheclaimant:
5.3.1. Inthecaseswhereinjuredhadsustainedmorethatonefracture
injuries,itmayappeartoTribunalthatdisabilitycertificateissuedby
the Doctor depicts the higher value of disability than the injured
claimant has actually sustained. In such situation, Ld. Judge of the
Tribunal finds it difficult to arrive at the exact amount of disability
sustained by the injured claimant. Normally, Doctors issue disability
certificateonthebasisofformulainventedbyDr.HenryH.Kesslerin
his book titled as 'Disability Determination & Evaluation'. For
determinationofdisabilityinsuchcases,Doctorsapplyformulaevolved
byDr.HenryH.Kessler.SaidFormulareadsasunder:
A+{[B(100A)]/100}
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5.3.2. In the said formula, 'A' stands for higher value of partial
disablement,whereas'B'standsforlowervalueofpartialdisablement.
Doctorsnormally, takedisadvantageofthecommentsgivenonpage
No.49 of the above referred book. Careful reading of the said
comments,leadstotheconclusionthatwheninjuredvictim/claimant
hassustainedinjuries,whichresultedintotwoormorefracturesontwo
different limbs of the body, then in such situation disablement in
relation to whole body may be assessed as per the above referred
formula.Butabovereferredformuladoesnotapplyinthecaseswhere
claimanthassustainedtwoormorefracturesonthesamelimbi.eone
fractureonrighthandandsecondonlefthandoronefractureonright
lagandsecondontheleftleg.Itisalsomentionedinthesaidbookthat
lowerpartofthebodyi.e.legsorupperpartofbodyi.e.twohandsare
consideredasonelimbofthebody(lowerlimborupper limb)and
when victim/claimant has sustained fractures on the one particular
limb then in such case, disablement in relation to whole may be
assessedasonehalfofthepermanentpartialdisablementassessedby
thedoctor. Say for anexample, claimanthassustainedone fracture
injuryonrightleganddoctorhasassesseddisabilityinrelationtoright
lowerlimbas27%andsecondfractureinjuryonleftleganddoctorhas
assesseddisabilityinrelationtoleftlowerlimbas7%andif,weapply
simple principle in the facts of the above referred example, the
disablementinrelationtowholebody,comesto17%.(27%inrelation
torightlowerlimbpluspermanentpartialimpairmentof7%inrelation
toleftlowerlimb,dividedbytwo[27%+7%]/2).But,ifweapply
the above referred formula, disablement in relation to whole body
23 MACP Reference Manual
comesto32.11%. {27+[7(10027)/100]}.Fromtheabove
referred discussion, it becomes clear that when victim/claimant has
sustained more than one fractures on one limb and when
victim/claimanthassustainedmorethanonefracturesontwolimbs,
assessmentofdisablementinrelationtowholebodyisrequiredtobe
assessedbyapplyingdifferentformulas.BookwrittenbyDr.HenryH.
Kessler,namely,'DisabilityDetermination&Evaluation'isconsidered
to be the authority as far as calculation of permanent partial
disablementisconcerned.However,itistobenotedthatDr.HenryH.
Kesslerhasalsomentionedinhisbookthatthereisalwaysvariationof
plus/minus5%,inthepermanentpartialdisablementassessedbythe
doctor.Therefore,whiledecidingpermanentpartialimpairmentofthe
injuredclaimant,abovereferredfactsarerequiredtoberemembered.
5.3.3 Reference may also be made to 'Manual For Doctors To
EvaluatePermanentPhysicalImpairment',whichisbasedonexpert
group meeting on disability evaluation and national seminar on
disability evaluation and dissemination, G.G.H.S. W.H.O. A.I.I.M.S.,
New Delhi 1981. Reference may also be made to 'Disability
GuidelinesissuedbyOfficeofChiefCommissionerforPersonswith
Disabilities, dated 1 st June 2001 . Guidelines issued in the above
referredreportsareasunder:
5.3.3.1. Guidelines for Evaluation of Permanent Physical Impairment in
UpperLimbs:
1. The estimation of permanent impairment depends upon the
24 MACP Reference Manual
measurementoffunctional
impairment,andisnotexpressionofapersonalopinion.
2.Theestimationandmeasurementmustbemadewhentheclinical
conditionisfixedand
unchangeable.
3.Theupperextremityisdividedintotwocomponentpartsthearm
componentandthe
handcomponent.
4.Measurementofthelossoffunctionofarmcomponentconsistsin
measuringtheloss
ofmotion,musclestrengthancoordinatedactivities.
5.Measurementofthelossoffunctionofhandcomponentconsistsin
determiningthePrehension,Sensation&Strength. Forestimationof
Prehension : Opposition, lateral pinch, Cylindrical grasp, spherical
graspandhookgrasphavetobeassessedasshowninthecolumnof
prehensioncomponentintheproforma.
6.Theimpairmentoftheentireextremitydependsonthecombination
ofthefunctionalimpairmentofbothcomponents.
ARMCOMPONENT:
Totalvalueofarmcomponentis90%.
PrinciplesofEvaluationofrangeofmotionofjoints
1.ThevalueformaximumR.O.M.inthearmcomponentis90%.
2.Eachofthethreejointsofthearmisweightedequally(30%).
Example
A.fractureoftherightshoulderjointmayaffectrangeofmotionsothat
25 MACP Reference Manual
active adduction is 90degree. The left shoulder exhibits a range of
activeabductionof180degree.Hencethereislossof50%ofabduction
movementoftherightshoulder.Thepercentagelossofarmcomponent
in the shoulder is 50 x 0.03 or 15% loss of motion for the arm
component.
If morethanonejointis involved,samemethodis applied,andthe
lossesineachoftheaffectedjointsareadded.
Sayforexample:
Lossofabductionoftheshoulder=60%
Lossofextensionofthewrist=40%
Then,lossofrangeofmotionforthe
arm=(60x0.30)+(40x0.30)=30%
PrinciplesofEvaluationofstrengthofmuscles:
1.Strengthofmusclescanbetestedbymanualtestinglike05grading.
2.Manualmusclegradingscanbegivenpercentageslike
3.100%
4.80%
5.60%
6.40%
7.20%
8.0%
9.Themeanpercentageofmusclestrengthlossismultipliedby0.30.
Iftherehasbeenalossofmusclestrengthofmorethanonejoint,the
valuesareaddedashasbeendescribedforlossofrangeofmotion.
26 MACP Reference Manual
PrinciplesofEvaluationofcoordinatedactivities:
1.Thetotalvalueforcoordinatedactivitiesis90%.
2.Tendifferentcoordinatedactivitiesaretobetestedasgiveninthe
Proforma.
3.Eachactivityhasavalueof9%.
CombiningvaluesfortheArmComponent:
1. The value of loss of function of arm component is obtained by
combining the values of rangeof movement, muscle strength&co
ordinatedactivities,usingthecombiningformula
A+b(90a)/90
Where'a'=highervalue&'b'=lowervalue
Example
Letusassumethatanindividualwithafractureoftherightshoulder
jointhasinadditionto16.5%lossofmotionofhisarm,8.3%lossof
strengthofmuscles,and5%lossofcoordination.Wecombinethese
valuesas:
Rangeofmotion:16.5% 16.5+8.3(9016.5)/90=23.3%
StrengthofMuscles:8.3%
Coordination:5% 23.3+5(9023.3)/90=27.0%
Sototalvalueofarmcomponent=27.0%
HANDCOMPONENT:
Totalvalueofhandcomponentis90%.
Thefunctionalimpairmentofhandisexpressedaslossofprehension,
lossofsensation,lossofstrength.
27 MACP Reference Manual
PrinciplesofEvaluationofPrehension:
TotalvalueofPrehensionis30%.Itincludes:
(A)Opposition(8%).Testedagainst
Indexfinger(2%).Middlefinger(2%)
Ringfinger(2%)&Littlefinger(2%)
(B)LateralPinch(5%).Testedbyaskingthepatienttoholdakey.
(C)CylindricalGrasp(6%).Testedfor
(D)Largeobjectof4inchsize(3%)
(E)Smallobjectof1inchsize(3%)
(F)SphericalGrasp(6%).Testedfor
(G)Largeobject4inchsize(3%)
(H)Smallobject1inchsize(3%)
(I)HookGrasp(5%).Testedbyaskingthepatienttoliftabag.
PrinciplesofEvaluationofSensations:
Totalvalueofsensationis30%.Itincludes:
1.GripStrength(20%)
2.PinchStrength(10%)
3. Strength will be tested with hand dynamometer or by clinical
method(GripMethod).
10%additionalweightagetobegiventothefollowingfactors:
1.Infection
2.Deformity
3.Malaignment
4.Contractures
5.Cosmeticappearance
28 MACP Reference Manual
6.AbnormalMobility
7.DominantExtremity(4%)
Combiningvaluesofthehandcomponent:
Thefinalvalueoflossoffunctionofhandcomponentisobtainedby
summingupvaluesoflossofprehension,sensationandstrength.
CombiningValuesfortheExtremity:
Values of impairment of arm component and impairment of hand
componentarecombinedbyusingthecombiningformula.
Example
Impairmentofthearm=27% 64+27(9064)/90=71.8%
Impairmentofthehand=64%
5.3.3.2. Guidelines for Evaluation of Permanent Physical Impairment in
LowerLimbs:
The lower extremity is divided into two components: Mobility
componentandStabilitycomponent.
MOBILITYCOMPONENT:
Total value of mobility component is 90%. It includes range of
movementandmusclestrength.
PrinciplesofEvaluationofRangeofMovement:
1Thevalueofmaximumrangeofmovementinthemobilitycomponent
is90%.
2. Each of the three joints i.e. hip, knee, footankle component, is
29 MACP Reference Manual
weightedequally0.30.
Example
AFractureoftherighthipjointmayaffectrangeofmotionsothat
active abduction is 27degree. The lift hip exhibits a rangeof active
abduction of 54degree. Hence, there is loss of 50% of abduction
movementoftherighthip.Thepercentagelossofmobilitycomponent
inthehipis50,0.30or15%lossofmotionforthemobilitycomponent.
If morethanone joint is involved,samemethodis appliedandthe
lossesineachoftheaffectedjointsareadded.
Example
Lossofabductionofthehip=60%
Lossofextensionftheknee=40%
Lossofrangeofmotionforthemobilitycomponent
=(60x0.30)+(40x0.03)=30%.
PrinciplesofEvaluationofMuscleStrength:
1.Thevalueformaximummusclestrengthinthelegis90%.
2.Strengthofmusclescanbetestedbymanualtestinglike05grading.
3.Manualmusclegradingscanbegivenpercentageslike
Grade0=100%
Grade1=80%
Grade2=60%
Grade3=40%
Grade4=20%
Grade5=0%
30 MACP Reference Manual
4.Meanpercentageofmusclestrengthlossismultipliedby0.30.
5.Iftherehasbeenalossofmusclestrengthofmorethanonejoint,the
valuesareaddedashasbeendescribedforlossofrangeofmotion.
CombiningValuesfortheMobilityComponent:
Letusassumethattheindividualwithafractureoftherighthipjoint
hasinadditionto16%lossofmotion8%lossofstrengthofmuscles.
CombingValues:
Motion16%,Strength8%
=16+8(9016)/90=22.6%
Where'a'=highervalue,'b'=lowervalue.
STABILITYCOMPONENT:
1.Totalvalueofstabilitycomponentis90%
2.Itistestedby2methods
3.Basedonscalemethod.
4.Basedonclinicalmethod
Threedifferentreadings(inkilograms)aretakenmeasuringthetotal
bodyweight(W),scaleAreadingandscaleBreading.Thefinalvalue
isobtainedbytheformula:
DifferenceinbodyweightdividedbyTotalbodyweight,multipliedby
90.
Intheclinicalmethodofevaluationninedifferentactivitiesaretobe
testedasgivenintheproforma.Eachactivityhasavalueoftenpercent
(10%).
31 MACP Reference Manual
5.3.3.4. Guidelines for Evaluation of Permanent Physical Impairment of
Trunk(Spine):
Thelocaleffectsoflesionsofspinecanbedividedintotraumaticand
nontraumaticlesions.
TRAUMATICLESIONS
CervicalSpineFracture
Percent Whole body Permanent Physical Impairment and Loss of
PhysicalFunctiontoWholeBody.
A.Vertebralcompression25%,oneortwovertebraladjacentbodies,no
fragmentation, no involvement of posterior elements, no nerve root
involvement,moderateneckrigidityandpersistentsoreness.
B. Posterior elements with Xray evidence of moderate partial
dislocation.
(a)Nonerverootinvolvement,healed15
(b)Withpersistentpain,withmildmotorandsensoryManifestations
25
(c)Withfusion,healednopermanentmotororsensorychanges25
C.Severedislocation,fairtogoodreductionwithsurgicalfusion
(a)Noresidualmotororsensorychanges25
(b) Poor reduction with fusion, persistent radicular pain, motor
involvement,onlyslightweaknessandnumbness35
(c)Sameas(b)withpartialparalysis,determineadditionalratingfor
lossofuseofextremitiesandsphincters.
CervicalIntervertebralDisc:
32 MACP Reference Manual
1.Operative,successfulremovalofdisc,withreliefofacutepain,no
fusion,noneurologicalresidual10
2. Same as (1) with neurological manifestations, persistent pain,
numbness,weaknessinfingers20
ThoracicandDorsolumbarSpineFracture:
Percent Whole body Permanent Physical Impairment and Loss of
PhysicalFunctiontoWholeBody
A.Compression25%,involvingoneortwovertebralbodies,mild,no
fragmentation,healednoneurologicalmanifestations.10
B.Compression50%,withinvolvementposteriorelements,healed,no
neurologicalmanifestations,persistentpain,fusionindicated.20
C.Sameas(B)withfusion,painonlyonheavyuseofback.20
D.Totalparaplegia.100
E. Posteriorelements,partialparalysiswithorwithoutfusion,should
beratedforlossofuseofextremitiesandsphincters.
LowLumbar:
1.Fracture
2.Vertebralcompression25%,oneortwoadjacentvertebralbodies,
littleorfragmentation,nodefinitepatternorneurologicalchanges.15
3.Compressionwithfragmentationposteriorelements,persistentpain,
weaknessandstiffness,healed,nofusion,noliftingover25pounds
40
4.Sameas(B),healedwithfusion,mildpain20
33 MACP Reference Manual
5.Sameas(B),nerverootinvolvementtolowerextermities,determine
additionalratingforlossofindustrialfunctiontoextremities
6. Same as (c), with fragmentation of posterior elements, with
persistentpainafterfusion,noneurologicfindings30
7.Sameas(c),withnerverootinvolvementtolowerextremities,rate
withfunctionallosstoextremities
8.Totalparaplegia100
9.Posteriorelements,partialparalysiswithorwithoutfusion,should
beratedforlossofuseofextremitiesandsphincters.
@.NeurogenicLowBackPainDiscInjury
A.Periodicacuteepisodeswithacutepainandpersistentbodylist,tests
forsciaticpainpositive,temporaryrecovery5to8weeks50
B.Surgicalexcisionofdisc,nofusion,goodresults,nopersistentsciatic
pain10
C.Surgicalexcisionofdisc, nofusion,moderatepersistentpainand
stiffness aggravated by heavy lifting with necessary modification of
activities20
D.Surgicalexcisionofdiscwithfusion,activitiesofliftingmoderately
modified15
E.Surgical excisionof discwith fusion,persistentpainandstiffness
aggravatedbyheavylifting,necessitatingmodificationofallactivities
requiringheavylifting25
34 MACP Reference Manual
NONTRAUMATICLESIONS:
Scoliosis
ThewholeSpinehasbeengivenratingof100%andregionwisethe
followingpercentagesaregiven:
DorsalSpine50%
LumbarSpine30%
CervicalSpine20%
Kobbsmethodformeasurementofangleofcurveinstandingposition
istobeused.Thecurveshavebeendividedintothreesubgroups:
Particulars Cervical Spine
Thoracic spine Lumber Spine
30degree (Mild)
2.00% 5.00% 6.00%
30-60degree (Moderate)
3.00% 15.00% 12.00%
Above 60degree (Severe)
5.00% 25.00% 33.00%
Inthecurvesrangingabove600,cardiopulmonarycomplicationsare
to be graded separately. The junctional curves are to be given that
ratingdependinguponlevelofapexofcurve.Forexample,ifapexof
dorsolumbarcurvefallsinthedorsalspinethecurvecanbetakenasa
dorsal curve. When the scoliosis is adequately compensated, 5%
reductionistobegivenfromfinalrating(forallassessmentprimary
curvesareconsideredforrating).
35 MACP Reference Manual
Kyphosis
Thesametotalrating(100%)asthatsuggestedforscoliosisistobe
givenforkyphosis.Regionwisepercentagesofphysicalimpairmentare:
DorsalSpine50%
CervicalSpine30%
LumbarSpine20%
Fordorsalspinethefollowingfurthergradingsare:
Lessthan20degree10%
21degree40degree15%
41degree60degree20%
Above60degree25%
Forkyphosisoflumbarandcervicalspine5%and7%respectivelyhave
beenallocated.
ParalysisofFlexors&ExtensorsofDorsalandLumbarSpine:
Themotorpowerofthesemusclestobegroupedasfollows:
Normal
Weak 5%
Paralysed 10%
ParalysisofMusclesofCervicalSpine:
Particulars Normal Weak ParalysedFlexors 0 5.00% 10.00%Extensors 0 5.00% 10.00%Rotation 0 5.00% 10.00%Side Bending 0 5.00% 10.00%
36 MACP Reference Manual
Miscellaneous:
Thoseconditionsofthespinewhichcausestiffnessandpartetc.,are
ratedasfollows:
A. Subjective symptoms of pain, No involuntary muscle spasm, Not
substantiatedbydemonstrablestructuralpathology. 0
B.Pain,Persistentmusclespasmandstiffnessofspine,substantiatedby
demonstrableandradiologicalchanges. 10%
C.SameasB,withmoderateradiologicalchanges. 15%
D.SameasB,withsevereradiologicalchangesinvolvinganyoneofthe
regionofspine(cervical,dorsalorlumbar) 20%
E.SameasD,involvingwholespine 30%
In Kyphoscoliosis, both curves to be assessed separately and then
percentageofdisabilitytobesummed.
5.3.3.5. Guidelines for Evaluation of Permanent Physical Impairment in
Amputees:
BasicGuidelines:
1. In case of multiple amputees, if the total sum of percentage
permanentphysicalimpairmentisabove100%,itshouldbetakenas
100%.
2.Amputationatanylevelwithuncorrectableinabilitytowearanduse
prosthesis,shouldbegiven100%permanentphysicalimpairment.
3.Incaseofamputationinmorethanonelimbpercentageofeachlimb
is counted and another 10%will be added, but when only toes or
fingersareinvolvedonlyanother5%willbeadded.
4.Anycomplicationinformofstiffness,neuroma,infectionetc.hasto
37 MACP Reference Manual
begivenatotalof10%additionalweightage.
5.Dominantupperlimbhasbeengiven4%extrapercentage.
UpperLimbAmputation:
Sr. No Particulars of Amputation Permanent Partial Impairment, in %
1 Fore-quarter 1002 Shoulder Disarticulation 903 Above Elbow upto upper 1/3 of
arm85
4 Above Elbow upto lower 1/3 of arm
80
5 Elbow Disarticulation 756 Below Elbow upto upper 1/3 of
forearm70
7 Below Elbow upto lower 1/3 of forearm
65
8 Wrist Disarticulation 609 Hand through carpal bones 5510 Thumb through C.M. or through
1st M.C. Joint 30
11 Thumb Disarticulation through metacarpophalangeal joint or through proximal phalanx
25
12 Thumb Disarticulation through inter phalangeal joint or through distal phalanx
15
38 MACP Reference Manual
AmputationofFinger:
Particulars IIndex Finger
Middle Finger
Ring Finger
Little Finger
Amputation through proximal phalanx or disarticulation through MP joint
115.00% 5.00% 3.00% 2.00%
Amputation through middle phalanx or disarticulation through PIP joint
110.00% 4.00% 2.00% 1.00%
Amputation through distal phalanx or disarticulation through DIP joint
55.00% 2.00% 1.00% 1.00%
LowerLimbAmputations:
1. Hindquarter 100%2. Hipdisarticulation 90%3. Abovekneeuptoupper1/3ofthigh85%4. Abovekneeuptolower1/3ofthigh80%5. Throughkeen 75%6. B.K.upto8cm 70%7. B.K.uptolower1/3ofleg 60%8. Throughankle 55%9. Syme's 50%10. Uptomidfoot 40%11. Uptoforefoot 30%12. Alltoes 20%13. Lossoffirsttoe 10%14. Lossofsecondtoe 5%15. Lossofthirdtoe 4%16. Lossoffourthtoe 3%17. Lossoffifthtoe 2%
39 MACP Reference Manual
5.4Whatshouldbetheamountofcompassioninthecaseswhereinjured
lostoneofthelimb(amputation):
5.4.1. Hon'bleApexCourtinthecaseofGovindYadavv/sN.I.A.Com.,
reportedin2012(1)TAC1(SC)=2012ACJ28(SC)hasheldthatas
thecostoflivingandcostofartificiallimb(prosthetic)hassubstantially
increasedand,therefore,Rs.2,00,000/tobeawardedunderthesaid
head.Rs.1,50,000/eachtobeawardedundertheheadsofpain,shock
&sufferingsandspecialdiet,attendance&transportationandlossof
amenities and enjoyment of life, respectively. And if injured is
unmarried and his/her prospects for marriage have considerably
reduced,Rs.1,00,000/maybeawarded.
5.5WhetherDependantsoftheinjuredclaimantwhodiedhisnaturaldeath
duringthependencyoftheclaimpetitionareentitledtogetanyamountof
compensation:
5.5.1. MaximActioPersonalisMoriturcumPersonaisapplicablein
suchcases.EvenprovisionsofSection306(alongwithIllustrations)of
IndianSuccessionAct, 1925wouldapply. InthecasesofPravabati
Ghosh&Anr.Vs.GautamDas&Ors.,reportedin2006(Suppl)1GLT
15,relyingontheratiolaiddownbytheHon'bleApexCourtinthecase
ofMelepurathSankunniEzuthassanv/sThekittilGeopalankuttyNair,
reportedin1986(1)SCC118,andthecaseofM.Veerappav/sEvelyn
Sequeria&Ors.,reportedin1988(1)SCC556,hasheldinparagraph8
ofthejudgmentthus:
therighttosuewillnotsurviveinfavourofhisrepresentatives,for,
40 MACP Reference Manual
insuchanappeal,whatthelegalrepresentativesofsuchaclaimant
wouldbedoingistoaskforcompensationandtherighttoaskfor
compensationtobeawardeddoesnotsurviveiftheclaimantdies
before the claim for compensation is awardedor decreed in his
favour,thecauseofdeathnotbeingtheinjuriessustainedbythe
deceasedclaimant.
5.5.2. From the above referred ratio it becomes clear that if the
claimantdiesbeforetheclaimforcompensationisawardedordecreed
in his favour is passed, claim petition at the behest of the legal
representativeofthesuchinjuredclaimantisnotmaintainable.
41 MACP Reference Manual
6.Howtodeterminemonthlyincomeofthedeceasedorinjuredwhenno
documentinsupportthereofisnotproduced:
6.1 InthecaseofGovindYadav(supra),paraNo.17ithasbeenheldthat
whenthereisnoproofofincome,incomeofthedeceasedorinjured
claimant shall be decided by taking into consideration prevalence
minimumwages.
6.2 SeveralStateGovernmenthaveissuednotificationsoftherelatingto
MinimumWagesAct,1948(hereinafterreferredas'1948Act').Details
ofsuchnotificationsareunder:
6.2.1. Governments of National Territory of Delhi has revised
minimum rates of wages applicable to all Scheduled Employees
covered under the 1948 Act, vide Notification dated 12.09.2008,
effectivefrom01.08.2008.
Categories Rates in Rupees
Dearness Allowance
Rates per month
Rates per Day
Un-Skilled 3633 50 3683 142Semi Skilled 3799 50 3849 148Skilled 4057 50 4107 158
6.2.2. Rates applicable to Clerical and NonTechnical Supervisory
Staff:
Categories Rates in Rupees
Dearness Allowance
Rates per month
Rates per Day
Non-matriculates
3826 50 3876 149
Matriculates but not graduates
4081 50 4131 159
Graduates and above
4393 50 4443 171
42 MACP Reference Manual
6.2.3. Government of National Territory of Delhi has revised
minimum rates of wages applicable to all Scheduled Employees
covered under the 1948 Act, vide Notification dated 26.07.2011,
effectivefrom01.04.2011.
Occupation Wages per month in Rupees
Wages per day in Rupees
Un-Skilled:- Peon, Watchman, Sweeper, Waterman, Cleaner etc.
6422 247
Semi-Skilled:- Bus conductor, Asst. Electrician, Asst. Plumber, Asst. Carpenter etc.
7098 273
Skilled:- Liberian, Lab Assistant, Driver, Physical Instructor, Electrician, Plumber, Carpenter etc.
7826 301
Non-matriculates 7098 273Matriculates but not graduates 7826 301Graduates and above 8502 327
6.2.4.Government of Gujarat has fixed the following rates (in Rupees) as minimum Wages, w.e.f. 01.04.2013.
Workers/Employees Category of Workers Basis Rates per Day
D.A. per day
Total per day
Agriculture - 100 No Provision
100
Other Schedule Employees
Un-Skilled 130-135 70 200-205
Other Schedule Employees
Semi-Skilled 135-140 70 205-210
Other Schedule Employees
Skilled 140-150 70 210-220
6.2.5. Data prior to 2008 is not available but it may be obtained from the office of Labour Commissioner.
43 MACP Reference Manual
7. Howtodetermineincomeof thedeceasedor injuredclaimantwhen
thereis documentaryevidenceonrecordtoshowthat thedeceasedor
injuredclaimantwasearninginforeigncurrencyandnotinIndianRupee:
7.1 Hon'bleApexCourtinthecaseofUnitedIndiaInsuranceCo.Ltdv/s
S.Malarvizhi,decidedon6June,2013hasheldthatwhenthedeceased
orinjuredclaimantwasgettingsalaryinforeigncurrency,theninsuch
situationsuchforeignsalary/incomeshouldbeconvertedinto Indian
Rupee,attheratesapplicableatthetimeofaccidentanddeductionof
higherpercentageof60%oftheincomeandlowmultipliershouldbe
applied.
7.2 ReferencemayalsobemadetoratiolaiddowninthecaseofInthe
caseof United India InsuranceCom.Ltd. v/s Patricia JeanMahajan,
reportedin2002(6)SCC281=2002ACJ1481=2002(4)Supreme
518.SaidcasebeforetheHon'bleSupremeCourtaroseoutofaclaim
madeonbehalfoftheDoctorofIndianoriginwhobecametheAmerican
citizenandwaskilled inaroadaccidentwhenhevisitedIndia. The
claim for compensation was based upon the income in the foreign
countryandwhileconsideringthesaidcase,amongotherthings,the
Hon'bleSupremeCourtobservedthatthetotalamountofcompensation
would work out to Rs.16.12 crores with interest and looking to the
IndianEconomy,fiscalandfinancialsituation,theamountiscertainlya
fabulousamountthoughinthebackgroundofAmericanconditionsit
maynotbeso.Itwasfurtherheldthatwhenthereissomuchdisparity
in theeconomicconditionsandaffluenceof twoplacesviz. place to
44 MACP Reference Manual
whichthevictimbelongandtheplaceatwhichthecompensationisto
bepaid, a goldenbalancemust bestrucksomewhere, toarriveat a
reasonableandfaircompensation.LookingbytheIndianstandardsthey
maynotbemuchtooovercompensatedandsimilarlynotverymuch
undercompensatedaswell, inthebackgroundofthecountrywhere
mostofthedependentbeneficiariesreside.
45 MACP Reference Manual
8. How to decide a claim petition where defence of Invalid, Learners
Licence & Fake Driving Licence and Defense of Qualification/Badge is
taken:
8.1 ReferenceisrequiredtobemadetoratiolaiddownbyHon'bleApex
CourtinthecaseofNationalInsuranceCom.Ltd.V/sSwaranSingh,
reportedinAIR2004SC1531, in ParaNo.105it hasbeenheldas
under:
105:Thesummaryofourfindingstothevariousissuesasraisedin
thesepetitionsareasfollows:
(i)ChapterXIoftheMotorVehiclesAct,1988providingcompulsory
insurance of vehicles against third party risks is a social welfare
legislationtoextendrelief bycompensationtovictimsof accidents
caused by use of motor vehicles. The provisions of compulsory
insurancecoverageofallvehiclesarewiththisparamountobjectand
theprovisionsoftheActhavetobesointerpretedastoeffectuatethe
saidobject.
(ii)Insurerisentitledtoraiseadefenceinaclaimpetitionfiledunder
Section163AorSection166oftheMotorVehiclesAct,1988inter
aliaintermsofSection149(2)(a)(ii)ofthesaidAct.
(iii)Thebreachofpolicyconditione.g.disqualificationofdriveror
invaliddrivinglicenceofthedriver,ascontainedinsubsection(2)(a)
(ii)ofSection149,havetobeprovedtohavebeencommittedbythe
insuredforavoiding liabilitybythe insurer.Mereabsence, fakeor
invaliddrivinglicenceordisqualificationofthedriverfordrivingat
the relevant time, are not in themselves defences available to the
46 MACP Reference Manual
insureragainsteithertheinsuredorthethirdparties.Toavoidits
liabilitytowardsinsured,theinsurerhastoprovethattheinsured
wasguiltyofnegligenceandfailedtoexercisereasonablecareinthe
matteroffulfillingtheconditionofthepolicyregardinguseofvehicles
bydulylicenseddriveroronewhowasnotdisqualifiedtodriveatthe
relevanttime.
(iv)Theinsurancecompaniesare,however,withaviewtoavoidtheir
liabilitymustnotonlyestablishtheavailabledefence(s)raisedinthe
saidproceedingsbutmustalsoestablish'breach'onthepartofthe
ownerofthevehicle;theburdenofproofwhereforewouldbeonthem.
(v)Thecourtcannotlaydownanycriteriaastohowsaidburden
wouldbedischarged,inasmuchasthesamewoulddependuponthe
factsandcircumstancesofeachcase.
(vi)Evenwheretheinsurerisabletoprovebreachonthepartofthe
insuredconcerningthepolicyconditionregardingholdingofavalid
licencebythedriverorhisqualificationtodriveduringtherelevant
period,theinsurerwouldnotbeallowedtoavoiditsliabilitytowards
insuredunlessthesaidbreachorbreachesontheconditionofdriving
licenceis/aresofundamentalasarefoundtohavecontributedtothe
cause of the accident. The Tribunals in interpreting the policy
conditionswouldapply"theruleofmainpurpose"andtheconceptof
"fundamentalbreach"toallowdefencesavailabletotheinsuredunder
Section149(2)oftheAct.
(vii)Thequestionastowhethertheownerhastakenreasonablecare
tofindoutastowhetherthedrivinglicenceproducedbythedriver,(a
47 MACP Reference Manual
fakeoneorotherwise),doesnotfulfiltherequirementsoflawornot
willhavetobedeterminedineachcase.
(viii) If a vehicle at the timeof accident was drivenby a person
havingalearner'slicence,theinsurancecompanieswouldbeliableto
satisfythedecree.
(ix) The claims tribunal constituted under Section 165 read with
Section168isempoweredtoadjudicateallclaimsinrespectofthe
accidentsinvolvingdeathorofbodilyinjuryordamagetopropertyof
thirdpartyarising inuseof motorvehicle. Thesaidpowerof the
tribunal is not restricted to decide the claims inter se between
claimantorclaimantsononesideandinsured,insureranddriveron
theother.Inthecourseofadjudicatingtheclaimforcompensation
andtodecidetheavailabilityofdefenceordefencestotheinsurer,the
Tribunalhasnecessarilythepowerandjurisdictiontodecidedisputes
intersebetweeninsurerandtheinsured.Thedecisionrenderedonthe
claimsanddisputesintersebetweentheinsurerandinsuredinthe
courseof adjudicationof claimforcompensationby theclaimants
and theawardmadethereon is enforceable andexecutable in the
samemannerasprovidedinSection174oftheActforenforcement
andexecutionoftheawardinfavouroftheclaimants.
(x)WhereonadjudicationoftheclaimundertheActthetribunal
arrivesataconclusionthattheinsurerhassatisfactorilyprovedits
defence inaccordance with theprovisions of Sections 149(2)read
withsubsection(7),asinterpretedbythisCourtabove,theTribunal
candirectthattheinsurerisliabletobereimbursedbytheinsuredfor
48 MACP Reference Manual
thecompensationandotheramountswhichithasbeencompelledto
pay to the third party under the award of the tribunal. Such
determinationofclaimbytheTribunalwill beenforceableandthe
moneyfoundduetotheinsurerfromtheinsuredwillberecoverable
onacertificateissuedbythetribunaltotheCollectorinthesame
mannerunderSection174oftheActasarrearsaslandrevenue.The
certificatewillbeissuedfortherecoveryasarrearsoflandrevenue
onlyif,asrequiredbysubsection(3)ofSection168oftheActthe
insuredfailstodeposittheamountawardedinfavouroftheinsurer
withinthirtydaysfromthedateofannouncementoftheawardby
thetribunal.
(xi) The provisions contained in subsection (4) with proviso
thereunderandsubsection(5)whichareintendedtocoverspecified
contingencies mentioned therein to enable the insurer to recover
amountpaidunderthecontractofinsuranceonbehalfoftheinsured
canbetakenrecourseofbytheTribunalandbeextendedtoclaims
anddefences of insurer against insuredby relegating themto the
remedy before regular court in cases where on given facts and
circumstancesadjudicationoftheirclaimsintersemightdelaythe
adjudicationoftheclaimsofthevictims.
8.2 Barereadingofabovereferredobservationsmakesit clear
thatmereabsence,fakeorinvaliddrivinglicenceordisqualification
ofthedriverfordrivingattherelevanttime,arenotinthemselves
defencesavailabletotheinsureragainsteithertheinsuredorthe
49 MACP Reference Manual
thirdparties.Toavoiditsliabilitytowardsinsured,theinsurerhas
toprovethatthe insuredwasguiltyof negligenceandfailedto
exercisereasonablecareinthematteroffulfillingtheconditionof
thepolicyregardinguseofvehiclesbydulylicenseddriverorone
who was not disqualified to drive at the relevant time. The
insurance companies are, however, with a view to avoid their
liabilitymustnotonlyestablishtheavailabledefence(s)raisedin
thesaidproceedingsbutmustalsoestablish'breach'onthepartof
theownerofthevehicle;theburdenofproofwhereforewouldbe
onthem.Evenwheretheinsurerisabletoprovebreachonthepart
oftheinsuredconcerningthepolicyconditionregardingholdingof
avalidlicencebythedriverorhisqualificationtodriveduringthe
relevant period, the insurer would not be allowed to avoid its
liabilitytowardsinsuredunlessthesaidbreachorbreachesonthe
conditionofdrivinglicenceis/aresofundamentalasarefoundto
havecontributed to the cause of the accident. TheTribunals in
interpretingthepolicyconditionswouldapply"theruleof main
purpose" and the concept of "fundamental breach" to allow
defencesavailabletotheinsuredunderSection149(2)oftheAct.
Ifavehicleatthetimeofaccidentwasdrivenbyapersonhavinga
learner'slicence,theinsurancecompanieswouldbeliabletosatisfy
thedecree.
8.3 It is also held in Para 105 (ix) and (x) that Tribunal is
empowered topass andorder toPayandRecover against the
insurer.
50 MACP Reference Manual
8.4Asfaras,defenceofinsurerquathequalification/badgeofthe
licence is concern, same can be decided by relying upon para
Nos.42,43&84oftheSwaranSingh'scase.Paras42,43&84
readsasunder:
42.Ifapersonhasbeengivenalicenceforaparticulartypeof
vehicleasspecifiedtherein,hecannotbesaidtohavenolicencefor
drivinganothertypeofvehiclewhichisofthesamecategorybutof
differenttype.Asforexamplewhenapersonisgrantedalicence
fordrivingalightmotorvehiclehecandriveeitheracarorajeep
anditisnotnecessarythathemusthavedrivinglicencebothfor
carandjeepseparately.
43.Furthermore,theinsurancecompanywithaviewtoavoidits
liabilities is not only required to showthat the conditions laid
downunderSection149(2)(a)or(b)aresatisfiedbutisfurther
requiredtoestablishthattherehasbeenabreachonthepartof
theinsured.Byreasonoftheprovisionscontainedinthe1988Act,
amoreextensiveremedyhasbeenconferreduponthosewhohave
obtained judgment against the user of a vehicle and after a
certificateofinsuranceisdeliveredintermsofSection147(3)a
thirdpartyhasobtainedajudgmentagainstanypersoninsuredby
thepolicyinrespectofaliabilityrequiredtobecoveredbySection
145,thesamemustbesatisfiedbythe insurer,notwithstanding
thattheinsurermaybeentitledtoavoidortocancelthepolicyor
mayinfacthavedoneso.Thesameobligationappliesinrespectof
ajudgmentagainstapersonnotinsuredbythepolicyinrespectof
51 MACP Reference Manual
suchaliability,butwhowouldhavebeencoveredifthepolicyhad
coveredtheliabilityofallpersons,exceptthatinrespectofliability
fordeathorbodilyinjury.
84. Section3oftheActcastsanobligationonadrivertohold
aneffectivedrivinglicenceforthetypeofvehiclewhichheintends
to drive. Section 10 of the Act enables Central Government to
prescribeformsofdrivinglicencesforvariouscategoriesofvehicles
mentionedinsubsection(2)ofsaidsection.Thevarioustypesof
vehiclesdescribedforwhichadrivermayobtainalicenceforone
ormoreofthemare:(a)Motorcyclewithoutgear,(b)motorcycle
with gear, (c) invalid carriage, (d) light motor vehicle, (e)
transportvehicle, (f)roadroller,and(g)motorvehicleofother
specifieddescription.ThedefinitionclauseinSection2oftheAct
definesvariouscategoriesofvehicleswhicharecoveredinbroad
typesmentionedinsubsection(2)ofSection10.Theyare'goods
carriage', 'heavygoods vehicle', 'heavy passenger motorvehicle',
'invalidcarriage', 'lightmotorvehicle', 'maxicab', 'mediumgoods
vehicle', 'medium passenger motorvehicle', 'motorcab',
'motorcycle', 'omnibus', 'private service vehicle', 'semitrailer',
'touristvehicle','tractor','trailer',and'transportvehicle'.Inclaims
for compensation for accidents, various kinds of breaches with
regardtotheconditionsofdrivinglicencesariseforconsideration
before the Tribunal. A person possessing a driving licence for
'motorcyclewithoutgear',forwhichhehasnolicence.Casesmay
alsoarisewhereaholderofdrivinglicencefor'lightmotorvehicle'
52 MACP Reference Manual
is foundtobedrivinga 'maxicab', 'motorcab' or 'omnibus' for
whichhehasno licence.Ineachcaseonevidence ledbeforethe
Tribunal,adecisionhastobetakenwhetherthefactofthedriver
possessinglicenceforonetypeofvehiclebutfounddrivinganother
typeofvehicle,wasthemainorcontributorycauseofaccident.If
onfacts,itisfoundthataccidentwascausedsolelybecauseofsome
otherunforeseenorinterveningcauseslikemechanicalfailuresand
similarothercauseshavingnonexuswithdrivernotpossessing
requisitetypeoflicence,theinsurerwillnotbeallowedtoavoidits
liability merely for technical breach of conditions concerning
drivinglicence.
8.4 Meaning thereby, even if driver of offending vehicle was not
qualifiedtoplytheoffendingvehicleorwasnothavingtherequired
badgetoplysuchvehiclethenalsoinsurerisliabletopayamountof
compensation.Beforepassinganyorder,Tribunalhastodecidewhether
thefactofthedriverpossessinglicenceforonetypeofvehiclebutfound
drivinganothertypeofvehicle,wasthemainorcontributorycauseof
accident.Ifonfacts,itisfoundthataccidentwascausedsolelybecause
ofsomeotherunforeseenorinterveningcauseslikemechanicalfailures
andsimilar othercauseshavingnonexuswithdrivernotpossessing
requisitetypeof licence, the insurerwill notbeallowedtoavoid its
liability merely for technical breach of conditions concerning driving
licence.
8.5 Reference is alsorequiredtobemadetotherecentdecisionof
53 MACP Reference Manual
Hon'bleApexCourtinthecaseofS.Iyyapanv/sUnitedIndiaInsurance
Com.Ltd.,dated01.07.2013.Wherein,afterreferringseveralratiosof
Hon'bleApexCourt,ithasbeenheldinParaNo.19that:
In the instant case, admittedly the driver was holding
a valid driving licence to drive light motor vehicle. There is no
disputethatthemotorvehicleinquestion,bywhichaccidenttook
place,wasMahindraMaxiCab.Merelybecausethedriverdidnotget
anyendorsementinthedrivinglicencetodriveMahindraMaxiCab,
whichisalightmotorvehicle,theHighCourthascommittedgrave
error of law in holding that the insurer is not liable to pay
compensationbecausethedriverwasnotholdingthelicencetodrive
thecommercialvehicle.Theimpugnedjudgmentis,therefore,liable
tobesetaside.
8.6 Eveninthecaseof NewIndiaAssuranceCo.Ltd.v.Roshanben
RahemanshaFakir,reportedinAIR2008SC2266,ithasbeenheldthat
whendriverofoffendingvehiclewasholderoflicenceofthreewheeler
i.e.autorickshawdeliveryvanandhislicencewasnotmeantfordriving
'transport vehicle' but for goods carryingpublic carrier, in suchcase
Insurerisnotliablebutdirectedtheinsurertofirstpayentireamountof
compensationwitha further direction to recover thesame fromthe
insured(thesedirectionswereissuedunderArticle142ofConstitution
ofIndia).
54 MACP Reference Manual
9. In whichcircumstances, Insurer is liable to paycompensationwhen
injuredclaimantordeceasedwastravellinginthegoodsvehicle:
9.1 It is the duty of the insurer to prove that injured claimant or
deceasedwastravellinginthegoodsvehicleand,therefore, it isnot
liable topayamountofcompensation,unless, samehasbeenprove,
insurerisliabletopayamountofcompensation.
9.2 Todecidewhether,injuredclaimantordeceasedwastravellingin
thegoodsvehicleornot, Panchnamaofsceneofaccidentplaysvery
vitalrole.If,afterreadingPanchnama,itappearsthatthereweregoods
loadedinthevehicleorwerefoundlyingatthesightofaccidentthenit
canbepresumedthatvehiclewasusedforcarryinggoods.However,
there are some points, which are required to be considered before
fasteningliabilityoninsurer,whichare:
9.2.1Whetherinjuredclaimantordeceasedwastravellinginthe
cabinofthegoodsvehicleornot.If,injuredclaimantordeceased
wastravellinginthecabinofthegoods,insurerisliableotherwise
not.ReferencebemadetoratiolaiddownbyHon'bleApexCourt
inthecaseofNationalInsuranceCo.Ltd.v/sCholletiBharatamma,
reportedinAIR2008SC484.
55 MACP Reference Manual
9.2.2Whethertheinsurerisliableinacasewheretheinjuredclaimantor
deceasedwastravellinginthegoodsvehicleasthelaboureroftheowneror
thehirer:
9.2.2.1. If it is proved that injured claimant or deceased was
travellinginthegoodsvehicleasthelaboureroftheownerofthe
goods then insurer is liable to pay amount of compensation,
provided additional premium of labourer/collie is paid by the
ownerbut insurerisnotliable inthesuchcaseswhereinjured
claimantordeceasedwastravellinginthegoodsvehicleasthe
labourerofthehirer.Referencebemadetotheratiolaiddownin
thecaseofSanjeevKumarSamratv/sNationalInsuranceCo.Ltd,
reportedinAIR2013SCW301,whereinitisheldthat:
theActpolicydoesnotcoverallkindsofemployees.Thus,onacontextualreading
oftheprovision,schematicanalysisoftheActandtheWorkmen'sCompensation
Act,1923itisquitelimpidthatthestatutorypolicyonlycoverstheemployeesofthe
insured,eitheremployedorengagedbyhiminagoodscarriage.Itdoesnotcover
any other kind of employee and therefore, someone who travels not being an
authorizedagentinplaceoftheownerofgoods,andclaimstobeanemployeeofthe
ownerofgoods,cannotbecoveredbythestatutorypolicy.
9.3 Whether insurer is liable in the case where injured claimant or
deceasedwastravellinginthegoodsvehicleastheownerorrepresentative
ofthegoods:
9.3.1. If it is proved that the injured claimant or deceased was
travellinginthegoodsvehicleastheownerorrepresentativeofthe
56 MACP Reference Manual
goods,insurerisliabletopayamountofcompensationotherwisenot.
ReferencebemadetoratiolaidowninthecaseofNewIndiaInsurance
Companyv/sDarshanaDevi,reportedinAIR2008(Supp)SC1639.
9.4WhetherinjuredclaimantordeceasedwastravellinginTractor/trolley
isentitledtogetamountofcompensation:
9.4.1 Normally,Tractortrailer/trolleyisusedforagriculturalpurpose
andifitfoundthatsamewasusedforagriculturalpurposeandsameis
coveredbythe'FarmerComprehensivePolicy'orthe'FarmerPackage
Policy',insuchsituation,insurerisliabletopaycompensation.Ifthe
abovereferredtwoconditionsarenotfulfilled,insurercannotbeheld
responsibletopayamountofcompensation.
9.4.2 It is also tobenotedthat inthe Annexure of IndianMotor
Tariff,listofMiscellaneousandSpecialtypesofvehiclesisgiven.Asper
the said list tractors can be used for Agricultural and if Trolley is
attachedtosuchTractor,samemaybeusedforcarryinggoods.Asper
the said list there is one another kind of Tractor, which is 'Traction
EngineTractor'.Ifisfoundthattractorisnotusedforthepurposeof
agriculturalworkandifitusedforcarryinggoods,suchtractortrolley
mustbeinsuredforsuchpurposeandifisnotinsuredassuch,insureris
notliabletopayanyamountofcompensation.
9.5 Ittobenotedthatwheninsurancepolicycontains'Avoidance
Clause', theninsuchsituation,insureris liabletopaycompensation
57 MACP Reference Manual
undertheprincipleof'PayandRecover'.Referencemaybemadetothe
ratiolaiddowninthecaseof NewIndiaAssuranceCo.Ltd.v.Vimal,
Devi, reportedin 2010ACJ2878andratiolaiddownbytheHon'ble
Full Bench of Hon'ble Gujarat High Court in the case of Shantaben
Vankarv/sYakubbhaiPatel,reportedin2012ACJ2715.
9.6.However,itistobenotedthattheissuewithrespecttopassingan
orderof'PayandRecover'ispendingforconsiderationbeforetheFull
BenchofHon'bleApexCourt.Referencebemadetojudgmentdelivered
inthecaseofNationalInsurancecom.Ltd.v/sParvathneni,reprtedin
2009(3)GLH377(SC).
58 MACP Reference Manual
10. Liability of insurer to pay compensation in the cases where injured
claimant or deceased was travelling in the private car as occupants or
travellingontwowheeleraspillionrider:
10.1.Intherecentdecision,Hon'bleApexCourtinthecaseofNational
InsuranceCompanyLtd.v.Balakrishnan,reportedinAIR2013SC473
hasheldinparaNo.21that:
comprehensive/package policy" would cover the liability of the
insurerforpaymentofcompensationfortheoccupantinacar.There
isnocavilthatan"ActPolicy"standsonadifferentfootingfroma
"Comprehensive/Package Policy". As the circulars have made the
positionvery clear and the IRDA, which is presently the statutory
authority, has commandedthe insurance companies stating that a
"Comprehensive/PackagePolicy"coverstheliability,therecannotbe
anydisputeinthatregard.Wemayhastentoclarifythattheearlier
pronouncementswererendered inrespect of the "Act Policy" which
admittedlycannotcoverathirdpartyriskofanoccupantinacar.
But, if thepolicy isa"Comprehensive/PackagePolicy", theliability
wouldbecovered.
10.1.1.InviewoftheobservationsmadebyHon'bleApexCourtin
the case of Balakrishnan (supra), occupant of private car or the
pillion rider of two wheeler is entitled to recover amount of
compensationfrominsurer,providedtheoffendingvehicleiscovered
with the 'Comprehensive/ Package Policy'. Reference may also be
madetoratiolaiddowninthecaseofOrientalInsuranceCompany
Ltd.v.SurendraNathLoomba,reportedinAIR2013SC483.
59 MACP Reference Manual
11.Howtodecideaclaimpetitionpreferredundersection163Aofthe
Act:
11.1. AspertheratiolaiddowninthecaseofDeepalGirishbhaiSoniand
Ors.v.UnitedIndiaInsuranceCo.Ltd.,Baroda(2004)5SCC385 =
AIR2004SC2107, Hon'ble Full Benchof ApexCourt hasheld that
claim petition preferred u/s 163A is under 'No Fault Liability'.
Whereas, in thecaseof National InsuranceCompanyLtd. v. Sinitha,
reported in AIR2012SC797, Hon'ble SupremeCourt hasheld that
claimpetitionpreferredu/s163Aisunder'FaultLiability'.
11.2. ItdoesnotbecomeclearfromthefactsoftheofDeepalGirishbhai
Soni's(supra)caseastowhether,morethanonevehicleswereinvolved
inthesaidaccidentornotbutfromthereadingoftheSinitha's(supra)
case, it becomes clear that there was only onevehicle involvedand
questionwhichwasrequiredtobedecidedbyHon'bleApexCourtasto
whether, insurer hassucceeded inprovingthat claimanthimself was
negligentincausingtheaccidentornot.
11.3. Fromthereadingofboththeabovereferredratios,itappearsthat
thereareconflictingviewsand,therefore,eachclaimpetitionmaybe
decidedonthebasisofit'sfacts.Thatistosay,ifonlyonevehicleis
involved,pointofnegligencemustbedecided.
11.4. Itistobenotedthatinaclaimpetition,preferredu/s163Aofthe
Act,incomeoftheinjuredclaimantorthedeceasedshouldnotbemore
thatRs.40,000/perannum.If,theincomeoftheinjuredclaimantor
60 MACP Reference Manual
the deceased is more that Rs.40,000/ per annum, in such cases,
claimant/smaybegivenanoptiontoconvertthesameunderSection
166 of the Act. If claim petition is not converted, even after the
order/direction,samebedismissed.Inthisregardsreferencemanybe
madetoratiolaiddowninthecaseofDeepalGirishbhaiSoni(supra).
11.5. ItalsorequiredtobenotedthatintheFatalinjurycases,multiplier
cannot be appliedas same is appliedonly in the cases whereclaim
petition is preferredby the injured. Referencebe made to ratio laid
down in the case of National Company Ltd. Versus Gurumallamma,
reported in AIR 2009 SCW 7434, para No.8. Similar kind of
observationsaremadebyHon'bleApexCourtinthecaseofSarlaVerma
(supra),atParaNo.17(pageNo.3112inAIR),whichreadsunder:
...Therefore,wheretheapplicationisundersection163AoftheAct,
it is possible to calculate the compensation on the structured
formula basis, even where compensation is not specified with
referencetotheannualincomeofthedeceased,orismorethanRs.
40,000/byapplyingtheformula:(2/3xA1xM),thatistwo
thirdsoftheannualincomemultipliedbythemultiplierapplicable
totheageofthedeceasedwouldbethecompensation.
11.6. Fromtheabovereferredratios,laiddownbyHon'bleApexCourt,it
becomesamplyclearthatTribunalisnotrequiredtomakecalculationof
compensationonthebasisof applicationofmultiplier.ButTribunalis
onlyrequiredtograntcompensationasperScheduleII of theMotor
61 MACP Reference Manual
VehicleAct,takingintoconsideringtheageandincomeofthedeceased
andfigureshownagainsttheageandincomeofthedeceased.Foran
example,if,monthlyincomeofthedeceasedwhowasagedabout48
years at the time of accident, is assessed as Rs.2,500/ per month
(Rs.30,000/perannum),howthecompensationshouldbecalculated.
Since Rs.30,000/ per annum is not shown anywhere in column of
ANNUAL INCOME of the Second Schedule of the Act, now, the
question,ishowtheamountofcompensationtobecalculated.Insuch
cases,averageoffiguresintheincomegroupofRs.24,000/perannum
and Rs.36,000/ per annum i.e Rs.2,86,000/ and Rs.4,32,000,
respectively are required to be taken into consideration. Average of
Rs.2,86,000/andRs.4,32,000,comestoRs.3,59,000.Outofthesaid
amountof3,59,000,1/3isrequiredtobedeductedinconsiderationof
expenses incurred by deceased towards maintaining himself and,
therefore, net amount of future income loss comes to approximately
Rs.2,40,000/. [Reference: National Insurance Com. Ltd. v/s P.C.
Chacko,reportedin2012ACJ1065(DevisionBenchofHon'bleKerala
HighCourt,ErnakulanBench)]
11.7. Itistoberememberedthatineveryclaimpetitionpreferredu/s163
AoftheAct,whetherthedeceasedismarriedornot,unlikeasclaim
petitionpreferredu/s166oftheAct,onethird(1/3rd)amountfromthe
actualincomeofthedeceasedshouldbedeductedtowardspersonaland
livingexpendituresofthedeceased.
62 MACP Reference Manual
11.8. Overandabovethefutureincomeloss,claimant/sis/areentitledto
suchamount,specifiedundertheSecondScheduleoftheAct.However,
inthecaseofSapanv/sUnitedIndiaInsuranceCom.Ltd.,reportedin
AIR2008SC2281,heldthatwhenclaimpetitionpreferredu/s163A
andclaimantwouldremaincrippledthroughoutlifeandwouldhaveno
enjoymentforlife,TribunalcanawardfurthersumofRs.75,000/for
futuremedicaltreatment.
63 MACP Reference Manual
12.Whatifthechequegivenforpaymentofpremiumofinsurancepolicyis
dishonoured:
12.1. Reference may be made to the ratios laid down in the cases of
Deddappav/sNationalInsuranceCom.Ltd.,reportedin(2008)2SCC
595=AIR2008SC767=2007AIRSCW7948andUnited India
InsuranceCom.Ltdv/sLaxmamma,reportedin2012ACJ1307(SC).In
both these judgments, it has been held that when cheque given for
payment of premium of policy, is dishonoured and on that count
InsuranceCompanycancelsthepolicybyintimatingtheinsuredofsuch
dishonourofchequebeforethedateofaccident,theninsuchsituation
Insurance Company cannot be held liable to pay amount of
compensation but if insurer fails to intimate the insured about such
dishonourandcancellationofpolicybeforethedateofaccident,thenin
suchsituationinsurerisheldliabletopayamountofcompensationand
InsuranceCompanymayprosecuteitsremedytorecovertheamount
paidtotheclaimantsfromtheinsurer.
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13.WhatisthemeaningofArisingoutofuseofMotorVehicle:
13.1. Legislaturehasadvisedlyusedtheexpression'arisingoutoftheuse
ofmotorvehicle'andnot 'connectedwiththeuseofmotorvehicle'
underSections140,163Aand166oftheActand,therefore,theremust
bemoredirectandpronouncedlinkageornexusbetweentheuseof
motor vehicle and the accident which has resulted. A mere casual
connectionisnotsufficient.
13.2. To decide the such issue one may advantageously refer to the
judgmentdeliveredbyHon'bleApexCourt,reportedasShivajiDayanu
PatilandAnr.v.VatschalaUttamMore,(1991)3SCC530=AIR1991
Sc1769.Inthesaidcase,Hon'bleApexCourtconsideredatlength,the
questionswhetherthefireandexplosionofthepetroltankerinwhich
deceasedlosthislifecouldbesaidtohaveresultedfromanaccident
arisingoutoftheuseofamotorvehicle,namelythepetroltanker.The
courtansweredthequestionintheaffirmative,thatistosay,infavour
oftheclaimantandagainsttheinsurancecompany.
13.3. ItistruethatthecaseShivajiDayanuPatil(supra)arosefromthe
claimfornofaultcompensationundersection92Aofthe1939Act(u/s
163AoftheNewAct).Allthematerialfactswereconsideredatlength
by Hon'ble Apex Court in above referred case and, therefore, said
principleisalsoapplicableintheclaimpetitionpreferredu/s166ofthe
Act.
65 MACP Reference Manual
13.4. RatiolaiddownbyHon'bleApexCourtinthecaseofShivajiDayanu
Patil (supra) is also relied upon by Hon'ble Apex Court in several
decisions,namely,SamirChanda,v/sManagingDirector,AssamState
TransportCorporation,reportedinAIR1999SC136andSmt.RitaDevi
v/sNewIndiaAssuranceCo.Ltd.,reportedinAIR2000SC1930and
NewIndiaAssuranceCo.Ltd.v.YaduSambhajiMore,reportedinAIR
2011SC666.
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14.WhetherFinanceCompany,whichhasadvancedloanforthepurposeof
purchaseofvehicleunderthe'HirePurchaseAgreement'canbesaidtobe
theowneroftheVehicle:
14.1. Hon'ble Apex Court in the case of Godavari Finance v/s Degala
Satyanarayananamma,reportedin2008ACJ1612hasheldinpara13
asunder:
13.IncaseofamotorvehiclewhichissubjectedtoaHirePurchase
Agreement,thefinanciercannotordinarilybetreatedtobetheowner.
Thepersonwhoisinpossessionofthevehicle,andnotthefinancier
being the owner would be liable to pay damages for the motor
accident.
14.2. Referencemayalsobemaderatio laiddownin thecaseof Anup
Sarmahv/sBholaNathSharma,reportedinIV(2012)CPJ3(SC),para
No.8&9.
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15. When an accident, involving two vehicles and driver of one of the
unknownvehiclespedawayaftertheaccident,whetherinsuchsituation,
claimpetitionismaintainableagainsttheothertortfeasor,inviewofthe
provisionscontainedunderSections161&163oftheAct:
15.1. Hon'ble Division Bench of Gujarat High Court in First Appeal
No.3354of2000withCivilApplicationNo.746of2005dated13.7.2005
hasheldinsuchsituationclaimpetitionisnotmaintainable.ButHon'ble
GujaratHighCourt inthecaseofBhanubenP.Joshi V/s. Kantilal B.
Parmar,reportedin1994ACJ714(DB)hasheldotherwise.Factsofthe
BhanubenP.Joshi(supra)asunder:
15.1.1. Inthesaidcaseaccidentoccurredbecauseoneunknowntruck
dashedthemotorcycle frombehindandafter theaccident, truck
driver sped away with the truck and remained unidentified and
pillion rider sustained fatal injuries. Claimants of the said claim
petitionaverredthatmotorcycle wasbeingdrivenby its riderat
excessivespeedandinrashandnegligentmanner.Tribunaldismissed
theclaimpetitionbyholdingthattherewasnorashnessonthepart
ofthemotorcyclist.AfternotingthesaidfactsHon'bleGujaratHigh
Courthasobservedthatmotorcyclewasbeingdriveninrashand
negligent manner and in flagrant violation of traffic rules and
regulationsandfinallyreversedthefindingofTribunal.
15.1.2. ItisalsoheldinparaNo.9oftheabovereferredratio,namely
BhanubenP.Joshi(supra)thatvictimsofroadaccidentareentitledto
68 MACP Reference Manual
claimcompensationfromalloranyofthejointtortfeasors,itwould
not be necessary to apportion the extent of contribution of each
driverofhappeningofunfortunateaccident.
15.2. Fromtheabovereferredratiositbecomesclearthatevenifdriver
andowneroftheunknownvehicleisnotjoinedaspartiesopponents,
claimpetitionismaintainableagainstanyoneofthetortfeasors.
69 MACP Reference Manual
16. Whether all the joint tortfeasors are required to be joined as party
opponentsintheclaimpetition:
16.1. Hon'ble Gujarat Court in the case of O.I.Com.Ltd. v/s Zubedaben
Pathan, in F.A. No.651 of 2012 and judgment dated 18.02.2010,
delivered by Hon'ble Kerala Court in the case of U.I.Com.Ltd. v/s
Mariamma George, in M.A.C.A. No.744 of 2005 have held that the
claimant/s is/are not entitled to recover amount of compensation,
jointlyandseverallyfromtheinsurancecompany/companies,ifallthe
tortfeasorsarenotjoined.
16.2. ButHon'bleGujaratHighCourtinthecaseofAmarsingJugabhaiv/s
VijyabenDhuliya,reportedin1996(3)GLR493hasheldinparaNo.23
that:
Whereapersonisinjuredinamotoraccidentwhichoccursnoton
accountofhisnegligence,butbecausethedriversofcollidedvehicles
were negligent, the claimants are entitled to damage jointly and
severallyfromthenegligentrespondents.Everywrongdoerisliable
for the whole damage and it does not matter whether they acted
betweenthemselvesasequals.Adecreepassedagainsttwoormore
tortfeasorscanbeexecutedagainst anyoneof thedefendantsand
suchdefendantcanbecompelledtopaytheentireamountofdamages
decreed.Itisfurtherclearthatthedefendantwhoiscompelledtopay
theentire amount of damages decreedhas a right tocontribution
from the other wrongdoer. The liability in the case of composite
negligence,unlessmustnormallyshouldnotbeapportionedbecause
70 MACP Reference Manual
theclaimant isabletorecoverthewholeamountof compensation
from owner or driver of either vehicles. In case of composite
negligence,liabilityforcompensationinnormalcircumstances,should
not be apportioned, as both wrongdoers are jointly and severally
liableforthewholeloss.Ruleofapportionmentofliabilityappliesin
acaseof contributorynegligence,i.e.,wheretheinjuredhimselfis
alsoguiltyofnegligence.
16.3. Hon'bleGujaratHighCourtinthecaseofKusumbenVipinchandra
Shahv.ArvindbhaiNarmadashankarRaval,reportedinAIR2007Guj.
121.Whereinitisheldthat:
AsheldinGujaratStateRoadTransportCorporationv.Gurunath
Shahu (supra), the finding given by the Tribunal in such a case
regarding apportionment of liability would be tentative for the
purpose of subsequent proceeding which might be filed by the
defendanttortfeasoragainsttheotherjointtortfeasorwhowasnota
partytothefirstproceeding.Butsuchtentativenessforthepurposeof
contributionbetween two joint tortfeasors did not at all affect the
right of the plaintiffclaimant to recover full damages from the
defendanttortfeasoragainstwhomthefirstproceedingwasfiled.
16.4. Fromtheabovereferredratiositbecomesclearthatclaimant/sis/are
notrequiredtojoinallthetortfeasorsaspartyopponent/s.
71 MACP Reference Manual
17.Whetherthepointofne
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