2016 (4) TMI 1426 - HC - Indian Laws

Appeal dismissed, confirming compensation award. Insurance liability upheld. Court accepts disability assessment. Guidelines for streamlined claims process.

The appeal was dismissed, confirming the Tribunal's award of Rs.18,37,840/- to the claimant for various components of compensation. The liability of the ... Validity of award and the decree passed by the Motor Accidents Claims Tribunal - Quantum of compensation awarded by the Tribunal - assessment of permanent disablement and possibly functional disability - HELD THAT:- Considering the date of accident (1.7.2011), the age (27 years) and the profession of the injured (Machine Operator), this court is not inclined to interfere with the compensation granted in a sum of Rs.12,66,940/- towards loss of future income. On the basis of the medical bills produced, the Tribunal granted a sum of Rs.3,71,000/- towards medical expenses. Hence, the same is confirmed. It is found that the claimants choose to examine a ‘select group of Doctors’ virtually ‘practising’ in this jurisdiction. The insurance companies and transport corporations repeatedly complain that they are ‘stock witnesses’ and challenge their assessments, even if accepted by claims tribunals after discounting the same. It is noted that some decisions which have been critical of the mode and manner of assessment of disability by these Doctors who regularly appear before the claims tribunals. It is not rocket science to identify the personnel who appear in these proceedings as they are found in the list of witnesses before various claims tribunals all over the State, very regularly. That has been the major grouse or grievance of the insurance companies and transport corporations that these medical professionals do not follow proper practices and their assessments are tilted to advance the interest of the claimants, at times, unfairly. This procedure and practice in assessment of permanent disability by various Doctors in various claims tribunal have led to huge pendency of appeals before this Court also. The sequence of facts, has led to believe that if there was a uniform and consistent practice and procedure in the assessment of permanent disablement and possibly functional disability thereof, then the scope for expeditious disposal of claims may be possible and avoidance of appeals may also become feasible. This Court has pointed out to Central Government Notification on assessment of disability - it is found that Disability (Permanent Physical Impairment) –Assessment and Certification- Guidelines & Gazette Notification- issued by Ministry of Social Justice & Empowerment, Government of India- Regd No.DL33004/99 ( Extraordinary) Part II, Sec 1, June,13, 2001- published by National Institute for the Orthopaedically Handicapped, is a comprehensive test and manual put in place. On going through the same, it is found that it has been drafted and crafted meticulously and has given formula which may lead to arithmetical accuracy in assessment of permanent disability. Or at least it reduces the scope for divergence in assessment and introduces the much needed element of uniformity and consistency in assessment of permanent disability. It is felt that if certificates of permanent disability are issued by Medical Boards in the Districts where the claims are pending and they are based on the Central Government Circular dt.13/6/2001, then scope for challenge of the same may be driven out to a large extent. In addition thereto, a positive fall out could be that such certificates could be marked without the need to examine the Medical Doctors , who are otherwise required to be examined. Time taken for proving the permanent disablement may be shortened and the proof also would be credible, authentic, uniform and consistent. It would be much needed and most welcome medicine for this jurisdiction now infested with far too many claims thanks to the burgeoning number of motor accidents. We have little hesitation in commending its acceptance as early as possible. The infrastructure must be in place before the Medical Boards for facilitating the issue of such certificates of disability. Equally, the stake holders need to get ready for this changed dispensation which would result in marking of the certificate of disability from the Medical Boards as a matter of course without need to have them marked through witnesses or be subjected to cross examination as before. There should be no difficulty to embrace this procedure is mandated to be Summary in nature ( Sec.169). So be it. There cannot be complaint or grouse from either side for the remedy of credibility, authenticity allied with uniformity and consistency would overwhelm any other aspect - The sorely missing element of uniformity and consistency would surely lead to early disposal of claims and possible settlements of the same. Further, scope for dispute in appeals on divergence in assessments of disability would be considerably reduced. In effect, the procedure hit upon and devised for follow up and practice would go a long way in aiding and assisting the Parliamentary mandate to provide speedy succor and relief to innocent motor accidents claims. It would truly be a win win situation for all stakeholders concerned. It is directed that in motor accidents claims the claims tribunals shall issue a letter to Medical Board in the District of Tamil Nadu. Within whose jurisdiction the claim petition was pending and in case there was no Medical Board in the said District to the nearest District Medical Board, to examine the injured claimant/victim and issue a certificate of disability within such time as may be specified by the claims tribunal - the Medical Board/s shall assess the permanent disability or lack thereof as per the Disability (Permanent Physical Impairment) –Assessment and Certification- Guidelines & Gazette Notification- issued by Ministry of Social Justice & Empowerment, Government of India- Regd No.DL33004/99 (Extraordinary) Part II, Sec 1, June,13, 2001- published by National Institute for the Orthopedically Handicapped - the High Court Registry shall issue a Circular on these directions along with the judgment with reasons to be sent to Medical Boards in all Districts of Tamil Nadu through the Registry of the District Courts in Tamil Nadu, as soon as possible. The award and the decree passed by the Tribunal are confirmed - appeal dismissed. Issues Involved:1. Quantum of compensation awarded by the Tribunal.2. Determination of liability for compensation payment.3. Assessment of permanent disability and its impact on compensation.4. Procedural guidelines for the assessment of disability and expeditious disposal of claims.Issue-wise Detailed Analysis:1. Quantum of Compensation Awarded by the Tribunal:The appeal primarily contested the quantum of compensation awarded by the Tribunal. The Tribunal had granted a total compensation of Rs.18,37,840/- to the claimant, which included amounts for future loss of earnings, medical expenses, pain and suffering, mental agony, loss of amenities, transport expenses, and nutrition expenses. The appellant insurance company did not dispute the Tribunal's finding that it was liable to pay the compensation but challenged the quantum awarded.2. Determination of Liability for Compensation Payment:The Tribunal's decision that the insurance company was liable to pay compensation to the claimant and recover the same from the vehicle owner was confirmed. The insurance company did not raise serious objections to this finding.3. Assessment of Permanent Disability and Its Impact on Compensation:The claimant presented medical evidence to substantiate the extent of injuries and resultant disability. The Tribunal assessed the claimant's income at Rs.6,000/- per month and added 50% for future prospects, calculating the loss of future income at Rs.12,66,940/-. The Court found no reason to interfere with this assessment considering the claimant's age, profession, and the date of the accident.4. Procedural Guidelines for the Assessment of Disability and Expeditious Disposal of Claims:The judgment emphasized the need for uniformity and consistency in the assessment of permanent disability to avoid excessive litigation and ensure expeditious disposal of claims. The Court referred to guidelines issued by the Ministry of Social Justice and Empowerment and advocated for the use of Medical Boards to assess and certify permanent disability. The Court issued several specific directions to streamline this process:- Claims Tribunals should refer claimants to District Medical Boards for disability assessment.- Medical Boards should follow the guidelines and procedures outlined in the Central Government's notification for disability assessment.- Certificates issued by Medical Boards should be accepted without the need for further oral evidence, except in exceptional cases.- The new procedure should be implemented from 1st August 2016, with necessary logistical support arranged beforehand.- The High Court Registry should circulate the judgment and directions to all relevant Medical Boards and District Courts in Tamil Nadu.Conclusion:The appeal was dismissed, and the Tribunal's award and decree were confirmed. The Court provided detailed procedural guidelines to ensure uniform and consistent assessment of permanent disability, aiming to reduce litigation and expedite the compensation process for motor accident victims. The claimant was permitted to withdraw the remaining award amount upon filing the appropriate application before the Tribunal.