Anoop Maheshwari vs Oriental Insurance Company Ltd

2025 INSC 1076 Non-Reportable

IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION

Civil Appeal Nos.12098-12099 of 2024 Anoop Maheshwari …Appellant Versus Oriental Insurance Company Ltd. & Ors. …Respondents JUDGEMENT

K. VINOD CHANDRAN, J.

The appeals are by the claimant/injured in a motor

accident, seeking enhancement of the award. The accident

occurred on 09.04.2007 when the motorbike, driven by the

claimant with a pillion rider, was hit by a truck which was driven

rashly and negligently. The Tribunal found the accident to be

proven and the negligence to be of the truck driver. The drivers

of both the vehicles were having valid licences, and the truck

was covered by a valid insurance policy. These findings have Signature Not Verified Digitally signed by babita pandey attained finality since the insurance company acceded to the Date: 2025.09.04 18:01:35 IST Reason:

dismissal of their appeal before the High Court.

Page 1 of 11 Civil Appeal Nos.12098-12099 of 2024

2. On the quantum, the Tribunal found the disability suffered

by the claimant to be 45% as against the claim of 90%, sought

to be established through production of a disability certificate

issued by the Medical Board, produced herein as Annexure 2.

The Tribunal looked at the Employees’ Compensation Act, 1923

and the schedule therein to find the amputation at hip having

been assessed at 90 % for loss of earning capacity; which the

Tribunal found to be for the amputation of both legs. It was

hence, 45% was adopted by the Tribunal as the disability of the

claimant who lost one leg. The High Court deciding the appeal

filed by the insurance company and the claimant having

rejected the claim of composite negligence made a nominal

enhancement of the disability as 50%.

3. On the income of the petitioner/claimant, who had just

completed his graduation, the Tribunal disbelieved the income

tax returns filed for the years 2005-2006, 2006-2007 and 2007-

2008. The Tribunal found that since the parents of the claimant

were running a big business, that run in the name of the

claimant was only a ruse to save income tax. The Tribunal hence

adopted the income as Rs.4,500/- per month and applied the

Page 2 of 11 Civil Appeal Nos.12098-12099 of 2024 multiplier of 17 and determined the loss of income due to

disability at 45%, totalling Rs.4,13,100/-. As far as the medical

expenses, the Tribunal awarded Rs.3,39,926/- out of the total

claim of Rs.12,54,985/- for which vouchers were produced. For

the purpose of artificial limb, an amount of Rs.4,70,805/- was

found payable. Together with Rs.1 lakh for attendant expenses,

the total award of the Tribunal came to Rs.13,23,831/-.

4. The High Court in the quantum appeal, enhanced the

monthly income to Rs.8,000/- finding that the reasoning of the

Tribunal to reject the income tax returns bordered on mere

surmises and conjectures and 40% was added for future loss of

income, applying the multiplier of 18, as against the multiplier

of 17 applied by the Tribunal. Insofar as the medical expenses

are concerned, the Tribunal increased the quantum to Rs.8

lakhs. The Tribunal awarded a further sum of Rs.1 lakh for pain

and shock and an amount of Rs.2 lakhs as loss of amenities,

awarding a total amount of Rs.23,09,600/-.

5. Mr. G.V. Rao, learned Senior Counsel, appearing for the

claimant submitted that even going by the Employees’

Compensation Act, the amputation of leg at the hip brings in

Page 3 of 11 Civil Appeal Nos.12098-12099 of 2024 90% disability which is evidenced further by the disability

certificate issued by the Medical Board. There was no reason

for the Tribunal or the High Court to go behind the medical

certificate issued by experts and reduce the disability to 45%

and 50%. It is further submitted that there were no amounts

granted for future medical expenses, especially since the

petitioner/claimant has been fitted with a prosthetic leg which

needs to be changed periodically. The learned Senior Counsel

also vigorously challenged the reduction of annual income

from that revealed in the income tax returns. Decisions were

placed to submit that income tax returns when produced has to

be accepted and, in any event, the High Court having found the

reasoning of the Tribunal to reject the income tax returns as

based on mere surmises and conjectures, failed to accept the

returns as such. The High Court merely adopted the income of

Rs.8,000/- per month without any basis and the reduction was

not reasoned. The learned Senior Counsel would also

specifically refer to various documents produced, invoices and

receipts for change of the prosthetic leg and its accessories as

produced along with the application for early hearing.

Page 4 of 11 Civil Appeal Nos.12098-12099 of 2024

6. The learned Counsel appearing for the insurance

company sought to uphold the award of the High Court and

strenuously resisted any enhancement. It was pointed out that

the income tax returns showed cooked up income, especially

when the claimant was an undergraduate at the time of the

accident. The High Court had doubled the income and awarded

future prospects, which cannot be in cases of disability,

wherein loss of income on the basis of disability is reckoned.

7. Insofar as the disability is concerned, we have no doubt

that the medical board’s certificate can be accepted, even

without a witness being examined. The disability certificate

also indicates that the amputation suffered by the petitioner is

of hemipelvectomy; which is the amputation of one leg and a

portion of the pelvic bone on the same side. The disability to be

assessed for the purpose of awarding compensation arising

from a motor accident is the functional disability which reduces

the earning capacity of the claimant and not strictly the medical

disability. In the present case, admittedly the claimant was

running a business, and the claimant has already been fitted

with a prosthetic limb to ensure his mobility. In the above

Page 5 of 11 Civil Appeal Nos.12098-12099 of 2024 circumstances, the order of the High Court holding the

disability to be 50% for the purpose of computing loss of

income as relatable to the loss of earning capacity is correct

and within the parameters to be considered for assessing the

loss of income arising from a motor accident which led to

disability of the victim. The disability assessed at 50% is the

functional disability and it is quite reasonable.

8. As far as the income is concerned, we agree with the High

Court that the Tribunal had entered into mere surmises and

conjectures to decline adoption of the income as per the

income tax returns. In this context, we have to notice that the

registration of the firm of the claimant took place on 06.03.2006

and the income tax returns produced are also for the

assessment years 2005-2006 and 2006-2007 relatable to the

financial years 2004-2005 and 2005-2006 which are prior to the

accident which occurred on 09.04.2007. It cannot be said that

the claimant apprehended an accident and got registration of a

firm and filed his income tax returns two years prior to the

accident. Further, the claimant had also produced sales tax

returns which was also rejected by the Tribunal on the ground

Page 6 of 11 Civil Appeal Nos.12098-12099 of 2024 that there was no taxable profits in the said year. Insofar as the

levy of sales tax is concerned, the levy is on the sales and not

on the profits. The finding of the Tribunal also is that in the first

year, there was no tax payable and hence there was no profits

or income. The exemption from tax is only because the

purchase and sales did not exceed the taxable value. The sale

proceeds being not within the taxable limit is not an indication

of the profit accrued, or the income received from the business

which is reflected in the income tax returns. On the above

reasoning, we have to accept the income tax returns for the

financial year 2007-2008 in which the total gross income is seen

as Rs.1,96,000/- out of which the tax of Rs.4,641/- has to be

deducted. The income, hence, has to be assessed at

Rs.1,91,000/-. In assessing the loss of income, the multiplier of

18 is perfectly in order and the disability is 50% as determined

by the High Court.

9. However, since just compensation is granted, we do not

find any reason to award compensation for loss of future

prospectus. It is clear that the claimant though has suffered a

disability, which has been determined to be 50%, there is no

Page 7 of 11 Civil Appeal Nos.12098-12099 of 2024 difficulty in continuing with the business and the claimant has

also been fitted with a prosthetic leg which ensures his mobility

and continuance of the business. The 40% enhancement in the

annual income for taking into account the future prospects is

found to be improper, especially in the context of 50%

disability having been reckoned for the purpose of loss of

earning capacity and the claimant enabled to continue his

business.

10. Insofar as the medical expenses are concerned, invoices

were produced for Rs.12,54,985/-. The Tribunal awarded only

an amount of Rs.3,39,926/-, which was held to be valid on

verification by the insurance company. It is not clear as to

whether in such verification the claimant was participated or

heard. There is nothing produced on record also to indicate

such verification having been conducted validly on the orders

of the Tribunal. The High Court also merely enhanced the claim

for medical expenses to Rs.8 lakhs without any reasoning. In

the above facts and circumstances, we are of the opinion that

the entire medical expenses claimed for which invoices were

produced, totalling Rs.12,54,985/- has to be paid to the

Page 8 of 11 Civil Appeal Nos.12098-12099 of 2024 claimant. The High Court has awarded an amount of Rs.1 lakh

for pain, shock and suffering and an amount of Rs.2 lakhs for

loss of amenities which we sustain.

11. In this context, we notice that Rs.1 lakh awarded by the

Tribunal for the attendant expenses has not been reckoned by

the High Court. Likewise, the Tribunal had granted an amount

of Rs.4,70,805/- for the purchase of prosthetic leg based on the

vouchers produced which was also not reckoned by the High

Court. Both these amounts are restored and awarded to the

claimant.

12. The learned Senior Counsel had specifically referred to

various vouchers produced and receipts, most of which are

dated prior to the order of the High Court, which should have

been produced before the High Court for advancing the claim.

The photocopies of the receipts produced are also not

authenticated and we are unable to place any reliance on the

same. However, it is a fact that the claimant would require

servicing and replacement of the accessories of the prosthetic

limb periodically. We were not shown any evidence led

regarding the frequency of change or the servicing of the

Page 9 of 11 Civil Appeal Nos.12098-12099 of 2024 prosthetic limb nor was there any evidence regarding the

quantum of expenditure. Considering that the Tribunal had

initially, on the basis of two vouchers, awarded an amount of

Rs.4,70,805/-, for purchase and fitment of prosthetic leg, we are

of the opinion that an amount of Rs.10 lakh would suffice to

account for the future expenses for continued use of the

prosthetic limb and the medical expenses arising. The total

compensation, hence, is enhanced and awarded as below.

Sr. No. Head Amount 1. Loss of income Rs. 17,19,000 Rs.1,91,000 x 18 x 50% 2. Medical expenses Rs. 12,54,985 3. Pain and suffering Rs. 1,00,000 4. Loss of amenities Rs. 2,00,000 5. Attendant expenses Rs. 1,00,000 6. Expenses for artificial limb as Rs. 4,70,805 awarded by the Tribunal 7. Future medical expenses and Rs. 10,00,000 servicing of the prosthetic limb/purchase of accessories of the artificial limb Total amount Rs. 48,44,790/-

13. The said amount shall be paid by the insurance company,

with interest at the rate of 6% per annum, commencing from the

date of application, after deducting the amounts already paid,

Page 10 of 11 Civil Appeal Nos.12098-12099 of 2024 within a period of three months from the date of this judgment.

The claimant shall be entitled to provide the details of his

account to which the insurance company shall transfer online

the balance compensation with interest as directed, within the

stipulated time.

14. The appeals are allowed as above.

15. Pending applications, if any, shall stand disposed of.

………….……………………. J.

(K. VINOD CHANDRAN)

………….……………………. J.

(N. V. ANJARIA)

New Delhi;

September 04, 2025.

Page 11 of 11 Civil Appeal Nos.12098-12099 of 2024