TATA AIG GENERAL INSURANCE CO. LTD. vs SUNIL ISHWARBHAI PANCHAL

C/SCA/3605/2025 JUDGMENT DATED: 03/03/2026
IN THE HIGH COURT OF GUJARAT AT AHMEDABAD
R/SPECIAL CIVIL APPLICATION NO. 3605 of 2025

FOR APPROVAL AND SIGNATURE:


HONOURABLE MR. JUSTICE HASMUKH D. SUTHAR

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Approved for Reporting Yes No
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TATA AIG GENERAL INSURANCE CO. LTD.
Versus
SUNIL ISHWARBHAI PANCHAL & ORS.
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Appearance:
MS KIRTI S PATHAK(9966) for the Petitioner(s) No. 1
NOTICE SERVED BY DS for the Respondent(s) No. 1,2,3,4,5,6
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CORAM: HONOURABLE MR. JUSTICE HASMUKH D. SUTHAR

Date : 03/03/2026

ORAL JUDGMENT
1) The present petition has been filed under Articles 226 and 227 of
the Constitution of India and under the provision of Section 166
of the Motor Vehicles Act, 2019, (which shall hereinafter be
referred to as “ the Act ” for short) by the petitioner – - original
opponent no.3 - TATA AIG General Insurance Co. Ltd.,
challenging the order dated 18.09.2024, below Exhibit 61,
passed by the learned Motor Accident Claims Tribunal,
Panchmahals at Godhra, (which shall hereinafter be referred to
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as “ the Tribunal ” for short) in MAC Petition No.264 of 2017,
whereby, the learned Tribunal has rejected the application filed
by the applicant - petitioner herein below Exhibit 61 for
production of a Disability Certificate issued by the District
Medical Board or any authorized body.
2) Heard learned Advocate Ms. K. S. Pathak, for the petitioner –
Insurance Company. The respondents are duly served but
remained absent.
3)
Learned Advocate for the petitioner has submitted that the
original claimant – respondent no.1 herein has filed MAC Petition
No.264 of 2017 before the learned Tribunal for getting
compensation in a vehicular accident in which he sustained
injuries. During the period 25.01.2017 to 09.02.2017, the
claimant underwent treatment at Param Orthopaedic Hospital
and operated for an open Grade III C injury with dislocation
fracture of the capitate bone and partial loss of the carpal bone.
She has further submitted that the surgical procedure involved
amputation of the index finger, removal of the second
metacarpal and flap surgery over the right thumb extending to
half of the dorsum of the right hand. Thereafter, Dr. Dilip
Solanki (M.S. Ortho) has issued Disability Certificate at Exhibit
38, who had not treated the claimant, however, the said Doctor
has assessed 90% disability in the Disability Certificate. The said
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Doctor was examined at Exhibit 36, wherein, he has opined that
the disability could be considered as 55% permanent disability of
the whole body. She has further submitted that as the Doctor
gave an evasive reply and the Insurance Company seeks a
reevaluation of the disability which falls under the domain of
Medical Expert, hence, the petitioner has filed the application at
Exhibit 61 before the learned Tribunal and argued that the
Disability Certificate is required to be issued by the Medical
Board or authorized body and requested to direct the claimant to
produce Disability Certificate issued by the Medical Board or
competent authority. However, the learned Tribunal has rejected
the said application vide order dated 18.09.2024, which is
impugned herein. She has further submitted that in the number
of injury cases false and vexatious medical claims are being
increased alarmingly. It has become easier to get a claim from
the Insurance Company rather from a private person by filing a
concocted cases based upon the concocted documents. The
Motor Vehicles Act which has been called as beneficial legislation
is being abused by unscrupulous elements and the claim
petitions are being filed based upon the concocted medical
documents through the victims have not sustained injuries as
written in the medical records, false implication of the vehicles,
manipulation of the accident, false implication of the same
vehicles at regular intervals and looting the public money in a
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planned manner to dupe the Insurance Companies who are the
custodian of the public money. She has further submitted that
the fraudulent activities of seeking compensation through the
bogus and dubious claims are being made in connivance with
police officials, medical practitioners and the medical
practitioners also involved who diddled and fudge the records
produced in the Tribunal. She has relied upon the judgment of
the Hon’ble Supreme Court in Bajaj Allianz General
Insurance Co. Ltd., Vs. Union of India , which directed that
Disability Certificates must be issued by the District medical
Board or any authorized body. Hence, she has requested to
allow the present petition.
4) Having heard the learned Advocate for the petitioner and
perusing the fact it appears that it is true that the Motor Vehicles
Act is a benevolent legislation and the benefits of such
benevolent provision and compensation granted under the Act is
required to be reached to the actual sufferer or the needy
claimant but many times the benevolent legislation being
misused and abused by unscrupulous elements and sometime
concocted record or medical documents are also produced on
the record. Though direction is issued by the Hon’ble Supreme
Court in Gohar Mohammed Vs. Uttar Pradesh State Road
Transport Corporation, reported in (2023) 4 SCC 381 , and
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Bajaj Allianz General Insurance Co. Ltd., Vs. Union of
India, reported in (2021) 17 SCC 530, to scrupulously follow
the provision of Section 158 of the Act and timely send the
Accident Information Report by concerned jurisdictional police to
jurisdictional Tribunal but the same is not followed in its true
letter and spirit. If in time prompt Accident Information Report is
forwarded to the concerned jurisdictional Tribunal then it may be
treated as claim petition which may avoid such concoction of
documents.
5) It is true that, in many cases the Disability Certificate issued by
the Doctor who has not treated the victim and exorbitant
disablement is opined without any reference book or any specific
guidelines. The guidelines are issued by the Ministry of Social
Justice and Empowerment, Government of India vide Gazette
Notification S. No.61, dated 05.01.2018, wherein, exhaustive
guidelines have been issued for issuance of Disability Certificate
in order to bring Pan India uniformity and the same is also taken
into consideration by the Hon’ble Supreme Court in the case of
of Bajaj Allianz (supra) has issued certain directions, reads as
under:
“(iv) As far as the aspect of the issuance of certificate on
disability of victims is concerned it is reiterated that the
guidelines laid down by this Court in Raj Kumar v. Ajay
Kumar and Anr., (2011) 1 SCC 343 mandatorily must be
followed by the MACTs, in respect of loss of income due to
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injury/disablement. The District Medical Board is also
directed to follow the guidelines issued by the Ministry of
Social Justice and Empowerment, Government of India
vide Gazette Notification S. No.61, dated 05.01.2018, for
issuance of Disability Certificate in order to bring Pan India
uniformity.
The consequence is that the MACT would ascertain that
permanent disability certificate issued by the District
Medical Board or body authorized by it is in accordance
with the Gazette Notification alone. Once the certificate is
issued in this manner, the same can be marked for
purposes of being taken into consideration as evidence
without the necessity of summoning the concerned
witness to give formal proof of the documents unless
there is some reason for suspicion on the document.”
6) Similarly, the Hon’ble Apex Court in the case of Union of India
& Anr. Vs Talwinder Singh , reported in (2012) 5 SCC 480 ,
has been pleased to hold that opinion of Medical Board which is
an expert body must be given due weightage and Medical
Certificate issued by the Medical Board is required to be
accepted without further proof. Even, as per the law laid down in
the case of Anoop Maheshwari vs Oriental Insurance Co.,
Neutral Citation – 2025 INSC 1075 , so far the disability is
concerned, the Certificate issued by the Medical Board can be
accepted, even without a witness being examined.
7) At this juncture, it is apposite to say that when “ready to use”
Disability Certificate is produced on record at that time the
learned Tribunal cannot sit as a mute spectator and the Tribunal
has directive role in the decision making process. If the Tribunal
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having doubt regard to authenticity and correctness of the
certificate then second opinion can be sought for. While
recording the evidence of the Doctor the Tribunal ought to have
played active role equipped with the medical document and ask
the Doctor. It is the duty of the Court and the Tribunals to
ascertain the functional disability of claimant in all injury cases
filed under the MV Act for getting compensation. At the same
time in Raj Kumar Vs. Ajay Kumar and Anr , reported in
(2011) 1 Supreme Court Cases 343 the Hon’ble Supreme
Court has taken the note and further observed about duty and
role of learned Tribunal in paragraphs 16 to 18, read as under :-
“16. The Tribunal should not be a silent spectator when
medical evidence is tendered in regard to the injuries and
their effect, in particular the extent of permanent
disability. Sections 168 and 169 of the Act make it evident
that the Tribunal does not function as a neutral umpire as
in a civil suit, but as an active explorer and seeker of truth
who is required to `hold an enquiry into the claim' for
determining the `just compensation'. The Tribunal should
therefore take an active role to ascertain the true and
correct position so that it can assess the `just
compensation'. While dealing with personal injury cases,
the Tribunal should preferably equip itself with a Medical
Dictionary and a Handbook for evaluation of permanent
physical impairment (for example the Manual for
Evaluation of Permanent Physical Impairment for
Orthopedic Surgeons, prepared by American Academy of
Orthopedic Surgeons or its Indian equivalent or other
authorized texts) for understanding the medical evidence
and assessing the physical and functional disability. The
Tribunal may also keep in view the first schedule to the
Workmen's Compensation Act, 1923 which gives some
indication about the extent of permanent disability in
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different types of injuries, in the case of workmen.
17. If a Doctor giving evidence uses technical medical
terms, the Tribunal should instruct him to state in
addition, in simple non-medical terms, the nature and the
effect of the injury. If a doctor gives evidence about the
percentage of permanent disability, the Tribunal has to
seek clarification as to whether such percentage of
disability is the functional disability with reference to the
whole body or whether it is only with reference to a limb.
If the percentage of permanent disability is stated with
reference to a limb, the Tribunal will have to seek the
doctor's opinion as to whether it is possible to deduce the
corresponding functional permanent disability with
reference to the whole body and, if so, the percentage.
18. The Tribunal should also act with caution, if it
proposed to accept the expert evidence of doctors who did
not treat the injured but who give `ready to use' disability
certificates, without proper medical assessment. There are
several instances of unscrupulous doctors who without
treating the injured, readily giving liberal disability
certificates to help the claimants. But where the disability
certificates are given by duly constituted Medical Boards,
they may be accepted subject to evidence regarding the
genuineness of such certificates. The Tribunal may
invariably make it a point to require the evidence of the
Doctor who treated the injured or who assessed the
permanent disability. Mere production of a disability
certificate or Discharge Certificate will not be proof of the
extent of disability stated therein unless the Doctor who
treated the claimant or who medically examined and
assessed the extent of disability of claimant, is tendered
for cross- examination with reference to the certificate. If
the Tribunal is not satisfied with the medical evidence
produced by the claimant, it can constitute a Medical
Board (from a panel maintained by it in consultation with
reputed local Hospitals/Medical Colleges) and refer the
claimant to such Medical Board for assessment of the
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disability.”

8) In the present case the Doctor is cross-examined, wherein, he
has given an evasive reply. It is needless to say that its the
matter of appreciation of evidence, however, the assessment of
the physical and functional disability both are all together
difference. The Doctor has to opine about the physical
disablement while the Tribunal has to consider functional
disablement. The Tribunal must have to consider functional
disablement with reference to the impact of the injury on the
claimant overall earning capacity and not merely on his inability
to continue the same avocation.
9) Mere production of the Disability Certificate or Discharge
Certificate is not the proof of the physical or functional
disablement. The Tribunal ought to have considered the impact
of injury on the earning capacity and considering the aforesaid
fact to assess functional disability is under the domain of the
Tribunal. The application filed by the appellant – original
opponent no.3 came to be dismissed by the learned Tribunal but
moot question remains that, if the disability is assessed at 90%
and without any reason straightaway the learned Tribunal accept
the same or body as a whole, even though the same cause
prejudice to other side qua evidence produced on record. In view
of above, if the party who wants to prove or rebut or wants to
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produce any rebuttal evidence on record to disprove the fact
then it is always open for the party to lead an evidence to
disprove the said fact and even keeping in mind the legal
principle that who asserts the fact has to prove the same.
10) Herein the petitioner – opponent no.3 has disputed the said
disability certificate hence, it is always open for the Insurance
Company to tender the rebuttal evidence to disprove the fact,
therefore, this Court is of the view that opportunity to rebut the
evidence is required to be given to the parties as well as the
impugned order passed by the learned Tribunal is required to be
quashed and set aside up to that extent and if the Insurance
Company is intended to rebut the evidence then it is kept open
for the appellant - Insurance Company to make an application
before the learned Tribunal to direct the claimant to remain
present before the Medical Board along with treatment papers
and to produce the Disability Certificate issued or disability
assessed by the Medical Board or the competent authority.
11)
If any such order has been passed by the learned Tribunal and
the original claimant fails to appear before the Medical Board or
to tender such evidence pursuant to such order, at that event,
the learned Tribunal ought to have draw an adverse inference
against claimant / injured and then based on, if any, material or
corroborative piece of evidence or expert opinion of the Medical
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Board based on the medical treatment or discharge papers
considering the avocation of the claimant, the learned Tribunal
has to assess the functional disability to award just
compensation, keeping in mind the directions issued by the
Hon’ble Supreme Court in Bajaj Allianz (supra).
12) In the wake of above, the present petition is allowed . The order
dated 18.09.2024, below Exhibit 61, passed by the learned
Motor Accident Claims Tribunal, Panchmahals at Godhra, in MAC
Petition No.264 of 2017, is quashed and set aside.
13) With the aforesaid directions the present petition stands
disposed of. Notice is hereby discharged. Interim relief granted
earlier stands vacated forthwith.
(HASMUKH D. SUTHAR,J)
ANKIT JANSARI
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