Tribunals must ensure disability certificates comply with Central guidelines and allow insurers to seek Medical Board re-evaluation.

The original claimant (Respondent No. 1) filed a claim petition (MAC No. 264 of 2017) following a vehicular accident where he sustained severe orthopedic injuries, including finger amputation and bone loss.

A Disability Certificate (Exhibit 38) was issued by a doctor (Dr. Dilip Solanki) who had not treated the claimant; the certificate assessed physical disability at 90%, though the doctor later testified to 55% disability of the whole body.

The Petitioner-Insurance Company, alleging the medical claims were potentially concocted or exaggerated, filed an application (Exhibit 61) seeking a re-evaluation by a District Medical Board or authorized body.

The Motor Accident Claims Tribunal (MACT), Panchmahals, rejected this application on September 18, 2024.

The Insurance Company challenged this rejection before the High Court.

Whether the Tribunal erred in rejecting the application for a fresh disability assessment by a Medical Board when the existing certificate was issued by a non-treating doctor and contested as evasive.

Whether the guidelines issued by the Supreme Court regarding the mandatory nature of Medical Board certificates in motor accident claims were applicable to the present case.

The Court applied Section 166 and 168 of the Motor Vehicles Act regarding "just compensation" and the Tribunal’s role as an "active explorer of truth" rather than a neutral umpire.

It relied on *Bajaj Allianz General Insurance Co. Ltd. v. Union of India* (2021) 17 SCC 530, which mandates that Disability Certificates should ideally be issued by District Medical Boards in accordance with the Ministry of Social Justice and Empowerment Gazette Notification dated 05.01.2018.

Furthermore, the court cited *Raj Kumar v. Ajay Kumar* (2011) 1 SCC 343, emphasizing that Tribunals must act with caution when accepting "ready to use" certificates from doctors who did not treat the injured party.

The Court reasoned that while the Motor Vehicles Act is benevolent legislation, it is frequently abused through concocted medical records and fraudulent claims.

It observed that the Tribunal cannot remain a "mute spectator" when the authenticity of a disability certificate is doubted; it has a directive role to ascertain true functional disability.

Since the doctor in this case provided "evasive" testimony and had not treated the claimant, the Court found that the Insurance Company had a right to lead rebuttal evidence to disprove the alleged 90% disability.

The Court emphasized that a Medical Board’s expert opinion carries significant weight and helps ensure "Pan India uniformity" in assessments.

Therefore, denying the request for a Medical Board evaluation deprived the Petitioner of a fair opportunity to contest the claim's magnitude.

The Court held that the Insurance Company is entitled to seek a directed assessment by a Medical Board.

It further directed that if the claimant fails to appear before such a Board after being ordered to do so, the Tribunal should draw an adverse inference against the claimant when assessing functional disability and compensation.

The matter was remanded for the Tribunal to facilitate the Medical Board assessment.