Madhya Pradesh High Court
The Oriental Insurance Company Ltd ... vs Smt Upasana Shakya on 31 March, 2026
1 M.A.No. 167/2025
IN THE HIGH COURT OF MADHYA PRADESH
AT G WA L I O R
BEFORE
HON'BLE SHRI JUSTICE ASHISH SHROTI
MISC. APPEAL No. 167 of 2025
THE ORIENTAL INSURANCE COMPANY LTD DIVISIONAL
OFFICE
Versus
SMT UPASANA SHAKYA AND OTHERS
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Appearance:
Shri Nirendra Singh Tomar - Advocate for the appellant/Insurance
Company.
Shri Purushottam Rai- Advocate for respondents no. 1 and 2/Claimants.
RESERVED ON: 18/03/2026
ORDER PASSED ON: 31/03/2026
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O R D E R
The appellant/Insurance Company has filed this appeal challenging the award dated 26/9/2024 passed by 23rd Motor Accident Claims Tribunal, Gwalior in MACC No.249/2020, whereby, the Claims Tribunal has awarded following amount under various heads in favour of the claimants:-
Sr. Head Amount (Rs.) No. 1 Permanent Disability 15,05,280/-
2 Medical Expenses 6,06,200/-
3 Physical Pain 30,000/-
4 Mental agony 20,000/-
5 Special diet 10,000/-
6 Attender & Travelling Expenses 10,000/-
7 Other Misc. Expenditures 5,000/-
8 Future Treatment 30,000/-
Total 22,16,480/-
2. Respondent no.1 & 2/Claimants filed a claim petition under Section Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 2 M.A.No. 167/2025 160 read with Section 140 of Motor Vehicles Act, 1988 in relation to an accident occurred on 2/12/2018 when the motorbike driven by one Dinesh Kumar (husband of respondent no.1/claimant) with the claimant no.1 as the pillion rider, was hit by the Dumper bearing No. MP-41-HA-0759, which was rashly and negligently driven by respondent no.4 and was owned by respondent no.3. The Tribunal has recorded a finding that the accident has been proved and the negligence on the part of dumper driver, respondent no.4, has also been proved. The appellant/Insurance Company has been held liable to make payment of compensation amount jointly and severally with respondent no.3 & 4 as the offending vehicle was insured with the appellant/Insurance Company.
3. The other findings of Tribunal with regard to compensation determined as per Clause 2 to 8 of the aforesaid table have not been challenged. The Company has challenged the impugned award only to the extent of amount of Rs.15,05,280/- awarded to the claimants towards permanent disability. This order confines adjudication of findings of Tribunal recorded with regard to permanent disability of claimant no.1. The Tribunal has found the functional disability suffered by claimant no.1 to the extent of 70% on the basis of the disability certificate marked as Ex. P/63 and the statement of Dr. Anand Sharma, Neurologist (PW/4). Further, the documents exhibited as P/22 to Ex. P/61 and Ex. P/64 to P/83 and Ex. P/86 to P/189 have been relied upon by the Tribunal while reaching to said finding. These are the documents relating to the treatment underwent by claimant no.1 on account of the injuries suffered by her in the accident.
4. Challenging the impugned award, learned counsel for the appellants/Insurance Company raised only one ground that the Tribunal erred in relying upon the disability certificate Ex. P/63 without examination of the doctor, who has issued the certificate. It is his submission that the disability certificate has been issued by the Civil Surgeon, Gwalior, wherein, the permanent disability of claimant no.1 has been shown to be Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 3 M.A.No. 167/2025 50%. However, said certificate has not been proved by the claimants by adducing evidence of doctor, who has issued the disability certificate. It is his further submission that the Tribunal erred in accepting the disability certificate only on the basis of statement of Amit Shivhare, PW/3, who was only a Record Keeper in the District Hospital and was not competent to prove the permanent disability of claimant. Learned counsel submitted that the disability certificate has not been proved as per the requirement of law, and therefore, could not have been relied upon by the Tribunal. In support of his submission, learned counsel placed reliance upon the Full Bench decision of this Court in the case of Kamal Kumar Jain Vs. Tazuddin & Ors., reported in 2004(2) MPLJ 472.
5. On the other hand, learned counsel for the claimants supported the impugned award. As per his submission, the disability certificate has been issued by a duly constituted Medical Board and its issuance has been established by the statement of one Amit Shivhari (PW/3), who has produced the register maintained in the District Hospital bearing entries of the persons, in whose favour, disability certificate has been issued. Learned counsel also referred to the documents marked as Ex. P/84 & P/85, which are the applications given by claimant no.1 for issuance of disability certificate and the copy of register, showing appearance of claimant no.1 before the Medical Board. Learned counsel thus, submitted that the aforesaid disability certificate of the claimant is corroborated by the statement of Dr. Anand Sharma, who has treated her for a long period of time. He also submitted that the claimants made an application before the Tribunal for summoning the doctor to prove the certificate, however, the Tribunal rejected the application on the ground that the certificate is already exhibited and examining the doctor is not necessary. The learned counsel thus submitted that the challenge to the award is unfounded and the appeal deserves to be dismissed.
6. Considered the arguments and perused the record.Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 4 M.A.No. 167/2025
7. The impugned award has been challenged solely on the ground that the disability certificate, Ex. P/63, has not been proved by claimants by examining the doctor, who has issued it. To appreciate the submissions made by learned counsel for appellants/Insurance Company, it is profitable to refer to the provisions whereunder the disability certificate has been issued.
8. The matter of issuance of disability certificate is governed by Section 57 of the Rights of Persons with Disabilities Act, 2016 (in short "Act of 2016") which provides for designation of certifying authorities while Section 58 thereof provides for procedure for certification. Section 57 & 58 of Act of 2016 being relevant, are reproduced hereunder:
"57. Designation of certifying authorities.--(1) The appropriate Government shall designate persons, having requisite qualifications and experience, as certifying authorities, who shall be competent to issue the certificate of disability. (2) The appropriate Government shall also notify the jurisdiction within which and the terms and conditions subject to which, the certifying authority shall perform its certification functions.
58. Procedure for certification.--(1) Any person with specified disability, may apply, in such manner as may be prescribed by the Central Government, to a certifying authority having jurisdiction, for issuing of a certificate of disability. (2) On receipt of an application under sub-section (1), the certifying authority shall assess the disability of the concerned person in accordance with relevant guidelines notified under Section 56, and shall, after such assessment, as the case may be,
--
(a) issue a certificate of disability to such person, in such form as may be prescribed by the Central Government;
(b) inform him in writing that he has no specified Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 5 M.A.No. 167/2025 disability.
(3) The certificate of disability issued under this section shall be valid across the country."
Under Section 56 of the said Act, the Central Government is empowered to notify guidelines for purposes of assessing the extent of specified disability in a person. Thus, the disability certificates are issued under Section 58(2) upon an application made by PWD (persons with disability) under Section 58(1) of the Act.
9. Further, exercising powers under Section 100 of Act, Rules namely "Rights of Persons with Disabilities Rules, 2017, (in short 'Rules') have been framed. Rule 17 & 18 lays down the procedure for issuance of disability certificate. Since, the certificate in question has been issued prior to 16.10.2024, when rules where substantially amended, the un-amended Rule 17 & 18 of Rules would apply in these cases which reads as under:-
"17. Application for certificate of disability.--(1) Any person with specified disability may apply in Form IV for a certificate of disability and submit the application to-
(a) a medical authority or any other notified competent authority to issue such a certificate in the district of residence of the applicant as mentioned in the proof of residence in the application; or
(b) the concerned medical authority in a government hospital where he may be undergoing or may have undergone treatment in connection with his disability:
Provided that where a person with disability is a minor or suffering from intellectual disability or any other disability which renders him unfit or unable to make such an application himself, the application on his behalf may be made by his legal guardian or by any organization registered under the Act having the minor under its care.
(2) The application shall be accompanied by--Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 6 M.A.No. 167/2025
(a) proof of residence;
(b) two recent passport size photographs; and
(c) aadhaar number or aadhaar enrollment number, if any.
Note.--No other proof of residence shall be demanded from the applicant who has aadhaar or aadhaar enrollment number.
18. Issue of certificate of disability.--(1) On receipt of an application under Rule 17, the medical authority or any other notified competent authority shall, verify the information as provided by the applicant and shall assess the disability in terms of the relevant guidelines issued by the Central Government and after satisfying himself that the applicant is a person with disability, issue a certificate of disability in his favour in Form V, VI and VII, as the case may be.
(2) The medical authority shall issue the certificate of disability within a month from the date of receipt of the application. (3) The medical authority shall, after due examination--
(i) issue a permanent certificate of disability in cases where there are no chances of variation of disability over time in the degree of disability; or
(ii) issue a certificate of disability indicating the period of validity, in cases where there is any chance of variation over time in the degree of disability.
(4) If an applicant is found ineligible for issue of certificate of disability, the medical authority shall convey the reasons to him in writing under Form VIII within a period of one month from the date of receipt of the application.
(5) The State Government and Union territory Administration shall ensure that the certificate of disability is granted on online platform from such date as may be notified by the Central Government."
10. Rule 19 of the Rules provides that a person to whom the certificate Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 7 M.A.No. 167/2025 has been issued under Rule 18 shall be entitled to apply for facilities, concessions and benefits admissible for persons with disabilities under schemes of the Government and of non-Governmental organisations funded by the Government. The certificate issued under the Act/Rules is thus recognized to be a valid proof of disability. Thus, a disability certificate issued pursuant to the provisions of Section 57 & 58 and after following procedure prescribed Rule 17 & 18, bears a statutory force and cannot be brushed aside without there being any cogent reason therefore. The claimant no.1 is possessed of a disability certificate issued under the provisions of the Act/Rules. It is not the case of appellants/Insurance Company that the certificate submitted by respondent no.1 is a forged document. Moreso, its issuance has been duly proved by Amit Shivhare, Record Keeper of District Hospital by producing relevant record of Hospital. Thus, without making out a reasonable doubt about the genuineness of certificate, the examination of certificate issuing doctor was not warranted.
11. Recently the Apex Court in the case of Anoop Maheshwari Vs. Oriental Insurance Company Ltd. & Ors., reported in 2025 SCC OnLine SC 1918, has held that the disability certificate issued by a Medical Board can be accepted even without a witness being examined. The observations of the Apex Court made in para 7 are as under:-
"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, Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 8 M.A.No. 167/2025 and the claimant has already been fitted with a prosthetic limb to ensure his mobility. In the above 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."
12. Thus, this Court is of the considered opinion that the Tribunal did not err in accepting the disability certificate while determining permanent disability of claimant no.1.
13. Challenge to the findings of the Tribunal is not acceptable for yet another reason. A reading of the findings recoded by the Tribunal in paragraph 18 to 21 of the award shows that the functional permanent disability of the claimant no.1 has been determined to be 70% as against the 50% permanent disability mentioned in certificate. Thus, the Tribunal's finding is not solely based upon the disability certificate. The Tribunal, after appreciating the documentary evidence as also the statement given by Dr. Anand Sharma, has recorded a finding that functional disability suffered by claimant no.1 is 70%. This finding of fact has not been challenged by the appellants/Insurance Company in this appeal.
14. Appellant's counsel placed reliance upon the Full Bench decision of this Court in the case of Kamal Kumar Jain (supra). However, the said decision is also of no help to the appellants. In the said case, the Full Bench held that "Mere fracture of bones and its re-union will not amount to permanent total disablement or permanent partial disablement, unless the doctor has examined the claimant and assessed the percentage of disability after performing scientific tests. Without performing scientific tests bald statement of the doctor and certificate is inadmissible in evidence." The Full Bench thus held that the disability of the claimant cannot be accepted solely Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM 9 M.A.No. 167/2025 based upon the oral testimony of the doctor without performing scientific tests. In the case in hand, it is seen that the disability certificate has been issued by the Medical Board duly constituted under the Act of 2016 and Rules framed thereunder. It is not the case of the appellants that the procedure prescribed under the Act of 2016 has not been followed. Thus, unless the appellant establishes reasonable doubt about the genuineness of the disability certificate, the certificate needs to be accepted.
15. Further, there is yet another important aspect of the matter, which needs to be taken note of. The claimants after exhibiting the disability certificate had filed an application under Order XVI Rule 1 of CPC requesting the Tribunal to summon the doctor, who has issued the disability certificate. This application was rejected by the Tribunal vide order dated 11/7/2024. Pertinently, a perusal of this order shows that the application was opposed by the appellants/Insurance Company. Apart from observing delay on the part of claimants, the Tribunal held that since the certificate has already been exhibited, further examination of doctor, who has issued certificate, for proving the certificate, is not required. Thus, it is clear that the claimants have made efforts for calling the doctor also for proving the certificate, and therefore, they cannot be held liable for his non- examination.
16. In view of the aforesaid discussion, this Court is of the considered opinion that the Tribunal did not commit any mistake in relying upon the disability certificate issued by duly constituted Medical Board under the provisions of Act/Rules, without establishing any reasonable doubt about the genuineness of the certificate. No ground is, therefore, made out warranting interference with the award passed by learned Tribunal. The appeal fails and is hereby dismissed.
(ASHISH SHROTI) JUDGE JPS/-
Signature Not Verified Signed by: JAI PRAKASH SOLANKI Signing time: 3/31/2026 5:39:10 PM