United India Insurance Co Ltd v. Chotey Lal

1 UNITED INDIA INSURANCE CO LTD..... Appellant Through: Mr. Pankaj Seth, Adv.

VERSUS

CHOTEY LAL & ANR..... Respondents Through: Mr. C. Siddharth, Adv. for R[1] Mr. Anil Garg and Mr. Mukesh Sachdeva, Advs. for R[2]. + FAO 83/2018 2 CHHOTEY LAL..... Appellant Through: Mr. C. Siddharth, Adv.

VERSUS

UNITED INDIA INSURANCE CO LTD AND ANR..... Respondents Through: Mr. Pankaj Seth, Adv. Mr. Anil Garg and Mr. Mukesh Sachdeva, Advs. for R[2]. CORAM: HON'BLE MR.

JUSTICE J.R. MIDHA JUDGMENT (ORAL)

1. The Commissioner, Employees’ Compensation has awarded compensation of Rs.10,55,760/- which is under challenge in these appeals.

2. On 31st May, 2014, the claimant, Chotey Lal was working for the 2018:DHC:3953 installation of the lift at the construction site when the lift fell on his body and he suffered grievous injuries and was taken to Indian Spinal Injuries Centre, Vasant Kunj. The employer intimated the accident to the Commissioner, Employees’ Compensation. The injuries suffered by the claimant resulted in 100% disability relating to both the lower limbs. The case summary of the claimant prepared by Indian Spinal Injuries Centre is reproduced hereunder:- “Mr.

CHOTTE LAL aged 20 Yrs/male was admitted in this hospital on 31/5/2014 and readmitted on 12/06/2014 Vide IPD no. 14/24825 with c/o pain in the back and pain in left side of chest since 30/5/2014. He was evaluated by the team of spine surgeons and was diagnosed as case of Fracture dislocation D11-D12 with paraplegia with bladder and bowel involvement with AIS-A with chest injury left side (left 9 th rib fracture with lung contusion). General surgeons reference given for abdomen and chest injury and was advised for NCCT chest and NCCT abdomen. NCCT chest was done which showed segmental collapse left side with mild effusion. NCCT abdomen was done which shows no significant abnormality and hence managed conservatively. Patient’s enzymes were raised, abdominal decompression with nasogastric tube done and managed conservatively. Patient was given inj. Solumedrol according to NASCIS protocol. Physician reference was given for high blood sugars and managed accordingly. Patient was advised for surgery. After PAC clearance, informed written consent and physician clearance he was taken upto OT on 2/6/2014 wherein pedicular screw fixation with bone grafting (D10-L[1]) was done, pedicle screw put in D10 (6.5x45), D12 (6.5x50), L[1] (6.5x50), reduction screws put in D11 bilateral (5.5x40) (Implant – GSM 8 screws crosslink). He was shifted to ICU post operatively. On 3/6/2014 bronchoscopy was done for left lung collapse. Drain removal was done on second post operative day. He was shifted to HDU. He was mobilized with APTLSO brace. Bowel training was started Physician reference was given who advised to send blood profile for hepatitis. He was shifted back to the ward. Bladder training was started. He was started on CIC fourth hourly. He was readmitted on free bed on 12/6/2014. Extensive physiotherapy and rehabilitation was started. Psychologist reference was given. Urology reference was given and advised to continue CIC fourth hourly. HBsAg report showed positive and anti IBc showed positive, HBcAg showed negative report and IgM anti HBc showed negative report which is likely carrier of hepatitis B. Physician advised to Gastroenterology consultation for the same. Gastroenterologist reference was given for ? malena and chronic hepatitis B and advised for HBV DNA (Quantitative) and advised for antiviral treatment and UGI endoscopy.

HBV DNA was 861 unit / ml. Physician advised to repeat LFT / Sr. HBV – DNA level (quantitative) after 6 months. 6 weeks prophylaxis treatment of DVT was completed. Vocational counselling was done. Wheelchair assessment skills were taught to the patient. Home modification explained to the patient. Presently he is undergoing comprehensive rehabilitation programme in this hospital and he is not able to walk.”

3. The Commissioner, Employees’ Compensation held that the claimant suffered injuries during the course of the employment. The Commissioner, Employees’ Compensation awarded Rs.10,55,760/- to the claimant. The Commissioner, Employees’ Compensation also awarded medical expenses of Rs.5,01,954/- incurred by the employer and directed the Insurance Company to reimburse the medical expenses to the employer.

4. Learned counsel for appellant in FAO 409/2015 urged at the time of hearing that the medical expenditure of Rs.5,01,954/- is on a higher side. It is submitted that as per its investigation report, medical expenses of Rs.4,02,155/- has been incurred by the claimant.

5. Learned counsel for appellant in FAO 83/2018 submits that the appellant has incurred further expenditure of Rs.3,14,123/- over and above the medical expenses awarded by the Commissioner, Employees’ Compensation. It is further submitted that the treatment is still continuing and further expenditure is being incurred.

6. This Court is of the view that the claimant, Chotey Lal suffered an accident during the course of his employment and there is no infirmity in the compensation of Rs.10,55,760/- along with interest thereon @ 12% per annum awarded by the Claims Tribunal. The medical expenses of Rs.5,01,954/- incurred by respondent No.2 in FAO 409/2015 on the treatment of the claimant and direction to the Insurance Company to reimburse is up held.

7. This Court is of the view that the claimant, Chotey Lal is entitled to further medical expenses incurred by him. The treatment of Chotey Lal is still continuing on which Rs.3,14,000/- has already been incurred. Since the treatment is continuing, it would be appropriate to remand this matter back to the Commissioner, Employees’ Compensation to determine and award up to date medical expenses to the claimant.