IN THE COURT OF THE LD. PRESIDING OFFICER-M.A.C.T.

,
EAST-DISTRICT , KARKARDOOMA COURTS, DELHI

MACT NO.________/2021

IN THE MATTER OF:

SMT. LALITA DEVI & OTHERS ... PETITIONERS

VERSUS

SHRI RAJENDRA PRASAD RANWA

& OTHERS ... RESPONDENTS

INDEX
S.No. Particulars Court Fee Pages

1. Form – A
2. Memo of Parties
3. Application U/s 164 and 166 of the
Motor Vehicles Act, 1988 with
supporting affidavit
4. List of documents alongwith
relevant documents
5. Vakalatnama

Filed By:

PRAKASH KUMAR
COUNSEL FOR THE PETITIONER
CHAMBER NO. 231,WESTERN WING,
TIS HAZARI COURTS, NEW DELHI-110054
MOBILE: 9810403392

Delhi
Dated
 IN THE COURT OF THE LD. PRESIDING OFFICER-M.A.C.T.,
EAST-DISTRICT , KARKARDOOMA COURTS, DELHI

MACT NO.________/2021

IN THE MATTER OF:

SMT. LALITA DEVI & OTHERS ... PETITIONERS

VERSUS

SHRI RAJENDRA PRASAD RANWA

& OTHERS ... RESPONDENTS

I, Lalita Devi, W/o Late Ashok Kumar, aged about 31 years R/o
Bahuarwa, West Champaran, Bihar-845306, the above named
Petitioner, give my consent to settle this case by mediation/
conciliation/ arbitration/ Lok Adalat/Judicial Settlement.

PETITIONER

Delhi
Dated: November 2022
 IN THE COURT OF THE LD. PRESIDING OFFICER-M.A.C.T.,
EAST-DISTRICT , KARKARDOOMA COURTS, DELHI

MACT NO.________/2021

MEMO OF PARTIES
IN THE MATTER OF:

1. SMT. LALITA DEVI AGE- 31YEARS

W/O LATE ASHOK KUMAR
2. MASTER ADITYA KUMAR AGE- 8 YEARS
S/O LATE ASHOK KUMAR
3. BABY ARCHANA KUMARI AGE- 6 YEARS
D/O LATE ASHOK KUMAR
4. BABY VIDYA KUMARI AGE- 4 YEARS
D/O LATE ASHOK KUMAR
5. MASTER ANSHU KUMAR AGE- 2 YEARS
S/O LATE ASHOK KUMAR

PETITIONER NO.2 TO 5 ARE MINER THROUGH THEIR

NATURAL GUARDIAN I.E. PETITIONER NO.1)
6. SH. NATHUNI SHAH AGE- 62 YEARS
S/O LATE HAMIDUR RAHAMAN
ALL RESIDENTS OF:
BAHUARWA, WEST CHAMPARAN, BIHAR-845306
... PETITIONERS

VERSUS

1. RAJENDRA PRASAD RANWA (DRIVER)

S/O SH. GAJANAND RANWA
R/O BUCHYASI, THANA.KHATU SHYAM JI,
TEHSIL. DATARAM, GARH,
DISTRICT. SIKAR, RAJSTHAN-332601

2. PROFITPLUS INFRA PRIVATE LIMITED (OWNER)

2ND FLOOR, 202 AGARWAL PLAZA,
POCKET 2, MAYUR VIHAR,
PHASE 3, EAST, NW DELHI-110096

3. TATA AIG GENERAL INSURANCE CO. LTD. (INSURER)

 UNIT NOS. 810-816, 8TH FLOOR,
WORLD TRADE TOWER, PLOT NO. C-001,
SECTOR-16, NOIDA-201301,
UTTAR PRADESH

... RESPONDENTS

Filed By:

PRAKASH KUMAR
COUNSEL FOR THE PETITIONER
CHAMBER NO. 231, WESTERN WING,
TIS HAZARI COURTS, NEW DELHI-110054
MOBILE: 9810403392

Delhi
Dated
 IN THE COURT OF THE LD. PRESIDING OFFICER-M.A.C.T.,
EAST-DISTRICT , KARKARDOOMA COURTS, DELHI

MACT NO.________/2021

IN THE MATTER OF:

1. SMT. LALITA DEVI AGE- 31YEARS

W/O LATE ASHOK KUMAR
2. MASTER ADITYA KUMAR AGE- 8 YEARS
S/O LATE ASHOK KUMAR
3. BABY ARCHANA KUMARI AGE- 6 YEARS
D/O LATE ASHOK KUMAR
4. BABY VIDYA KUMARI AGE- 4 YEARS
D/O LATE ASHOK KUMAR
5. MASTER ANSHU KUMAR AGE- 2 YEARS
S/O LATE ASHOK KUMAR

PETITIONER NO.2 TO 5 ARE MINER THROUGH THEIR

NATURAL GUARDIAN I.E. PETITIONER NO.1)
6. SH. NATHUNI SHAH AGE- 62 YEARS
S/O LATE HAMIDUR RAHAMAN
ALL RESIDENTS OF:
BAHUARWA, WEST CHAMPARAN, BIHAR-845306
... PETITIONERS

VERSUS

2. RAJENDRA PRASAD RANWA (DRIVER)

S/O SH. GAJANAND RANWA
R/O BUCHYASI, THANA.KHATU SHYAM JI,
TEHSIL. DATARAM, GARH,
DISTRICT. SIKAR, RAJSTHAN-332601

2. PROFITPLUS INFRA PRIVATE LIMITED (OWNER)

2ND FLOOR, 202 AGARWAL PLAZA,
POCKET 2, MAYUR VIHAR,
PHASE 3, EAST, NW DELHI-110096

3. TATA AIG GENERAL INSURANCE CO. LTD. (INSURER)

UNIT NOS. 810-816, 8TH FLOOR,
 WORLD TRADE TOWER, PLOT NO. C-001,
SECTOR-16, NOIDA-201301,
UTTAR PRADESH
... RESPONDENTS

P.S.: MAYUR VIHAR

APPLICATION FOR GRANT OF COMPENSATION UNDER

SECTION 164 AND 166 OF THE MOTOR VEHICLE ACT, 1988
(AS AMENDED) ON THE BASIS OF THE FOLLOWING FACTS
AND INFORMATION

1. Name and father’s name of Late Ashok Kumar S/o Shri

the person dead/injured Nathuni Sah
(husband name in case of
married women and widow)
2. Full Address of the person Also at:
injured/deceased Bahuarwa, West Champaran,
Bihar-845306

3. Age of the person About 32 Years

injured/deceased
4. Occupation of the person Delivery Boy
injured/deceased
5. Name and address of the N/A
employer of the person
injured/deceased
6. Monthly income of the Rs.30,000/- Per month
person injured/ deceased. (Rs.15,000/-as a mason and
Rs.15,000/- part time Mobile
Repair)
7. Does the person in respect No
of who compensation is
claimed pay income tax? If
 so, state the amount of the
income tax (to be supported
by documents).
8. Place, date and time of On 13.07.2022 at around
accident. 10:00/11:00A.M. in front of
Spice Jet Company, Phase 5,
Udyog Vihar, Gurugram in
the jurisdiction of P.S.
District Gurugram, Haryana.
9. Brief particulars of the The accident had taken place
accident. on 13.07.2022 at around
10:00/11:00A.M Deceased
Ashok Kumar was going to
Vatika City from his Office
Wazirabad by motor cycle
No.HR-20AA-3927 (Hero) at a
normal speed and on correct
side of the Road. When the
motor cycle reached Red Light,
Badshahpur Road, PS: Sector-
50, Distt. Gurugram, Haryana,
in the meanwhile a Dumper
bearing registration No.HR-
55P-1466 which was being
driven by its driver/respondent
No.1 at a very high speed,
rashly, negligently, without
taking necessary precaution,
without proper lookout,
violating the traffic rule, in a
zigzag manner and without
blowing any horn came from
back side and hit the motor
cycle with great force. As a
result of this the motor cycle
fell down on the road and he
sustained grievous injuries i.e.
CRUSH INJURY LEFT LOWER
LIMB AND AMPUTATION OF
(LT) THIGH and other multiple
injuries. He was immediately
taken to Park Hospital, Q
Block, South City-II, Sohna
Road, Main Sector-47,
Gurgaon, Haryana, where his
MLC No.231/18 was prepared
by the doctor, where he
hospitalized from 18.01.2018
to 19.01.2018, thereafter he
was taken to Paras Hospital, C-
1 Sushant Lok, Phase-I,
Sector-43, Gurgaon (Haryana),
where he hospitalized from
19.01.2018 to 26.01.2018,
thereafter he was taken to RBS
Hospital, U-37, Road Rao
Balbir Singh Market,
Nathupur, DLF Phase-3,
Gurgaon where he hospitalized
from 26.01.2018 to 10.02.2018
where during the course of
treatment his left thigh
amputated. The treatment of
the petitioner is still continuing
as an outdoor patient. within
the jurisdiction of P.S. Udyog
vihar, District Gurugram,
Haryana involving the
deceased and the offending
vehicle being a Fortuner with
 registration no.DL-10CE-
5415. Further details about
the accident are enumerated
in para no.27 of the present
petition.
10. Name and address of police PS: Sushant Lok,Gurugram
station in whose FIR No.: 0026/2021
jurisdiction the accident Dated: 08.02.2021
took place. U/s: 279/304-A/427 IPC
11. Was the person in respect of Yes. On 08.02.2021, the
whom compensation is deceased was travlling from
claimed travelling by the Harijan colony, Sushant Lok
vehicle involved in the to Katarpuri village, Palam
accident? If so, give the ViharGurugram, on his bike
name and place of starting Honda No. HR26DK-6381
the journey and destination. after meet his maternal
unclewhile the accident took
place in near the dam a little
ahead of the Super Mart-2,
Sushant Lok, Gurugram
12. Nature of the injury Fatal
sustained and disablement,
if any, caused.
13. Name & address of the The deceased expired during
medical officer/practitioner, the course of reaching the
if any, who attended on the hospital and was declared
injuries brought dead on 08.02.2021
at around 01:30A.M. by the
concerned doctors of Max
Hospital, Gurugram. The
post mortem of the deceased
was conducted by the
concerned doctors of Civil
Hospital, Gurugram vide Post
Mortem Report No.SH/19/21
 dated 08.02.2021.

14. Period of treatment and The deceased was declared

expenditure, if any, brought dead on 08.02.2021
incurred. at around 01:30A.M.

15. Registration number & type Fortunercar with registration

of vehicle involved in no.DL-10-CE-5415.
accident.
16. Name and address of the Respondent No.1 as per
owner of vehicle. Memo of Parties
17. Name and address of the Respondent No.1 as per
driver of the vehicle. Memo of Parties

18. Name and address of the Respondent No.2 as per

insurer of the vehicle. Memo of Parties

19. Has any claim been lodged No

with the owner/insurer? If
so, with that result.
20. Name and address of the
applicant.
21. Relationship with the
deceased/ injured.
22. Title of the property of the
deceased/injured.
23. Amount of compensation
and basis thereof.
As per title of the petition
Widow, children and infirm
parents of the deceased
N/A
Rs.27,00,000/ (Rupees
Twenty Seven Lakhs only)

24. Whether reports from the The report in Form-“A” and

police and the registering Form-“D” might have been
authority have been sent to the Learned tribunal
obtained in Form-“A” and directly by the I.O. of the
Form-“D” (if so, to be case and by the registering
annexed). authority. The petitioners
 has no knowledge of the
same.
25. Whether Affidavit of the Yes
applicant and witnesses as
per rule 8 are annexed (give
details).
26. Whether documents Yes
mentioned in rule 8 are
being annexed duly indexed
(give details).

27. Any other information that may be necessary and

helpful in the disposal of the case:-

i) That the deceased used to work as a Raj mistri

(mason) at District Gurugram and was also taking
part time Mobile repairing on rental mobile shop.

ii) That on 07.02.2021, the deceased went to Harijan

Colony, Sushant Lok on 07.02.2021with his own
Honda bike bearing no.HR26DK-6381 to meet his
maternal uncleSadam Hussain. While he was
returning from the meeting to his local residence
(located at Village Katarpuri, Palam Vihar) at around
12:30/1:00 a.m. on the unfortunate dateof
08.02.2021,as soon as he was about to reach the dam
located ahead of Super Mart-2 mall,the Respondent
no.1 (the driver of a Fortunercar) who was driving the
offending vehicle having registration number DL-10-
CE-5415 in a rash and negligent manner without
caring for traffic rules,hit the bike of the deceased
 straight from behind, due to which the deceased got
badly injured. After the accident, some good
Samaritan(s) took the deceased to the hospital.

iii) The deceased expired during the course of reaching

the MaxHospital Gurugram and was declared ‘brought
dead’ on 08.02.2021 at around 01:30A.M. by the
concerned doctors of Max Hospital vide MLC No.4220.
Thereafter, the post mortem of the deceased was
conducted by the concerned doctors of Civil Hospital,
Gurugram vide Post Mortem Report SH/19/21 dated
08.02.2021.

iv) That at the time of the accident, the deceased was a

25-year-old young man in good health and free from
any ailment/disease. The Petitioners lost the sole
earning member of their family. The Petitioners also
incurred around Rs.50,000/- (Rupees fifty thousand
only) on performing last rites of the deceased.

v) That the accident took place due to rash and negligent

driving on the part of the Respondent No.1 who drove
the offending vehicle at a very high speed without
caring for the traffic rules. The fatal injuries sustained
by the deceased had arisen out of the sheer
callousness on the part of Respondent no.1. The
Respondent No.1 is also the owner of the offending
vehicle, while the Respondent No.2 is the insurer.
 Thus, both the Respondents are jointly and severally
liable to pay compensation to the Petitioners.

vi) That Petitioners, therefore, claim a sum of

Rs.27,00,000/- (Rupees Twenty Seven Lakhs only) as
compensation on account of unnatural, untimely and
sudden death of the deceased in the accident in
question, mental pain and agony, loss of love and
affection, loss of future income and funeral expenses
incurred. General expenses as admissible under the
various provisions of the Motor Vehicles Act may also
be granted to the Petitioners along with 18% per
annum from the date of realization.

vii) That the accident in question occurred within the

jurisdiction of this Hon'ble Tribunal. Hence this
Hon’ble Tribunal has the jurisdiction to try this
petition.

28. Amount of compensation Rs.1,00,000/- (Rupees

claimed as interim award One Lakh only)
Reasons for claim of interim The Petitioners lost their
29. award sole earning member of
the family at a young age
of 25 years and thereby
underwent severe trauma.
Whether documents The report in Form-“A”
30. mentioned in sub-rule (4) and and Form-“D” might have
sub-rule (5) of Rule 20 have been sent to the Learned
been annexed? tribunal directly by the
I.O. of the case and by the
 registering authority. The
petitioners have no
knowledge of the same.

PRAYER:

It is most respectfully prayed as under:

i) An award of Rs.27,00,000/- (Rupees Twenty SevenLakhs

only) alongwith the interest @ 09% per annum may kindly be
passed in favour of the Petitioners and against the
Respondents jointly and severally.
ii) An interim award of Rs.1,00,000/- (Rupees One Lakh only)
alongwith the interest 09% per annum may kindly be passed
in favour of the Petitioners and against the Respondents
jointly and severally.
iii) Cost of the petition may also be granted.

Such other or further relief which this Hon’ble Tribunal

deems fit and proper in the circumstances and in the interest of
justice may also be granted to the Petitioners against the
Respondents.

PETITIONERS
Through

PRAKASH KUMAR
COUNSEL FOR THE PETITIONER
CHAMBER NO. 231,WESTERN WING,
 TIS HAZARI COURTS, NEW DELHI-110054
MOBILE: 9810403392

Delhi
Dated

VERIFICATION

VERIFIED at Delhi on ______ day of August, 2021 that the

contents of the above application/claim petition are true and
correct to my knowledge and belief and no part of it is false.

PETITIONERS
 IN THE COURT OF THE LD. PRESIDING OFFICER-M.A.C.T.,
EAST-DISTRICT , KARKARDOOMA COURTS, DELHI

MACT NO.________/2021

IN THE MATTER OF:

SMT. MEHERJAN BIBI & OTHERS ...

PETITIONERS

VERSUS

SHRI ISHWAR SINGH & ANOTHER ... RESPONDENTS

AFFIDAVIT

I, MEHERJAN BIBI, W/O LATE MOJAHAR HUSSAIN, AGED

ABOUT 22 YEARS R/O KHANJAPUR (I), DAKSHIN DINAJPUR,
WEST BENGAL-734125 (PRESENTLY AT GURUGRAM), THE
ABOVE NAMED DEPONENT,DO HEREBY SOLEMNLY AFFIRM
AND DECLARE AS UNDER:

1. That I am the Petitioner No.1 in the above mentioned case

representing myself as well as the other Petitioners and fully
conversant with the facts and circumstances of the case and
hence I am competent to depose this affidavit.

2. That the accompanying petition U/s 166 and 164 of the M.V.
Act has been drafted by my counsel on my instructions. I
have been explained the contents of the said petition in
vernacular language. I have understood and found the said
petition quite in order and according to my instructions.

3. That the deponent had not received any compensation

regarding any accident involving any motor accident.

4. That the statements of facts made in the said petition are

correct. The contents of the petition are not being reproduced
here in this affidavit for the sake of brevity and the same be
treated as part and parcel of this affidavit.
 DEPONENT
VERIFICATION

VERIFIED at Delhi on _____ August 2021that the contents of

Para 1 to 4 of the above affidavit are true to my knowledge and no
part of it is false and nothing material has been concealed
therefrom.

DEPONENT

18. Copy of Aaanganbari card of Petitioner No.2

19. Copy of Aadhar Card, Pan Card & Bank Pasbook of

Petitioner No.3

20. Copy of Aadhar Card, Pan Card & Bank Pasbook of

Petitioner No.4

21. Copy of Aadhar Card & Driving Licence of Deceased

22. Copy of Vehicle Registration Certificate of Deceased

23. Copy of Death Certificate

24. Certified Copy of Driving Licence & pollution of

Respondant No.1

filed by

PRAKASH KUMAR
COUNSEL FOR THE PETITIONER
CHAMBER NO. 231,WESTERN WING,
TIS HAZARI COURTS, NEW DELHI-110054
MOBILE: 9810403392
Delhi
Dated