1

IN THE COURT OF THE DISTRICT & SESSIONS JUDGE AT UDUPI

ADDITIONAL M.A.C.T. AT KUDNAPURA
M.V.C.No. /2018
Between:
Divakara Achari@Divakara K.N(55 Years)
S/o.Narasimha Achari
R/o. Jodukattu Bailu, Petitioner
Keslur Village & Kammaradi Post
Thirthahalli Taluk
Shivamogga District-577125
Since petitioner is completely bedridden
and not able to walk stand and speak
and is under unconscious state due
to severe accidental injuries such as
closed head injuries hence he is
represented by his wife & guardian as
Smt.Lalitha(42 Years),
W/o.Divakara Achari@Divakara K.N
Residing at:Jodukattu Bailu
Keslur Village,Kammaradi Post
Thirthahalli Tq, Shivamogga Dt.,

AND

1. Harsha Kundar (43 Years)

S/o.Laxmana Suverna
R/a. # 1-79B, Shri Rama Raksha
Kankeri, Opp.Divine Park
Gundmi Village & Post, Airody
Brahmavara Taluk, Udupi Dt-576226
Also R/a.
Vajrakshi Nilaya, Hosabengre Post Respondents
Kodi Kanyana Village, Brahmavara Taluk
Udupi District-576218

2. United India Insurance Co.Ltd

Rep by its Present Branch Manager,
Branch Office, Saligrama Branch
Mantapa, Srinivasa,Nilaya,Ground Floor
Near NH.66&Near Saligrama Bus Stop,
Brahmavara Taluk,Udupi District-576225

POLICY No.2405813118P101364450 Valid From 27/04/2018 to 26/04/2019

APPLICATION FILED UNDER SECTION 166 OF INDIAN
MOTOR VEHICLES ACT 1988 AND APPLICATION IN FORM
NO. 63 (RULE 232) OF THE KARNATAKA MOTOR VEHICLE
RULES 1989.
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The petitioner above named begs to submit as follows:

I. I, Lalitha(42Years), W/o.Divakara Achari Alias Divakara K.N,
permanent resident of above address, do hereby apply for
grant of compensation for the injuries sustained by
husband Divakara Achari Alias Divakara K.N, S/o.Narasimha
Achari, in a Motor Vehicle Accident.

II. Necessary particulars regarding the vehicles involved in

the accident are furnished herein below.
1. Name and father’s name of the Divakara Achari Alias Divakara
claimant K.N (55 Yrs)
S/o.Narasimha Achari
2. Full address of the person As detailed in the cause title
injured
3. Age of the person injured 55 years
4. Occupation of the injured Blacksmith and Centring Work
person Mason
5. Name and Address of the Self Employment
Employer of the injured
6. Monthly income of the injured Rs.20,000/-

7. Does the person in respect of No

whom compensation is claimed
was paying income tax?
8. Place, Date, and time of the Opposite Parvathi Jewelers
Accident Near NH.66, Pandeshwara Village
Udupi District
Date:30/04/2018,Time:11.30AM
9. Brief particulars of the accident In detail in Para III (a)

10. Name and Address of the police Kota Police Station in Crime
station in whose jurisdiction, No.108/2018
the accident took place was
registered
11. Was the person in respect Yes
whom compensation claimed The petitioner Divakara Achari
travelling in the vehicle involved Alias Divakara K.N was riding a
in the accident? motor cycle along with a pillion
If so give the name of place of rider bearing Vehicle Reg No.KA-
starting of journey and 14-EQ-1810 and the said motor
destination cycle was stopped near Parvathi
Jewellers of Pandeshwar Village
12. Nature of injuries sustained, As detailed in the Wound
Continuing affect if any of the Certificate Enclosed
said injury, whether it caused
 3

permanent disablement?

13. Name and Address of the 1)Dr.Shankar.M.Bakkanavar

Medical Officer who attended KMC Reg.No.63093
the injured Associate Professor
Forensic Medicine 7 Toxicology
Clinical Forensic Medicine Unit
KMC Hospital Manipal-576104
2)Dr.Nishanth.A
KMC Hospital Manipal-576104
14. Period of treatment and Initially admitted and Treated in
Expenditure incurred thereon as an inpatient at Mahesh
Hospital at Brahmavara on
30/04/2018 and as per the
suggestion of the treated doctors
therein he was shifted to KMC
Hospital Manipal and he was
admitted as an inpatient therein
kept in ICU Observations and
was treated there from
30/04/2018 to 01/06/2018 for
about 33 days and then again
shifted from KMC Hospital
Manipal to Adarsha Hospital
Udupi and again was admitted
therein in the Adarsha Hospital
Udupi from 09/06/2018 to
23/06/2018 for about 15 days,
hence over all the petitioner was
treated for about 48 days in the
said hospitals
The petitioner has already spent
a sum of Rs 5,50,000/- (Rupees
Five Lakh Fifty Thousand
Only)towards the medical
expenses
15. Registration No,.& type of Hyundai Xcent Car Bearing
vehicle involved in the accident Vehicle Reg No.KA-20-MA-8529
16. Name and address of the Owner 1st Respondent
of the vehicle
17. Name, Policy No. , Insurance 2nd Respondent
particulars and address of the Policy Number:
insurer of the vehicle? 2405813118P101364450 VALID
FROM 27/04/2018 to 26/04/2019
18. Name and address of the Driver 1st Respondent(the 1st respondent
of the Vehicle himself driving the motor
vehicle(Car) belonging to himself)
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---------------------------------------
Harsha Kundar (43 Years)
S/o.Laxmana Suverna
R/a. # 1-79B, Shri Rama Raksha
Kankeri, Opp.Divine Park
Gundmi Village & Post, Airody
Brahmavara Taluk, Udupi Dt-
576226
Also R/a.
Vajrakshi Nilaya,Hosabengre Post
Kodi Kanyana Village,
Brahmavara Taluk, Udupi
District -576218
Mob:9986867910

19. Has any claim been lodged with No

the owner/insurer of the
vehicle?
20. Name and address of the As Detailed in the cause title
applicant? above
21. Relationship with the injured? Does not arise

22. Title to the property of the Does not arise

injured?

23. Amount of Compensation Rs.58,95,000/-

Claimed? And Basis thereof
24. Whether the report from the Report from the police is annexed
Police and the report from the and report from the registering
Registering Authority haveauthority not annexed as it is
been? not available at present and will
If so to be annexed? be produced during the trail of
the case
25. Whether the affidavit from the Annexed
Applicant/Witness as per rule
232© are annexed?
26. Whether documents mentioned Annexed, as detailed in the
in Rule 232© are being documents
annexed?
Duly indexed?

27. Any other information that may

be necessary or helpful in the -
disposal of the claim?

III.
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A) That on 30/04/2018 at about 11.30AM, the petitioner

along with the pillion rider in a motor cycle bearing
vehicle Reg No.KA-14-EQ-1810 came from Pandeshwara
road and both were standing near the Parvathi Jewellers
of Pandeshwara Village of Brahamavara Taluk which is
situated to the left side of the Kundapura to Udupi NH.66
and at that time a Car bearing Vehicle Reg.No.KA-20-MA-
8529, coming from Kundapura side to Udupi Side,
driven by its driver i.e. 1 st Respondent himself, in a very
high speed, rash and negligent manner without following
any traffic rules , came to the extreme left side of the
said road and dashed against the bike of the petitioner
from the front side , due to the said impact the petitioner
along with the bike and pillion rider fell down to the road
nearby and sustained grievous injuries as detailed in the
wound certificate produced herewith.
B) That the accident occurred solely due to the high speed,
rash and negligent and careless driving of the driver (1 st
Respondent himself) of the Car bearing Vehicle Reg.No.KA-
20-MA-8529 belonging to the 1 st Respondent, i.e. he
himself, who was driving the said Car in a high speed and
in a very rash and negligent, careless manner violating
every traffic rules and without observing the traffic rules
and without proper care circumspection and vigil.

C) That the petitioner was unconscious due to the said

accidental trauma and was immediately lifted to the
nearby Mahesh Hospital at Brahmavara in a hired vehicle
and he was given first aid therein, and thereafter as per
the suggestion of the treated doctors therein, the petitioner
was immediately shifted to the KMC Hospital , Manipal in
a hired vehicle , and therein he was admitted as an
inpatient from 30/04/2018 and was treated for the said
injuries sustained by him in the said accident and he was
kept in ICU under observation from 30/04/2018 for about
28 days therein and he was given various treatments and
he underwent various surgeries and X-Rays for the
fracture injuries were taken and he underwent CT
Scanning for the head injuries and he was inserted rod
implant for the fracture of the right leg and he was given
various treatments and various clinical evaluations were
done for the head injuries and then he was shifted to ward
and then discharged on 01/06/2018 from the said KMC
Hospital and throughout his treatment he was
unconscious and he had respiration problem due to which
he was given tracheostomy and then he was discharged
and again he was admitted to the Adarsha Hospital at
Udupi on 09/05/2018 and was kept under observations
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in ICU for about 6 days and was given various treatments

and then discharged from the said hospital on
23/05/2018, hence, the petitioner was admitted as an
inpatient in the KMC Hospital Manipal for about 33 days
and admitted as an inpatient in the Adarsha Hospital
Udupi for about 15 days , in overall he was under
treatment for about 48 days as an inpatient in the said
Hospitals and have taken various treatments Thus, in all
petitioner has spent sum of Rs.5,50,000/-(Rupees Five
Lakh Fifty Thousand Only) towards medical expenses.
And still the petitioner has not come out of his
unconscious stage and still he is under treatment, and he
is still bed ridden and cannot even speak properly and
stand, sit or walk of his own and cannot even feed himself
voluntarily, still he is under treatment and is having a
need of assistant for his routine activities and the doctors
treated him have suggested him to take constant
outpatient treatment and review along with x-ray and
scanning checkups as well as the need future treatment
and surgeries. He may require more than Rs.2,50,000/-
(Rupees Two Lakh Fifty Thousand Only) for his future
treatment and surgeries etc as suggested by his treated
doctors.
D) That the petitioner spent a sum of Rs.1,20,000/-
(Rupees One Lakh Twenty Thousand Only) towards
nursing and attendant charges and Rs.90,000/-(Rupees
Ninety Thousand Only) towards food and extra
nourishment. That, the petitioner also spent sum of
Rs.85,000/-(Rupees Eight Five Thousand Only) towards
conveyance charges.
E) That the petitioner was quite hale and healthy and
had a well built physique at the time of the
accident. And was aged 55 years. He was working as a
Black Smith and also as a Centring Work Mason, and he
was earning more than Rs.20,000/- (Rupees Twenty
Thousand Only)per month. Due to the accidental injuries
he could not able to attend or do his work thereby he had
lost his income. The accidental injuries resulted on the
mental anguish of greatly impaired general health
of the petitioner. The petitioner has undergone heavy
pain and sufferings. The injuries have taken away the
amenities of the petitioner. Due to the accidental injuries
the petitioner sustained permanent disablement. The
petitioner has lost prospective hopes in his employment.
His treatment is not yet completed. Thus on a prudent
and reasonable estimation the petitioner has sustained
general damages to the tune of Rs.48,00,000/- (Rupees
Fourty Eight Lakhs only) inclusive of damages
 7

towards pain and sufferings, loss of amenities of life,

loss of income, loss of future earnings, loss of future
expectations of life, etc.

IV. Therefore it is prayed that the 1 st respondent as the

owner and the 2nd respondent as the insurer of the car
bearing Vehicle Reg.No.KA-20-MA-8529, are liable to
pay jointly and severally a sum of Rs.58,95,000/-
(Rupees Fifty Eight Lakhs Ninety Five Thousand Only)
towards damages sustained by the petitioner along
with interest at the rate of 12% per annum from
the date of accident till realization.

V. Hence it is prayed that the Honorable Court may be

pleased to pass an award against the respondents for
the following relief’s.
1. Directing them to pay a sum of Rs. Rs.48,00,000/-
48,00,000/-(Rupees Fourty Eight Lakhs
Only) towards the general damages.
2. Directing them to pay a sum of Rs. Rs.5,50,000/-
5,50,000/-(Rupees Five Lakh Fifty
Thousand Only) towards medical
expenses
3. Directing them to pay a sum of Rs. 85,000/-
Rs.85,000/-(Rupees Eighty Five
Thousand Only) towards conveyance
charges
4. Directing them to pay a sum of Rs. Rs. 2,10,000/-
90,000/-(Rupees Ninety Thousand
Only) towards food and extra
nourishment & Rs.1,20,000/-(Rupees
One Lakh Twenty Thousand Only)
towards nursing and attendants
charges
5. Directing them to pay a sum of Rs.2,50,000/-
Rs.2,50,000/-(Rupees Two Lakh Fifty
Thousand Only) towards future
medical treatment charges

6. Directing them to pay interest over

the above sum at the rate of 12% p.a.
from the date of the accident till
realization & to pass such other
reliefs.
Total Rs.58,95,000/-

Place: Udupi
Date: - -2018 Advocate for the Petitioner Petitioner
(Rep By his Guardian
 8

& Wife Lalitha)

I, the above named petitioner do hereby declare that
what is stated herein above are all true and correct to
the best of my knowledge, belief and information.

Place: Udupi
Date: -2018 Petitioner
(Rep By his Guardian
& Wife Lalitha)

VERIFICATION
Verified at Kundapura on this …… day of _____________2018,
that the contents of the above application are true and correct
to my knowledge and belief.

Kundapura.
Date: - -2018 Petitioner
(Rep By his Guardian
& Wife Lalitha)

LIST OF DOCUMENTS FILED ON BEHALF OF PETITIONER

1. True copy of the FIR and complaint.
2. True Copy of the Charge Sheet of Final Report
3. True copy of the Spot mahazar.
4. True copy of the wound certificate
5. True copy of the IMV report.
6. True Copy of the Accident Information Report Register issued
by Kota Police Station in Cr.No.108/2018
7. Notarized copy of the Epic Card of the petitioner
8. Notarized copy of the Aadhaar Card of the petitioner and of
his Guardian Lalitha

9. Notarized copy of the Vehicle Insurance Policy Issued by the

2ND Respondent to the Motor Vehicle/Car of the 1 st Respondent
bearing Vehicle Reg No.KA-20-MA-8529 bearing Policy
No.2405813118P101364450 valid from 27/04/2018 to
26/04/2019

Place: Udupi
Date: - -2018 Advocate for the Petitioner
 9

IN THE COURT OF THE DISTRICT & SESSIONS JUDGE AT UDUPI

ADDITIONAL M.A.C.T. AT KUDNAPURA
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----- Respondents

AFFIDAVIT
I, Lalitha , aged about 42 years, W/o. Divakara
Achari@Divakara K.N, residing at Jodukattu Bailu, Keslur Village,
Kammaradi Post, Thirthahalli Taluk, Shivamogga District ,being the
wife and guardian of my husband Divakara Achari@Divakara K.N ,
aged 55 years, S/o.Narasimha Achari, residing at Jodukattu Bailu,
Keslur Village, Kammaradi Post, Thirthahalli Taluk, Shivamogga
District, do hereby solemnly affirm and oath as follows:
1) I say that I am the deponent herein and the guardian of
the petitioner in the above case

2) I say that, I have filed above petition against Respondents

for compensation of the injury sustained by my husband
Divakara Achari@Divakara K.N in a road traffic accident.

3) I say that, averments made in the above petition are all true
and correct to the best of knowledge, belief and information.

4) I say that, I have not preferred any claim application or

petition preferred any compensation with regard to the
cause of action of my above said petition or road traffic
accident met by my husband as stated in my petition

5) I say that, I have duly instructed my counsel to prepare the

above petition and I have signed the same after due
verification on behalf of my husband Divakara
Achari@Divakara K.N, being his guardian and wife and
found to be in accordance with my instructions.

6) I say that, facts stated herein above are all true and correct.

Place: Udupi
Dated: - -2018 DEPONENT
 10

Identified By Me:-

IN THE COURT OF THE DISTRICT & SESSIONS JUDGE AT UDUPI

ADDITIONAL M.A.C.T. AT KUDNAPURA
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----- Respondents

LIST OF DOCUMENTS FILED ON BEHALF OF PETITIONER

1. True copy of the FIR and complaint.
2. True Copy of the Charge Sheet of Final Report
3. True copy of the Spot mahazar.
4. True copy of the wound certificate
5. True copy of the IMV report.
6. True Copy of the Accident Information Report Register issued
by Kota Police Station in Cr.No.108/2018
7. Notarized copy of the Epic Card of the petitioner
8. Notarized copy of the Aadhaar Card of the petitioner and of
his Guardian Lalitha

9. Notarized copy of the Vehicle Insurance Policy Issued by the

2ND Respondent to the Motor Vehicle/Car of the 1 st Respondent
bearing Vehicle Reg No.KA-20-MA-8529 bearing Policy
No.2405813118P101364450 valid from 27/04/2018 to
26/04/2019

Place: Udupi
Date: - -2018 Advocate for the Petitioner
 11

IN THE COURT OF THE DISTRICT & SESSIONS JUDGE AT UDUPI

ADDITIONAL M.A.C.T. AT KUDNAPURA
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----- Respondents

PROCESS FEE MEMO/BATTA MEMO

It is submitted that;
The counsel for the Petitioner has paid the
process fee of Rs. 16-00 is herewith. That this
Honorable Court may be pleased to issue Notice to the
respondents through RPAD in the above case.

1. Harsha Kundar (43 Years)

S/o.Laxmana Suverna
R/a. # 1-79B, Shri Rama Raksha
Kankeri, Opp.Divine Park
Gundmi Village & Post, Airody
Brahmavara Taluk, Udupi Dt-576226……………….8.00
Also R/a.
Vajrakshi Nilaya, Hosabengre Post
Kodi Kanyana Village, Brahmavara Taluk
Udupi District-576218

2. United India Insurance Co.Ltd

Rep by its Present Branch Manager,
Branch Office, Saligrama Branch
Mantapa, Srinivasa,Nilaya,Ground Floor……………….8.00
Near NH.66&Near Saligrama Bus Stop,
Brahmavara Taluk, Udupi District-576225

======
Total Rs. 16=00
======
 12

Place: Udupi
Date: - -2018 Advocate for the Petitioner

C.P.C.(100) I.A. NOTICE IN C.M.P.

In the Court of the M.A.C.T at Kundapura
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----- Respondents

To
R1,
Harsha Kundar (43 Years)
S/o.Laxmana Suverna
R/a. # 1-79B, Shri Rama Raksha
Kankeri, Opp.Divine Park
Gundmi Village & Post, Airody
Brahmavara Taluk, Udupi Dt-576226
Mobile No:9986867910/9920653910

Whereas the above named...................................................has

made application to this court that …………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………

You are hereby warned to appear in this court in person or by a

pleader duly instructed, on the ………….day of …………20……..
At 11 O’ clock in the forenoon to show cause against the
application falling which the said application will be heard and
determined exparte.

Given under my hand and seal of the Court this ………………..

day of …………………………….. 2018.

(By order of the court)

 13

Advocate for Petitioner Central Nazir

C.P.C.(100) I.A. NOTICE IN C.M.P.

In the Court of the M.A.C.T at Kundapura
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----- Respondents

To
R2,
United India Insurance Co.Ltd
Rep by its Present Branch Manager,
Branch Office, Saligrama Branch
Mantapa, Srinivasa,Nilaya,Ground Floor
Near NH.66&Near Saligrama Bus Stop,
Brahmavara Taluk, Udupi District-576225
Tel:-0820-2564060/+91-9448108233

Whereas the above named...................................................has

made application to this court that …………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………

You are hereby warned to appear in this court in person or by a

pleader duly instructed, on the ………….day of …………20……..
At 11 O’ clock in the forenoon to show cause against the
application falling which the said application will be heard and
determined exparte.

Given under my hand and seal of the Court this ………………..

day of …………………………….. 2018.

(By order of the court)

 14

Advocate for Petitioner Central Nazir

IN THE COURT OF THE DISTRICT & SESSIONS

JUDGE AT UDUPI AND ADDL. M.A.C.T AT
KUNDAPURA
M. V. C. No. /2018
Between :
Divakara Achari@Divakara K.N } ----- Petitioner
Rep By His Guardian& Wife }
Smt.Lalitha }
AND
Harsha Kundar }
& another } ----Respondents
INDEX
Sl.N Description Pages C.F.
o Paid
1) Petition with verification Rs.10/-

2) Affidavith

3) Vakalath

4) Process Fee Memo/Batta Memo Rs.16/-

5) List Of Documents(Originals)

6) Copy of the Petition(2 sets)

7) List Of Documents(True Copy)

TOTAL
Rs.26/-
 15

Place: Kundapura
Date: - -2018
Advocate for the Petitioner

IN THE COURT OF THE ADJ/SCJ AND ADDL.

M.A.C.T AT KUNDAPURA
M. V. C. No. /2018
Between :
Laxmana Kulal@ Laxmana } ----- Petitioner
}
AND
Hussainar.K }
& another } ----- Respondents
 16

BY RPAD/BY RLAD

To:-
Hussainar K(63 Years)
S/o.Late Mulla Ahamed Nainar Saheb
R/a. Khateeja Manzil
M.Kodi, Kodi Kasba, Kodi Kasba Post
Kundapura Kasba Village
Kundapura Taluk, Udupi Dt-576217
Mobile No:8971073839

BY RPAD/BY RLAD

To:-
ICICI Lombard General Insurance Co.Ltd
Rep by Branch Manager,
Branch Office, Bangalore
Second Floor, SVR Complex-28
Hosur, Main Road, Madivala, 1st Stage
Koramangala,Bangalore-560068