Page 749 - The Central Motor Vehicles Rules, 1989

ANNEXURE-XIII THE CENTRAL MOTOR VEHICLE RULES, 1989 721

(viii) Medical Expenses
(ix) Funeral Expenses

(x) Any other pecuniary loss/damage
Non-Pecuniary Losses:
(xi) Loss of consortium
(xii) Loss of love and affection
(xiii) Loss of estate
(xiv) Emotional harm/trauma, mental and
physical shock, etc.
(xv) Post-traumatic stress disorder (anxiety,
depression, hostility, insomnia,
self-destructive behaviour, nightmares,
agitation, social isolation, etc.) panic
disorder or phobia(a) which got
triggered by the incident/death of the
deceased victim.
(xvi) Any other non-pecuniary loss/damage

Total loss suffered

II. Injury Case

S. No. Description Particulars
22. Name of the injured
23. Father’s/Spouse’s name
24. Age of the injured
25. Gender of the injured
26. Marital status of the injured
27. Occupation of the injured
28. Income of the injured

29. Nature and description of injury
30. Medical treatment taken by the injured
31. Name of hospital and period of
hospitalisation

32. Details of surgeries, if undergone
33. Whether any permanent disability? If
yes, give details