Page 759 - The Central Motor Vehicles Rules, 1989

ANNEXURE-XIII THE CENTRAL MOTOR VEHICLE RULES, 1989 731

22. Total amount including interest (L+M)
23. Award amount released

24. Award amount kept in FDRs
25. Mode of disbursement of the award amount to the
claimant(s).
26. Next Date for compliance of the award.

FORM-XVI
SUMMARY OF THE COMPUTATION OF AWARD AMOUNT IN INJURY CASES
TO BE INCORPORATED IN THE AWARD
1. Date of accident ..................................................................................................................
2. Name of the injured ...........................................................................................................
3. Age of the injured ..............................................................................................................
4. Occupation of the injured .................................................................................................
5. Income of the injured ........................................................................................................
6. Nature of injury .................................................................................................................
7. Medical treatment taken by the injured ........................................................................
8. Period of hospitalisation ..................................................................................................
9. Whether any permanent disability? If yes, give details ..............................................
...............................................................................................................................................

10. Computation of Compensation
S.No. Heads Awarded by the Tribunal
11. Pecuniary Loss:
(i) Expenditure on treatment
(ii) Expenditure on conveyance

(iii) Expenditure on special diet
(iv) Cost of nursing/attendant
(v) Cost of artificial limb
(vi) Loss of earning capacity
(vii) Loss of income
(viii) Any other loss which may require any special
treatment or aid to the injured for the rest of his life
12. Non-Pecuniary Loss:
(i) Compensation for mental and physical shock
(ii) Pain and suffering
(iii) Loss of amenities of life

(iv) Disfiguration