<p>To, </p><p>The Secretary DHCLSC, New Delhi. </p><p>Sub: Application to refer pending MAC Appeal No. ………………... title as ...... to Lok Adalat.</p><p>Sir, </p><p>The claimant/ insurance company in the abovementioned matters wants to settle the case in Lok Adalat. As per Claimant/Insurance Company the grounds of enhancement/reduction of compensation are on following heads:</p><p>Grounds of enhancement of compensation Approximate Amount Sr. No. </p><p>1. Multiplier</p><p>2. Pecuniary/non-pecuniary damages</p><p>Loss of working capacity in relation to 3. disability </p><p>4. Any other head </p><p>TOTAL </p><p>Pending connected Appeal/ case, if any...... </p><p>DECLARATION</p><p>Applicant/ claimant further declare that the above said particulars are true and correct to the best of his knowledge. </p><p>Date: ……………….. (Signature of Claimant/Insurance Co./Counsel)</p>