Case Note & Summary
The appellant, Reliance General Insurance Co. Ltd., filed an appeal against the judgment and order of the Motor Accident Claims Tribunal, Mumbai, which awarded compensation of Rs.14,44,314/- to the claimant, Mr. Aman Sanjay Tak, for injuries sustained in a motor accident. The accident occurred on 17th March 2014 when the claimant was riding a motorcycle with his friend Trisha Jain, and a motor dumper owned by M/s M. K. Enterprises and insured by the appellant dashed the motorcycle from behind due to the sole negligence of the dumper driver. The claimant sustained injuries and incurred medical expenses. The Tribunal awarded compensation including medical expenses of Rs.12,17,592/-. The appellant contended that the claimant had already received medical reimbursement of Rs.12,17,592/- from another insurance company under a Mediclaim policy taken by his father, and therefore this amount should be deducted from the compensation. The claimant argued that the Mediclaim policy was a separate contractual benefit for which his father paid premium, and the appellant, as insurer of the offending vehicle, was liable to pay compensation under the Motor Vehicles Act, 1988. The Court held that the Mediclaim reimbursement was a contractual benefit independent of the statutory compensation under the Motor Vehicles Act. The accident was caused by the negligence of the driver of the vehicle insured by the appellant, and the appellant is liable to pay the full compensation without deduction of the medical reimbursement amount. The appeal was dismissed with no order as to costs.
Headnote
A) Motor Accident Compensation - Medical Reimbursement - Deduction - The issue was whether the amount received under a Mediclaim policy by the claimant should be deducted from the compensation awarded by the Tribunal. The Court held that the Mediclaim policy was a contractual liability between the claimant's father and the insurance company, and the premium was paid by the father. The accident occurred due to the sole negligence of the driver of the offending vehicle insured by the appellant. The compensation payable under the Motor Vehicles Act, 1988 is statutory and independent of any private insurance contract. Therefore, the amount received under the Mediclaim policy cannot be deducted from the compensation awarded. (Paras 1-6)
Issue of Consideration
Whether the amount received by the claimant under a medical reimbursement (Mediclaim) policy can be deducted from the compensation awarded by the Motor Accident Claims Tribunal?
Final Decision
The appeal is dismissed. The amount received by the claimant under the Mediclaim policy cannot be deducted from the compensation awarded by the Tribunal. No order as to costs.
Law Points
- Medical reimbursement under a separate Mediclaim policy is a contractual benefit
- not deductible from compensation under Motor Vehicles Act
- 1988
- Compensation under Motor Vehicles Act is statutory and independent of private insurance contracts
- Principle of just compensation does not require deduction of amounts received from third-party insurers.
Case Details
2023 LawText (BOM) (04) 72
First Appeal No. 1051 of 2022
Ms. Shalini Shankar for the Appellant, Mr. Jitendra P. Gor for the Respondents
Reliance General Insurance Co. Ltd.
Mr. Aman Sanjay Tak and M/s M. K. Enterprises
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Nature of Litigation
Appeal against the judgment and order of the Motor Accident Claims Tribunal awarding compensation for injuries sustained in a motor accident.
Remedy Sought
The appellant insurance company sought deduction of the medical reimbursement amount received by the claimant under a Mediclaim policy from the compensation awarded by the Tribunal.
Filing Reason
The appellant contended that the Tribunal failed to deduct the medical reimbursement amount of Rs.12,17,592/- received by the claimant from another insurance company under a Mediclaim policy.
Previous Decisions
The Motor Accident Claims Tribunal, Mumbai awarded compensation of Rs.14,44,314/- to the claimant.
Issues
Whether the amount received under a Mediclaim policy can be deducted from the compensation awarded under the Motor Vehicles Act, 1988?
Submissions/Arguments
Appellant: The claimant received medical reimbursement of Rs.12,17,592/- under a Mediclaim policy from another insurance company, so this amount should be deducted from the compensation awarded by the Tribunal.
Respondent: The Mediclaim policy was a contractual liability between the claimant's father and the insurance company, and the premium was paid by the father. The appellant, as insurer of the offending vehicle, is liable to pay compensation under the Motor Vehicles Act, 1988, and the medical reimbursement cannot be deducted.
Ratio Decidendi
The amount received under a Mediclaim policy is a contractual benefit arising from a separate insurance contract for which premium was paid, and it cannot be deducted from the statutory compensation payable under the Motor Vehicles Act, 1988 by the insurer of the offending vehicle. The compensation under the Motor Vehicles Act is independent of any private insurance benefits.
Judgment Excerpts
The issue involved in this appeal is, the amount received under medical reimbursement by the claimants be reduced from compensation amount.
If claimant has already received amount under the Mediclaim Policy, he is not entitled to get this amount of Rs.12,17,592/- of medical reimbursement from Appellant/Insurance Company, but this fact is not considered by the Tribunal and awarded the compensation of Rs.14,44,314/-.
It is contention of learned counsel for the Respondent/Claimant that, the said policy was taken by his father for whole family. It was contractual liability between father of claimant and that Insurance Company, a premium was paid by the father of claimant to said Insurance Company for reimbursement of medical expenses.
In the present case, the appellant is the insurer of offending vehicle, who dashed the claimant's motorcycle from backside. The accident occurred due to sole negligence of the driver of offending vehicle. They are liable to pay the compensation.
Procedural History
The Motor Accident Claims Tribunal, Mumbai awarded compensation of Rs.14,44,314/- to the claimant. The appellant insurance company filed First Appeal No. 1051 of 2022 before the High Court of Judicature at Bombay challenging the award on the ground that the medical reimbursement amount should have been deducted. The High Court heard the appeal and dismissed it on 12th April 2023.
Acts & Sections
- Motor Vehicles Act, 1988:
