Compensation awarded under the Motor Vehicles Act must deduct amounts reimbursed under a Mediclaim policy to prevent double recovery.

JUDGMENT :

This appeal is filed under Section-173(1), of the Motor Vehicles Act, 1988 (hereinafter referred to as ‘MV Act’ for brevity) by the appellant/insurance company, challenging the judgment and award dated 22.03.2013, passed in MVC No.3314/2009, on the file of Special XI Additional Judge and MACT, at Bangalore (SCCH-12) (hereinafter referred to as ‘the Tribunal’ for brevity).

2. The accident occurred, the injuries sustained and the liability of the insurance company are not in dispute.

3. The question to be considered in this appeal is whether once the claimant has got reimbursement of the medical expenses under the Mediclaim Policy, can be awarded once again under the medical expenses and hospitalisation charges, while determining compensation under the MV Act.

4. In the present case, the Tribunal has awarded compensation under various heads as follows:

5. The Tribunal, under the medical expenses, has granted compensation of Rs.5,24,639/-. According to the learned counsel for the appellant/insurance company, it is amounting to granting compensation twice on the head medical expenses, on the ground that the claimant has got reimbursement of the medical expenses under the Mediclaim Policy. Therefore, it is submitted that once the claimant has got reimbursement of medical expenses, then under the provisions of the MV Act, while determining compensation, the amount under the head medical expenses once again cannot be granted. Therefore, questioned grant of compensation under the medical expenses.

6. He places reliance on the division bench judgment of this Court in MFA.No.6950/2007 c/w MFA.Nos.6952/2007 and MFA.No.15422/2007, dated 11.10.2012 in the case between The New India Assurance Co. Ltd., vs. Manish Gupta and another (Manish Gupta case).

7. On the other hand, the learned counsel for the respondents/claimants submits that the medical reimbursement amount is by virtue of contract of insurance between the claimant and the insurance company in that medical claim; therefore, the claimant is statutorily entitled for compensation while determining the same under the provisions of MV Act. Therefore, it is submitted that it does not amount to double claim in respect of medical expenditure. In support of his arguments, he has placed reliance on the judgment of the High Court judicature at Bombay in First Appeal.No.1051/2022, dated 12.04.2023 in the case between Reliance General Insurance Co. Ltd., v. Mr.Aman Sanjay Tak (Aman Sanjay Tak case) and another and the interim order of the Hon'ble Supreme Court in SLP.No.28706/2023, dated 07.08.2023.

8. In the present case, the only ground urged by the learned counsel for the appellant/insurance company is that the award of amount of Rs.5,24,639/- under medical expenses is not correct, since the claimant has got reimbursement of the medical expenses under the Mediclaim policy. Therefore, prays to set aside the said compensation amount.

9. The facts as set out in the Bombay High Court judgment in Aman Sanjay Tak's case referred to supra, it was urged that the father of the claimant had taken an insurance policy by paying separate premium for the whole family. Under these circumstances, the single bench of the Bombay High Court held that the amount granted under the medical expenses cannot be deducted, from the amount which the appellants are liable to pay as compensation. This order was challenged before the Hon'ble Supreme Court in SLP.No.28706/2023 referred to supra, and the Hon'ble Supreme Court has passed an interim order directing the insurance company to deposit the amount of medical bill before the Mo