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2019 Supreme(Bom) 247

IN THE HIGH COURT OF JUDICATURE AT BOMBAY
N.J. Jamadar, J.
Royal Sundaram Alliance Insurance Co. Ltd. - Appellant
Vs.
Sarojani Naidu And Other - Respondents
First Appeal No. 1620 of 2012 along With Civil Application No. 4005 of 2012
Decided On : 19-03-2019

Advocates Appeared:
For the Appellant :Mr. Mehta I/b KMC Legal Venture, Advocate
For the Respondent:Mr. T.J. Mendon, Advocate

The court established the principle that the insurer's statutory liability under the Motor Vehicles Act, 1988, prevails over the contractual liability under a medical insurance policy, and the reimbursement of medical expenses should not be deducted from the compensation payable under the Act.

Headnote:

Motor Accident Claims Tribunal - Motor Vehicles Act, 1988 - Section 166 - Section 147 - Third Party Liability - Medical Insurance - Compensation - Double Benefit

Fact of the Case:

The case involved a motorcycle accident where the applicant sustained multiple injuries, including a grievous injury to the right forearm with fracture of ulna, resulting in 70% disability. The Motor Accident Claims Tribunal (MACT) awarded compensation to the applicant, which was challenged by the insurer in appeal.

Finding of the Court:

The court found that the accident occurred due to negligence of the driver of the dumper, and the insurer was liable to pay the compensation. The court also held that the reimbursement of medical expenses under a mediclaim policy should not be deducted from the compensation payable under the Act.

Issues: The issues included the liability of the insurer, the admissibility of medical expenses, and the possibility of recovering the amount from the insured for breach of policy conditions.

Ratio Decidendi: The court interpreted the statutory liability of the insurer under the Motor Vehicles Act, 1988, and the contractual liability under the medical insurance policy. It held that the insurer was liable to pay the compensation and that the reimbursement of medical expenses should not be deducted from the compensation payable under the Act.

Final Decision: The appeal was dismissed, and the court upheld the MACT's award of compensation to the applicant.

JUDGMENT :

N.J. JAMADAR, J.

1. Admit.

2. With the consent of the counsels for the parties, heard finally.

3. This appeal is directed against the Award dated 2nd May 2012 passed by the learned Member, Motor Accident Claims Tribunal, Mumbai (MACT) in Application No. A.25/2007, under Section 166 of the Motor Vehicles Act, 1988 (hereinafter referred to as ‘the Act’ for short).

4. The parties are, hereinafter, referred to in the capacity in which they were arrayed before the MACT.

5. Shorn of superfluities, the background facts leading to this appeal can be stated as under :-

On 18th October 2006, at about 11:00 am., the applicant (respondent No.1 herein) was riding a motorcycle on his way to Chembur from Dadar, Mumbai. When he came near T-Junction, the Dumper bearing No.MH06-CG-164, owned by the opponent No.1 and insured with the opponent NO.2(the appellant herein) came from behind in a high speed. The driver of the dumper drove it in a rash and negligent manner and gave dash to the applicant from behind. The applicant sustained multiple injuries including a grievous injury to the right forearm with fracture of ulna. The right forearm of the applicant was thus amputed. The applicant, thus, approached MACT and claimed compensation of Rs.7 lakhs.

6. The Tribunal, after appraisal of the evidences adduced and documents tendered, came to the conclusion that the accident occurred due to negligence of the driver of the offending Dumper. The applicant suffered grievous injury and 70% disability on account of traumatic amputation of right forearm. Thus, the Tribunal awarded compensation as under :”

“Treatment expenses

Rs. 1,20,000/-

Conveyance

Rs. 3,000/-

special diet

Rs. 2,000/-

loss of income

Rs. 36,000/-

pain and suffering

Rs.1,00,000/-

Disability

Rs. 2,01,600/-

Loss of amenities of life

Rs. 40,000/-

Total

Rs. 5,02,600/-”

7. Being aggrieved by and dissatisfied with the aforesaid award, the insurer came in appeal.

8. I have heard Shri Mehta, the learned counsel appearing for the appellant and Shri Mendon, the learned counsel for respondent No.1applicant.

9. The learned counsel for the appellant advanced a two-pronged submission. Firstly, it was urged that the Tribunal committed a manifest error in fastening the liability upon the insurer without properly appreciating the nature of the contract of insurance. It was submitted that the contract, under which the opponent No.1 was insured, was Contractor's Plant and Machinery Policy. Thus, the liability of the insurer was limited to the incidents which occurred within the precincts of the plant. In the case at hand, the accident had occurred on a public road and was not at all covered by the contract of insurance. Secondly, the Tribunal was not justified in awarding the compensation under the head of treatment expenses (Rs.1,20,000/-), without there being any documentary evidence to substantiate the same. As a second limb of this submission, it was urged that, the Tribunal arrived at the said sum of Rs.1,20,000/-on the basis of the amount reimbursed to the applicant under a mediclaim policy. Thus, the applicant was unjustifiably allowed a double benefit, i.e., statutory, under terms of the policy in question, and contractual, in terms of the policy under which the applicant had insured himself, for one and the same expenses.

10. In contrast to this, the learned counsel for the respondent No.1 urged that none of the aforesaid challenges to the impugned award merit countenance. The learned counsel for the respondent No.1 would submit that it is indubitable that the accident arose out of the use of a motor vehicle and, thus, the Tribunal had competence to award the compensation. The Dumper in question falls within the definition of ‘motor vehicle’ under Section 2(28) of the Act. Thus, the fact that the accident occurred on the public road cannot be a gr
























































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