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2015 Supreme(Ker) 1140

IN THE HIGH COURT OF KERALA
P.R. Ramachandra Menon and K. Harilal, JJ.
National Insurance Company Ltd. – Appellant
Vs.
Akber Badsha – Respondents
M.A.C.A. No. 1623 of 2013
Decided On : 08-09-2015

Advocates:
Advocate Appeared:
For the Appellant : Ziyad Rahman, Lal K. Joseph and V.S. Shiraz Bava
For the Respondents: C.K. Sajeev, Biju Martin and D.M. Nowfal

Headnote:

Motor Vehicles Act 1988 - Sections 166 & 147( 2) - Accident claim - Fixation of quantum of Compensation - Mediclaim policy - Held, very purpose of insurance is to see that un-anticipated risk is covered to the extent necessary, lest there should be any loss to the party concerned because of the unforeseen contingency which occurred during the policy period - if a party sustains damage in respect of a vehicle or was made to spend a certain amount for availing treatment in connection with the injuries and if the said amount is satisfied by the insurer under a separate policy issued is liable to be reckoned for fixing the quantum of compensation payable under the M.V. Act

JUDGMENT :

P.R. Ramachandra Menon, J.

1. This appeal is placed before us by virtue of the 'Reference Order' dated 14.07.2015 passed by the learned single Judge, doubting correctness of the decision rendered by another learned single Judge reported in National Insurance Company Ltd. v. V.S. Bijumon & Ors., (2011 (2) KLT 20), which has been relied on by the Tribunal to decline the relief sought for by the Insurance Company for setting off the amount obtained by the claimant under a separate 'Mediclaim policy' in connection with the same injuries sustained in a road traffic accident. The point to be considered is whether reimbursement of the medical expenses under a 'Mediclaim policy' is liable to be set off from the amount of compensation worked out under S. 166 of the Motor Vehicles Act, in relation to the statutory obligation under S. 147(2) of the Act. Gist of the factual position for the purpose of deciding this issue is that the claimant, while travelling in a car bearing No. KL.07.AX/4114 sustained injuries on 21.01.2008, when the said car collided with a Maruti car bearing No. KL.07.AV.7338, parked on the side of the road, was suddenly taken to the road without any signal. Serious injuries were caused to the claimant, which was sought to be compensated by filing claim petition before the Tribunal. The owner and driver of the Maruti car bearing No. KL.07.AV.7338, sought to remain ex parte. The claim was resisted by the insurance company on different grounds. The Tribunal arrived at a finding that the accident was only because of the negligence on the part of the driver of the Maruti car insured by the appellant. The total compensation payable was worked out as Rs. 99500/-, which was directed to be satisfied by the appellant/insurer of the said car, with interest at the rate of 8% per annum, which is the subject matter of challenge in this appeal.

2. The case of the appellant/Insurer is that, in connection with the injuries sustained to the claimant, a sum of Rs. 78500/- was claimed as medical expenses and that the said amount was already satisfied by the Insurance Company under a separate 'Mediclaim policy' obtained by the claimant, which was sought to be set off. The said proposition was objected by the claimant stating that the said amount satisfied by the insurer was under a separate policy, by virtue of the premium paid by the claimant to meet the eventualities and that the same did not have any connection whatsoever with the statutory liability to be satisfied by the insurer as envisaged under S. 147(2) of the Act. The plea of the insurance company was rejected by the Tribunal relying on the decision rendered by a learned single Judge of this Court reported in 2011 (2) KLT 20 (cited supra).

3. The present matter was argued in detail by both the sides before the learned single Judge, who found it difficult to agree with the proposition in 2011 (2) KLT 20. Doubting the correctness of the said decision, it was observed that the decision sought to be relied on by the learned single Judge in 2011 (2) KLT 20 was more with reference to the amount payable by the Life Insurance Corporation of India, which stood entirely on a different footing. It was also observed that the ruling rendered by the Madhya Pradesh High Court as per the decision in M.P. State Road Transport Corporation v. Priyank, (2000 ACJ 701) referred to therein was actually based on the decision rendered by a Full Bench of the same High Court, which in turn had dealt with the case under a Life Insurance Policy and as such, the matter required a re-look. It was further brought to the notice of the Court that the decision rendered by the Karnataka High Court reported in Shaheed Ahmed v. Sanakaranarayana Bhat (ILR 2008 Kamt. 3277) referred to in the verdict, to the effect that the amount obtained under 'Mediclaim policy' was not liable to be set off in respect of a claim under S. 166 of the M.V. Act, was subsequently doubted by another learned Judge of the Karnataka H




























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