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2012 Supreme(Mad) 4924

IN THE HIGH COURT OF MADRAS, MADURAI BENCH
R. Subbiah, J.
Cholamandalam Ms. General Insurance Co. Ltd. – Appellant
Versus
A. Saravanan and Another – Respondents
C.M.A. (MD) No. 18 of 2011
Decided On : 16-03-2012

Advocates Appeared:
For the Appellant : S. Srinivasa Raghavan
For the Respondent: T. Selvakumaran

The main legal point established in the judgment is that the claimant is not entitled to double compensation, and the amount received from another insurance company should be deducted from the compensation awarded.

Headnote:

Medical Expenses - Motor Accidents Claims - [Motor Vehicles Act, 1988, Section 166] - The court discussed the issue of deducting medical expenses already reimbursed by another insurance company from the compensation awarded. The court referred to judgments in Mrs. Helen C. Rebello and Others Vs. Maharashtra State Road Transport Corpn. and Another, (1999) 1 SCC 90, and United India Insurance Co. Ltd. Vs. Patricia Jean Mahajan and Others Etc. Etc., (2002) 6 SCC 281, to establish that the claimant is not entitled to double compensation and that the amount received from another insurance company should be deducted from the compensation awarded. The court reduced the awarded medical expenses from Rs. 2,88,100 to Rs. 88,100, confirming the rest of the award.

Fact of the Case:

The appellant insurance company challenged the award passed by the Motor Accidents Claims Tribunal regarding the medical expenses incurred by the injured in a motor vehicle accident.

Finding of the Court:

The court found that the medical expenses already reimbursed by another insurance company should be deducted from the compensation awarded, reducing the awarded medical expenses from Rs. 2,88,100 to Rs. 88,100.

Issues: The main issue was whether the medical expenses awarded by the Tribunal, which had been reimbursed by another insurance company, should be deducted from the compensation.

Ratio Decidendi: The court relied on legal principles established in previous judgments to conclude that the claimant is not entitled to double compensation and that the amount received from another insurance company should be deducted from the compensation awarded.

Final Decision: The civil miscellaneous appeal was allowed, and the appellant insurance company was directed to deposit the modified amount of Rs. 1,83,100 with 7.5 per cent interest. The awarded medical expenses were reduced from Rs. 2,88,100 to Rs. 88,100, and the rest of the award was confirmed. No costs were awarded, and connected M.Ps. were closed.

JUDGMENT :

R. Subbiah, J.

Challenging the award dated 8.9.2010 passed by the Motor Accidents Claims Tribunal (Chief Judicial Magistrate Court), Karur, in M.C. O.P. No. 52 of 2009, Cholamandalam MS General Insurance Co. Ltd. has filed the present appeal. At the outset, the learned counsel for the appellant insurance company fairly submitted that the present appeal is filed questioning a sum of Rs. 2,88,100 awarded by the Tribunal towards the medical expenses incurred by the injured.

2. According to the respondent No. 1-claimant, he made a claim for a sum of Rs. 7,00,000 as compensation for the injuries sustained by him in the accident that had occurred on 29.11.2008 involving the vehicle insured with the appellant insurance company. The Tribunal, after analysing the entire evidence, has passed an award for a sum of Rs. 3,83,100 consisting of the sum of Rs. 2,88,100 towards the medical expenses incurred by the victim.

3. With regard to the medical expenses awarded to the victim, it is the case of the appellant insurance company that a sum of Rs. 2,00,000 has already been reimbursed to the claimant by Star Health Insurance Company under the mediclaim policy and, as such, the claimant is not entitled to claim the same once again from the appellant insurance company. Therefore, respondent No. 1 is not entitled for the amount which was reimbursed by Star Health Insurance Company. The learned counsel further submitted that in the claim petition, the respondent No. 1 had claimed a sum of Rs. 2,50,000 towards medical treatment; and he has also produced documentary evidence before the Tribunal, marked as Exhs. P9 to P13 and P17, to show that he had spent a sum of Rs. 2,88,100 towards medical treatment. But before the Tribunal, the appellant insurance company had taken a stand that the amount of Rs. 2,00,000 spent for medical expenses was reimbursed by Star Health Insurance Company under mediclaim policy and, therefore, he is not entitled for the entire expenses incurred towards medical treatment. But the Tribunal without assigning any valid reason has awarded the entire sum of Rs. 2,88,100 towards medical treatment. Therefore, the said amount awarded under the medical treatment is liable to be deducted from the award amount. In support of his contentions, learned counsel relied on the judgments in Mrs. Helen C. Rebello and Others Vs. Maharashtra State Road Transport Corpn. and Another, (1999) 1 SCC 90, and United India Insurance Co. Ltd. Vs. Patricia Jean Mahajan and Others Etc. Etc., (2002) 6 SCC 281,

4. Per contra, the learned counsel for the respondent No. 1-claimant submitted that the amount reimbursed by Star Health Insurance Company cannot be deducted while awarding the compensation because the amount was paid by Star Health Insurance Company under the contract of insurance, for which he has paid the premium. In support of this contention, the learned counsel relied on the decisions in Mrs. Helen C. Rebello and Others Vs. Maharashtra State Road Transport Corpn. and Another, (supra) and Vrajesh Navnitlal Desai Vs. K. Bagyam and Another, (supra)

5. In view of the submissions made by the learned counsel appearing on either side, the question that has arisen for consideration in this appeal is, whether the amount awarded by the Tribunal towards medical expenses incurred by the respondent No. 1, having been reimbursed by Star Health Insurance Company under a mediclaim policy, is liable to be deducted?

6. On a perusal of the award, I find that the Manager of Star Health Insurance Company, PW 4, has stated in his evidence that Rs. 2,00,000 had been paid to Kovai Medical Centre Hospital towards the medical expenses incurred by the injured since the victim, being a government employee, was covered by Star Health Insurance Company. It is the contention of the respondent No. 1-claimant that the amount reimbursed by Star Health Insurance Company cannot be deducted from the award amount because the reimbursement was under the contract of insurance, f







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