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2018 Supreme(P&H) 2633
IN THE HIGH COURT OF PUNJAB AND HARYANA
Before
Hon’ble Mr. Justice Anil Kshetarpal
FAO No.4755 of 2016 (O&M)
ICICI Lombard General Insurance Company Ltd.
v.
Harminder Singh Rosha & Ors
{Decided on 17/08/2018}
Mr. Ashit Malik, Advocate with Ms. Savita Rana, Advocate for appellant (In FAO No.3590 of 2016) and for respondent No.1 (In FAO Nos.4755 and 4759 of 2016)
Accident – Medical Expenses – Amount received as a reimbursement on account of personal mediclaim policy towards the medical expenses including hospitalization charges, shall be liable to be adjusted
Accident – Disability – Functional disability would always depend on the nature of work injured was capable of carrying
Headnote:(A) Motor Vehicles Act, 1988, S.166 – Accident – Medical Expenses – Amount received as a reimbursement on account of mediclaim policy towards the medical expenses including hospitalization charges, shall be liable to be adjusted while calculating the compensation payable on account of medical expenses – At the most, the claimant(s), can be held entitled to the premium paid for purchasing the mediclaim policy because that was the amount which was invested by the injured or the deceased, as the case may be, so as to secure. (Para 16)
The basis purpose of enacting the provisions for grant of compensation under the Motor Vehicles Act is to compensate the injured or to compensate the legal heirs for the loss which they have suffered on account of accident. However, such compensation cannot result in either unjust enrichment or bonanza for the injured or the legal heirs. The claimant cannot be allowed to make a fortune out of a misfortune. The Motor Vehicles Act, does not provide for double payment. As per Section 168 of the Motor Vehicles Act, 1988, Motor Accident Claims Tribunal is to determine the amount of compensation which appears to it to be just. Just would obviously mean what is reasonable. The entire effort of the Court should be to compensate the injured in the case of injury or the legal heirs in the case of death and not to give bonanza to the claimant(s). (Para 15)
(B) Motor Vehicles Act, 1988, S.166 – Accident – Damage to Vehicle – Amount received by the claimant(s) for damage to the vehicle from his own insurance company, is also liable to be adjusted as the claimant cannot be allowed to make a fortune out of a misfortune and it cannot result in bonanza or double to the claimant(s). (Para 18)
(C) Motor Vehicles Act, 1988, S.166 – Accident – Disability – Functional disability would always depend on the nature of work injured was capable of carrying. (Para 34)
(D) Motor Vehicles Act, 1988, S.166 – Accident – Disability – Functional Disability – Injured was working as an Insurance Agent (Advisor) as well as imparting education to the students by doing tuition work – After the date of accident, she is not able to continue with the aforesaid work – Functional disability held to be rightly considered as 75%. (Para 32)
Mr. Anil Kshetarpal, J. - Arguments were heard. Judgment was reserved. The judgment is being released.
2. By this common judgment, four appeals, three filed by the Insurance Company and one filed by the Injured-Claimant arising from one accident resulting in filing of three claim petitions disposed of by a common judgment shall stand decided.
3. In the considered opinion of this Court, two issues which need determination, are as follows:-
1. Whether an amount received by the injured-claimant or legal heirs of the deceased towards reimbursement of hospital charges on account of its own mediclaim policy, is liable to be adjusted while adjudicating the compensation payable under the head of medical expenses?
2. Whether an amount received by the insured from his own Insurance Company on account of damage to the vehicle, is liable to be adjusted while calculating the amount of compensation payable or not? Let us first take the issue No.1:-
4. Arguments have been heard in detail from the learned counsel for the parties. Both the learned counsels have relied upon the various judgments passed by the different Courts taking divergent views. Hence, it has become necessary to deliberate on the issues in detail.
5. Learned counse.3l appearing on behalf of the injured, while relying upon the judgments passed by Hon’ble the Supreme Court in the case of Helen C. Rabello Vs. Maharashtra State Road Transport Corporation, (1999) 1 SCC 90 and by this Court in the case of Manoj Kumar Yadav Vs. Azad and others, 2015(3) Punjab Law Reporter 211, has submitted that the amount received by the injured on account of mediclaim policy purchased by him or her cannot be adjusted, as this would amounts to giving the benefit to the wrong doers. The Motor Accident Claims Tribunal has also relied upon the judgments passed by the Gujarat High Court in the case of Gujarat State Road Transport Corporation Vs. Hargovindas R. Modi and others, AIR 2007 (Gujarat) 39, and by the Kerala High Court in the case of National Insurance Company Limited Vs. Bijumon, 2012(1) RCR (Civil) 325, to take a view that the aforesaid amount reimbursed to the claimant-injured is not liable to be adjusted while calculating the damages payable.
6. On the other hand, learned counsel for the Insurance Company while relying upon the judgment of this Court in CWP No.9763 of 2015, decided on 19.09.2016, titled as National Insurance Company Limited Vs. Shashank Bhardwaj and another, reported as 2017(2) PLR 29, contends that such amount reimbursed by the Insurance Company to the claimant-injured, is liable to be adjusted, as the injured-claimant cannot be given double benefit. She also relied upon another judgment passed by this Court in the case of Vishal Vs. Bugga Singh and others, 2016(3) Punjab Law Reporter 51.
7. Let us first carefully examine the judgment of Hon’ble the Supreme Court in Helen C. Rabello’s case (supra).
8. On careful examination of the judgment passed by Hon’ble the Supreme Court, it is apparent that Hon’ble the Supreme Court was dealing with the amount received by the legal heirs under a life insurance policy on the death of the policy holder in an accident. Hon’ble the Supreme Court has held that the life insurance policy is purchased for variety of reasons including investment so as to secure the future by way of forced saving. In India, even insurance policies are purchased for entitlement of deduction towards income tax liability. Life insurance policies are also purchased to secure a loan to cover the risk in the case of untoward incident happening. In para 17 of the judgment, the Court dealt with the reasons why the insurance policy is purchased. Thereafter in para 29 of the judgment, Hon’ble the Supreme Court dealt with the provisions of Motor Vehicles Act, 1939 and ultimately concluded that if the pecuniary advantage resulting from death is interpreted
