Amount Reimbursed Under Mediclaim Policy Can't Be Deducted From Compensation Payable By Offending Vehicle's Insurer: Bombay High Court

Justice Shivkumar Dige upheld an award by the Motor Accident Claims Tribunal to an accident victim who received medical reimbursement under his father’s Mediclaim policy.

“The Appellant/Insurance Company cannot claim deduction of the amount for which separate premium was paid by different person under different contractual liability. The Appellant/Insurance Company is liable to indemnify the contractual liability between them and owner of offending vehicle. So, the amount received under contractual liability is different amount of medical reimbursement, it cannot be deducted from the amount which the appellants are liable to pay as compensation”, the court held.

In March 2014, one Aman Tak was proceeding on a motorcycle along with a friend. A motor dumper collided with the motorcycle resulting in injuries to the motorcycle riders.

Tak claimed that he suffered partial permanent disability of neurological nature and has difficulty in walking, memory loss, and difficulty in maintaining balance.

The Motor Accidents Claim Tribunal awarded him a compensation including medical expenses of Rs. 14,44,314/-. Reliance General Insurance, the insurer of the offending dumper, challenged the award in the present appeal.

Advocate Shalini Shankar for Reliance contended that the claimant has received medical reimbursement of Rs.12,17,592/- from another insurance company under the Mediclaim policy. Thus, he is not entitled to receive medical reimbursement from Reliance. The amount received under the Mediclaim policy has to be deducted from the compensation amount, Shankar contended.

Advocate Jitendra P. Gor for the claimant Aman Tak submitted that the policy was taken by Tak’s father for the family and on that basis he received the medical reimbursement.

The court noted that the claimant’s father paid separate premium for the Mediclaim policy while the owner of the offending vehicle paid premium to his insurance company.

The court said that the contractual liability between the accident victim and another insurance company is different from the contractual liability between owner of offending vehicle and its insurance company. The two contractual liabilities cannot be held at an equal footing, the court held.

Therefore, the vehicle’s insurance company cannot claim deduction of the amount received by the victim under separate insurance, the court held and dismissed the appeal.

Case no. – First Appeal No. 1051 Of 2022

Case Title – Reliance General Insurance Co. Ltd. v. Aman Sanjay Tak and Anr.