Bengaluru: The Karnataka High Court has clarified that compensation awarded to motor vehicle accident victims under the head of medical expenses and hospitalisation charges must account for any reimbursement received through mediclaim policies.
Case Background
- Incident: On December 10, 2008, S. Hanumanthappa and his wife met with an accident near Srikantapura Lake on Hindupur main road when an autorickshaw collided with their motorcycle. Both sustained fractures and received treatment at multiple hospitals.
- Claim: Hanumanthappa, aged 58, a teacher earning ₹10,000 per month, filed a claim with the Motor Accident Claims Tribunal (MACT), Bengaluru, which awarded a total compensation of ₹6,73,839. This included ₹5,24,639 under medical expenses.
- Insurer’s Appeal: Oriental Insurance Company contested the award, arguing that ₹1.8 lakh received by Hanumanthappa through a mediclaim policy should be deducted from the compensation.
High Court Decision
Justice Hanchate Sanjeevkumar, citing precedents such as the Manish Gupta case, ruled in favor of the insurer:
- Deduction of Mediclaim Reimbursement:
- The ₹1.8 lakh reimbursed under the mediclaim policy from TTK Healthcare TPA must be deducted from the ₹5,24,639 awarded as medical expenses.
- Revised Compensation:
- After the deduction, Hanumanthappa’s medical expenses award was reduced to ₹3,44,639. The total compensation payable was recalculated at ₹4,93,839.
- Interest Payment:
- The revised compensation amount is to be paid along with 6% annual interest.
Legal Implications
- Deduction Principle: The ruling reinforces that any reimbursement under a mediclaim policy must be deducted from compensation under the Motor Vehicles Act to avoid unjust enrichment.
- Clarity for Future Cases: Insurers can now rely on this precedent to ensure fair computation of compensation in similar cases.
Observations
The judgment highlights the importance of transparency in compensation claims and the necessity of considering all financial sources involved in covering medical expenses. It ensures that victims are compensated fairly while preventing overlapping claims.
