Mediclaim amount can’t be deducted from accident claim compensation: HC | Mumbai news

MUMBAI: In an important ruling, a three-judge bench of the Bombay high court has held that the amount received by an accident victim towards health insurance or Mediclaim policy cannot be deducted from the accident claim compensation payable to him or her.

Referring to apex court rulings, the bench comprising justice AS Chandurkar, justice Milind Jadhav and justice Gauri Godse said that the amount received on account of health insurance is due to the contractual obligations entered into by the insured with the insurance company.

“Having paid premium, the beneficial amount would accrue to the share of the deceased either on maturity of the policy or on death, whatever be the manner of death and the tortfeasor (wrong doer – vehicle owner involved in the accident or his insurer) cannot take advantage of the foresight and wise financial investments made by the deceased,” it added while deciding a reference.

The reference was made to the three-judge bench after a single judge bench of the high court, while hearing an appeal filed by New India Assurance Company Ltd, challenging an order of the Accident Claims Tribunal, Mumbai, in an accident claim case, came across judgements of two different benches in which contradictory views were adopted on the issue.

One of the challenges in the appeal was to the refusal by the Tribunal to exclude the medical amount from the clause of medical expenses awarded to the accident victim. During the course of hearing, the insurance company cited a judgement delivered in September 2013 in Dineshchandra Shah’s case, whereas the claimants cited another judgement pronounced in 2006 in Vrajesh Desai’s case in support of their respective claims.

The three-judge bench, after considering apex court rulings on the nature of insurance claims and on the compensation granted under section 166 of the Motor Vehicles Act, held that any amount received by a claimant under a Mediclaim policy or under a medical insurance policy cannot be deducted from the amount of compensation payable to an accident claimant under the head ‘medical expenses’.