Amount paid under mediclaim policy deductible from motor vehicle accident compensation: Karnataka High Court

Bengaluru: The High Court of Karnataka has ruled that the amount received by the claimant under the mediclaim policy is required to be deducted from the total compensation under the head medical expenses and hospitalisation charges under Motor Vehicles (MV) Act.

Justice Hanchate Sanjeevkumar said this while directing the insurance company to pay a compensation of Rs 4,93,839 along with an interest at 6 per cent per annum to the family members of S Hanumanthappa, after deducting Rs 1.8 lakh received from the Mediclaim policy.

Hanumanthappa, a resident of Marathahalli, Bengaluru city, had met with an accident on December 10­, 2008. While returning to Seva Mandir village from Lepakshi, an autorickshaw dashed against his motorcycle. Hanumanthappa and his wife sustained grievous fractural injuries.

The Hindupur rural police had registered the case and Hanumanthappa moved the Motor Accident Claims Tribunal, Bengaluru seeking compensation. On March 22, 2013, the tribunal awarded Rs 6,73,839 compensation, including Rs 5,24,639 under the head medical expenses.

Challenging this order, the insurer contended that since the claimant had got reimbursement of the medical expenses under the Mediclaim policy, awarding of Rs 5,24,639 under the medical expenses head was not correct.

The court cited the Manish Gupta case of the Karnataka High Court wherein it was held that if the claimant has received reimbursement under the medical expenses and hospitalisation charges, it can be deducted while determining and awarding compensation under the provisions of the MV Act.

“Therefore, in the present case, the amount received by the claimant under the Mediclaim insurance policy is liable to be deducted from the medical expenses, while determining the compensation under the said head. The appellant (insurance company) has produced additional evidence that the claimant has received Mediclaim reimbursement amount of Rs 1.8 lakh from TTK Healthcare TPA Private Limited. This factum is not disputed by the respondents/claimants. Hence, the said additional evidence is allowed. Therefore, the said amount of Rs 1.8 lakh is deducted from the amount of Rs 5,24,639, then it would be Rs 3,44,639 under medical expenses,” the court said.