The amount received by an accident victim under a mediclaim policy must be deducted from the total compensation under the head of medical expenses and hospitalisation charges, Karnataka HC has held based on Motor Vehicles Act.
Justice Hanchate Sanjeev Kumar directed Oriental Insurance Company to pay Rs 4.93 lakh along with interest of 6 per cent a year to the family of S Hanumanthappa, a resident of Marathahalli in Bengaluru, after deducting Rs 1.8 lakh he had received from mediclaim. Hanumanthappa and his wife were travelling on a bike on Dec 10, 2008 when an autorickshaw dashed against them. He suffered fractures and was treated in various hospitals.
He moved the Motor Accident Claims Tribunal, Bengaluru. He claimed he was aged about 58 years, working as a teacher, and was drawing a salary of Rs 10,000 per month. On March 22, 2013, the tribunal awarded Rs 6.7 lakh, including Rs 5.2 lakh under the head of medical expenses.
The insurer challenged the order, contending that Rs 5.2 lakh medical expenses was not correct, as Hanumanthappa got mediclaim reimbursements earlier.
Justice Sanjeev Kumar cited another Karnataka HC case in which the court had held that if the claimant got his medical expenses reimbursed, they can be deducted from accident compensation.
“Therefore, in the present case, the amount received by the claimant under mediclaim is liable to be deducted from medical expenses while determining the compensation under the said head. The appellant (insurer) has produced evidence that the claimant received a mediclaim reimbursement amount of Rs 1.8 lakh. This fact is not disputed by the respondents/claimants,” the judge said. The HC ordered a deduction of Rs 1.8 lakh from Rs 5.2 lakh awarded as medical expenses to Hanumanthappa, determining the payout under this head at Rs 3.4 lakh.
