“Mediclaim Reimbursement To Be Deducted From Accident Compensation”: Karnataka HC

The Karnataka High Court has reiterated the necessity for compensation awarded under the Motor Vehicles (MV) Act to account for prior reimbursements received through Mediclaim insurance policies.

Justice Hanchate Sanjeevkumar delivered this ruling while directing the insurance company to compensate the family of S. Hanumanthappa with Rs. 4,93,839, subject to a 6% annual interest rate.

In this case, the court mandated a deduction of Rs. 1.8 lakh, an amount already reimbursed through a mediclaim policy. Hanumanthappa, a resident of Marathahalli, Bengaluru, sustained severe injuries in a road accident on December 10, 2008, when his motorcycle was struck by an autorickshaw while en route to Seva Mandir village from Lepakshi. His wife, who accompanied him, was also injured in the collision.

Subsequent to the incident, the Hindupur Rural Police registered a case, prompting Hanumanthappa to file a compensation claim before the Motor Accident Claims Tribunal in Bengaluru.

On March 22, 2013, the tribunal awarded a total compensation of Rs. 6,73,839, which included Rs. 5,24,639 specifically allocated for medical expenses.

The insurance company challenged this award, arguing that the Rs. 1.8 lakh reimbursed under a mediclaim policy should be deducted from the compensation granted for medical expenses. The court concurred with the insurer’s contention, referencing a prior judgment in the Manish Gupta case, which established the legal precedent that compensatory awards must exclude amounts already reimbursed through insurance mechanisms.

Acknowledging the undisputed nature of the mediclaim reimbursement, the court proceeded to deduct the reimbursed amount from the compensation initially awarded for medical expenses.

Consequently, the revised compensation for medical expenses was recalculated at Rs. 3,44,639, resulting in a total compensation of Rs. 4,93,839.

This judicial pronouncement underscores a critical legal doctrine: claimants cannot receive dual compensation for the same expense. By adhering to this principle, the court reinforces the notion that compensation should equitably reflect the actual financial burden borne by the claimant, thereby precluding instances of unjust enrichment.

Furthermore, the Karnataka High Court’s ruling elucidates the methodology for calculating compensation in motor accident claims, particularly concerning the interplay between statutory compensation and insurance reimbursements.

This judgment is poised to serve as a guiding framework for future cases adjudicated under the MV Act, fostering consistency in the interpretation and application of pertinent legal standards.

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