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

The Karnataka High Court has emphasized that compensation for medical expenses awarded under the Motor Vehicles (MV) Act must be adjusted to reflect any reimbursements received through mediclaim insurance policies.

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

The court ordered a deduction of Rs. 1.8 lakh, which had already been reimbursed through a mediclaim policy. Hanumanthappa, a resident of Marathahalli, Bengaluru, suffered severe injuries in a road accident on December 10, 2008, when an autorickshaw collided with his motorcycle while he was returning to Seva Mandir village from Lepakshi. His wife, who was riding with him, was also injured.

Following the accident, the Hindupur Rural Police registered a case, and Hanumanthappa subsequently filed a claim with the Motor Accident Claims Tribunal in Bengaluru.

On March 22, 2013, the tribunal awarded him Rs. 6,73,839 in compensation, which included Rs. 5,24,639 for medical expenses.

Challenging this award, the insurance company contended that the Rs. 1.8 lakh reimbursement under a mediclaim policy should be deducted from the compensation awarded for medical expenses. The court agreed, citing a precedent set in the Manish Gupta case, which established that amounts reimbursed through mediclaim must be factored into the final compensation calculation.

The court noted that since the mediclaim reimbursement was undisputed, it warranted deduction from the medical expenses. Consequently, after recalculating, the compensation for medical expenses was revised to Rs. 3,44,639, bringing the total compensation to Rs. 4,93,839.

This judgment underscores the principle that double compensation for the same medical expenses cannot be allowed. It reinforces the legal precedent that compensation must reflect actual expenses incurred by the claimant after accounting for any insurance reimbursements. With this clarification, the court has ensured equitable compensation while avoiding unjust enrichment.

The Karnataka High Court’s decision highlights the importance of accurate compensation calculation in motor accident claims and provides clarity on the treatment of mediclaim reimbursements in such cases. The ruling is expected to guide future adjudications under the MV Act, ensuring consistency in the application of legal principles.

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