United India Insurance Co. Ltd. v. Anjana w/o. Nileshkumar Parmar
2012-02-01
MRIDULA BHATKAR
body2012
DigiLaw.ai
JUDGMENT :- Admit. Heard by consent of the parties on the issues. 2. The Appeal is filed by the Insurance Company against the award passed by the Motor Accident Claims Tribunal, Dadra and Nagar Haveli, Silvassa, awarding compensation of Rs.21,40,400/- (Twenty One lakhs Forty Thousand and Four Hundred Only) on account of injuries sustained in the vehicular accident. In this Appeal, the Insurance Company has challenged the amount of compensation to the tune of Rs. 5 Lakhs and has not challenged the remaining amount of compensation. 3. The Original Applicant i.e. the Opponent who was proceeding on a scooter in the morning of 1st December, 2006 from Silvassa to Bhoyapada, Masant Raod, met with an accident. A truck bearing Registration No.DN-09-8469 came in a rash and negligent manner from the back side and dashed against the scooter of the Applicant. She sustained serious injuries like injuries to abdomen and back, pelvic fracture and abrasions all over the body of the Applicant. She filed claim for Rs. 36,35,072/-. After recording the evidence of the witnesses examined, the Tribunal allowed the claim for Rs. 21,40,400/-. The hus1.'and of the Applicant was working as a Manger in Reliance Industries Ltd. and there is a facility of Group Insurance Hospitalization Policy from the Company. Under the said scheme, total coverage ofRs.5 lakhs per annum is to be paid in such accident cases. In the present case amount ofRs.5 lakhs was paid by the Company of the husband of the Applicant. Hence, in the Appeal, the Appellant Insurance Company challenges the award to the tune of RS.5 lakhs and prays that it should be deducted from the compensation amount. 4. Learned Counsel for the Appellant-Insurance Company submits that one Mr. Vinit Vishnu Dugal was examined as a Court witness. He stated that he was working as a Head of Human Resources Department in the Reliance Industries Limited, Silvassa. He was examined on the point of facility of Group Hospitalization Policy for the employees of the Company. Learned Counsel submitted that at the time of cross-examination of this witness, he was not cross-examined by the Original Claimant on the point of reimbursement of the said medical claim of Rs.5 lakhs.
He was examined on the point of facility of Group Hospitalization Policy for the employees of the Company. Learned Counsel submitted that at the time of cross-examination of this witness, he was not cross-examined by the Original Claimant on the point of reimbursement of the said medical claim of Rs.5 lakhs. It was submitted that subsequent to the evidence of this witness, the Applicant amended the pleadings in the original claim and it was contended that amount of Rs.5 lakhs which was contributed by the Company is recoverable advance. Learned Counsel submits that this should have been put in the cross-examination to the witness, as such, the case was not made out by the Applicant in the cross-examination of the witness. The Tribunal has erred in awarding compensation of Rs.5 lakhs which was paid under the Group Hospitalization Insurance Policy. 5. Per contra, learned Counsel for the original Applicant states that this amount of Rs. 5 Lakhs is recoverable subsequently as it is paid as an advance by the Company. It is pointed out that the payment of Rs. 5 lakhs is conditiona1. If the Applicant leaves service or retires from service, this amount is deductible from the final settlement amount. Learned Counsel in support of his contention, has relied on a decision of this High Court in the case of Vrajesh Navnitlal Desai v/s. K. Bagyam and another reported in 2006 ACJ 65 . 6. In this Appeal, whether amount of Rs.5 lakhs from the total amount of compensation awarded is to be deducted as it is paid under the Group Hospitalization Policy by the employer of the husband of the Applicant or not, is the issue? In the judgment of the Tribunal, the evidence of Vinit Vishnu Dugal is extensively dealt with. Though he was not cross-examined on the point of deduction of the amount of medical reimbursement of Rs.5 lakhs, the Applicant has amended the pleadings in the original Application below Exhibit-40 and it is made clear that the amount of Rs.5 lakhs is deductible or recoverable at the time of settlement of retirement dues. So, at present, the Applicant's burden of RS.5 lakhs though seems to be reduced, will be a future burden and, therefore, the addition amount of Rs.5 lakhs, in the compensation amount is a correct view taken by the Tribunal.
So, at present, the Applicant's burden of RS.5 lakhs though seems to be reduced, will be a future burden and, therefore, the addition amount of Rs.5 lakhs, in the compensation amount is a correct view taken by the Tribunal. Reliance is placed on paragraph 4 of the case of Vrajesh Desai (supra) on the point of deduction of the reimbursement of medical expenses from the compensation. Paragraph 4 of the said decision is reproduced as follows :- "4. He further contended that the Tribunal, while awarding the compensation, came to the conclusion that the medical expenses incurred by the appellant were to the tune of Rs.46,000/-. However, the Tribunal has wrongly deducted Rs. 29,000/- which the claimant received as medical reimbursement. He has relied upon the judgment of Madhya Pradesh High Court in Madhya Pradesh State Road Trans. Corpn. v. Priyank, 2000 ACJ 701 (MP). The issue before the court was similar, whether the medical reimbursement can be deducted from the compensation payable and Madhya Pradesh High Court answered the issue in the negative, i.e. that amount cannot t e deducted because it is paid to him und r the contract of insurance for which he had paid premiums. I do not find any reason to take any different stand in this matter. The judgment is directly applicable to the facts and circumstances of the present case." 7. In view of the above, there is no merit in this Appeal and no case is made out to interfere with the impugned order passed by the Tribunal. Hence, the Appeal is dismissed. Appeal dismissed.