NATIONAL INSURANCE COMPANY LTD Vs. V S BIJUMON

JUDGEMENT

(1.) This appeal is preferred against the award of the Motor Accidents Claims Tribunal, Thrissur in O.P.(MV)3427/03. The insurance company has come up in appeal challenging the refusal to reduce the amount which the claimant has obtained under the medi-claim policy. The cross objection is filed by the claimant for enhancement of the compensation. It is seen that the 2nd respondent in the claim petition is dead. But since I am going to deal with the substantial question of law and as none of his legal representatives has chosen to come on record or challenge the award, his name is deleted from the party array. It is so done because the insurance coverage is admitted.

(2.) The short question that falls for determination when the amount under the Medical Insurance policy is received whether the claimant is again entitled to claim that amount from the tortfeasor. The learned counsel for the insurance company would contend it amounts to double payment and there will be unjust enrichment and therefore the claimants should not be granted that amount. On the contra the learned counsel for the claimant would contend that medical claim policy is altogether a different contract for which premium has been paid and it covers a wider field and therefore there cannot be any deduction from the amount. The learned counsel for the insurance company had cited two decisions, one United India Insurance Co. Ltd. v. Patricia Jean Mahajan, 2002 AIR(SC) 2607 and the other reported in Helen C. Rebello v. Maharashtra, S.R.T.C., 1999 1 SCC 90. In those cases the Hon'ble Supreme Court was considering the question that when a person has assured his life by insurance and he meets with death and receives the amount under the policy whether that has to be deducted from the compensation that is liable to be paid under the M.V.Act. The Hon'ble Supreme Court held that in such cases it is an independent contract and irrespective of the question whether it is an accidental death or a natural death legal representatives will be entitled to claim the amount and therefore on that account deduction cannot be allowed. In the Hon'ble Supreme Court held that,

(3.) The first decision I find is the decision of the Madhya Pradesh High Court , (Madhya Pradesh State Road Trans. Corpn. and another v. Priyank, 2000 ACJ 701) where the question of deduction of the amount from medical claim was considered. The Division Bench of the Madhya Pradesh High Court negatived the contention holding that this amount could not be deducted as it was paid to the claimant under a contract of insurance for which he had paid premium. This was based upon a decision of the Full Bench of the same Court . In that decision the Full Bench considered various headings like life insurance, Provident Fund, Gratuity etc. and held with respect to the life insurance as follows.