(1.) The appeal is for seeking compensation for injuries suffered in a motor accident that took place on 21.08.2001. The boy was aged 11 years and he was said to be run over by a tractor in his pelvic region. There had been a pereneal injury and colostomy was done. There had been a fracture of the left ileac bone as well as the fracture right medial epicondytes. He has three spells of treatment from 21.08.2001 to 20.10.2001, 26.11.2001 to 01.12.2001 and 10.12.2001 to 20.12.2001 for a period of 77 days. Discharge summary reveals the nature of surgeries done and the period of hospitalisation as mentioned above. The post operative observations reveal that the patient gone through an uneventful period and discharged on full satisfactory condition. The boy had medi-claim coverage and the amount of Rs.1,70,000/- had been admittedly recovered from the National Insurance Company towards the medical expenses incurred. The Tribunal dismissed the petition holding that since he had been fully covered under the policy and he had the benefit of recoveries, the claim before the Tribunal was not competent.
(2.) The counsel appearing on behalf of the appellant contends that the medi-claim recovered through insurance company cannot be deducted because the amount was paid in consideration for premium paid and the tort feasor or the insurer cannot take the benefit of any recoveries obtained in a medi-claim policy. The further contention is that the Tribunal has failed to make out provision for attendant charges, special diet and transportation which were not covered under the medi-claim policy and had also not properly assessed the claim for damages for pain and suffering.
(3.) A run over of tractor of a small boy over the lower abdominal region ought to have been exceedingly painful and the major surgeries which have been undertaken ought to have extremely painful. Considering the fact that the body had three fractures in the most sensitive areas of the body and he also underwent surgeries on three occasions, I will make a provision for pain and suffering at relatively higher sum of Rs.75,000/-. I will also make provision for attendant charges at Rs. 10,000/-, special diet at another Rs.10,000/- and transportation for Rs.5000/-.