Indian Kanoon - Search engine for Indian Law

24. Here, the appellant insurance company urges that whatever money the victim received upon settlement of his Mediclaim policy, prior to the impugned award, should be deducted from the compensation determined to be payable to him under the head 'reimbursement of medical expenses'. Let me now consider, on the basis of my own understanding of the law, how far such a claim is justified without being unduly troubled by the divergent opinions expressed by the different high courts of the country on the point. Decisions having been rendered either way, the view I propose to take would find some support from some of them. I place on record that there is no decision of the Supreme Court directly on the point and hence the slate is clean.

25. The Mediclaim policy bought by the victim from an insurer led to an insurance contract between the two and both bound themselves by the terms and conditions of such policy. The same envisaged an assured amount in favour of the victim upon a contingency of the nature covered by the policy happening, and thereby to indemnify the victim. The liability under the policy was purely contractual. It is common knowledge that unless premiums ~ either monthly, bi-monthly, quarterly, half- yearly, annually or even one-time, as the case may be ~ are paid by the insured, the insurer would not in the first place settle his claim and indemnify the insured. Premiums must have been paid, resulting in the insurer settling the claim of the victim. The liability under the insurance contract, upon the accident happening, was discharged by the insurer. The contract between the parties, thus, worked itself out. It is this amount of money, i.e., Rs.1,50,000/-, which the insurer paid to the victim that has triggered the appellant insurance company to urge this Court to deduct such amount from the compensation awarded by the tribunal.

26. On the flip side, there is an insurance policy that was bought by the owner of the offending motor vehicle from the appellant insurance company in terms whereof the appellant insurance company agreed to indemnify the owner of any liability arising out of an accident involving the use of his insured motor vehicle. This was obviously a statutory liability.

27. The argument of Mr. Singh was that compensation that is determined under Section 168 of the Act of 1988 should not be a bonanza for the victim and care must be exercised to ensure that the victim does not receive 'double benefit'. True it is, the tribunals/high courts should guard against determination of just compensation which would amount to a bonanza for an accident victim or his family. But, at the same time, is it not the duty of the tribunals/high courts to determine just compensation in a manner that an insurance company, which is under a statutory liability to pay, does not escape the rigours of paying compensation and thus evade its obligation under the contract of insurance that exists between it and the owner of the offending vehicle? Should such an insurance company despite receiving premiums from the insured to indemnify him be allowed to achieve gains merely because the victim of the accident has received some money out of faithful discharge of contractual liability by another insurance company? The answers to the aforesaid questions cannot be in favour of the insurance company which is under a statutory liability to pay. One should not forget that what the victim gets from his Mediclaim policy is the return for making payment of premiums. It is the hard earned money that he puts in, in insurance business as premium, that is returned to him upon happening of an accident. The money received, thus, does not come free. In most cases, the accident and its aftermath are not only heart breaking for the victim but may also result in severe physical disability to him. To lead a paralysed life, is sometimes more painful than death itself. Such an accident victim may ask "why me"? The return that he receives from his insurer on the claim arising out of Mediclaim policy is consolation money, in the circumstances. To consider such return as a benefit received from other sources while determining compensation, to my mind, would be an approach of a narrow-mind, not intended in the best interests of the victim who might be left high and dry, battling for the rest of his life to survive only on the compensation money. I hold that any money received by an accident victim as return for money invested by him ought not to be comprehended as a benefit received and, therefore, question of the victim in this case being doubly benefitted does not and cannot arise.