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Documents citing The National Insurance Company Ltd vs Akber Badsha on 27 March, 2013

Royal Sundaram Alliance Insurance ... vs Sarath Kumar (Minor) on 3 November, 2017

In the circumstances, the finding of the tribunal awarding compensation of Rs.45,532/- (Rupees forty five thousand five hundred and thirty two only) for treatment expenses is hereby set aside and the matter is remitted to the trial court for fresh consideration in view of the decisions rendered by the apex court in Rajkumar v. Ajay Kumar and Anr. [2011 ACJ 1] and a Division Bench of this Court in National Insurance Company Ltd. v. Akbar Badsha 2015 (4) KLT 442. Both parties are directed to appear before the tribunal on 12.01.2018. The learned tribunal shall dispose of the matter as per law within three months from the date of appearance of the parties.
Kerala High Court Cites 5 - Cited by 0 - Full Document

The New India Assurance Co.Ltd vs Peter.T.S on 29 April, 2013

5. Coming to the factual position involved in this case, the learned counsel appearing for the appellant submits (after getting instructions) that two policies were issued by the company; out of which one was a road safety insurance for a sum of 1,00,000/-, wherein the sum assured was 1,00,000/- towards the personal accident. In respect of the other policy, it was a 'Mediclaim' policy for a value of 50,000/-. The premium collected in respect of the former policy is a sum of 185/-, whereas in the second case it is 1,055/-. Under the first policy, a sum of 1,00,000/- was disbursed and under the second policy, M.A.C.A.No.2270 of 2013 4 reimbursement to the tune of 7,581/- was effected; thus disbursing a total sum of 1,07,581/-. The Tribunal has awarded a total sum of 1.26 lakhs towards the medical expenses and after deducting the sum of 1,07,581/- already effected under the other policies in respect of the same cause of action, the balance payable comes to 18,419/-. By virtue of the law declared by this Court in National Insurance Co. Ltd. v. Akber Badsha (2015 (5) KHC 327) overruling the verdict passed by a learned Single Judge of this Court reported in National Insurance Co. Ltd. v. Bijumon (2011 (2) KLT 20), the amount spent by the party for procuring the concerned mediclaim policy, i.e., the amount remitted as premium is liable to be satisfied by the insurance company. In the instant case, the premium satisfied under the two policies comes to (185+1,055)= 1,240/-. The said amount requires to be added to the actual compensation to be paid to the tune of 18,419/-. M.A.C.A.No.2270 of 2013 5 The figure comes to 19,615/-. The aforesaid amount requires to be satisfied with interest @ 8% per annum. It is made clear that the award passed by the Tribunal stands modified to the said extent.
Kerala High Court Cites 3 - Cited by 0 - P R Menon - Full Document

M/S. The National Insurance Company ... vs M/S. The National Insurance Company ... on 30 April, 2015

7. The sum and substance of the case projected by the appellant/insurer is that, out of the total amount of 2,88,057/- awarded by the Tribunal, admittedly a sum of 90,000/- was settled/obtained under a separate 'mediclaim policy'. The learned counsel for the 1st respondent submits that the said MACA.2370/2015 & Cross Objn.No.183/15 -4- amount was obtained under a different policy, paying separate premium, that too from a different Company and as such, there is nothing wrong on the part of the Tribunal having allowed the said amount as well. But the scope of such contention was meticulously considered by this Court as per decision reported in National Insurance Company Ltd. v. Akber Badsha (2015 (4) KLT 442), whereby the decision rendered by the learned Single Judge in National Insurance Company Ltd. v. Bijumon (2011 (2) KLT 20) was overruled and it was held that the concept of insurance did not contemplate any overlapping payment and the cause of action to the requisite extent alone could be compensated placing the party/victim on the same pedestal, from where he was fallen down because of the mishap/accident. This being the position, this Court finds that the sum of 90,000/- obtained by the claimant is liable to be deducted and only the balance requires to be paid by the appellant/Company. At the same time, the amount paid by the claimant as 'premium' for procuring the 'mediclaim policy' turns to be a loss in so far as the grievance is concerned and as such, MACA.2370/2015 & Cross Objn.No.183/15 -5- the said amount is liable to be repaid by the appellant immediately on production of necessary proof with regard to the actual amount paid for obtaining the said 'mediclaim policy'.
Kerala High Court Cites 2 - Cited by 0 - P R Menon - Full Document

New India Assurance Co. Ltd vs R.Ramesh on 1 February, 2021

15.It is the case of the respondents 3 and 4 in the appeal that the claimant got reimbursement of Rs.1,90,370/- under the Mediclaim policy and the Tribunal failed to deduct the same from the compensation awarded towards medical expenses. From the award of the Tribunal it is seen that the claimant has admitted that he availed reimbursement of Rs.1,90,370/- from the Star Health Insurance. As per the judgment of the Division Bench of the Kerala High Court reported in 2016 ACJ 807 [National Insurance Co. Ltd., Vs. Akber Badsha and others], the claimant is not entitled to the said sum of Rs.1,90,370/-, under the head, medical expenses, which has been reimbursed by the Star Health Insurance. The Division Bench of the Kerala High Court, after considering the judgments on this issue in paragraph nos.12, 15 and 17, held as follows:
Madras High Court Cites 10 - Cited by 0 - V M Velumani - Full Document

The Branch Manager vs Abirami Fathima Marie on 22 February, 2021

13.As far as compensation awarded by the Tribunal for medical expenses is concerned, in support of her claim, the 1st respondent has marked Exs.P6 to P18 to prove the medical expenses incurred by her for treatment. In the said documents, a seal reflecting “Central National de remboursement des Soins à I'Étrangers C.N.S.E” has been affixed. Once the 1st respondent has got reimbursement of the amounts spent for medical treatment, she is not entitled to have the very same amount for the injuries suffered in the accident as that will amount to double payment and 1 st respondent will be unjustly enriching herself. The reimbursement is in the nature of amounts paid under the Medi claim policy. A similar issue was considered by the Division Bench of the Kerala High Court reported in 2016 ACJ 807 [National Insurance Co. Ltd., Vs. Akber Badsha and others], wherein it has been held as follows:
Madras High Court Cites 10 - Cited by 0 - V M Velumani - Full Document

New India Assurance Co. Ltd vs R.Ramesh on 1 February, 2021

15.It is the case of the respondents 3 and 4 in the appeal that the claimant got reimbursement of Rs.1,90,370/- under the Mediclaim policy and the Tribunal failed to deduct the same from the compensation awarded towards medical expenses. From the award of the Tribunal it is seen that the claimant has admitted that he availed reimbursement of Rs.1,90,370/- from the Star Health Insurance. As per the judgment of the Division Bench of the Kerala High Court reported in 2016 ACJ 807 [National Insurance Co. Ltd., Vs. Akber Badsha and others], the claimant is not entitled to the said sum of Rs.1,90,370/-, under the head, medical expenses, which has been reimbursed by the Star Health Insurance. The Division Bench of the Kerala High Court, after considering the judgments on this issue in paragraph nos.12, 15 and 17, held as follows:
Madras High Court Cites 10 - Cited by 1 - V M Velumani - Full Document

The Branch Manager vs Ganesan on 4 October, 2018

?7. The policy issued by the Life Insurance Corporation and similar bodies providing coverage for life , stands entirely on a different footing than the policy issued by General Insurance Companies covering such other risks; whether it be a policy to cover the statutory insurance under the M.V. Act or the policy of insurance issued under the Workmen's Compensation Act (presently the Employees' Compensation Act) or whether it be a Mediclaim policy. In the case of the former, ( i.e. Life Insurance Policies) life of the insured is assured and if there is any threat to the life, it is of course liable to be compensated by the Insurance Company. But satisfaction of the amount covered by such policy does not depend upon occurrence of death/accident and even if nothing happens to the insured, by virtue of the M.A.C.A.No.1623 OF 2013 terms of the policy, the sum assured ( which is inclusive of the premium paid and the bonus assured and accrued) is liable to be paid to the insured, once the term of the policy is over. In other words, if a Life Insurance policy has been taken to an extent of Rs.One lakh, paying the requisite amount of premium, during the period of policy, say 10 years, if nothing happens to the life of the insured, the entire amount covered by the policy, plus bonus accrued and such amounts, if any, as per the terms of the policy will be payable to the insured and as such, it is the vested right of the insured to get the said amount, notwithstanding the fact that no contingency has occurred. If any death occurs in the meanwhile, it goes without saying that the beneficiary will be entitled to get the amount covered by the policy without payment of any further premium, as per the terms of the policy. It is not the position in the case of other policies, i.e. latter group referred to above, issued by General Insurance sector. In the case of latter group of policies, it also is a contract of insurance, subject to payment of premium. It is true that, for obtaining Mediclaim M.A.C.A.No.1623 OF 2013policy as well, various formalities have to be completed by the insured, as to the production of various documents and satisfaction of the premium to the requisite extent. But, so as to make the insured eligible to obtain the amount covered by the policy, the 'contingency' as mentioned in the policy has necessarily to occur, i.e., accident or illness, as the case may be and only subject to suffering the injuries/accident, that the damages/compensation will become due under the said policy. In the case of policy issued under the M.V.Act or Workmen's Compensation Act, occurrence of the accident is a 'sine quo non' so as to make the beneficiaries entitled and eligible to get the amount covered under the policy to the specified extent.
Madras High Court Cites 10 - Cited by 0 - V M Velumani - Full Document

Bharti Axa General Insurance Co. Ltd vs Yogesh Kumar And Ors on 4 July, 2018

Reliance can be placed upon a judgment in Akber Badsha's case (supra), where it has been held that Insurance Company was entitled to set off the amount with respect to the medical bills which were received by the claimant under the medi claim policy. If the claimant keeps the medi claim policy intact than the entire payment of bills has to be reimbursed by the Tribunal but if the claimant chooses to obtain due amount under the medi claim policy than the deduction has to be made to the extent of the premium satisfied under the medi claim policy.
Punjab-Haryana High Court Cites 10 - Cited by 0 - R Bahri - Full Document
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