# United India Insurance Co. Ltd v. Sonu Kumar & Ors

- **Citation:** (2026) 1 ILRA 1407
- **Court:** High Court of Judicature at Allahabad
- **Decided:** 2026-01-20
- **Case number:** First Appeal from Order No. 103 of 2026
- **Bench:** Sandeep Jain
- **Source:** https://unisonlegal.in/judgment/allahabad-high-court/united-india-insurance-co-ltd-v-sonu-kumar-ors-54051
- **Pages:** 12

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1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1407

17. Therefore, in view of facts of this case as noted above, viz. continuance of appellant-writ
petitioner for considerable period of 7 years coupled with the fact that the respondent authority
could not lay any foundation of fraud and manipulation practised by appellant-writ petitioner to
secure the appointment and further error of judgement if any (in computing the correct age of the
petitioner) was of the respondents, that aspect may have escaped the attention of the learned Single
Judge. To the extent, an error on principle may have been caused in the order of the learned Single
Judge, thus, the instant Special Appeal as well as Writ Petition deserve to be partly allowed. The
order dated 08.05.2025 passed by Writ Court, which is impugned herein as well as the order dated
28.10.2023 passed by respondent no.3, Basic Shiksha Adhikari, Moradabad are set-aside.

18. In order to balance equities in facts of this case, we direct that the appellant shall be
permitted to continue to hold the post in question, but she shall not be entitled to the payment of
salary for the period she has not performed her duties/ remained out of service.

19. A copy of this order may also be kept with the record of the writ petition.

20. No order as to costs.
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(2026) 1 ILRA 1407
APPELLATE JURISDICTION
CIVIL SIDE
DATED: ALLAHABAD 20.01.2026

BEFORE

THE HON'BLE SANDEEP JAIN, J.

First Appeal from Order No. 103 of 2026

United India Insurance Co. Ltd. ...Appellant
Versus
Sonu Kumar & Ors. ...Respondents

Issue for Consideration
(i) Whether the finding of contributory negligence recorded by the Tribunal required interference on the basis
of site plan and material on record;
(ii) Whether the amount reimbursed to the claimant under a mediclaim policy was liable to be deducted from
the compensation awarded under the Motor Vehicles Act, 1988.

Headnotes
Motor Vehicles Act, 1988 - Accident - Negligence - Contributory negligence - Evidentiary
value of site plan:

Held: The question of negligence is to be determined on the basis of evidence adduced before the Tribunal
and not merely on the basis of site plan prepared in criminal proceedings - Mere reliance on site plan to infer
manner of accident or negligence is impermissible - Even if the claimant was overtaking from the left side, it
cannot by itself establish contributory negligence - In absence of cogent evidence, contributory negligence
cannot be enhanced - The finding of the Tribunal on contributory negligence was not liable to be interfered
with in absence of cross appeal by the claimant. [Paras 14-15]
1408 INDIAN LAW REPORTS ALLAHABAD SERIES
Motor Vehicles Act, 1988 - Compensation - Medical expenses - Mediclaim policy - Deduction
- Permissibility:

Held: Amount received by the claimant under a mediclaim policy is not liable to be deducted from the
compensation awarded under the Motor Vehicles Act - Such amount is received under a contract of insurance
for which premium has been paid and has no nexus with statutory compensation payable by the tortfeasor -
It cannot be treated as pecuniary advantage for the purpose of deduction - The Tribunal rightly refused to
deduct the reimbursed amount from compensation. [Paras 23-24]

Motor Vehicles Act, 1988 - Compensation - Reimbursement - Double benefit:

Held: Where only part of the treatment expenses has been reimbursed under mediclaim policy and original
bills are produced before the Tribunal, there is no question of double reimbursement - The claimant cannot
be denied compensation on the ground of partial reimbursement under a separate contract of insurance. [Para
22]

Motor Vehicles Act, 1988 - Appeal - Interference - Scope:

Held: In absence of any illegality or perversity in the findings of the Tribunal and no other issue having been
pressed, the appeal preferred by the Insurance Company was devoid of merit and liable to be dismissed at the
admission stage. [Paras 25-27]

Appeal dismissed. (E-14)

Case Law Cited
National Insurance Co. Ltd. v. Akber Badsha, 2016 (1) TAC 305 (Ker) - referred to; ICICI
Lombard General Insurance Co. Ltd. v. Rajani Sahoo, (2025) 2 SCC 599 - relied on; Ranjeet v.
Abdul Kayam Neb, 2025 SCC OnLine SC 497 - relied on; Jiju Kuruvila v. Kunjujamma Mohan,
(2013) 9 SCC 166 - relied on; Prabhavati v. Managing Director, BMTC, 2025 SCC OnLine SC 455
- relied on; Prem Lal Anand v. Narendra Kumar, (2024) 9 SCC 441 - relied on; New India
Assurance Co. Ltd. v. Dolly Satish Gandhi, 2025 SCC OnLine Bom 752 - relied on.

List of Acts / Statutes
Motor Vehicles Act, 1988; Indian Penal Code, 1860

List of Keywords
Motor accident; Contributory negligence; Site plan; Evidence; Mediclaim policy; Medical expenses; Deduction;
Pecuniary advantage; Compensation.

Case Arising From
Judgment and award dated 08.10.2025 passed by the Motor Accident Claims Tribunal, Ghaziabad in M.A.C.P.
No. 108 of 2018 (Sonu Kumar vs. Sachin Joshi and others.

Appearance for Parties
For the Appellant: Sri Sushil Kumar Mehrotra
For the Respondents: -.
(Delivered by Hon'ble Sandeep Jain, J.)

1. The instant appeal has been filed by the insurer of the offending Fortuner vehicle No.DL-1N-8711 under Section 173 of the Motor Vehicles Act, 1988 against the impugned judgment and
award dated 08.10.2025 passed by the Motor Accident Claims Tribunal, Ghaziabad in M.A.C.P.
No.108 of 2018 (Sonu Kumar vs. Sachin Joshi and others), whereby for the injuries sustained by
1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1409
the claimant in a road accident that occurred on 04.12.2017, a compensation of Rs.5,20,100/- along
with interest @ 7.5% per annum has been awarded to the claimant, which has been ordered to be
indemnified by the insurer of the above offending vehicle No.DL-1-N-8711.

2. Learned counsel for the appellant-Insurance Company submitted that the claimant was
driving his motorcycle No.UP-14-BP-4276 in a rash and negligent manner at the time of the
accident, who tried to overtake the offending Fortuner vehicle from the left side, which was
impermissible. Learned counsel submitted that the accident occurred due to the sole negligence of
the claimant, but the Tribunal has concluded that the claimant was having only 30% contributory
negligence in the accident, which was erroneous. Learned counsel submitted that in the facts and
circumstances and keeping in view the site plan prepared in the criminal case as well as the oral
evidence on record, it was proved that the accident occurred due to the sole negligence of the
claimant. It was further submitted that the claimant was reimbursed for the expenses of treatment,
since he was having a mediclaim policy, but the Tribunal has ignored this fact and has held that the
reimbursment made to the claimant in pursuance of his mediclaim policy was not liable to be
deducted from the compensation payable to the claimant, which is erroneous. Learned counsel in
support of his submission relied upon the case law of National Insurance Company Limited vs.
Akber Badsha, 2016 (1) T.A.C. 305 (D.B. Kerala). It was further submitted that since the claimant
has already been reimbursed the medical expenses, since he was having a mediclaim policy, as
such, if again, he is reimbursed the expenses of medical treatment, then it will amount to bonanza,
which is impermissible. With these submissions, it was prayed that the appeal be admitted for
hearing.

3. I have heard learned counsel for the appellant and perused the impugned judgment and
documents submitted with the appeal.

4. The claimant Sonu Kumar examined himself as PW-1 and Vinod Kumar as PW-2, whereas
the claim petition was not contested by the owner and driver of the offending vehicle and it was
decided ex-parte against them. Further, the Insurance Company has not led any oral evidence.

5. PW-1 deposed that on 04.12.2017 at about 12:30 p.m., he was driving his motorcycle No.
UP-14-BP-4276 from Pari Chowk, Noida to Jewar. When he reached ahead of Kheda Bridge and
was crossing the canal bridge, his motorcycle was hit from behind by vehicle No. DL-1-N-8711,
which was being driven in a rash and negligent manner, as a result of which he suffered grievous
injuries. He was taken, with the help of other persons and the police, to Kailash Hospital, Jewar for
treatment. He further deposed that an F.I.R. regarding the accident was registered at Police Station
Rabupura, District Gautambuddhnagar, being Case Crime No. 283 of 2017, under Sections 279,
337, 338, and 427 I.P.C.

6. In his cross-examination, he deposed that he was hit by the offending vehicle from behind,
that he was driving his motorcycle on his left side of the road, and that the offending vehicle did
not blow the horn. He further deposed that after the accident he became unconscious, and while in
an unconscious state, he was admitted to Kailash Hospital, Jewar, from where he was referred to
Kailash Hospital, Sector-27, Noida. He further deposed that the F.I.R. was lodged by his brother on
04.12.2017.
1410 INDIAN LAW REPORTS ALLAHABAD SERIES

7. PW-2 Vinod Kumar is the person, who registered the F.I.R. regarding the accident, who is
the brother of the claimant, who admitted in cross-examination that he was not an eye witness of
the accident and had merely registered the F.I.R. on the basis of what was told to him by the
claimant.

8. It is apparent that the owner and driver of the offending vehicle have not contested the claim
petition, which has been decided ex-parte against them and further they have not appeared in the
witness box to contradict the claim. It is further evident that even the insurer has not led any
independent evidence to contradict the claim and after investigation in the criminal case, a charge
sheet has been submitted against the offending driver Sachin Joshi, under Sections 279, 337, 338
and 427 I.P.C. on which cognizance has been taken by a competent criminal court.

9. The Apex Court in the case of ICICI Lombard General Insurance Company Limited vs.
Rajani Sahoo and Others (2025) 2 SCC 599, has held as under:-

"8. As regards the reliability of charge-sheet and other documents collected by the police
during the investigation in motor accident cases, this Court in Mangla Ram v. Oriental Insurance
Co. Ltd. [(2018) 5 SCC 656 : (2018) 3 SCC (Civ) 335 : (2018) 2 SCC (Cri) 819 : 2018 INSC 311] ,
held in para 27, thus : (SCC p. 672)

"27. Another reason which weighed with the High Court to interfere in the first appeal
filed by Respondents 2 and 3, was absence of finding by the Tribunal about the factum of
negligence of the driver of the subject jeep. Factually, this view is untenable. Our understanding of
the analysis done by the Tribunal is to hold that Jeep No. RST 4701 was driven rashly and
negligently by Respondent 2 when it collided with the motorcycle of the appellant leading to the
accident. This can be discerned from the evidence of witnesses and the contents of the charge-sheet
filed by the police, naming Respondent 2. This Court in a recent decision in Dulcina Fernandes
[Dulcina Fernandes v. Joaquim Xavier Cruz, (2013) 10 SCC 646 : (2014) 1 SCC (Civ) 73 : (2014)
1 SCC (Cri) 13] , noted that the key of negligence on the part of the driver of the offending vehicle
as set up by the claimants was required to be decided by the Tribunal on the touchstone of
preponderance of probability and certainly not by standard of proof beyond reasonable doubt.
Suffice it to observe that the exposition in the judgments already adverted to by us, filing of
charge-sheet against Respondent 2 prima facie points towards his complicity in driving the
vehicle negligently and rashly. Further, even when the accused were to be acquitted in the
criminal case, this Court opined that the same may be of no effect on the assessment of the
liability required in respect of motor accident cases by the tribunal."

9. It is true that the Tribunal had looked into the oral and documentary evidence
including the FIR, final report and such other documents prepared by the police in connection with
the accident in question. The Tribunal had also taken note of the fact that based on the final report,
the driver of the offending truck was tried and found guilty for rash and negligent driving. The
High Court took note of such aspects and found no illegality in the procedure adopted by the
Tribunal and consequently dismissed the appeal.

10. In the contextual situation it is relevant to refer to a decision of this Court in Mathew
Alexander v. Mohd. Shafi [(2023) 13 SCC 510 : 2023 INSC 621] , this Court held thus : (SCC p.
514, para 12)
1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1411

"12. ? A holistic view of the evidence has to be taken into consideration by the Tribunal
and strict proof of an accident caused by a particular vehicle in a particular manner need not be
established by the claimants. The claimants have to establish their case on the touchstone of
preponderance of probabilities. The standard of proof beyond reasonable doubt cannot be applied
while considering the petition seeking compensation on account of death or injury in a road traffic
accident. To the same effect is the observation made by this Court in Dulcina Fernandes v.
Joaquim Xavier Cruz [(2013) 10 SCC 646 : (2014) 1 SCC (Civ) 73 : (2014) 1 SCC (Cri) 13] which
has referred to the aforesaid judgment in Bimla Devi [Bimla Devi v. Himachal RTC, (2009) 13
SCC 530 : (2009) 5 SCC (Civ) 189 : (2010) 1 SCC (Cri) 1101] .?

11. Thus, there can be no dispute with respect to the position that the question regarding
negligence which is essential for passing an award in a motor vehicle accident claim should be
considered based on the evidence available before the Tribunal. If the police records are available
before the Tribunal, taking note of the purpose of the Act it cannot be said that looking into such
documents for the aforesaid purpose is impermissible or inadmissible.

12. It is also a fact that the appellant had attributed that the respondent claimants
connived with police and fraudulently prepared the charge-sheet. The contention is that the vehicle
insured with the appellant was not involved in the accident and the accident had occurred solely
due to the rash and negligence on the part of the deceased. But the evidence on record would
reveal that pursuant to the filing of the final report, cognizance was taken for rash and negligent
driving which resulted in the death of Udayanath Sahoo."
(emphasis supplied)

10. The Apex Court in the case of Ranjeet and another vs. Abdul Kayam Neb and another
2025 SCC OnLine SC 497, has held as under:-

"4. It is settled in law that once a charge sheet has been filed and the driver has been
held negligent, no further evidence is required to prove that the bus was being negligently driven
by the bus driver. Even if the eyewitnesses are not examined, that will not be fatal to prove the
death of the deceased due to negligence of the bus driver."
(emphasis supplied)

11. The Apex Court in the case of Jiju Kuruvila & Ors. vs. Kunjujamma Mohan & Ors.
(2013) 9 SCC 166, held as under:-

"20.5. The mere position of the vehicles after accident, as shown in a scene mahazar,
cannot give a substantial proof as to the rash and negligent driving on the part of one or the other.
When two vehicles coming from opposite directions collide, the position of the vehicles and its
direction, etc. depends on a number of factors like the speed of vehicles, intensity of collision,
reason for collision, place at which one vehicle hit the other, etc. From the scene of the accident,
one may suggest or presume the manner in which the accident was caused, but in the absence of
any direct or corroborative evidence, no conclusion can be drawn as to whether there was
negligence on the part of the driver. In absence of such direct or corroborative evidence, the Court
cannot give any specific finding about negligence on the part of any individual.

20.6. The post-mortem report, Ext. A-5 shows the condition of the deceased at the time of
death. The said report reflects that the deceased had already taken meal as his stomach was half-
1412 INDIAN LAW REPORTS ALLAHABAD SERIES
full and contained rice, vegetables and meat pieces in a fluid with strong smell of spirit. The
aforesaid evidence, Ext. A-5 clearly suggests that the deceased had taken liquor but on the basis of
the same, no definite finding can be given that the deceased was driving the car rashly and
negligently at the time of accident. The mere suspicion based on Ext. B-2 ?scene mahazar? and
Ext. A-5 post-mortem report cannot take the place of evidence, particularly, when the direct
evidence like PW 3 (independent eyewitness), Ext. A-1 (FIR), Ext. A-4 (charge-sheet) and Ext. B-1
(FI statement) are on record."

12. The Apex Court in the case of Prabhavati & Ors. vs. Managing Director, Bangalore
Metropolitan, Transport Corporation 2025 SCC OnLine SC 455, held as under:-

"10. We are unable to agree with the view taken by the High Court on the 25%
contributory negligence of the deceased and 75% upon the driver of the bus. We find ourselves to
agree with the view taken by the Tribunal on this issue. The Tribunal rightly, after considering the
evidence on record and on perusal of the Ex. P3 Spot Mahazar, came to the conclusion that there
wasn't any sufficient evidence on record, indicating that the accident occurred due to negligent
driving on the part of the deceased, and after considering the oral evidence of P.W.1, held the
cause of the accident to be rash and negligent on the part only of the offending vehicle.

11. Thus, in our considered view, the contributory negligence taken by the High Court at
25% of the deceased is erroneous. We advert to the principles laid down in Jiju Kuruvila v.
Kunjujamma(supra) where it was held that in the absence of any direct or corroborative evidence
on record, it cannot be assumed that the accident occurred due to the rash and negligent driving of
both the vehicles. This exposition came to be followed in Kumari Kiran v. Sajjan Singh (2015) 1
SCC 539. In the present case, therefore, on an allegation simpliciter, it cannot be presumed that
the accident occurred due to rash and negligent driving of both vehicles, for having driven at high
speed."

13. The Apex Court in the case of Prem Lal Anand & Ors. vs Narendra Kumar & Ors.
(2024) 9 SCC 441, held as under:-

13. In the attending facts and circumstances, merely because a person was attempting to
overtake a vehicle, cannot be said to be an act of rashness or negligence with nothing to the
contrary suggested from the record. Further, it is the appellant claimants who lost a member of
their family. Not only was the appellant-claimant, Prem Lal Anand doing an act which is an
everyday occurrence on the road that is overtaking a vehicle, but resultantly suffered extensive
injuries himself. That apart, it has also been proved that the offending vehicle was driven rashly
and negligently. These two factors taken together lead us to the conclusion that the finding of
contributory negligence against Appellant 1 was erroneous and unjustified. Consequently,
compensation awarded on this count has to be revised.
(emphasis supplied)

14. It is apparent from the impugned judgment that the Tribunal has considered the site plan
prepared in the criminal case, which disclosed that the accident occurred on Yamuna Expressway,
when the claimant was trying to overtake the offending vehicle from the left side. The Tribunal
concluded that from the technical inspection report of the Fortuner vehicle, it was evident that its
1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1413
left side rear light, rear bumper, rear side and rear wind glass was damaged whereas, the front
mudguard, headlight, both indicator and both side mirror of the motorcycle was damaged in the
accident and on this basis, the Tribunal concluded that the accident occurred when the claimant was
trying to overtake the Fortuner from the left side and it collided from the rear side of the offending
vehicle. In these circumstances, the Tribunal concluded that there was contributory negligence in
the ratio of 30:70 of the claimant and the driver of the Fortuner, which is an erroneous finding
because the Tribunal was not supposed to decide the factum of contributory negligence on the basis
of site plan prepared in the criminal case.

15. It is well settled that merely on the basis of site plan, it cannot be inferred how an accident
occurred and what was the negligence of a particular driver in the accident. It is well settled that the
claim petition is to be decided on the basis of evidence adduced before the Tribunal, but the
Tribunal has been unnecessarily influenced in this case from the site plan. Even if, it is assumed
that the site plan was disclosing the correct factual position, even then, judicial notice of this fact
can be taken that accident occurred on Yamuna Expressway on which it is permissible for the
vehicles to overtake from the left side of another vehicle, as such, merely on this ground that the
claimant was trying to overtake the Fortuner vehicle from left, it cannot be inferred that there was
contributory negligence on the part of the claimant, who was driving his motorcycle at the time of
the accident. On Expressway, the drivers are supposed to remain vigilant and a vehicle can
overtake from both the left and right side, as such, the driver of the Fortuner vehicle should have
been vigilant when the claimant was trying to overtake his vehicle from the left and should not
have swerved his vehicle towards the left, which caused the accident and had the Fortuner driver
kept his vehicle straight, the accident may not have occurred. Be that as it may, since the claimant
has not filed any cross appeal to challenge the conclusion of contributory negligence on his part, as
such, merely on the basis of site plan, the quantum of contributory negligence attributed to the
claimant, cannot be increased any further.

16. It is further evident that the claimant claimed that he has spent an amount of Rs.6,47,572/-
in his treatment, for which he remained admitted in Kailash Hospital, Noida. The claimant in his
cross-examination deposed that he has spent about Rs.15 lacs on his treatment and also admitted
that an amount upwards of Rs.4,00,000/- has been reimbursed to him because he was having a
mediclaim policy with an Insurance Company. It is pertinent to mention here that the claimant has
neither filed any disability certificate nor Tribunal has awarded any compensation towards it.

17. Before the Tribunal also it was submitted on behalf of the learned counsel for the
Insurance Company that since a payment of about Rs.4,00,000/- has been made to the claimant on
account of having a mediclaim policy, as such, he was not entitled to get this amount but this
contention of the Insurance Company was rejected by the Tribunal on the ground that since the
claimant paid premium towards the mediclaim policy under a contract, as such, the amount
reimbursed to him on account of that policy cannot be adjusted from the compensation payable to it
by the Insurance Company.

18. This Court is required to examine whether the above reasoning of the Tribunal is correct or
not?
1414 INDIAN LAW REPORTS ALLAHABAD SERIES

19. The Division Bench of the Kerala High Court in National Insurance Company Limited
vs. Akber Badsha (supra) has considered the issue of reimbursement of medical expenses made to
the claimant and has concluded that if a party has obtained only a lesser amount under a mediclaim
policy taken by him by paying premium separately, then the balance amount, if any, can be claimed
in a claim petition to be preferred before the Tribunal with reference to the statutory coverage. It
was held by the Division Bench that if a portion of the sum assured under the mediclaim policy had
already been satisfied, the claimant will be entitled to coverage only in respect of the balance sum
assured during the remaining period/tenure of the policy. It was further held that if the claimant
meets with any other accident or suffers from any other disease, in the meanwhile, he cannot aspire
anything more.

20. In the above referred case, both the policies i.e. the insurance of the offending vehicle and
the mediclaim policy were issued by one and the same Insurance Company and since the Insurance
Company had already made a payment of Rs.78,418/- towards the treatment expenses, as claimed
under the mediclaim policy, it was pleaded by the Insurance Company that it was not required to
pay the above amount twice and it should be set off. It is further evident that the claimant failed to
submit original bills before the tribunal, since they were already submitted to the insurance
company in the mediclaim.

21. A Full Bench of the High Court of Bombay in New India Assurance Company Limited
vs. Dolly Satish Gandhi and another, 2025 SCC Online Bom 752, has considered whether the
amount received by a claimant under a mediclaim policy or under a medical insurance policy is
liable to be deducted from the amount of compensation payable to a claimant under the head
medical expenses in proceedings under Section 166 of the Motor Vehicles Act, 1988 and has come
to the following conclusion:

10. In Helen C. Rebello [(1999) 1 SCC 90], a Bench of two learned Judges of the
Supreme Court considered the question as to whether the life insurance money received on account
of a demise of the insured was liable to be deducted from the amount of compensation that the
claimants - family members were entitled to receive under the Act of 1939. After referring to
various decisions including the decision in Bradburn (supra), it was held that the amount of
insurance is payable only on the contingency referred to in the contract and if the contingency of
injury or death does not happen, the insured is the gainer as it receives more under premium than
to pay on maturity of the policy. In case the contingency occurs, the claimant is the gainer as he
receives the amount even before paying the full premium and the gain is to the proportion of the
balance unpaid premium, whether on account of injury or death. In paragraph 35 of the said
decision, it has been observed as under:-

"35............Similarly, life insurance policy is received either by the insured or the heirs
of the insured on account of the contract with the insurer, for which the insured contributes in the
form of premium. It is receivable even by the insured if he lives till maturity after paying all the
premiums. In the case of death, the insurer indemnifies to pay the sum to the heirs, again in terms
of the contract for the premium paid. Again, this amount is receivable by the claimant not on
account of any accidental death but otherwise on the insured's death. Death is only a step or
contingency in terms of the contract, to receive the amount. Similarly any cash, bank balance,
shares, fixed deposits, etc. though are all a pecuniary advantage receivable by the heirs on account
1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1415
of one's death but all these have no corelation with the amount receivable under a statute
occasioned only on account of accidental death. How could such an amount come within the
periphery of the Motor Vehicles Act to be termed as ?pecuniary advantage? liable for deduction.
When we seek the principle of loss and gain, it has to be on a similar and same plane having nexus,
inter se, between them and not to which there is no semblance of any corelation. The insured
(deceased) contributes his own money for which he receives the amount which has no corelation to
the compensation computed as against the tortfeasor for his negligence on account of the accident.
As aforesaid, the amount receivable as compensation under the Act is on account of the injury or
death without making any contribution towards it, then how can the fruits of an amount received
through contributions of the insured be deducted out of the amount receivable under the Motor
Vehicles Act. The amount under this Act he receives without any contribution. As we have said, the
compensation payable under the Motor Vehicles Act is statutory while the amount receivable under
the life insurance policy is contractual."

11. In Patricia Jean Mahajan [(2002) 6 SCC 281], after referring to the decision in
Helen C. Rebello (supra), it was held that the amount received on account of social security must
have a nexus or relation with the accidental injury or death, for being deductible from the amount
of compensation. The amount received on account of an insurance policy of the deceased cannot be
deducted from the amount of compensation though a receipt of the insurance amount was
accelerated due to premature death of the insured. This decision was also rendered by a Bench of
two learned Judges.

12. In Sebastiani Lakra [(2019) 17 SCC 465], the aforesaid two decisions were
considered by a Bench comprising of three learned Judges. After considering the provisions of
Section 168 of the M.V. Act which required payment of "just compensation" to the claimants, it
was held in paragraphs 12 and 13 as under:-

"12. The law is well settled that deductions cannot be allowed from the amount of
compensation either on account of insurance or on account of pensionary benefits or gratuity or
grant of employment to a kin of the deceased. The main reason is that all these amounts are earned
by the deceased on account of contractual relations entered into by him with others. It cannot be
said that these amounts accrued to the dependents or the legal heirs of the deceased on account of
his death in a motor vehicle accident. The claimants/dependents are entitled to ?just
compensation? under the Motor Vehicles Act for death of the deceased in a motor vehicle accident.
Therefore, the natural corollary is that the advantage which accrues to the estate of the deceased
or to his dependents as a result of some contract or act which the deceased performed in his
lifetime cannot be said to be the outcome or result of the death of the deceased even though these
amounts may go into the hands of the dependents only after his death.

13. As far as any amount paid under any insurance policy is concerned, whatever is
added to the estate of the deceased or his dependents is not because of the death of the deceased
but because of the contract entered into between the deceased and the insurance company from
where he took out the policy. The deceased paid premium on such life insurance and this amount
would have accrued to the estate of the deceased either on maturity of the policy or on his death,
whatever be the manner of his death. These amounts are paid because the deceased has wisely
invested his savings. Similar would be the position in case of other investments like bank deposits,
shares, debentures, etc. The tortfeasor cannot take advantage of the foresight and wise financial
investments made by the deceased."
1416 INDIAN LAW REPORTS ALLAHABAD SERIES

From the aforesaid decisions, it is now clear that the amount received on account of
insurance is due to the contractual obligations entered into by the insured with others. Having paid
premium it was clear that the beneficial amount would accrue to the share of the deceased either
on maturity of the policy or on death, whatever be the manner of death. The tortfeasor cannot take
advantage of the foresight and wise financial investments made by the deceased. This is the settled
position of law.

13. In Dineshchandra Shantilal Shah (supra), the learned Single Judge was considering
an appeal filed by the New India Assurance Company wherein the award passed by the Tribunal
was under challenge. Before the Tribunal it was noted that an amount of Rs. 5,14,286/- towards
compensation included the amount of reimbursement that was granted under a mediclaim policy of
the claimant. It was urged by the insurer that the amount received under the mediclaim policy was
liable to be deducted from the total amount of compensation as the claimant had already been
reimbursed the said amount. After referring to the judgment of the Delhi High Court in National
Insurance Company Ltd. v. R.K. Jain, 2012 SCC OnLine Del 3303 (MSE Appeal No. 346/2010
decided on 2nd July 2012) and on the basis of ratio of the decisions of the Supreme Court in Helen
C. Rebello and Patricia Jean Mahajan (supra), it was held that the amount received by the
claimant under the mediclaim policy was liable to be deducted from the total amount of
compensation.

In our considered opinion, a deduction of the amount received under a mediclaim policy
by the claimant could not be directed to be so deducted in the light of the law laid down in
Sebastiani Lakra (supra) after considering the ratio of the decisions in Helen C. Rebello and
Patricia Jean Mahajan (supra). As held therein, the amount under a mediclaim policy is received
in view of a contract entered into by the claimant with the insurance company and the same is
received in view of the terms of the contract. It is thus clear that the ratio of the decision in
Dineshchandra Shantilal Shah (supra) does not indicate the correct legal position.

14. We may note that the Karnataka High Court in Manish Gupta (2013 ACJ 2478)
considered a reference made to the Division Bench as to whether the amount received under a
mediclaim policy could be deducted from the total amount of compensation awarded under Section
168 of the M.V. Act. It was held that the amount received by a claimant under a mediclaim policy
was required to be deducted from the total amount of compensation received by the claimant under
the head ?medical expenses?. It was further held that if no amount was received under the
mediclaim policy, the Tribunal was then required to assess the amount spent by the claimant
towards medical expenses and grant such amount with respect to the bills produced. Similarly if
the amount awarded under a mediclaim policy was less than the actual amount spent by the
claimant towards medical expenses, the shortfall or the balance was required to be made good by
the tortfeasor.

15. The Division Bench of the Kerala High Court in Akber Badsha (supra) also
considered a similar reference made to the Division Bench as regards permissibility of deduction
of the amount received by the claimant under a mediclaim policy. After referring to various
decisions including the judgment of the Karnataka High Court in Manish Gupta (supra), a similar
view was taken that such deduction of the amount received under a mediclaim policy from the total
amount of compensation was permissible.

In our view, in the light of the decision in Sebastiani Lakra (supra), the deduction of any
amount received by a claimant under a mediclaim policy would not be permissible. We are
1 All. United India Insurance Co. Ltd. Vs. Sonu Kumar & Ors.
1417
therefore not in a position to agree with the view taken by the Karnataka High Court and the
Kerala High Court in the aforesaid two decisions.

16. Various learned Single Judges have taken the view that any amount received under a
medicalim policy is not liable to be deducted from the amount of compensation awarded under the
head "medical expenses". Such view as taken in Vrajesh Navnitlal Desai, Ajit Chandrakant Rakvi,
Anjana Nileshkumar Parmar, Vaswati Samiran Ganguly, Suryakant Uttam Gaude and Aman
Sanjay Tak (supra) is consistent with the view taken by the Supreme Court in Sebastiani Lakra
(supra) that no such deduction of the amount of mediclaim from the amount of compensation
awarded is permissible. It is not necessary for us to refer to various other decisions rendered by
learned Single Judges that have consistently taken the view that the amount received under a
mediclaim policy is not liable to be deducted from the amount of compensation awarded under
Section 168 of the M.V. Act. In our view, the legal position has been correctly laid down in the
aforesaid decisions of this Court.

17. We may also refer to the judgment of the Division Bench of the Calcutta High Court
in New India Assurance Company Ltd. v. Bimal Kumar Shah, 2019 ACJ 1532 in this regard.
Dipankar Datta, J. (as His Lordship then was) in his concurring opinion held that what a victim
gets from his mediclaim policy is the return for making payment of premiums. It is the hard-earned
money that he puts in towards premium which is thereafter returned to him upon happening of an
accident. The return that a victim receives from his insurer on a claim arising out of a mediclaim
policy in the circumstances is consolation money. To consider such benefit as a benefit received
from other sources while determining the amount of compensation would be a narrow minded
approach, not intended in the best interest of the victim. He therefore observed that the money
received by an accident victim as return for money invested by him ought not to be comprehended
as a benefit received and therefore the question of the victim being doubly benefited did not and
could not arise. We are in respectful agreement with the aforesaid view as taken after referring to
the decisions in Helen C. Rebello and Patricia Jean Mahajan (supra).

18. In the light of the foregoing discussion, we are of the considered opinion that the
question as framed ought to be answered in the negative. Thus, any amount received by a claimant
under a mediclaim policy or under a medical insurance policy is not liable to be deducted from the
amount of compensation payable to a claimant under the head "medical expenses" in proceedings
under Section 166 of the M.V. Act.

22. It is further evident that the claimant deposed in his cross-examination that about Rs.15
lacs was incurred by him on his treatment, but only Rs.4 lacs was reimbursed to him under the
mediclaim policy. It is apparent that there is a shortfall of about Rs.11 lacs in the treatment
expenses reimbursed to him. It is further evident that the claimant has submitted original bills
before the tribunal, which itself proves that they were not submitted previously in the mediclaim.
For claiming reimbursement in mediclaim, original bills are required and once they are submitted
in the mediclaim, they cannot be submitted again before the tribunal. From these facts, it is
apparent that the claimant was not going to be reimbursed twice, in any manner whatsoever.

23. It is apparent there there was a contract of insurance between the claimant and the
Insurance Company regarding mediclaim policy for which a premium was paid by the claimant and
in pursuance of that contract of insurance, the claimant was indemnified in respect of the expenses
incurred by him on his treatment, which was not at all relevant for assessment of compensation in a
1418 INDIAN LAW REPORTS ALLAHABAD SERIES
claim case, which is based on statutory liability. From the above decisions of the Apex Court and
different High Courts, it is evident that any amount reimbursed to the claimant on account of
insurance due to the contractual obligations entered into with others, having paid premium, it was
not liable to be deducted from the statutory compensation payable under the Motor Vehicles Act,
1988 because it cannot be termed to be a pecuniary advantage.

24.