Employer-provided medical reimbursement may be deducted from accident compensation, unlike benefits under a claimant-funded Mediclaim policy.

The claimant sustained fractures to the tibia and fibula of his left leg in a road accident on 9 May 2020.

He sought compensation under Section 166 of the Motor Vehicles Act, 1988, stating that he had been employed as a Senior Accounts Executive and had resigned because of his injuries.

The Tribunal awarded him Rs.10,18,934, including compensation for future loss of income based on 10% functional disability, but deducted Rs.1,60,000 in medical expenses reimbursed by his employer.

The claimant appealed under Section 173(1), seeking enhancement, including recognition of the doctor’s disability assessment and reimbursement of the medical expenses

1. Whether the claimant was entitled to enhancement of compensation, including on account of functional disability and amounts awarded under other heads

2. Whether the Rs.1,60,000 in medical expenses reimbursed by the claimant’s employer should be included in the compensation

Sections 166 and 173(1) of the Motor Vehicles Act, 1988, respectively provide for a claim for compensation arising from a motor vehicle accident and an appeal against a Tribunal’s award

Compensation under the Act is guided by the principle of just and fair compensation.

The Court considered New India Assurance Co. Ltd. v. Dolly Satish Gandhi and Another, which held that reimbursement under a Mediclaim policy purchased by a claimant is independent of compensation under the Act and is not to be treated as a “double benefit”

It also noted the claimant’s reliance on V. V. Pradeep v. Avinash Sadakale and Another

The Court distinguished the Mediclaim principle where the medical reimbursement was provided by the claimant’s employer rather than under a policy purchased by the claimant

The Court found that the claimant had not established that his work required long-distance travel or that his injuries prevented him from performing his accounts work while seated.

The employer’s witness also confirmed that the claimant had not been removed for continuous absence, and the evidence showed that he worked after the accident in May 2020.

The Court therefore declined to enhance the compensation based on the doctor’s disability assessment or the asserted resignation

It also rejected the argument that the employer-reimbursed Rs.1,60,000 should be added to the medical expenses, distinguishing the cited Mediclaim decision because the reimbursement here was provided by the employer, not under a policy purchased by the claimant

Although it observed that the Tribunal had awarded less under pain and suffering, loss of amenities, and loss of income during the laid-up period, it found no occasion to reassess those heads in view of the compensation already awarded for future loss of income

The Tribunal’s award of Rs.10,18,934 with interest at 6% per annum remained undisturbed