Medical expenses reimbursed under a health insurance policy cannot be deducted from motor accident compensation.

The claimant sustained an open fracture of the ulna and radius in a road traffic accident on 17 March 2022 involving a car allegedly driven rashly and negligently by respondent No. 1.

The Tribunal awarded ₹1,95,846, including ₹20,000 for pain and suffering, ₹20,000 for loss of amenities, ₹15,000 for loss of earnings during treatment, and ₹93,846 in medical expenses; it disallowed a further ₹1,80,623 in medical expenses on the ground that the claimant had received reimbursement from Star Health Insurance.

The claimant appealed under Section 173(1) of the Motor Vehicles Act, 1988, seeking enhancement.

1. Whether the compensation awarded for pain and suffering, loss of amenities, and loss of income during the laid-up period required enhancement in view of the claimant’s injuries.

2. Whether medical expenses reimbursed under the claimant’s health insurance policy could be deducted from the compensation payable.

Section 173(1) of the Motor Vehicles Act, 1988, provides for an appeal against an award of the Motor Accident Claims Tribunal.

The Court relied on New India Assurance Company Limited v. Dolly Satish Gandhi and another, 2026 LiveLaw (SC) 504, for the rule that medical expenses reimbursed under a separate insurance policy cannot be deducted when assessing compensation for accident-related medical expenses.

The Court also assessed compensation by reference to the proved injuries, period of treatment and recovery, and medical expenses.

Given the claimant’s open fractures, the Court found the Tribunal’s awards for pain and suffering and loss of amenities inadequate, increasing them to ₹80,000 and ₹60,000 respectively.

It considered two months’ rest appropriate and awarded ₹31,000 for loss of income during the laid-up period.

It upheld the ₹47,000 awarded for attendant, conveyance, food, and nourishment expenses, having regard to the 23-day hospital admission.

Applying the cited Supreme Court decision, it included the ₹1,80,623 reimbursed by the claimant’s health insurer in the medical-expense award, bringing total medical expenses to ₹2,74,469.

The Court fixed total compensation at ₹4,92,469, an enhancement of ₹2,96,623 over the Tribunal’s award.

The enhanced sum carries interest at 6% per annum from the date of the claim petition until realization, except for the 330-day delay period in filing the appeal. The insurer was directed to deposit the enhanced compensation with interest before the Tribunal within six weeks, and the claimant was permitted to withdraw the entire enhanced compensation.