Rs 4 lakh mediclaim not deductible: Punjab and Haryana HC lifts award for boy hit by car to Rs 36.15 lakh
Justice Deepinder Singh Nalwa dismissed an appeal by Tata AIG seeking to deduct a mediclaim payout from a Rewari tribunal award, and raised the compensation for a 14-year-old student injured in 2014 from Rs 22.2 lakh to Rs 36,14,991 by assessing his income at the skilled minimum wage and adding future prospects and marriage prospects.
An insurer cannot shrink a road accident award by pointing to what the victim’s own mediclaim policy has already paid, the Punjab and Haryana High Court has held. The court rejected Tata AIG General Insurance Company’s bid to deduct Rs 4 lakh from compensation awarded to a schoolboy injured in Rewari.
Justice Deepinder Singh Nalwa decided the insurer’s appeal together with the claimant’s plea for enhancement on 31 October 2026. He raised the award from Rs 22,20,000 to Rs 36,14,991, to be paid to the boy’s legal heirs, since he died while the appeals were pending.
Hit from behind on a roadside berm
At about 8.30 pm on 3 December 2014, Tushar Yadav and his friend Karambir were standing on the kutcha berm of Garhi Bolni Road in Rewari. A car driven by Jeet Ram came from the Garhi Bolni side at high speed, rashly and negligently, and hit both of them from behind.
The driver got out but then fled with the car. Tushar, then about 14 and a student, was given first aid in Rewari and moved to Medanta Hospital, Gurgaon, where he stayed from 4 December 2014 to 19 January 2015.
He was treated for an open fracture of the lower third of the right femur, extending into the joint with bone loss, and a fracture of the right tibia. He claimed Rs 1 crore before the Motor Accident Claims Tribunal, Rewari.
The Tribunal decided both boys’ claims by a common award on 11 November 2016. It assessed Tushar’s functional disability at 40% and awarded Rs 22,20,000, including Rs 18,91,000 for medical and hospital expenses and Rs 29,000 for transport.
The rest was two lump sums: Rs 2 lakh for future prospects and Rs 1 lakh for pain and suffering, special diet and loss of amenities. The insurer and the claimant both appealed.
Mediclaim is a separate contract
Mr Sachin Gupta, for the insurer, raised a single point. Tushar had received Rs 4 lakh from E-Meditek TPA under a mediclaim policy against his medical bills, so that sum should have been deducted from the award.
Justice Nalwa held that a mediclaim payment from personal medical insurance is “not to be deducted from final compensation awarded under the Motor Vehicles Act, 1988” (para 7). He called this well settled law.
The court relied on the Supreme Court’s ruling in New India Assurance Company Limited v. Dolly Satish Gandhi, 2026 (3) RCR (Civil) 135. Mediclaim benefits are contractual and arise from premiums paid, while compensation under the Act is statutory and meant to be just compensation for injury in a motor accident.
The Supreme Court passage the High Court reproduced also explains why calling it double benefit is wrong. Deducting it would strip the claimant of the fruit of premiums paid and hand an unjust benefit both to the mediclaim insurer and to the insurer of the offending vehicle. The insurer’s appeal was rejected on that basis.
A minor is not a non-earner
Ms Deepshikha, appearing for Mr Anil Kumar Gahlawat for the claimant’s heirs, said the Tribunal had never assessed the boy’s income at all. She argued for the skilled minimum wage, future prospects under Pranay Sethi, and awards for loss of future earnings, attendant charges and marriage prospects, adding that pain and amenities awards were too low.
The court agreed that the minimum wage of a skilled worker at the time of the accident must be used for a minor who suffers permanent disability. It relied on Hitesh Nagjibhai Patel v. Bababhai Nagjibhai Rabari, 2025 SCC OnLine SC 3446, which in turn cites Kajal v. Jagdish Chand and Baby Sakshi Greola.
Haryana’s minimum wage for a skilled worker on 3 December 2014 was Rs 6,159 a month, and the court took that as Tushar’s income.
Future prospects for the living too
Following Pappu Deo Yadav v. Naresh Kumar, 2022 (13) SCC 790, the court held that a permanently disabled claimant is entitled to loss of future earnings and, separately, future prospects on the Pranay Sethi principle. It added 40% to the income.
The disability certificate, Ex. PW-7/A, put permanent disability at 57%, from markedly restricted movement and instability of the right knee with shortening, scarring and pain. It also said the disability was likely to improve after five years given the claimant’s young age.
Balancing the two, Justice Nalwa held that he would still struggle with daily activities and fixed functional disability at 40% for loss of future earnings.
Marriage prospects and attendant charges
The boy spent 65 to 66 days in hospital, the court noted, and his permanent disability would substantially affect his prospects of marriage. It allowed Rs 5 lakh for loss of marriage prospects and Rs 50,000 as attendant charges.
Finding the Tribunal’s figures for pain and loss of amenities on the lower side, it awarded Rs 2 lakh under each head.
How Rs 36.15 lakh was reached
Annual income of Rs 73,908 plus 40% future prospects gave Rs 1,03,471. Applying a multiplier of 18 at 40% disability, loss of future earnings came to Rs 7,44,991.
The medical expenses of Rs 18,91,000 and transport of Rs 29,000 stayed as the Tribunal fixed them. With the new heads, the total is Rs 36,14,991, an enhancement of Rs 13,94,991 over the Tribunal’s award.
Order
The award was modified to Rs 36,14,991 with interest at 7.5% a year, as the Tribunal had allowed, from the filing of the claim petition until realisation. The driver, owner and Tata AIG must deposit the enhanced amount, jointly and severally, with the Tribunal within two months.
The Tribunal will release it in equal shares to the claimant’s legal heirs, who must give their bank details. The insurer’s appeal, FAO-1389-2017, was dismissed and the claimant’s appeal, FAO-5626-2017, was allowed.