2026 INSC 498

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 1 of 27

REPORTABLE

IN THE SUPREME COURT OF INDIA

CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO. OF 2026

(@ Special Leave Petition (Civil) Nos.18267 of 2025)

NEW INDIA ASSURANCE

COMPANY LIMITED … APPELLANT(S)

VERSUS

DOLLY SATISH GANDHI & ANR. …RESPONDENT(S)

J U D G M E N T

SANJAY KAROL J.

Leave Granted.

THE APPEAL

2. ‘A’ met with an accident. They filed a claim before the jurisdictional

Tribunal i.e., Motor Accidents Claims Tribunal

1

seeking compensation in which

1

MACT

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 2 of 27

inter alia, loss of income, future prospects, special diet, transportation and

medical expenses have been claimed for. Simultaneously, claims set out with

insurance under the claim of medical insurance for the very same medical

expenses are allowed and money received. Is it legally permissible for the MACT

to account for such amounts received, and as such deduct the same or not, is the

question involved herein.

3. A Bench of three Judges of the High Court of Judicature at Bombay in

deciding a conflict between judgments of the said Court, namely The New India

Assurance v. Dineshchandra Shantilal Shah and Ors

2

, on the one hand, and

Vrajesh Navnitlal Desai v. K. Bagyam and Anr

3

., Royal Sundaram Alliance

Insurance Co. Ltd., Kolkata v. Ajit Chandrakant Rakvi and Anr

4

, on the other,

in terms of the impugned judgment, held that the amount received by a claimant

by way of his own Mediclaim, is not deductible when such a claimant is before

the jurisdictional MACT seeking compensation for injuries he has suffered as a

result of an accident. New India Assurance Co. Ltd., is aggrieved and questions

the correctness of such a finding before us, in this appeal.

3.1 We are, therefore, to decide the question of law as to whether the

amount of money received as Mediclaim, in terms of a ediclaim policy, is

deductible from an award passed by a Claims Tribunal or not. The factual

matrix in which this question arises does not have a bearing on the

conclusion of this question of law, and hence, is not relevant for the present

2

(2013) 09 BOM CK 0240 (First Appeal No.657 of 2013)

3

2005 SCC OnLine Bom 156

4

2019 SCC OnLine Bom 496

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 3 of 27

determination.

ARGUMENTS OF THE PARTIES

4. We heard the learned Counsel for the parties.

4.1 Learned Counsel for the appellant submitted:

4.1.1 It is an admitted position that the respondent-insured has

already been reimbursed for medical expenses through a Mediclaim

policy. Once such reimbursement has taken place, the loss under that

specific head is neutralized and so, awarding the same amount again

under the head of medical expenses would go beyond restitution and

lead to or result in a duplication of benefit. The appellant-insurer has

submitted this position to be inconsistent with the principle of just

compensation.

4.1.2 This position, it is argued, has found support in the decision

of this Court in Reliance General Insurance Co. Ltd. v. Shashi

Sharma

5

, where the Court emphasised that double benefits should

not be granted while computing compensation in reference to a claim

petition arising out of a motor vehicle accident. In that case, amounts

received by the claimants by way of ex gratia financial assistance

have been held liable for deduction from compensation awarded

under a corresponding head. The underlying rationale was that

overlapping benefits under the same head distort the concept of just

5

(2016) 9 SCC 627

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 4 of 27

compensation.

4.1.3 The appellant-insurer also dealt with the judgment in Helen

C. Rebello v. Maharashtra SRTC

6

, which held that benefits such as

life insurance, provident fund and pension, are not deductible since

they accrue independently of the accident and would be payable in

any event. However, the appellant-insurer has submitted that the

present case stands on a different footing. A Mediclaim

reimbursement is directly linked to the injury sustained in the

accident and has arisen only because of the medical expenses

incurred due to that event. Unlike life insurance proceeds, it is not a

benefit that accrues irrespective of the accident. Even on the

principle articulated in Helen Rebello (supra) amounts that bear a

direct causal connection with the loss in question are liable to be

adjusted to avoid duplication.

4.1.4 The statutory framework has also supported this position.

Under Sections 146 and 147 of the Motor Vehicles Act 1988

7

,

insurance against third party risk has been mandatory, and the

insurer has been required to indemnify the owner or driver for

liability arising from death or bodily injury caused by the use of the

vehicle. However, such liability has been premised on the existence

of an actual loss. If the medical expenses have already been

reimbursed, the question arisen is whether any liability survives in

6

(1999) 1 SCC 90

7

MVA

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 5 of 27

respect of that head. The appellant-insurer has submitted that in the

absence of a subsisting loss, there can be no corresponding liability

to compensate.

4.1.5 It has further been submitted that the distinction between

statutory and contractual liability, as discussed in Helen Rebello

(supra) has arisen in the context of death cases where certain

pecuniary advantages have accrued to the dependents independently

of the accident. In contrast, the present matter has involved an injury

claim where the reimbursement of medical expenses has been

directly and exclusively connected to the accident. This has created

a clear overlap between the loss claimed and the amount already

received, making it a case where the principle against double

recovery applies with full force.

4.1.6 The appellant-insurer has also relied on the decision in

Oriental Insurance Co. Ltd. v. R. Swaminathan

8

, where this Court

has approved the deduction of medical expenses that had already

been reimbursed by the employer. Even though the Court had

enhanced compensation under other heads, it consciously did not

award medical expenses again, recognizing that such duplication is

impermissible.

4.2 Per contra, the learned counsel for the respondent – insured

contended:

8

CA 2715 of 2002

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4.2.1 There exists a distinction between statutory and contractual

entitlements. Compensation under the MVA is a statutory right that

arises upon proof of negligence and resulting injury. It is not

contingent upon any prior contribution by the claimant. In contrast,

a Mediclaim policy constitutes a contract of insurance, supported by

the payment of premiums and governed by agreed terms. The

respondent-insured submits that these two entitlements operate in

separate domains, and that the statutory right to compensation cannot

be diminished by importing considerations arising from a contractual

benefit.

4.3. In Helen Rebello (supra) the Court held that amounts such as

provident fund, pension, and life insurance proceeds are not liable to be

deducted from compensation under the MVA, as they bear no correlation

to the accident. The respondent – insured, submits that the governing

principle emerging therefrom is that deductions are permissible only where

a direct nexus exists between the receipt and the accident giving rise to the

claim.

4.3.1 This principle was reiterated in United India Insurance

Co. Ltd. v. Patricia Jean Mahajan

9

, where the Court held that

insurance proceeds and other benefits cannot be deducted unless

they are directly attributable to the accidental death or injury. The

respondent insured submits that a broad interpretation encompassing

9

(2002) 6 SCC 281

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 7 of 27

all post-accident receipts would defeat the object of awarding just

compensation and unjustly benefit the wrongdoer.

4.3.2 Further reliance is placed on Sebastiani Lakra v. National

Insurance Co. Ltd.

10

, where the Court reaffirmed that benefits

arising from contractual or service-related entitlements, including

insurance, pension, and gratuity, cannot be deducted from

compensation. The respondent insured contends that such benefits

accrue independently of the accident and cannot be treated as gains

arising from the same cause.

4.3.3. The respondent-insured also submits that the principle

recognised in Bradburn v. Great Western Railway Co

11

affirms that

damages payable by a wrongdoer are not to be reduced on account

of insurance benefits received by the injured party. This ensures that

the appellant insurer or the tortfeasor does not derive advantage from

the prudence of the claimant in securing insurance coverage.

4.3.4. Turning to the statutory framework, the respondent-insured

submits that the MVA is a beneficial legislation intended to provide

relief to victims of motor accidents. Section 166 confers the right to

claim compensation, while Section 168 obligates the Tribunal, to

award just compensation based on fairness, reasonableness, and

equity. As elucidated in National Insurance Co. Ltd. v. Pranay

Sethi

12

, the determination of just compensation must strike a balance

10

(2019) 17 SCC 465

11

(1874-80) All ER Rep 195

12

(2017) 16 SCC 680

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 8 of 27

and reflect a realistic assessment of loss. The respondent insured

contends that deducting Mediclaim benefits would undermine this

objective and result in inadequate compensation.

4.3.5. In response to the contentions of the appellant-insurer, it is

submitted that no prejudice or irreparable loss is caused by allowing

the respondent-insured to receive both contractual and statutory

benefits. The liability under the MVA arises from the wrongful act

of the driver, whereas the liability under the Mediclaim policy arises

from a contract supported by consideration. The respondent-insured

submits that these liabilities are distinct and coexist without overlap

and that the appellant- insurer retains the ability to adjust premiums

in accordance with risk.

4.4 It should be noted that in the course of arguments, learned counsel

for the appellant pointed out that there were contrarian views galore on this

question, and that the question needed to be settled, specifically in the

context of Mediclaim/medical insurance.

ANALYZING DIVERGENT VIEWS

5. We find, somewhat surprisingly, that single judges as also division

benches even of the same Court, have taken opposite views across the High

Courts. One view is that Mediclaim, as a claim is independent from a claim

under Section 166 MVA and the award received need not be deducted. In

a tabular form we further take notice of such a view taken by the High

Court(s).

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 9 of 27

BOMBAY HIGH CO URT CASES

1. Vrajesh Navnitlal Desai v. K. Bagyam,

2005 SCC OnLine Bom 156

1J

2. Royal Sundaram Alliance Insurance Co. Ltd. v. Ajit

Chandrakant Rakvi,

2019 SCC OnLine Bom 496

1J

3. State of Goa v. Michael Joaquim F.D. Souza, 2022 SCC

OnLine Bom 1672

1J

4. United India Insurance Co. Ltd. v. Anjana, 2012 SCC OnLine

Bom 129

1J

5. Reliance General Insurance Co. Ltd. v. Aman Sanjay Tak,

2023 SCC OnLine Bom 883

1J

MADHYA PRADESH HIGH COURT CASES

6. Madhya Pradesh State Road Trans. Corpn. v. Priyank, 1999

SCC OnLine MP 18

2J

7. Mamta Yadav v. Amrat Singh,

2023 SCC OnLine MP 7166

1J

OTHER HIGH COURT S CASES

8. Shaheed Ahmed v. Shankaranarayana Bhat, 2008 SCC

OnLine Kar 166

[Kar. HC]

1J

9. Royal Sundram General Insurance Co. Ltd. v. Meenakshi

Mann, 2019 SCC OnLine P&H 7801

[Punjab & Haryana HC]

1J

10. New India Assurance Company Limited v. Bimal Kumar

Shah, 2018 SCC OnLine Cal 10368

[Cal. HC]

2J

11. National Insurance Co. Ltd. v. Bijumon, 2010 SCC OnLine

Ker 4775 [Ker. HC]

1J

12. National Insurance Co. Ltd. v. Aman Kapur, 2013 SCC OnLine

Del 4891 [Del. HC]

1J

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 10 of 27

6. The other view is that the amount received from a Mediclaim is in fact

deductible from the total compensation, which in a tabular form we indicate the

cases as under:-

S. No. Case Title Bench Strength

DELHI HIGH COURT CASES

1. Jaswant Kaur Sethi v. Tamal Das, MAC. APP. No. 352 of 2006 1J

2. National Insurance Co. Ltd. v. R.K. Jain, 2012 SCC OnLine

Del 3303

1J

3. National Insurance Co.

v. Deepmala Goel, 2012 SCC OnLine Del 1958

1J

4. IFFCO Tokio General Insurance Co. v.

Kisanlal Sharma, 2019 SCC OnLine Del 11091

[Claimant surrendered claim under medical expenses]

1J

5. IFFCO Tokio General Insurance Co. Ltd. v. Shambhu

Pathak, 2012 SCC OnLine Del 1361

1J

6. National Insurance Co. Ltd. v. Shiela Avinashi, 2012 SCC

OnLine Del 532

1J

7. Bajaj Allianze General Insurance Co. Ltd. v. Ganpat Rai

Sehgal, 2012 SCC OnLine Del 42

1J

8. UP State Road Transport Corporation v. Rama Chugh, 2019

SCC OnLine Del 11627

1J

9. New India Assurance Co. Ltd. v. Arjun Singh, 2019 SCC

OnLine Del 11625

1J

10. Oriental Insurance Co. Ltd. v. Ravi Jain, 2025 SCC OnLine

Del 8966

1J

KERALA HIGH COURT CASES

11. National Insurance Company Ltd. v. Akber Badsha, 2015

SCC OnLine Ker 26742

2J

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 11 of 27

12. Mariamma James v. Alphones Antony, 2016 SCC OnLine Ker

29226

2J

PUNJAB AND HARYANA HIGH COURT CASES

13. National Insurance Co.

Ltd. v. Shashank Bhardwaj, CWP No. 9763 of 2015

1J

14. ICICI Lombard General Insurance Co. v.

Harminder Singh Rosha, FAO No. 4755 of 2016

1J

15. United India Insurance Co. Ltd. v. Jaswant Singh, FAO No.

532 of 2014

1J

BOMBAY HIGH CO URT CASES

16. The New India Assurance Co. v. Dineshchandra

Shantilal Shah & Ors. First Appeal No. 657 of 2013

1J

17. Shirkant @ Srikant Kashinath Gaude v. Suryakant

Uttam Gaude. F.A. No. 64 of 2009

1J

MADRAS HIGH COURT CASES

18. S. Sevagi v. State of Express Transport, C.M.A. Nos. 3618–

3620 of 2013

2J

MADHYA PRADESH HIGH COURT CASES

19. Jitendra vs. Rahul, MANU/MP/0366/2008 1J

OUR CONSIDERATION

7. Inter-alia, two opposing reasons come forth from the perusal of the above-

mentioned High Court decisions. Those in favor of deduction hold so in view of

the principle of “double benefit” since the same medical expenses would be

compensated from two sources. Those against the deduction posit that the origin

of the two methods of compensating the same is different and, therefore, it cannot

be said to exclude each other. One is a statutory remedy and the other arises out

of a contract. Let us understand the same.

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7.1 The principle governing “double benefit” in motor accident

claims is that there should be no duplication for the same head of loss in

respect of the victim/claimant in a claim petition arising out of a motor

vehicle accident. A claimant cannot recover compensation twice for the

same injury or loss, as that would amount to unjust enrichment. The

unquestionable position is that compensation must be “just

compensation” which is meant to fairly make good the loss suffered, not

to create a windfall. Therefore, where two payments in relation to the very

same claim petition compensate for the same loss, one of them must

ordinarily be adjusted or deducted.

7.2. What is to be examined is the source and nature of the benefit.

The primary consideration in such an analysis is whether the additional

benefit is a substitute for the same loss, in which case it is liable to be

deducted, or whether it is independent, or an entitlement, in which case it

is not. For instance, where the family of a deceased person receives

statutory compensation or ex gratia payment from the State on account of

death, such amount may be deducted from the compensation awarded

under MACT. The reasoning therefor, is straightforward. Both payments

are addressing the same loss. Similarly, where one aspect of

compensation directly replaces the same income stream lost due to the

accident, and is triggered by that very event, permitting full recovery

under both heads would amount to double compensation.

7.2.1. However, the position is different where the benefit is

independent in nature. It has repeatedly been clarified by this

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 13 of 27

Court that certain payments cannot be deducted merely because

they accrue upon death. Employment benefits such as provident

funds, gratuity, and pension are not deductible, as they arise from

the contract of employment and represent deferred earnings or

accrued rights. They are not compensation for the accident, but

entitlements earned over time.

7.3 Let us now look at the primary reason taken by those who have

favoured the grant of both MACT compensation and Mediclaim.

7.3.1 A statutory benefit is an entitlement that exists because a

law creates it. Its source is legislation enacted by the State, and

not any private agreement between individuals. Meeting the

conditions laid down in the statute ipso facto, leads to entitlement.

There is nothing required further such as negotiation or consent.

Such benefits are generally in furtherance/fulfillment of broader

public purposes like welfare, regulation, and they can be altered

or withdrawn only if the law itself is amended.

7.3.2. A contractual benefit, on the other hand, is in the nature

of a private agreement between parties. Its source is the contract

itself, and the benefit flows from the parties having mutually

agreed to certain terms. These benefits depend on consent and are

defined by what the contract provides. They are enforceable under

the law of contract and cannot be changed except in accordance

with the terms of the agreement.

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 14 of 27

7.3.3. The distinction, put simply, is that a statutory benefit

flows from the authority of law, while a contractual benefit flows

from the will and agreement inter se parties. Naturally, statutory

benefits are available to all persons, provided that they fulfill its

prerequisites whereas a contractual benefit is limited inter se the

parties.

8. Having noticed the crucial distinction, we now move to appreciating the

law on deductions from motor accident claims.

8.1 Helen Rebello

In this case, the husband of the appellant was gravely injured while

travelling on a bus of the Maharashtra State Road Transport Corporation,

when it collided with a bus of the Karnataka State Road Transport

Corporation, while he was on his way from Rathore Badruk to Pune,

eventually succumbing to the injuries sustained. The quantum of

compensation was not subject matter of challenge before the co-ordinate

Bench of this Court. The issue was whether the amount received by the

appellant and other legal heirs in the form of the life insurance policy of

the deceased was deductible from the compensation received under the

1939 version of the MVA. The Court, speaking through A.P Misra J.,

discussed a number of English cases and then observed that Section 110,

of the 1939 Act made clear that the constitution of the Tribunal was not

meant to “include that which the claimant receives on account of other

forms of deaths, which he would have received even apart from accidental

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 15 of 27

death. Thus, such pecuniary advantage would have no correlation to the

accidental death for which compensation is computed. Any amount

received or receivable not only on account of the accidental death but that

which would have come to the claimant even otherwise, could not be

construed to be the “pecuniary advantage”, liable for deduction.”

Observations made further ahead are also apposite for the present case:

“How thus an amount earned out of one's labour or contribution

towards one's wealth, savings, etc. either for himself or for his

family which such person knows under the law has to go to his heirs

after his death either by succession or under a Will could be said to

be the “pecuniary gain” only on account of one's accidental death.

This, of course, is a pecuniary gain but how this is equitable or could

be balanced out of the amount to be received as compensation under

the Motor Vehicles Act. There is no corelation between the two

amounts. Not even remotely. How can an amount of loss and gain

of one contract be made applicable to the loss and gain of another

contract. Similarly, how an amount receivable under a statute has

any corelation with an amount earned by an individual. Principle of

loss and gain has to be on the same plane within the same sphere, of

course, subject to the contract to the contrary or any provisions of

law.”

8.2 Patricia Jean Mahajan

This case concerned the death of an Indian origin, USA-based doctor who

died while on a visit to this Country, travelling from Jaipur to Delhi. The

Tribunal awarded a sum of Rs. 1.16 crores with 12% interest p.a., as

against a claim of Rs. 54 Crores. The appellant challenged the

determination before the High Court of Delhi. The compensation was

enhanced to Rs. 16.12 crores with the said interest. Still further, the merits

of the computation were challenged before this Court. Brijesh Kumar J.,

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 16 of 27

writing for the Court recorded agreement with the principle in Helen

Rebello (supra). Considerable discussion was made in regard to

transposing absolute numbers in terms of US earnings to India, applying

the exchange rate thereto, and awarding compensation, but such a view

was not entirely accepted in view of issues such as the possibility of over

compensating, and also mechanical use of the multiplier, which would

mean high multiplicand and high compensation on account of directly

translating USD to its equivalent value in INR. It was observed:

“36. …. According to the decisions referred to in the earlier part

of this judgment, it is clear that the amount on account of social

security as may have been received must have a nexus or relation

with the accidental injury or death, so far to be deductible from

the amount of compensation. There must be some correlation

between the amount received and the accidental death or it may

be in the same sphere, absence (sic) the amount received shall not

be deducted from the amount of compensation. Thus, the amount

received on account of insurance policy of the deceased cannot

be deducted from the amount of compensation though no doubt

the receipt of the insurance amount is accelerated due to

premature death of the insured. So far as other items in respect of

which learned counsel for the Insurance Company has

vehemently urged, for example some allowance paid to the

children, and Mrs Patricia Mahajan under the social security

system, no correlation of those receipts with the accidental death

has been shown much less established. Apart from the fact that

contribution comes from different sources for constituting the

fund out of which payment on account of social security system

is made, one of the constituents of the fund is tax which is

deducted from income for the purpose. We feel that the High

Court has rightly disallowed any deduction on account of receipts

under the insurance policy and other receipts under the social

security system which the claimant would have also otherwise

been entitled to receive irrespective of accidental death of Dr

Mahajan. If the proposition “receipts from whatever source” is

interpreted so widely that it may cover all the receipts, which may

come into the hands of the claimants, in view of the mere death

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 17 of 27

of the victim, it would only defeat the purpose of the Act

providing for just compensation on account of accidental death.

Such gains, maybe on account of savings or other investment etc.

made by the deceased, would not go to the benefit of the

wrongdoer and the claimant should not be left worse off, if he

had never taken an insurance policy or had not made investments

for future returns.

(emphasis supplied)

8.3 Shashi Sharma

In this matter, the question that concerned the Court was whether

compensation under MVA is affected by the grant of compensation under

Haryana Compassionate Assistance to Dependents of deceased

Government Employees Rules, 2006 issued under Article 309 of the

Constitution of India. It was held that since both these grounds of

compensation have statutory force, claimants cannot be permitted to set up

claims under both scenarios. The relevant discussion of the three-judge

Bench is reproduced below:

“25. The claimants are legitimately entitled to claim for the loss

of “pay and wages” of the deceased government employee against

the tortfeasor or insurance company, as the case may be, covered

by the first part of Rule 5 under the 1988 Act. The claimants or

dependants of the deceased government employee (employed by

the State of Haryana), however, cannot set up a claim for the same

subject falling under the first part of Rule 5—“pay and

allowances”, which are receivable by them from employer (the

State) under Rule 5(1) of the 2006 Rules. In that, if the deceased

employee was to survive the motor accident injury, he would have

remained in employment and earned his regular pay and

allowances. Any other interpretation of the said Rules would

inevitably result in double payment towards the same head of loss

of “pay and wages” of the deceased government employee

entailing in grant of bonanza, largesse or source of profit to the

dependants/claimants. Somewhat similar situation has been spelt

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 18 of 27

out in Section 167 of the Motor Vehicles Act, 1988 which reads

thus:

“167. Option regarding claims for compensation in

certain cases.—Notwithstanding anything contained

in the Workmen's Compensation Act, 1923 (8 of 1923)

where the death of, or bodily injury to, any person gives

rise to a claim for compensation under this Act and also

under the Workmen's Compensation Act, 1923, the

person entitled to compensation may without prejudice

to the provisions of Chapter X claim such

compensation under either of those Acts but not under

both.”

(emphasis supplied)

26. Indeed, similar statutory exclusion of claim receivable under

the 2006 Rules is absent. That, however, does not mean that the

Claims Tribunal should remain oblivious to the fact that the claim

towards loss of pay and wages of the deceased has already been

or will be compensated by the employer in the form of ex gratia

financial assistance on compassionate grounds under Rule 5(1).

The Claims Tribunal has to adjudicate the claim and determine

the amount of compensation which appears to it to be just. The

amount receivable by the dependants/claimants towards the head

of “pay and allowances” in the form of ex gratia financial

assistance, therefore, cannot be paid for the second time to the

claimants. True it is, that the 2006 Rules would come into play if

the government employee dies in harness even due to natural

death. At the same time, the 2006 Rules do not expressly enable

the dependants of the deceased government employee to claim

similar amount from the tortfeasor or insurance company because

of the accidental death of the deceased government employee.

The harmonious approach for determining a just compensation

payable under the 1988 Act, therefore, is to exclude the amount

received or receivable by the dependants of the deceased

government employee under the 2006 Rules towards the head

financial assistance equivalent to “pay and other allowances” that

was last drawn by the deceased government employee in the

normal course. This is not to say that the amount or payment

receivable by the dependants of the deceased government

employee under Rule 5(1) of the Rules, is the total entitlement

under the head of “loss of income”. So far as the claim towards

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 19 of 27

loss of future escalation of income and other benefits is

concerned, if the deceased government employee had survived

the accident can still be pursued by them in their claim under the

1988 Act. For, it is not covered by the 2006 Rules...”

8.4 Sebastiani Lakra

In this case, the Court while dealing with the total compensation payable

to the claimants on account of the death of the 52 year old government

servant, the question was whether the amount received by the claimants

under the Employees Family Benefit Scheme

13

being Rs.50,082/- per

month should be deducted from the compensation as calculated by the

Tribunal. The High Court had allowed the deduction, however, did not

provide any reasons for having taken such a view. This Court concluded

that the case stood on a different footing from Shashi Sharma as the

benefit herein was not statutory in nature. Further, it was observed that the

amount payable under the EFB Scheme happens only once the benefits

received by the legal heirs of the deceased are deposited. In other words,

amounts of gratuity and all other benefits totaling to Rs.27,43,991/- were

deposited and now they were receiving Rs.50,082/- per month till the date

of retirement as would have been, of the deceased. The Court noted that

this situation was beneficial for the claimants since, if the two amounts are

compared, even a 12% interest rate on Rs.28,00,000/- approximately would

be about Rs.22000/- less per month. The said amount, therefore, could not

be deducted at the time of computation under MVA.

13

EFB

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 20 of 27

8.5 Swaminathan

In this case, a co-ordinate Bench of this Court allowed an appeal filed by

the Insurance Company being aggrieved by the increase of compensation

beyond the original claimants ask. While this submission was rejected and

it was held that the Court could increase the compensation beyond what

had been asked for by the claimants, it was observed that the deduction of

medical expenses by the learned Single Judge on account of the fact that

the employer had already paid the same, was affirmed. We are, however,

of the view that the holding in this case may not aid the appellant insurer

herein for the reason that the observation made by this Court arose in a

specific fact of the employer having reimbursing medical expenses.

Neither reimbursement by the employer a general condition prevalent

across cases, nor is it clear from the order of this Court whether the

respondent in the said case had a Mediclaim policy to his name.

9. Having considered judgments of this Court as above, we are of the

considered opinion that the answer to the question raised in this appeal is not a

matter of Sherlockian deduction. A Mediclaim policy is a policy that is purchased

by a person, accounting for the uncertainties of life and preparing a financial base

for an unfortunate possible eventuality. The human body is a coming together of

intricate systems where there is always a possibility that something may go wrong

or may need mending. In today’s time when medical expenses are skyrocketing

for a variety of reasons, the ability to meet such expenses, suddenly as and when

they may arise, is not something that rests with all. It is, as such, a necessary facet

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 21 of 27

of preparation that people undertake. It doesn’t specifically deal with accidental

coverage only.

10. The contractual benefit of reimbursement of medical expenses as a result

of this policy is, therefore, independent of any other claim. The provisions of the

MVA are only triggered in the unfortunate eventuality if a death or injury arising

out of a motor vehicle an accident occurs. That in itself, when it does arise, cannot

eclipse the contractual benefit to which a person who has paid premiums, is

entitled too. Compensation under MVA while it recognizes reimbursement of

medical expenses is distinct from the contractual benefit, though it may be with

respect to the very same heads. If the view of the High Courts that this would

amount to “double benefit” is agreed to by this Court, a peculiar situation will

arise. On the one end, it may save compensation from being affected by double

benefit, if it can be called that, but on the other, it would denude the claimant of

the benefits that arise out of them parting with their hard-earned money in the

form of Mediclaim premiums. It would also amount to an undue advantage to the

company granting the Mediclaim policy to the claimant if the claimant’s claim is

extinguished by the award of the MACT having granted medical expenses for,

they would have received the premium but would not be required to pay any

amount in the event of medical bills having arisen. Similarly, it may amount to

an unjust benefit to the insurer of the offending vehicle if they are not required to

compensate under one of the heads of medical expenses solely on account of the

fact that the claimant had received the benefit of a policy for which they had been

paying premiums for years on end. There is yet another aspect. The guiding

yardstick in Mediclaim vis a vis MVA is different. In the former, a Mediclaim

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 22 of 27

policy is taken up to a certain amount and if the claim of the policy holder once

found to be holding merit go beyond it, the holder has no option but to foot the

bill out of pocket however in the latter, because of its beneficial nature the only

guide is the broad principle of just and fair compensation. Put differently, the

compensation that may be awarded thereunder has no strict monetary limits.

11. We may also say that looking at these two amounts as “double benefit”

may not be appropriate since one situation is only the fruit of amounts already

paid in the past. Only because they appear same or similar, they cannot be termed

as “double benefit”. Still further there is another reason why these two amounts

stand on a different footing. The amount received under MVA arises from a

beneficial legislation and as guided by just compensation which is intended to put

the injured or the claimants (legal representatives of the deceased) in a position,

as far as possible, at least monetarily, if the accident in question had not taken

place. Naturally, this stands on a higher pedestal - not only because it is a statutory

entitlement of compensation but also because the nature of the statute is entirely

beneficial. To equate these two amounts to pulling down the MVA or

unnecessarily hyping up the Mediclaim policy.

A SECONDARY, BUT IMPORTANT ISSUE

12. There is one other issue that we must address. The chart that is given in

paras 4 and 5 of this judgment reveals something unsettling. There are contrary

positions of law being taken by the same High Court, whether it be by the benches

of the same strength or by the benches of lesser strength in ignorance of

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 23 of 27

pronouncements made by the benches of higher strength. Some illustrations from

the tables above are:

DELHI HIGH COURT CASES

Sl.No. Mediclaim Not Granted Bench

Strength

Mediclaim Granted Bench

Strength

1. Jaswant Kaur Sethi v. Tamal Das,

MAC. APP. No. 352 of 2006

1J National Insurance Co.

Ltd. v. Aman Kapur,

2013 SCC OnLine Del

4891

1J

2. National Insurance Co. Ltd. v. R.K.

Jain, 2012 SCC OnLine Del 3303

[Distinguishes Helen Rebello]

1J

3. National Insurance Co.

v. Deepmala Goel, 2012 SCC OnLine Del

1958

1J

4. IFFCO Tokio General Insurance Co.

v. Kisanlal Sharma, 2019 SCC

OnLine Del 11091

[Claimant surrendered claim under

medical expenses]

1J

5. National Insurance Co. Ltd. v. Shiela

Avinashi, 2012 SCC OnLine Del 532

1J

6. Bajaj Allianze General Insurance Co.

Ltd. v. Ganpat Rai Sehgal, 2012 SCC

OnLine Del 42

1J

7. UP State Road Transport Corporation

v. Rama Chugh, 2019 SCC OnLine Del

11627

1J

8. New India Assurance Co. Ltd. v. Arjun

Singh, 2019 SCC OnLine Del 11625

1J

9. Oriental Insurance Co. Ltd. v. Ravi

Jain, 2025 SCC OnLine Del 8966

1J

KERALA HIGH COURT CASES

10. National Insurance Company Ltd. v.

Akber Badsha, 2015 SCC OnLine Ker

26742

2J National Insurance Co.

Ltd. v. Bijumon, 2010

SCC OnLine Ker 4775

1J

11. Mariamma James v. Alphones Antony, 2016

SCC OnLine Ker 29226

2J

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 24 of 27

PUNJAB AND HARYANA HIGH COURT CASES

12. National Insurance Co.

Ltd. v. Shashank Bhardwaj,

2016 SCC OnLine P&H 19393

1J Royal Sundram General

Insurance Co. Ltd. v.

Meenakshi Mann, 2019

SCC OnLine P&H 7801

1J

13. ICICI Lombard General Insurance Co. v.

Harminder Singh Rosha,

2018 SCC OnLine P&H 7738

1J

14. United India Insurance Co. Ltd. v.

Jaswant Singh, FAO No. 532 of 2014

1J

15. Vishal v. Bugga Singh, 2016 SCC OnLine

P&H 1338

1J

BOMBAY HIGH COURT CASES

16. The New India Assurance Co. v.

Dineshchandra

Shantilal Shah & Ors. First Appeal No. 657

of 2013

1J Vrajesh Navnitlal Desai

v. K. Bagyam, 2005 SCC

OnLine Bom 156

1J

17. Shirkant @ Srikant Kashinath Gaude

v. Suryakant Uttam Gaude.

F.A. No. 64 of 2009

1J Royal Sundaram Alliance

Insurance Co. Ltd. v. Ajit

Chandrakant Rakvi, 2019

SCC OnLine Bom 496

1J

18. State of Goa v. Michael

Joaquim F.D. Souza,

2022 SCC OnLine Bom

1672

1J

19. United India Insurance

Co. Ltd. v. Anjana, 2012

SCC OnLine Bom 129

1J

20. Reliance General

Insurance Co. Ltd. v.

Aman Sanjay Tak, 2023

SCC OnLine Bom 883

1J

MADHYA PRADESH HIGH COURT CASES

21. Jitendra vs. Rahul, MANU/MP/0366/2008 1J Madhya Pradesh State

Road Trans. Corpn. v.

Priyank, 1999 SCC

OnLine MP 18

2J

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 25 of 27

Mamta Yadav v. Amrat

Singh, 2023 SCC OnLine

MP 7166

1J

13. When such inconsistencies are left unaddressed, it leads to various

problems, primary among them being that it leads to judicial inconsistency and

uncertainty. This creates difficulties for counsel and the Court for, opposing

judgments may give clients hope for differing outcomes or even for a Court in

the future to have to examine multiple cases with differing opinions on the same

point. Till such times the opposing views exist, judicial uncertainty is in play for

settled precedents ensure definitive outcomes but if contrary views exist, it

becomes a matter of choice to follow one and leave aside the other, and it remains

no longer, a matter of law. Connected to this is its direct impact on judicial

efficiency for if the law on a point is clear it is a matter of fair ease to follow

settled precedents leading to a reduction in future effort thereby saving time.

Performing a judicial duty or rendering justice which is certain, just, fair and

expeditious.

14. When considering these issues, the roles both the Bar and the Bench must

be addressed. Counsel appearing in Court to plead the case of a particular party

making all effort possible, while balancing ethics and their duty towards the

Court, to secure a victory for their clients. It is this duty towards the Court which

requires them to bring to the Court’s notice judgments both that aid their case and

also those that do not. It is here that the counsel’s awareness of law and grasp on

facts are their greatest assets, enabling them to distinguish judgments that may

seemingly be against them and still secure a favourable order. This duty is all the

C.A.No…..of 2026 @ SLP©No.18267 of 2025 Page 26 of 27

more important in the present day because all the Courts are polyvocal. Tens of

orders and judgments are pronounced every day across a range of issues and so,

the Court before which they are appearing may not be aware of the latest

pronouncement. They must disclose the same to the Court ensuring consistency.

That being so, the entire burden cannot be placed only on counsel. The Court

itself has an independent tri-fold duty, to apply correct law even if the counsel

does not cite the same, ensure consistency with precedent, and avoid per incuriam

decisions. While this duty is one part of reality, a Court hearing nearly hundred

matters a day and in some cases across a variety of laws and jurisdictions, having

to dictate daily orders, write judgments and so much more, is the other part. So,

in essence, both the Bar and the Bench are responsible for minimising the

problems that arise in the face of inconsistent judicial opinion. They are both

constituents of the justice delivery system, and all actions must be guided by a

sense of service to the system, further facilitating reduction of pendency.

CONCLUSION

15. In fine, we hold that the amount received as part of Mediclaim/medical

insurance is not deductible from compensation as calculated by the concerned

Tribunal, adjudicating a claim for compensation under the MVA which may also

include compensation under the head of medical expenses, if claimed. These two

stand on a different footing - one is statutory while the other is contractual and

the latter is only a sequitur of premiums having been paid in the past while the

other is an entitlement as a consequence of an accident or death in a motor vehicle

accident.

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16. The matter is remanded to the High Court for making a determination

consistent with this opinion. The appeal is dismissed as meritless. Pending

application(s), if any, shall stand disposed of.

…………..……………….J

(SANJAY KAROL)

……………………………J.

(VIPUL M. PANCHOLI)

New Delhi;

May 15, 2026