Madhya Pradesh High Court
Khushboo Gopalani vs Mohd. Saleem on 7 November, 2025
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IN THE HIGH COURT OF MADHYA PRADESH
AT INDORE
BEFORE
HON'BLE SHRI JUSTICE PAVAN KUMAR DWIVEDI
ON THE 7 th OF NOVEMBER, 2025
MISC. APPEAL No. 2172 of 2019
KHUSHBOO GOPALANI
Versus
MOHD. SALEEM AND OTHERS
Appearance:
Shri Aadesh Shinde, learned counsel for the appellant.
Shri Monesh Jindal, learned counsel for respondent No.3.
ORDER
The present miscellaneous appeal has been filed under Section 173(1)
of the Motor Vehicles Act being aggrieved by the award dated 16.01.2019
passed by the VIII Additional Member, Motor Accident Claims Tribunal,
Ujjain in Claim Case No.07/2018, whereby challenging the quantum of
compensation as well as the exclusion of the amount incurred on treatment
which had been reimbursed under a mediclaim policy.
2. The brief facts of the case are that the appellant Khushboo was
traveling from Pune to Ujjain on 25.08.2015 by Bus bearing registration
number MP-09-FA-5705. At around 11.50 pm, the driver of the said bus was
driving in a rash and negligent manner. When they were near Police Station
Rakri, Dist. Ahmednagar, Maharashtra on the Manmad Highway, an
accident occurred, as a result of which several passengers including the
appellant sustained grievous injuries. The appellant suffered a compound
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fracture of the right hip, femur bone and also sustained injuries to other parts
of her body. She remained hospitalised and underwent multiple surgical
operations.
2.1 The appellant filed a claim petition under Section 166 of the Motor
Vehicles Act claiming compensation for the injuries sustained in the
aforesaid accident. The Claims Tribunal after recording evidence, concluded
that the accident occurred due to rash and negligent driving of the insured
vehicle's driver, which resulted in injuries to the appellant. Accordingly, a
total compensation of Rs.6,20,000/- was awarded.
3. Learned counsel for the appellants submits that the Tribunal while
awarding compensation has ignored the permanent disability sustained by the
appellant to the extent of 15%. He submits that in support of the permanent
disability, the appellant has produced Ex. P-98, the permanent disability
certificate, which was issued by a Government doctor at Ujjain. He further
submits that the Tribunal has awarded a meagre amount of compensation
under other heads as well, despite the fact that the appellant remained under
constant treatment for a prolonged period and was operated upon repeatedly.
Her entire femur bone of the right lower limb was crushed, necessitating the
insertion of rods and screws, which has resulted in restriction of movement.
This not only affected her earning capacity but has also severely impaired
her reproductive ability. Thus, he prays for enhancement of compensation on
this count.
3.1 Apart from this learned counsel has specifically submitted that the
Tribunal while awarding compensation, considered the expenditure incurred
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on treatment in paras 12 and 13. In doing so, the Tribunal took into account
the amount of mediclaim received by the appellant and by deducting the
same, reduced the compensation awarded for treatment. This, he submits is
not sustainable in the eyes of law in view of the settled position on this issue.
He places reliance on the judgment passed by the Hon'ble Apex Court in the
case of Sebastiani Lakra and Others vs. National Insurance Company
Limited and Others in AIR 2018 SC 5034 as well as an order passed by the
co-ordinate Bench of this Court in the case of Smt. Mamta Yadav vs. Amrat
Singh and Another in MA No.29/2019 vide order dated 22.12.2023. He,
therefore, prays for enhancement of compensation.
4. Per contra learned counsel for the Insurance Company submits that
Ex.P-98, the permanent disability does not indicate that any recognized
method of calculation was applied in assessing the permanent disability.
There is no reference to any examination or to the application of a particular
method under which the permanent disability was determined. It has also
clearly emerged during the cross examination of the appellant that no fresh
X-ray was conducted by the doctor who issued the certificate. He further
submits that the doctor who issued the certificate did not appear to prove the
permanent disability or the validity of the said certificate.
4.1 A bare perusal of the certificate would show that it is completely
vague and unreliable.
4.2 As regards the other heads, he submits that with respect to the
deduction for the amount received under mediclaim, there is no plea in the
appeal memo. It is further argued that in the absence of any reliable evidence
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regarding permanent disability, the same cannot be considered at this stage.
4.3 Learned counsel for the Insurance Company further submits that
under the entire Motor Vehicles Act, there is no provision for reimbursement
of medical expenditure. He, therefore, prays for dismissal of the appeal.
5. In rejoinder submissions, learned counsel for the appellant submits
that the nature of the injuries must be considered from the documents
available on record. It is clear that the appellant has suffered grievous injury
to the right lower limb, which has resulted in a permanent disability. This
injury is directly related to the loss of amenities of life and has also affected
her marriage prospects.
6. Heard learned counsel for the party and perused the record.
7. On perusal of the record and the findings of the claims Tribunal
from paras 7 to 10 of the impugned awards as well as the documents
available on record, it is clear that the appellant has suffered grievous injury
to the femur bone of her right leg. The injury not only necessitated prolonged
treatment but also required the insertion of a rod and placement of screws to
stabilize the bone. Such injuries have undoubtedly affected the future
prospects of a girl who was 22 years of age at the time of accident.
8. In view of this, the meagre amount of Rs.30,000/- awarded for such
grievous injury appears inadequate, particularly when the Tribunal itself has
acknowledged that the appellant underwent treatment for a prolonged period.
The period of treatment was considered significant, and the Tribunal
awarded only Rs. 3,00,000/- for loss of earnings, which does not fully reflect
the severity and impact of the injury.
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9. In this view of the matter, this Court is of the considered opinion
that the appellant deserves to be awarded a lump sum amount of
compensation for the nature of injuries sustained by her and the resultant
pain agony loss of marriage prospects, loss of amenities of life.
10. In the considered view of this Court, a lump sum amount of
Rs.2,75,000/- would constitute just compensation.
11. As regards the deduction for the amount received under
mediclaim, the issue is no longer res integra. The Hon'ble Apex Court in the
case of Sebastiani Lakra (Supra) has clearly held in para 12 that deductions
cannot be allowed from the amount of compensation whether on account of
insurance, pensionary benefits, gratuity, or even the grant of employment to
the kin of the deceased.
12. The Hon'ble Apex Court while considering this aspect has
observed that the amounts referred to are earned by the deceased on account
of contractual relations entered into by him with others. In the present case, it
is clear that the mediclaim was a result of a contract between the appellant
and the company providing the mediclaim facility on payment of premium.
The appellant must have paid the premium for receiving such benefits. Thus,
the tortfeasor and its indemnifier cannot claim any benefit under such a
contract for which the premium was paid by the appellant.
13. The issue has also been dealt with by this Court in the case of Smt.
Mamta Yadav (Supra) , which clearly covers the matter. Accordingly, it is
hereby held that the deductions made by the Tribunal in paras 12 and 13 on
account of mediclaim received by the appellant are set aside. The amount so
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deducted comes to Rs.2,39,465/-, which shall be paid to the appellant.
14. In view of the above, the present appeal stands disposed of.
15. However, before closing the matter, a reference deserves to be
made to the application by the appellant under Order XLI Rule 27 of the
CPC.
16. In view of the fact that the subsequent documents filed here before
this Court under the said application have not been subjected to scrutiny, this
Court is not inclined to entertain the same. However, having regard to the
material that was available before the Tribunal, this Court has recorded its
finding strictly based on the record before the Tribunal.
17. In view of the same, I.A. No.4659 of 2025 is closed.
18. In view of the total amount of compensation enhanced herein, the
appellant is directed to pay the deficit Court fees on the enhanced amount
which shall be paid within a period of four weeks from the date of receipt of
this order.
19. The enhanced amount shall carry interest at the rate of 6% per
annum from the date of filing of claim petition before the claims Tribunal.
Certified copy as per rules.
(PAVAN KUMAR DWIVEDI)
JUDGE
Anushree
