Bombay High Court
HDFC ERGO GENERAL INSURANCE COMPANY LTD.,versusBHUSHAN SURESH SONAR AND ANR.
- Decided
- Disposal
- Partly Allowed
- Bench
- R M JOSHI
Holding
The insurer’s appeal is dismissed and the claimant’s appeal is partly allowed, with the insurer remaining liable for compensation and the claimant entitled to repayment of the Mediclaim amount with interest.
Summary
The High Court heard two appeals arising from the same motor accident compensation award. The insurer (HDFC Ergo GIC) appealed on the ground that the driver of the offending vehicle did not possess a valid licence, alleging a fake licence defence, while the claimant (Bhushan Suresh Sonar) sought enhancement of compensation for injury, permanent disability, loss of future earnings and to recover a sum deducted for a Mediclaim reimbursement. The Court held that the insurer had not raised a specific pleading regarding the licence issue, so the evidence was rightly excluded and the insurer remained liable. It found that the claimant had not proved that his disability affected future promotions or earnings, and therefore no additional compensation for loss of income was warranted. However, the Court corrected the tribunal’s deduction of the Mediclaim amount, ordering that the claimant be repaid Rs. 3,67,270 with interest. The insurer’s appeal was dismissed and the claimant’s appeal was partly allowed.
Issues considered
- The insurer’s defence that the driver lacked a valid driving licence negates liability for compensation.
- Whether the tribunal erred in failing to enhance compensation for the claimant’s injury, permanent disability, and future loss of income and prospects.
- Whether the deduction of the Mediclaim reimbursement from the compensation award is permissible.
Subjects
- insurance liability
- motor accident compensation
- fake driving licence
- compensation enhancement
- future loss of earnings
- mediclaim deduction
- tribunal award
- appellate jurisdiction
Judgment
52-FA-1848-2025+.DOC
Shephali
IN THE HIGH COURT OF JUDICATURE AT BOMBAY
CIVIL APPELLATE JURISDICTION
FIRST APPEAL NO. 1848 OF 2025
Bhushan Suresh Sonar …Appellant
Versus
Reliance Industries Ltd & Ors …Respondents
WITH
FIRST APPEAL NO. 2287 OF 2025
HDFC Ergo GIC …Appellant
Versus
Bhushan Suresh Sonar & Anr …Respondents
Ms Shradha K Nakadi, with Rupesh K Bobade, for the Appellant in
FA/1848/2025 and for Respondent No. 1 in FA/2287/2025.
Mr Sarthak Diwan, for the Respondent in FA/1848/2025 and for
the Appellant in FA/2287/2025.
CORAM: R. M. JOSHI, J.
DATED: 13TH JANUARY 2026
PC:-
1. By consent of both sides heard finally at the stage of
Admission.
2. Both Appeals arise out of the same Judgement and
Order and involve same question of law and facts. By consent
of both sides, heard and decided together.
Digitally
signed by
SHEPHALI
SHEPHALI SANJAY
SANJAY MORMARE
MORMARE Date:
2026.01.20
18:24:34
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3. Insurer has filed Appeal taking exception to the
Judgment and Order dated 17th May 2022 passed in MACP
No. 600 of 2016 essentially on the ground that the Insurer is
not liable to pay the compensation in view of the fact that the
Insurer by leading evidence has substantiated before the
Tribunal that at the relevant time, the driver driving the
offending vehicle was not holding valid and effective driving
license.
4. As far as Claimant is concerned, he seeks enhancement
of the compensation on the ground that the Tribunal has
failed to take into consideration the nature of injury caused to
the Claimant and the disability assessed by the Doctor. The
enhancement is also sought on the ground that the Tribunal
has failed to consider the future loss of income, so also,
future prospects.
5. Learned counsel for the Insurer submits that the Insurer
has raised defence of fake driving license, so also, in
paragraph 5 of the Written Statement, it is specifically
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claimed that the driver was not holding valid and effective
license. According to him, after taking such specific plea, the
Insurer has led evidence before the Tribunal to show that the
driver of the offending vehicle was not holding valid and
effective license to drive the heavy goods vehicle. It is his
submission that Tribunal ought to have considered the said
evidence on record and discharge the liability of the Insure.
On these amongst other contentions exception is taken the
impugned Judgment and Award.
6. Learned counsel for the Claimant opposed the said
contention by pointing out the Written Statement, so also, the
findings recorded by the Tribunal on the issue.
7. Needless to emphasise that any amount of evidence led
by a party sans pleading needs to be kept out of
consideration. Though it is sought to be argued now that
there is a specific plea raised by the Insurer in the Written
Statement with regard to driver not holding valid and effecive
driving license, a conjoint reading of paragraph 4 and 5
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indicates that the said statement is not with regard to the
valid and effective driving license held by driver but it is to
support the claim of the Insurer with regard to the fake
license. Thus, in absence of any specific plea being raised by
the Insurer, the evidence led before the Tribunal requires
discardance and it been rightly done so by the Tribunal. In
these circumstances, no fault can be found with the findings
of the Tribunal on the said issue.
8. In so far as the enhancement sought by the Claimant, it
is the contention of the learned counsel for the Claimant that
the Tribunal has failed to consider the evidence led by the
Claimant with regard to the injuries and the permanent
disability caused arising out of the said injuries. It is further
argued that the Claimant has led evidence of the employer
which indicates that in case the Claimant had not sustained
disability, he would have got promotion as a Manager and
since the same has not been achieved by him, there is loss of
income, so also, his future prospects are adversely affected. In
this regard, references are made to the evidence of claimant
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as well as the employer. It is further argued that the Tribunal
has erred in deducting a sum of Rs. 3,67,270/-which was
received by the Claimant under the Mediclaim Policy. It is her
submission that any such amount received by the claimant
cannot be deducted from the payment of compensation. To
support all these submissions, she placed reliance on the
following Judgments:
(a) Vasant Bugde vs Vasant Raghunath Joshi;1
(b) Mohd Sabeer alias Shabir Hussain vs Regional
Manger, UP State Road Transport Corporation.2
9. Learned counsel for the Insurer opposed the plea of
enhancement on the ground that the Tribunal has taken into
consideration the admissions of the claimant with regard to
he having received at least two promotions after the
occurrence of the accident and his salary is also increased
considerably. It is a submission that having regard to all
these facts, the Tribunal has rightly refused the compensation
for future loss of income and future prospects. He drew
1 2015 2 ACC 219: 2015: 2 BomCR 326.
2 2023 ACJ 1: 20231 Supreme 564.
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attention of the Court to the amount of compensation granted
by the Tribunal, according to him, is just and fair
compensation in the facts of the case.
10. No doubt, in case the claimant is in the position to
establish that there is a loss of income or on account of the
permanent disability, and the future income is likely to be
affected, he is entitled to be compensated for the same. The
perusal of the evidence on record, more particularly, the
admission of the claimant in his cross-examination that his
salary is increased after the occurrence of the accident, so
also, he is granted two promotions and at the time of
deposition before the Tribunal, he was holding the post of
Assistant Manager. No doubt the employer claims that the
Claiming could have got the promotion as a manager,
however, in the cross-examination, candid admission is given
to the effect that except for the bare statement of this witness,
there is no other material to support the said contention. As
far as grant of promotion, there are number of factors on the
basis of which decision of grant or refusal thereof is
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dependant. In absence of specific evidence, that owing to
disability of Claimant, promotion has been refused, it cannot
be held so.
11. Having regard to the nature of injuries caused to the
claimant, and the other evidence which shows that there is no
adverse effect on his income or even future prospects, the
Tribunal was fully justified in not compensating him for the
same.
12. The Tribunal, however, ought not to have directed
deduction of a sum of Rs. 3,67,270/- towards the
reimbursement received by him under the Mediclaim Policy.
Now it is the settled position of law that the entitlement of
the compensation is not dependent upon the reimbursement
made under any other policy/ Mediclaim Policy, which is
obtained by paying premium.
13. In view of the above discussion, Appeal filed by the
Insurer is dismissed. Appeal filed by the Claimant is partly
allowed. It is held that over and above the compensation
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granted by the Tribunal, Claimant is entitled to receive a sum
of Rs. 3,67,270/- along with the interest at rate of 8% per
annum from the rate of filing of the application till
realisation. Rest of the Judgment and Award passed by
Tribunal to remain unchanged.
14. In view of the above, I pass the following order:
ORDER
(a) The Appeal is dismissed.
(b) The Claimants are permitted to withdraw the
deposited amount along with accrued interest
thereon.
(c) The statutory amount be transmitted to the Tribunal
along with accrued interest thereon. The parties are
at liberty to withdraw it as per Rule.
(d) R & P be sent back to the Tribunal.
15. In view of dismissal of the Appeal, pending Applications, if
any, stand disposed of.
(R. M. JOSHI, J.)
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