Karnataka High Court
The Regional Director vs Mrs Shakitha on 16 February, 2018
Author: Aravind Kumar
Bench: Aravind Kumar
IN THE HIGH COURT OF KARNATAKA AT BENGALURU
DATED THIS THE 16TH DAY OF FEBRUARY, 2018
BEFORE
THE HON'BLE MR.JUSTICE ARAVIND KUMAR
MFA NO.2898 OF 2017 (ESI)
BETWEEN:
1. The Regional Director,
The ESI Corporation,
Regional Office (Karnataka),
No.10 Binni Fields, Binny Pet,
Bangalore-23.
2. The Deputy Director,
The ESI Corporation,
Regional Office (Karnataka),
No.10 Binny Fields, Binny Pet,
Bangalore-23
...Appellants
(By Sri.Narasimha Holla, Advocate)
AND:
1. Mrs.Shakitha,
W/o Ravindra Suvarna,
Janaki Thota,
Kannur Post,
Mangalore-575 007
Employee of M/s.Boston Tea (India) Ltd.,
Mangalore-575 002.
2. Director, Govt of Karnataka,
Directorate of ESIS Medical Services,
Rajajinagar, Bangalore-560 010.
...Respondents
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This MFA is filed under Section 82(2) of Employees
State Insurance Act 1948, against the order dated
13.01.2017 passed in ESI application No.3/2013 on the
file of VI Additional District and Sessions Judge,
Dakshina Kannada, Mangaluru and Presiding Officer,
Labour Court, D.K., Mangaluru C/c, Presiding Officer,
Labour Court cum ESI at Mangaluru, D K., allowing the
application filed under Section 75 of the ESI Act, 1948.
This MFA coming on for Orders, this day, the Court
delivered the following:
ORDERS ON IA.NO1/2017
2. The Employee State Insurance Corporation
(for short 'Corporation') in this appeal is assailing the
correctness and legality of the order passed by the
Labour Court/ESI Court, Dakshina Kannada,
Mangaluru in ESI Application No.3/2013 whereunder,
the application filed by the respondent No.1 herein
seeking for reimbursement of medical expenses
amounting to Rs.81,553/- with interest at 18% P.A. has
been allowed in part with a direction to the appellants-
Corporation to pay the said amount with interest at 6%
P.A. from date of application till date of realization.
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2. There is delay of 15 days in filing this appeal.
In the normal course, this Court would have ordered
notice on the application. However, in order to satisfy as
to whether any fruitful purpose would be served by
issuing notice on this application and on appeal, this
Court has examined and perused the judgment and
order passed by ESI Court on merits and finds that
absolutely there is no merit in this appeal for being
entertained for the reasons set forth herein below.
3. Respondent No.1 was working as packer in
M/s Boston Tea (India) Ltd., Mangalore, which is a
covered establishment under the Employees State
Insurance Corporation Act, 1948 (for short 'ESI'). On
29.07.2009 while she was discharging her duties at
about 4 PM her forearm got stuck into a machine,
resulting in sustaining grievous injury. Immediately, she
was admitted to the nearby A.J.Hospital & Research
Centre, Kuntikan, Mangalore and she was inpatient at
said hospital from 29.07.2009 to 26.09.2009. Medical
expenses incurred by her for treatment was in a sum of
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Rs.1,56,553/-. She sought for reimbursement of the
same by submitting an application/letter through her
husband. The Corporation reimbursed partial amount of
Rs.75,000/-. On 08.09.2017, through communication, it
was intimated that they are unable to reimburse the
amount of Rs.81,553/- towards medical expenses.
4. Contending inter-alia no justifiable reasons
have been offered by Corporation for rejection of her
claim, she approached the Labour Court cum ESI Court
by filing an application under Section 75 of ESI Act,
1948 and on being notified, the appellants herein
appeared and filed its statement of objections contending
that she has been admitted to a private hospital even
though ESI hospital facilities were available nearby
working place. The jurisdictional Court has found that
Corporation having partially satisfied the claim by paying
a sum of Rs.75,000/- and after having received
subscription from the employer, it was incumbent upon
the Corporation to reimburse the medical bills submitted
by the applicant i.e. respondent No.1 herein and as such
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has directed to pay the amount with interest at 6% P.A.
as against of 18% P.A.
5. Mr.Narasimha Holla, learned counsel
appearing for the Corporation would vehemently contend
that norms has been prescribed by Sanjay Gandhi
Hospital and rates indicated by them was the basis on
which reimbursement has been made and Labour Court
having noticed this fact since Officials of the Corporation
who were examined had deposed to said effect it erred in
arriving at a conclusion that there were no documents
produced on behalf of the Corporation to establish that
claim made by the application is either not in
consonance with the injury sustained or being contrary
or claim being exorbitant and contrary to the norms
prescribed by the Sanjeev Gandhi Hospital. Hence, he
contends ESI Court was not justified in directing the
payment of balance amount of Rs.81,883/-.
6. ESI Court has ordered for reimbursement of
the balance amount withheld by Corporation with
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interest. However, the interest claimed by the applicant
at 18% P.A has been turned down and has ordered the
Corporation to pay 6% P.A. interest from the date of
application till date of payment which cannot be
considered either exorbitant or excessive. Considering
the nature of injury sustained by the applicant viz.,
crush injury to forearm, the medical bill submitted by
the applicant cannot be held as being excessive and it
was also not the case of Corporation before ESI Court
that bills submitted by the applicant were fabricated or
claimant had not sustained the injuries as reflected in
the medical records. On the other hand, it is the
grievance of the Corporation that claims made under
certain heads in excessive and not in consonance with
norms prescribed by Sanjay Gandhi Hospital. When
Corporation is not disputing the nature of injuries
sustained, the amount claimed to have been expended
by claimant for obtaining treatment to the said injury
cannot be turned down as contrary to norms and
particularly when it has received employees contribution.
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Claimant having sustained a crush injury on account of
forearm having got struck in the machine she was
shifted to the nearest Hospital and treatment having
been obtained by her at a private hospital and not at ESI
hospital by itself would not be a ground to reject her
claim. In these circumstances, the order of the Tribunal
cannot be construed as a precedent.
7. In that view of the matter, this Court finds
that there is no substantial question of law involved in
this appeal for being formulated and adjudicated and as
such issuing notice on the application for delay would
not serve any purpose. Hence, the following order;
ORDER
i. Application for condonation of delay is hereby dismissed and consequently, appeal is hereby dismissed.
ii. Order passed by the Labour Court/ESI Court dated 13.01.2017 in ESI application No.3/2013 is hereby affirmed.
8Hence, IA.No.1/2017 is hereby dismissed.
Consequently, appeal is also hereby dismissed.
In view of dismissal of the main appeal, IA.No.2/2017 does not survive for consideration.
SD/-
JUDGE SB