State Consumer Disputes Redressal Commission
Karamchari Rajya Bima Nigam vs Ajay Sharma on 13 April, 2023
Daily Order M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PLOT NO.76, ARERA HILLS, BHOPAL FIRST APPEAL NO. 422 OF 2017 (Arising out of order dated 09.01.2017 passed in C.C.No.164/2016 by District Commission, Ujjain) 1. KARAMCHARI RAJYA BIMA NIGAM, THROUGH MANAGER, NEAR AUSHADHALAYA, PATEL NAGAR, INDORE (M.P.) 2. KARAMCHARI RAJYA BIMA NIGAM, THROUGH MANAGER, B.O.MILL AREA, 15, YASHWANT NIWAS, INDORE (M.P.) .... APPELLANTS. Versus 1. AJAY SHARMA, S/O SHRI SOMESHWAR SHARMA, R/O GALI NO.4, AVANTIPURA, UJJAIN (M.P.) 2. NAI DUNIYA PRESS, INDORE, THROUGH MANAGER FOURTH & FIFTH FLOOR, VIKRAM URBAN, 25-A, SCHEME NO.54, INDORE (M.P.) 452 010 .... RESPONDENTS. BEFORE : HON'BLE SHRI JUSTICE SHANTANU S. KEMKAR : PRESIDENT HON'BLE SHRI D. K. SHRIVASTAVA : MEMBER
HON'BLE DR. (MRS) MONIKA MALIK : MEMBER COUNSEL FOR PARTIES : Shri Hashim Ali, learned counsel for the appellants. Ms. Mona Paliwal, learned counsel for the respondent no.1. None for the respondent no.2. O R D E R (Passed on 13.04.2023)
The following order of the Commission was delivered by Dr.(Mrs) Monika Malik, Member:
This appeal by the opposite party no.1 & 2/appellants-Karamchari Rajya Bima Nigam (hereinafter referred to as 'appellants') is directed against the order dated 09.01.2017 passed by the District -2- Consumer Disputes Redressal Commission, Ujjain (for short 'District Commission') in C.C.No.164/2016, whereby the District Commission has partly allowed the complaint filed by the complainant/respondent no.1 (hereinafter referred to as 'respondent no.1').
2. Briefly put, facts of the case are that the complainant/respondent no.1 during his service hours met with an accident on 01.06.2013 in the office of the opposite party no.3/respondent no.2 in Ujjain. He received treatment in Patidar Hospital, Ujjain and was advised bed rest. He could not rejoin duty for a period of three months. The respondent no.1, seeking reimbursement of expenses incurred in his treatment with medical benefits, had approached the appellants. It is alleged that the appellants did not pay the claim amount despite several reminders. Therefore alleging deficiency in service on part of the opposite parties, he approached the District Commission, seeking relief.
3. The right to file reply of opposite party no.1 & 2/appellants was closed by the District Commission. However, the District Commission decided the question of maintainability of complaint raised by the appellants. The opposite party no.3/respondent no.2 did not file any reply to the complaint.
4. The District Commission partly allowed the complaint and directed the opposite party no.1 & 2/appellants, jointly and severally to pay -3- Rs. 24,059/- to the complainant/respondent no.1 with Rs.2,000/- as litigation costs within a period of two months, failing which the aforesaid amount is directed to be paid with interest @ 7% p.a. Hence this appeal.
5. Heard. Perused the record.
6. Learned counsel for the appellants argued that the District Commission has not taken into consideration the fact that it had no jurisdiction to entertain the complaint under the provisions of Section 53 of the Employees' State Insurance Act, 1948. He also argued that liability regarding payment, whatsoever, lies with the State Government. He also argued that as per Section 74 of Employees' State Insurance Act 1948, the jurisdiction to hear the matters related to insured persons lies with the Employees' Insurance Court. The Consumer Courts have no jurisdiction to entertain such complaints. He therefore, argued that the impugned order deserves to be set-aside.
7. Learned counsel for the complainant/respondent no.1 argued that the District Commission has rightly passed the impugned order taking into consideration all relevant aspects of the matter. The Consumer Courts are not barred for entertaining complaints regarding employees' insurance matters. The District Commission has rightly decided the case.
8. Prime objection of the appellants is regarding question of maintainability of the complaint. As regards the question of maintainability -4- of complaint before the Consumer Commissions, we find that Hon'ble Supreme Court in Kishori Lal Vs Chairman, Employees' State Insurance Corporation decided on 8 May, 2007, in para 14 has held that:
'We are of the opinion that the service provided by the ESI Hospitals/Dispensaries falls within the ambit of 'Service' as defined in the Section 2(1)(o) of the CP Act. ESI Scheme is an insurance scheme and it contributes for the service rendered by the ESI hospitals/dispensaries of medical care in its hospitals/dispensaries, and as such service given in the ESI hospitals/dispensaries to a member of the Scheme or his family cannot be treated as gratuitous.' Further in para 17, the Hon'ble Supreme Court has held that:
'The trend of the decision of this Court of the jurisdiction of the Consumer Forum should not and would not be curtailed unless there is an express provision prohibiting the Consumer Forum to take up the matter which falls within the jurisdiction of Civil Court or any other forum as established under same enactment. The Court had gone to the extent of saying that if two different fora have jurisdiction to entertain the dispute in regard to same subject, the jurisdiction of the Consumer Forum would not be barred and the power of the Consumer Forum to adjudicate upon the dispute could not be negated. ' Hon'ble Supreme Court in para 20 (c) has held that:
................Further, it can be seen that any claim arising out of and within the purview of the Employees' Insurance Court is expressly barred by virtue of sub- section (3) to be adjudicated upon by a civil court, but there is no such express bar for the consumer forum to exercise the jurisdiction even if the subject matter of the claim or dispute falls within clauses (a) to (g) of sub-section (1) of Section 75 or where the jurisdiction to adjudicate upon the claim is vested with the Employees' Insurance Court under clauses (a) to (f) of sub- section (2) of Section 75 if it is a consumer's dispute falling under the CP Act.-5-
9. The employee's contribution towards the insurance scheme under the Employees' State Insurance Act, 1948 was being deducted regularly from his salary and deposited by his employer with the Corporation. The District Commission vide order dated 12.09.2016 has appropriately decided the question of maintainability of the complaint case. Aforesaid discussion leaves no doubt that the complainant is a 'consumer' within the ambit of Section 2(1)(d) of the Consumer Protection Act, 1986 and the complaint filed by him can be adjudicated before the Consumer Courts.
10. The District Commission, after considering the documents and medical bills available on record has elaborately decided the matter. It has rightly found the complainant/respondent no.1 eligible for reimbursement of medical expenses borne by him, along with sickness benefits and has awarded compensation in accordance with the provisions. We do not find any infirmity or illegality in the impugned order and it is hereby upheld.
11. As a result, this appeal is dismissed, with no order as to costs.
(JUSTICE SHANTANU S. KEMKAR) (D.K.SHRIVASTAVA) (DR. MONIKA MALIK) PRESIDENT MEMBER MEMBER