F.A.No.813 OF 2008 AGAINST C.C.NO.150 OF 2006 DISTRICT CONSUMER FORUM KURNOOL
Between
1. The Manager,
M/s Kapil Chit Funds Pvt. Ltd.,
Kurnool Branch, Opp Zilla Parishad,
Kurnool
2. The Assitant General Manager,
M/s Kapil Chit Funds Pvt., Ltd.,
Kurnool Branch, Opp. Zilla Parishad
Kurnool
3. The Managing Director,
M/s Kapil Chit Funds Pvt. Ltd.,
Plot No.84, P&T Colony
Gunrock Enclave, Secunderabad
Appellants/opposite parties Nos.1 to 3
A N D
1. Mr.G.Sharat Babu S/o G.Krishna Murthy
R/o Door No.26, 348, Peta, Kurnool
Respondent/ complainant
2. The Manager,
E.S.I. Corporation, Opp. Balaji Hotel
Bellary Road, Kurnool
Respondent/opposite partyno.4
Counsel for the Appellants Sri N.Amarnath
Counsel for the respondent No.1 Sri M.Venkata Ramana Reddy
Counsel for the Respondents No.2 Sri S.Prabhakar Reddy
F.A.No.859 OF 2008 AGAINST C.C.NO.150 OF 2006
Between
1. The Manager,
E.S.I. Corporation, Opp. Balaji Hotel
Bellary Road, Kurnool rep. by its Asst.
Director of Regional Office Mr.G.S.N.Moorthy
S/o G.V.Road, aged about 55 yrs, Occ: Employee
5-9-23, Hill Fort Road, Hyderabad
Appellants/opposite parties No.4
A N D
1. Mr.G.Sharat Babu S/o G.Krishna Murthy
R/o Door No.26, 348, Peta, Kurnool
Respondent/ complainant
2. The Manager,
M/s Kapil Chit Funds Pvt. Ltd.,
Kurnool Branch, Opp Zilla Parishad,
Kurnool
3. The Assitant General Manager,
M/s Kapil Chit Funds Pvt., Ltd.,
Kurnool Branch, Opp. Zilla ParishadKurnool
4. The Managing Director,
M/s Kapil Chit Funds Pvt. Ltd.,
Plot No.84, P&T Colony
Gunrock Enclave, Secunderabad
Respondents/opposite parties no.1 to 3
Counsel for the Appellant Sri S.Prabhakar Reddy
Counsel for the respondent No.1 Sri M.Venkata Ramana Reddy
Counsel for the Respondents No.2 to 4 Sri N.Amarnath
F.A.No.903 OF 2008 AGAINST C.C.NO.150 OF 2006
Between
Mr.G.Sharat Babu S/o G.Krishna Murthy
R/o Door No.26, 348, Peta, Kurnool
Appellant/complainant
A N D
1. The Manager,
M/s Kapil Chit Funds Pvt. Ltd.,
Kurnool Branch, Opp Zilla Parishad,
Kurnool
2. The Assitant General Manager,
M/s Kapil Chit Funds Pvt., Ltd.,
Kurnool Branch, Opp. Zilla Parishad
Kurnool
3. The Managing Director,
M/s Kapil Chit Funds Pvt. Ltd.,
Plot No.84, P&T Colony
Gunrock Enclave, Secunderabad
4. The Manager,
E.S.I. Corporation, Opp. Balaji Hotel
Bellary Road, Kurnool
Respondents/opposite parties
Counsel for the Appellants Sri M.Venkata Ramana Reddy
Counsel for the Respondents No.1 to 3 Sri N.Amarnath
Counsel for the respondent No.4 Sri S.Prabhakar Reddy
QUORUM:
THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT
&
SRI R.LAKSHMINARSIMHA RAO, MEMBER
MONDAY THE THIRTIETH DAY OF NOVEMBER
TWO THOUSAND NINE
Oral Order ( As per R.Lakshminarsimha Rao, Member)
***
The three appeals arise out of the same order passed by the District Forum Kurnool in C.C.No.150 of 2006.
Briefly stated the facts of the case are that:
The complainant is an employee of the opposite parties no.1 to 3. The opposite parties no.1 to 3 deducted an amount of Rs.68/- per month from out of the salary of the complainant and remitted the same to the opposite partyno.4. The complainant met with an accident on 23.7.2005 whereby he sustained burn injuries. The complainant was shifted to opposite partyno.4 hospital where he was denied treatment on the ground that the opposite parties no.1 to 3 did not remit contribution. The complainant had taken treatment in Viswa Bharathi Hospital Kurnool. He had incurred an amount of Rs.one lakh for his treatment. The complainant has to incur Rs.2,000/- per month towards medical expenditure. The complainant has to undergo plastic surgery for his ear which requires an amount of Rs.2 lakhs. The complainant after discharge from Viswabharathi Hospital where he was treated for 11 days, approached the opposite parties no.1 to 3 and informed them about the opposite party no.4 refusing to provide treatment as also reimbursement of the amount he had incurred towards medical expenditure. The opposite parties no.1 to 3 as also the opposite partyno.4 had rendered deficient service to the complainant.
Opposite parties’ no.1 to 3 filed counter contending that it is not their duty to furnish ESI card to the complainant. It is the duty of the opposite party no.4 to issue the ESI Card to the complainant. The legal notice as also the reply notice had no mention of any role of the opposite parties no.1 to 3 in regard to their duty of issuing the ESI Card to the complainant.
The opposite party no.4 had contended that it has no role in making medical treatment or payment of reimbursement towards medical treatment or payment of reimbursement towards medical treatment of insured persons and their family. The opposite parties no.1 to 3 had submitted declaration form for issue of identity card only after the complainant left the service. Therefore, the opposite partyno.4 is not responsible for discharging medical benefits, ambulance services etc., to the insured persons though he may be entitled as per eligibility. The declaration form was made on 17.4.2006. The return of contributions was submitted n 10.10.2006 to the opposite party no.4. The complainant was injured in an accident on 23.12.2005. He was admitted to a private nursing home for 11 days. He was bed ridden and under treatment for two months. The complainant and the opposite parties no.1 to 3 are jointly and severally liable for the delay in submission of the declaration. Hence, the opposite partyno.4 is not liable to pay any amount to the complainant.
The District Forum has allowed the complaint holding the opposite parties no.1 to 4 jointly and severally liable to reimburse the complainant to an extent of Rs.3 lakhs towards medical expenditure, Rs.20,000/- as compensation as also Rs.3,000/- towards costs.
Being aggrieved by the order of the District forum, the opposite parties no.1 to 3 filed F.A.No.813 of 2008 and the opposite partyno.4 filed F.A.No.859 of 2008 contending that they are not liable to pay any amount much less the amount awarded. The complainant has preferred appeal F.A.No.903 of 2008 claiming enhancement of the amount from Rs.3 lakhs to Rs.13 lakhs.
The point for consideration is whether there was deficiency in service on the part of the opposite parties
The complainant is an employee working under the opposite partyno.1. opposite parties no.2 and 3 are the Asst. General Manager and Managing Director of Kapil Chit Fund Company Limited. Opposite party no.4 is the Manager of ESI Kurnool. Opposite parties no.1 to 3 said to have received contribution from the complainant through the opposite parties no.1 to 3. Basic salary of the complainant was fixed at Rs.2909/-. His gross salary was Rs.3885/-. An amount of Rs.68/- used to be deducted every month from out of the salary of the complainant by the opposite parties no.1 to 3 towards the employees contribution to the opposite partyno.4. On 23.7.2005 the complainant met with a sudden fire accident at his house resulting in severe burn injuries to him. The complainants suffered burn injuries to his left ear as also the other parts of his body. The complainant believing to be eligible for treatment in the opposite epartyno.4 hospital, approached it where he was appraised of the fact that he was not eligible for free treatment under ESI scheme as no contribution was paid by his employers, the opposite parties no.1 to 3. Subsequently the complainant was treated in some private hospital, Viswa Bharathi Hospital, Kurnool. The complainant incurred an amount of Rs.one lakh for his treatment.
The complainant stated to have been confined to bed for a period of two months during the period of treatment. The complainant was paid half of his monthly salary during the period of treatment. The ear problem of the complainant was not cured. The complainant states that he would incur a sum of Rs.2000/- per month towards medical expenses. The complainant informed the opposite parties no.1 to 3 about the refusal by the opposite party no.4 to pay the expenditure incurred by him for his treatment. The complainant submitted that opposite parties’ no.1 and 2 informed him that they paid their share of contribution to the opposite party no.4 regularly. The opposite party no.4 denied in receipt of contribution said to have been made by the opposite parties no.1 to 3. Ultimately, the complainant was compelled to approach the District Forum.
It is not in dispute that the complainant being an employee of the opposite parties no.1 to 3 and is entitled to get free treatment in the opposite party no.4. hospital provided the employment contribution is made by the opposite parties no.1 to 3 to the opposite party no.4. Though the opposite parties no.1 to 3 stated that they had credited the amount towards contribution of the complainant to the opposite party no.4, there is no evidence to that effect. Opposite parties no.1 to 3 disown their duty to furnish ESI card to the complainant. It is their contention that it is the duty of the opposite partyno.4. Regulation No.17 of Employees State Insurance Regulation 1980 casts duty on the opposite partyno.4 who receives the declaration of the employee through his employer. Ex.B1 was submitted by opposite partyno.1 to the oppospartyno.4. Hence the duty is cast on opposite partyno.4 to issue necessary identity card to the employee i.e., complainant of the opposite parties no.1 to 3.
The dispute in regard to the issuing of ESI identity card is only a subsequent incident that follows the issue whether the employee contribution was credited by the opposite parties no.1 to 3 to the opposite party no.4. It is manifest on the face of the records particularly in the light of Ex.A6, copy of legal notice dated 6.7.2006 got issued on behalf of the complainant and reply thereto under Ex.A7 that the opposite parties no.1 to 3 did not credit the contribution of the complainant to the opposite party no.4 resulting in the humiliation suffered by the complainant in the hands of the opposite party no.4 whom he approached with the fond hope that he would be treated free of charge basing on the contribution made by his employer i.e., opposite parties no.1 to 3 to the opposite party no.4. Therefore, we have no hesitation in holding the opposite parties no.1 to 3 deficient in service in regard to their failure to credit the contribution to the opposite party no.4. It is pertinent to note that the opposite parties no.1 to 3 have not complied the regulation no.14 of Employees State Insurance (General) Regulations, 1980 which contemplates submission of declaration of the employee by the employer on the date of the employee joining his employment. The opposite parties no.1 to 3 are also required to submit along with the declaration, Form No.3 within 10 days therefrom. An amount of Rs.68/- p.m. was deducted from the salary of the complainant by the opposite party no.1 who however failed to credit the said amount along with their contribution to the opposite party no.4.
The Employees State Insurance Act, 1975 provides benefits to the employees in case of sickness, maternity and employment injury and for certain other matter in relation thereto. The sickness mentioned in Sec.2(20) of ESI Act, 1948 is any condition which requires medical treatment, abstains from work on medical grounds. Ex.A2 case sheet shows that the complainant required medical attendance and treatment for the injuries sustained in the accident. He was paid half pay salary during the period of his treatment. Therefore, the requirement envisaged by Sec.2(20) of ESI Act, 1948 in regard to medical attendance and treatment in case of sickness has been satisfied for the purpose of extending the insurance benefit under the ESI Act.
Insofar as the liability of the opposite party no.4 is concerned, a reference to Sec.39(5)(a) of the ESI Act is essential to cull down the liability of the opposite party no.4 which in fact the District Forum had made on par with the liability of the opposite parties no.1 to 3. Sec.39(5)(a) of ESI Act lays down that if any contribution payable under the ESI Act is not paid by the employer on the date on which such contribution has become due he shall be liable to pay simple interest @ 12% per annum or such rate as may be specified in the regulation till the date of actual payment. Therefore, the role of the opposite party no.4 commences from the date of receipt of declaration along with Form No.3 pertaining to the complainant sent by the opposite parties no.1 to 3. Evidently, the opposite parties no.1 to 3 had not remitted the contribution to the opposite party no.4. Therefore, the opposite party no.4 cannot be held deficient in rendering its service to the complainant.
The complainant has claimed an amount of Rs.10 lakhs towards compensation and Rs.3 lakhs towards medical expenditure. However, the complainant had not placed any evidence on record to hold him entitled to the compensation and damages. The only evidence on record is that of PW1 Dr.Sudershan, a plastic surgeon and consultant to Viswabarathi hospital where the complainant was treated for his burn injuries. The doctor had given an estimate of expenditure of Rs.one lakh for plastic surgery in regard to the operation of ear of the complainant. The amount said to have been incurred by the complainant under Exs.A4 (2 bills), Ex.A5(bunch of 41 bills) has not been disputed by the opposite parties. The total amount under Exs.A3 to A5 comes to Rs.3,55,530.60 rounded of to 3,55,531/-. The claim under ESI Act can be entertained to the extent of Rs.3 lakhs only. Therefore, reimbursement of reasonable expenses can only be awarded. Hence, the complainant is held entitled to a sum of Rs.3 lakhs but not the amount of Rs.8 lakhs as claimed by him. Accordingly the appeals are disposed of.
In the result F.A.No.813 of 2008 filed by the opposite parties no.1 to 3 and F.A.No.903 of 2008 filed by the complainant dismissed. The appeal F.A.No.859 of 2008 is allowed setting aside the impugned order to the extent of liability of opposite partyno.4. No costs.


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