Thread: Yashashwini Co-Operative Farmer’s Health Care Trust

S. Jagathpal Jain
S/o Late Ananthraj Jain @ Ananthraj Shetty
Aged about 69 years,
Occupation : Agriculturist,
D.No.664, Chowkipet,
DAVANAGERE.

(Sri. M.N. Ranganathan, Advocate)

V/s
OPPONENTS:
1. State of Karnataka By
The Secretary – Ministry of Co-Operation,
Government of Karnatka,
Vidhana Soudha, Bangalore – 560001.
1A. The Yashashwini Co-Operative Farmer’s
Health Care Trust,
By its Chairman – The Principal – Secretary,
Department of Co-Operative, Government of Karnataka
Vidhanasoudha, Bangalore.
2. Family Health Plan Limited,
Yashaswini Co-Operative Farmers
Health Care Scheme
# 1335, VII Main, II Stage, ‘A’ Block,
Rajaji Nagar, Bangalore- 560010.
3. The Co-Ordinator F.H.P.L.,
District Registrar of Co-Operative Societies,
Pune – Bangalore Road,
Davanagere
4. Davanagere City Agricultural Service
Co-Operative Society Bank Ltd.,
(Vyavasaya Seva Sahakara Sangha Bank Niyamith)
Pooja International Opp., P.B. Road,
Davanagere.

Date of filing : 23-02-2008
Date of Disposal : 19-06-2009

: JUDGMENT :

The complainant Sri.Jagathpal Jain.S. has filed this complaint against the opponents 1, 1 (a) 2 to 4 U/s U/sec. 12 of the Consumer Protection Act to direct the Opponents particularly opponent No.2 to pay a sum of Rs.1,32,703-60 paise and damages and cost of this litigation.

2. The facts of the case in brief are as follows :-

The complainant is in agriculturist owning 28 cents of land at Sanganabettu village in Bantval Hobli Dakshina Kannada District. The above property is his property. He was personally cultivating the same and later to supplement his income he came to Davanagere in search of a job and took a job in private firm. He would visit his native place periodically to supervise cultivation and manage the property and to receive the yield from the land. The Government of Karnataka launched a scheme for promotion, protection and care of the health of the farmer’s community in the state. It also promulgated to provide for the actual cost of certain surgical operations which the farmers would not be able to meet under normal circumstances. The Government started the scheme Yashaswini Co-Operative Farmers Care Health Scheme.

The Scheme is managed by the trust called Yashaswini Co-Operative Farmers Health Care Trust which is the governing body for administrative and over all function, in the state of Karnataka. The Opponent No.2 is the implementing agency. Under the Scheme a net work of hospitals are covered who have to carry out the object of the scheme like providing medical treatment more particularly the required surgical operations without receiving the cash from the farmers (a member and beneficiary of the scheme).

3. The normally farmers are that the particular farmer should become the member of the service co-operative society who would in turn secure the membership of the above scheme to the said member. The opponent No.2 would also issued an ID card to the member farmer. The farmer should present the ID card with the requisite papers to the network hospital in which he proposes to receive the medical treatment or surgical operation. The concerned hospital would send papers to the opponent No.2 for scrutiny with the estimate bill of the cost of treatment including surgery. After receiving the clearance from the said agency, the hospital would perform operation on the farmer without receiving cash from the patient. The agency would pay or reimburse the actual cost involved. This is the broad outline of Yashswini Scheme and the procedure for the beneficiary to receive the care treatment.

4. The complainant an agriculturist desired to avail the benefit and service of the above scheme. The complainant became a member of the Yashswini Co-operative Farmers Health Scheme by becoming the member of the Davanagere City Seva Sahakara Bank Ltd., by paying Rs.115/- to the said Co-Operative Society on 25-05-2004. He also become a member of the society by paying the Rs.120/- in the yeas 2004-05, 2005-06 vide receipt Nos.867117 & 865643. The opponent No.2 issued identity card of UHID No.DVG 2312451. The complainant had a Heart Problem and so he approached Narayana Hrudayalan, Bangalore for Medical Check-up, investigation and treatment on 17/02/2006. He was admitted as an inpatient in the said hospital for a thorough checkup. After checkup the doctors of the said hospital informed that an emergent surgical heart operation will have to be performed on the Heart (CAGB surgery). The hospital authorities sent the details of the medical examination report for necessary scrutiny on 20/02/06.

The opponent No.1 sent the papers to the District Registrar of Co-Operative Societies, Advantage to receive the report relating to the society. The complainant was in Bangalore contacted the said officer who informed that the concerned officer incharge of the Yashaswini unit in his office and gave his mobile number. But it was of no use to the complainant, as the concerned officer did not talk to him properly. However, the opponent No.3 is stated to have returned the papers to Narayana Hrudayalaya, Bangalore with an endorsement “As per the society verification it has been found that the documents are not properly maintained (tallied), thus rejected dated: 01-03-2006.

5. The complainant as the member of the scheme is entitled for receiving the service of monetary benefit to meet the operation expenses, because of the rejection of the complainant’s claim or service of monetary benefit, he is denied a service which the opponents particularly opponent NO.2 is obliged to provide. The opponents No.3 ought not to have rejected complainant’s claim for the service or the omissions or negligence of the opponent No.4, when the opponent No.2 has issued the I.D. card to the complainant vide UHID No.DVG 23124541. The opponents are bound by this and estopped from denying the claim of service of monitory benefit to the complainant. The complainant is a consumer entitled for the service of meeting his medical expenses by the opponent No.2 issue of I.D. card by the opponent No.2 to the complainant created a contract of providing service to him and denial of the same has given rise to a Consumer Dispute.

6. Since the exigency demanded immediate attention to his health and care the complainant who was obliged to spend money from his pocket i.e., paying of the money to the hospital by missing loans from as per the bill sent to the opponent No.2 that an amount of Rs.1,04,966/- was to be borne by the Yashaswini Scheme. Since, the said amount was not sent, the complainant spent the amount and he was operated on 06-03-06. The complainant had to adjust money from the sources as stated above to meet the above operational expenditure and incidentals like ward charges and other medicines, etc.

This caused great mental agony to the complainant. Therefore, has opted to claim re-imbursement of the above sum of Rs.1,04,966/- besides claiming damages for mental agony at the rate of Rs.1 ½% p.m. from the date of rejection of the complainants claim by the opponent No.2 and 3. The complainant has claimed Rs.1,04,966/- being the operation expenditure which was to be borne by the opponent No.2 plus damages at 1 ½ % from 01-03-06 to 11-02-08 Rs.26,737-60 paise and notice fee of Rs.1,000/- in all Rs.1,32,703-60. Under the above said facts and circumstances of the case, the complainant has filed this complaint against the opponents for the above said reliefs.

7. In pursuance of statutory notices issued by this Forum, the opponent No.1 entered appearance through District Government Pleader and Opponent No.2 to 4 entered appearance through their advocate. The opponent No.2 and 3 have filed their version separately. The opponent No.1 adopted version filed by the opponent No.2 and 3. 4th opponent has filed its version separately.

8. The opponents No.2 and 3 have contended in their version that, the complainant has not approached this Forum with clean hands. As per the reported Judgment of the Hon’ble High Court reported in 1965(1) Mysore Law Journal Page 370, wherein it is held that;

“ One of the main consideration is the fairness and

good conduct of the party invoking of the aid of the

court. The court denies the relief to the suitor who

is himself guilty of misconduct in respect of the

matter in controversy”

9. In the present case the complainant without disclosing the real and true facts of the case has filed the complaint. Therefore, there is no merit in the complaint. Hence, it is liable to be dismissed with exemplary costs. The very reading of the complaint itself clearly speaks that the complainant is making false claim. The complainant in the first place contends that he is owning 28 cents of land of Sangabettu village in Bantval Hobli, Dakshina Kannada District. But as very strangely is alleged to have taken the membership at Davanagere District. As such it is clear case as fraud committed by the complainant only to have unlawful gain. The District Co-Ordinator i.e., opponent No.3 after receipt of the pre-authorization has conducted the enquiry and has found that the Co-Operative Society i.e., Opponent No.4 has maintained two cash books and further the name of the complainant has been inserted in the cash books and manipulated and further the share ledger books are not tallying with the cash book. There will be only one cash book for a society.

Two cash books are maintained by the opponent No.4 colluding with the complainant only to help the complainant. A detailed enquiry in this regard is also required and Co-Operative Society is also party to the proceedings as opposite party No.4. If such kind of false complaint are entertained the real beneficiaries will suffer. It is also learnt that the complainant is a jeweller by profession and the very purpose for which the Yashaswini Scheme is introduction for the purpose for farmers will be frustrated if such false complaints are entertained. Therefore, there is no merit in the complaint. Hence, the complaint is liable to be dismissed with exemplary costs.

10. The Opponents No.2 and 3 i.e., Family Health Plan Ltd is only an implementing agency and it works in accordance with the rules framed by the Yashaswini Co-Operative Farmers Health Care Trust. The Opponent No.2 and 3 Family Health Plan Ltd is appointed by the Trust and it is not a reimbursing authority. It is the Yashaswini Co-Operative Farmers Health Trust i.e., Opponent No.1 which is only a reimbursing authority. The opponent NO.2 and 3 i.e., Family Health Plan Ltd., works only as a third party Administrator and acts as a facilitator and further it is only the trust which is monitoring the funds of the Yashaswini scheme.

The complainant is not a Consumer of the opposite parties No.2 and 3 since opponent No.2 and 3 are only implementing agency and not the reimbursing authority. The complainant ought not to have impleaded the opposite parties No.2 and 3 as parties to the proceedings and as such the complaint is liable to be dismissed on the ground of mis-joinder of the necessary parties. Viewed from any angle the complainant has utterly failed to make out a prima-facie case and further the Family Health Plan Ltd., which is only a implementing agency i.e., which has come into existence only to implement the scheme has not committed any deficiency in its service.

It is only the trust which collects the premium amount from the beneficiaries and as such it is the trust alone which is monitoring the funds. The Family Health Plan Ltd., i.e., Opponent NO.3 and and Yashaswini Co-Operative Farmers Health Care Trust i.e., the opponent No.1 are two different entities and are in existence. Hence, the complainant cannot implead the Family Health Plan Ltd., as party to the proceedings and as such the complaint is liable to be dismissed for mis-joinder of the parties. Therefore, there is no merit in the complaint. Hence, the complaint should be dismissed with exemplary costs.

11. 4th Opponent has contended that, the complainant made a requisition seeking the membership of Davanagere City Agricultural Co-Operative Service Society, P.B. Road, Davanagere. Accordingly, the petition was placed before the executive committee of the society and his membership was accepted. The required fee was also received and receipts were also passed against the payment, but till today, the 4th opponent has not received any intimation to furnish the particulars of the document pertaining to the complaint.

As such the context of raising any finger against the opponent No.4 does not or did not arise at all. The complainant has arrayed the opponent No.4 unnecessarily and opponent No.4 is nothing to do with the allegations made with the opponent No.1 to 3. Such allegations are not within the knowledge of the 4th opponent. Hence, the complaint should be dismissed.

12. The complainant has filed his affidavit evidence by way of Chief-Examination. One. B.Manjunath, 4th Opponent has filed his affidavit evidence by way of Chief-examination. The complainant has produced several documents in support of his case. The learned counsel for complainant has submitted his written arguments.

13. Now, the points that arise for consideration of this Forum are as follows:-

i). Whether there is any deficiency of service on the part of

the opponents?

ii) If so, whether the complainant is entitled to the reliefs as sought?

iii) What Order?

14. Our findings on the above points are as follows:-

i) Point No.1: Negative

ii) Point No.2: As does not arise

iii) Point No.3: See, as per order below:


for the following:-
REASONS
Points 1 and 2 :-

15. It is not in dispute that the complainant is an agriculturist owning 28 cents of land at Sangabettu Village in Bantval Hobli and Taluk of Dakshina Kannada District and the complainant was personally cultivating the same land, later to supplement his income he came to Davanagere in search of a Job in private firm and he would visit his native place periodically to supervise cultivation and manage the property and to receive the yield from the land. The complainant has produced the RTC to show that, he is an agriculturist and owning 28 cents of dry land. The name of the complainant has been shown as owner and as cultivator in cultivator’s column and he purchased the said land during 1996-97 under Registered sale deed. It is not in dispute that, now the complainant is presently doing job in private firm at Davanagere.

It is an admitted fact that the Government of Karnataka introduced a scheme for promotion, protection and care of the health of the farmer’s community in the state. The Government of Karnataka sponsored the scheme called the Yashaswini Co-Operative Farmer’s Care Health Scheme. It is also not dispute that the said scheme is managed by a trust called Yashaswini Co-Operative Farmer’s Health Care Trust which is the Governing body for administrative and over all function. It is not in dispute that the opponent No.2 is the implementing agency. Under this scheme a network of hospitals are covered who have to carryout the object of the scheme like providing medical treatment more particularly required surgical operations without receiving the cash from the farmers.

16. It is an admitted fact that the 2nd opponent would also issued I.D. card to the member farmer and the member farmer should present the I.D. card alongwith the requisite papers to the network hospitals in which he proposes to receive the medical treatment or surgical operation and the concerned network hospital would send the papers to the opponent NO.2 for scrutiny with the estimate bill of the cost of treatment including surgery. It is not in dispute that, after receiving the clearance of the said agency. The hospital would perform operation on the farmer without receiving cash from the patient and the agency would pay or reimburse the actual cost involved. According to the complainant that the complainant became member of the Yashaswini Co-Operative Farmer’s Health Scheme by becoming the member of the Davanagere City Seva Sahakara Sangha Bank Ltd., by paying Rs.115/- to the said Co-Operative Society on 25-05-04. He also became a member of the society by paying Rs.120/- in the years 2004-05, 2005-06 vide receipt Nos.867117.

17. The complainant has produced the receipt for having deposited Rs.115/- to the Davanagere City Seva Sahakara Bank Ltd., on 20/05/04. The complainant has produced receipt for having paid Rs.120/- on 21/03/06 and deposited Rs.125/-. From these receipts it is found that, he continued as a member of the said Yashaswini scheme from 20/5/04 and further the said membership continued from 20/4/2004 to 20/4/2005. The complainant has produced the identity card issued by the VSSBN, Davanagere City. The UHID number mentioned as DVG2312451. The 2nd opponent has issued an I.D. card to the complainant. According to the complainant, the complainant paid Rs.115/- to the said Co-Operative Society on 25/5/04 and he also became a member of the society by paying Rs.120/- for the years 2004-2005, 2005-2006.

The above said fact is supported by documentary evidence. According to the complainant that in order to have benefit of the said scheme particular farmers should become the member of the service co-operative society who would in turn secure the membership of the above scheme to the said member and the opponent No.2 would also issue an I.D. Card to the member farmer. The member farmer should present the I.D. card with the requisite papers to the network hospital in which he proposes to receive the medical treatment or surgical operation and the concerned network hospital would send the papers to the opponent No.2 for scrutiny with the estimate bill of the cost of treatment including surgery. According to the complainant, after receiving the clearance from the said agency, the hospital would perform operation on the farmer without receiving cash from the patient and the agency would pay or reimburse the actual cost involved.

18. According to the complainant that the complainant had a Heart problem and so he approached Narayana Hrudayalaya, Bangalore for medical check-up, investigation and treatment on 17-02-06. During that day he was the member of the said scheme. According to the complainant that, he was admitted as inpatient in the said hospital for a thorough check-up and after checkup the doctors of the said hospital informed that an emergent surgical heart operation will have to be performed on the heart.

The hospital authorities sent the details of the medical examination report for necessary scrutiny on 20/02/2006 and the opponent No.1 sent the papers to the District Registrar, Co-Operative Societies, Davanagere to receive the report relating to the society and the complainant who was in Bangalore contacted the said officer who informed that the concerned officer incharge of the Yashaswini Unit in his office and gave his mobile number. But it was of no use to the complainant as the concerned officer did not talk to him properly. But, the opponent No.3 is stated to have returned the papers to Narayana Hrudayalaya, Bangalore with an endorsement “As per the society verification it has been found that the documents are not properly maintained (tallied), thus rejected” dated:01-03-2006.

19. According to the complainant that as the member of the scheme, he is entitled for receiving the service of monetary benefit to meet the operation expenses. Because of the rejection of the complainant’s claim or service or monetary benefit, the said benefit is denied a service which the opponents particularly opponent No.2 is obliged to provide. According to the complainant that the 3rd opponent ought not to have rejected the claim for the above service or the omissions or negligence of the opponent No.4. According to the complainant that, when the opponent No.2 has issued the I.D. Card to the complainant vide UHID No.DVG 23124541. The opponents are bound by this and estopped from denying the claim of service of monetary benefit to the complainant.

According to the complainant that the complainant is a consumer entitled for the service of meeting his medical expenses by the opponent No.2 issue of I.D. Card by the opponent No.2 to the complainant created a contract of providing service to him and denial of the same has given rise to a consumer dispute. It is not in dispute that the complainant spent own money and he was operated on 6/3/06. No doubt, the complainant has stated that he adjusted the money from raising loan and paid the bill amount of Rs.1,04,966/-. According to the complainant that, there is deficiency of service on the part of the opponents.

20. The complainant has admitted to Narayana Hrudayalaya, Bangalore for medical check-up, investigation and treatment on 17/02/2006 as inpatient for a thorough check-up and after check-up the doctors of the said hospital informed that an emergent surgical heart operation will have to be performed on the Heart and the hospital authorities sent the details of the medical examination report for necessary scrutiny on 20/02/2006 and the opponent No.1 sent the papers to the District Registrar of Co-Operative Societies, Davanagere to receive the report relating to the society. And the complainant contacted the concerned officer incharge of the Yashaswini Unit from Bangalore at Advantage. But it was of no use to the complainant as the concerned officer did not talk to him properly and the 3rd opponent is stated to have returned the papers to Narayana Hrudayala, Bangalore with an endorsement “As per the society verification it has been found that the documents are not properly maintained (tallied) thus rejected” dated: 01-03-06.

21. According to the opponents No.2 and 3, the complainant without disclosing real and true facts of the case has filed the complaint and there is no merit in the complaint. According to the opponent No.2 and 3 that the complainant is making false claim. Further according to opponents No.2 and 3, the complainant in the first place contends that he is owning 28 cents of land at Sangabettu Village in Bantval Hobli, Dakshina Kannada Taluk and District. According to the complainant that, the complainant has not taken any membership of the Co-Operative Society at Dakshina Kannada District, but he alleged to have taken the membership at Davanagere District and as such it is clear case of fraud committed by the complainant only to have unlawful gain.

According to the opponents that, the District Co-Ordinator i.e., Opponent No.3 after receipt of the pre-authorization has conducted the enquiry and has found that the Co-Operative Society i.e., Opponent No.4 has maintained two cash books and further the name of the complainant has been inserted in the cash books and manipulated and further the share ledger books are not tallying with the cash books. According to the opponents there will be only one cashbook for the society. But two books maintained by the opponent No.4 colluding with the complainant only to help the complainant. Under the above said circumstances the opponent No.3 return the papers to Narayana Hrudayala, Bangalore with an endorsement.

22. Inview of the contentions taken by the opponent No.2 and 3 the complainant very strangely has not taken membership of a Co-Operative Society at Dakshina Kannada District, but as very strangely is alleged to have taken membership at Davanagere District and that it is a clear case of fraud committed by the complainant only to have unlawful gain. It is also clear from the contentions taken by the opponents that the opponent No.3 has conducted the enquiry and has found that the Co-Operative Society i.e., Opponent No.4 has maintained two cash books and further the name of the complainant has been inserted in the cash books and manipulated and further the share ledger books are not tallying with the cash books and there will be only one cash book with a society.

Two cash books are maintained by the 4th opponent colluding with the complainant only to help the complainant. According to the opponents that, the complainant is a Jeweller by profession and very purpose of which the Yashaswini Scheme is introduced for the purpose of farmers will be frustrated if such false complaints are entertained.

23. Inview of the contention taken by the opponents No.2 and 3 that, there is great deal of oral and documentary evidence is required to be produced and complicated issue to be decided and in this matter complicated question of law and facts are involved. When this being the case on hand the facts needing more elaborate evidence which could be dealt only by a Civil Court. Inview of the same the complaint filed by the complainant before this Forum is not maintainable.

The dispute between the complainant and the opponents is serious in nature and there are so many complicated questions of law and facts involved in this complaint and the Consumer Forum is not the proper forum to decide those serious questions of law and facts. Under the above said facts and circumstances, we are of the opinion that this is not a suitable case for adjudication by the District Forum. In our considered view it is just and proper to direct the complainant to seek his remedy in competent Civil Court i.e., for appropriate remedy. Inview of our foregoing discussion we have no hesitation to hold that there are sound and justifiable good grounds to dismiss the complaint filed by the complainant directing the complainant to approach the Civil Court to seek his remedy in competent Civil court. Accordingly, we answer point No.1 in Negative, Point No.2 as does not arise.

Point No.3

24. Inview of our findings on Points 1 and 2, the complaint filed by the complainant has to be dismissed. In the result we pass the following;

: ORDER :

· The complaint filed by the complainant against the opponents is hereby dismissed.

· However, the complainant is at liberty to approach the Civil Court for redressal of his grievances, if law and limitation permits and, if so advise.

· Having regard to the facts and circumstances of the case, there is no order as to costs.