Haryana

Yamunanagar

CC/37/2010

Surinder Singh S/o Natha Singh - Complainant(s)

Versus

Employee's State Insurance Corporation - Opp.Party(s)

Sahib Singh Gurjar

16 Nov 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR

                                                                                           Complaint No. 37  of  2010.

                                                                                           Date of institution: 18.1.2010

                                                                                           Date of decision: 16.11.2015.

Surinder Singh son of Shri Natha Singh aged about 40 years resident of Gali No.4, Luxmi Nagar, Camp, Yamuna Nagar, Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                    …Complainant.

                                    Versus

 

1. Employees’ State Insurance Corporation, near ESI, Hospital, Jagadhri through its Incharge/ Manager.
2. M/s Nutan enterprises, Plot No.33 Industrial Area, Yamuna Nagar through its Proprietor-Shri Nutan Vohra. 

 

                                                                                                         … Opposite parties.

 

BEFORE:         SH. ASHOK KUMAR GARG, PRESIDENT

                        SH. S.C.SHARMA, MEMBER.

           

Present: Sh. S.S.Gujjar, Advocate, counsel for complainant.   

              Sh. Ashok Kamboj, Advocate, counsel for OP No.1.

              Sh. N.S. Rana, Advocate, counsel for OP No.2. 

 

ORDER

 

1.                     Complainant Sh. Surinder Singh has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying therein that respondents (hereinafter referred as OPs) be directed to pay a sum of Rs. 1,40,000/- spent on medical and travelling expenses  alongwith interest and further to pay Rs. 1,00,000/- as compensation on account of mental agony harassment etc. and Rs. 10,000/- as litigation expenses.  

2.                     Brief facts of the present complaint, as alleged by the complainant, are that complainant is/was the employee of OP No.2 under the kind supervision of OP No.2. The complainant was fully insured with OP No.1 bearing insurance cover note No. 5347707 being employee of OP No.2 and employer code no. is 13/23201. Hence, there exists a relationship of consumer and service provider between the parties. On 23.3.2007, the complainant was working as usual in the firm of OP No.2 and he was uplifting iron cutting from the press machine and suddenly the corner of hard punch of dye broken and hit the right eye of the complainant due to which his right eye fully damaged. After the incident, the complainant went to Dr. Arvind Gupta of Arvind Eye Hospital, Yamuna Nagar and thereafter he got treatment from PGI Chandigarh. The complainant was still under treatment and spent a sum of Rs. 1,00,000/-  on his treatment and complainant also spent a sum of Rs. 40,000/- on travelling expenses, taxi rent etc. for routine checkup of his eye at Chandigarh in Nehru Hospital. Photo copies of bills, medicines receipts etc. are enclosed with this complaint as Annexure C-1 to C-39. The complainant being fully insured with OP No.1 as employee of OP No.2 and requested so many times to the OPs to give financial assistance to complainant which was spent on his treatment, travelling expenses and taxi rent etc. but they did not pay even a single penny to him and totally refused to provide any financial aid to the complainant. In this way, the Ops are deficient and negligent in providing proper services to the complainant and they are indulged in unfair trade restrictive practices, due to which the complainant has suffered a lot of mental, physical and financial loss for which the Ops are liable to pay compensation to the complainant. Hence, this complaint.

3.                     Upon notice, OPs appeared and filed their written statement separately. OP No.1 filed written statement admitted to the extent that the complainant is an insured and an employee of OP No.2. The ESI Act is a Special Central Statute which itself is a complete Code where under only ESI Court has jurisdiction to entertain any dispute between employer and the corporation or employee and the corporation touching the issue of contribution funds and medical benefits available and permissible to an insured. It is also admitted to the extent that the complainant suffered under employment injury and he is getting all the legitimate medical benefits from the corporation as well as pensionery benefits admissible and permissible under ESI Act. The OP No.1 has no concern whatsoever with the alleged expenditure incurred by complainant on his treatment. It is within the purview of ESI dispensary/ hospital to look into the matter who has not been impleaded as a party in the complaint, so the complaint itself is not maintainable in the EI Act.  ESI Court as per notification of State of Haryana applicable to Jagadhri is the court of senior most Civil Judge as such this Forum has got no jurisdiction to entertain and try the present complaint.  Hence, the complainant is not entitled to get any reimbursement of the medical bills and other expenses as stated by him in complaint.  Lastly prayed for dismissal of the complaint.      

4.                     OP No.2 filed its written statement admitted to the extent that complainant is employee of OP No.2 and there is no relationship of consumer and service provider. It has been further stated that if the complainant got injury and was covered under ESIC he must got admitted in ESIC Hospital for his treatment and total amount incurred on his treatment was to be borne by the said ESIC. The legislation has enacted special law regarding the person injured in the employment of the company, then the matter to be referred to the said ESIC tribunal and this Court is not competent to decide the present controversy. The complaint of complainant is totally false and frivolous and the same is liable to be dismissed with special costs.

5.                     To prove his case, complainant tendered into evidence his affidavit as Annexure CX and documents such as Photo copies of medical bills issued by Chandigarh medical Centre as Annexure C-1 to C-6, Photo copy of bill alongwith treatment record issued by PGI Chandigarh as Annexure C-7 to C-12, Photo copies of Medicine Bills issued by Banga Medical Store Yamuna Nagar as Annexure C-13 to C-17, Photo copy of Accident Report From Employer as Annexure C-18, Photo copies of bills issued by Chandigarh medicine Centre as Annexure C-19 to C-21, Photo copy of D.T. Notes issued by Nehru Hospital, Chandigarh as Annexure C-22, Photo copy of PGI record alongwith medical bill as Annexure C-23 to C-36, Photo copy of receipt for ESI Corporation (Insurance) as Annexure C-37, Photo copy of prescription slip of Arvind Eye Hospital as Annexure C-38  Photo copy of report of Dr. Mehta’s X-ray & Ultrasound Centre as Annexure C-39 and closed his evidence.

6.                                 On the other hand, counsel for the OPs made a statement that they did not file any evidence on behalf of OPs and closed the evidence on behalf of OPs.

7.                     We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on file minutely & carefully.  Learned counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for the opposite parties reiterated the averments made in the reply and prayed for its dismissal.

8.                     Learned counsel for the complainant hotly argued that complainant Surinder Singh received injuries on 23.3.2007on right eye while working on the machine and when he was uplifting iron cutting from the press machine and suddenly the corner of hard punch of dye was broken and hit the right eye of the complainant due to which his right eye was fully damaged and remained under treatment of Dr. Arvind Gupta of Arvind Eye Hospital, Yamuna Nagar and thereafter he got treatment from PGI Chandigarh and he has spent Rs. 1,40,000/- on treatment and travelling expenses taxi etc. and submit the bills Annexure C-1 to C-39 and the claim was lodged with the OPs but the Ops flatly refused and did not give even a single penny to the complainant.

9.                     On the other hand, learned counsel for the OPs argued at length that ESI Act is a Special Act which itself a complete Code where only ESI court has jurisdiction to entertain any dispute between the employer or employee touching the issue of contribution funds and medical benefits available and permissible to an insured and further argued that complaint of the complainant is hopelessly time barred as the treatment and medical bills pertains to the period of 23.3.2007 to 4.4.2007 and the present complaint has been filed on 18.1.2010 i.e. after a period of near about 3 years. Hence the complaint is hopelessly time barred. Learned counsel for the OPs further argued that the complaint of the complainant is also bad for non joinder and mis joinder of necessary parties as neither the ESI Hospital has been impleaded as party nor any claim alongwith original bills and medical papers have been submitted with the ESI Hospital. OP No.1 is only payment authority after recommendation and scrutinize the bills by ESI Hospital. The actual grievances of the complainant is  with the ESI Hospital, if any, which had not been made a party in the complaint despite objection raised in para No.4 of the reply of OP No.1. However, the complainant has already been given legitimate medical benefits as per legal provision of the Act as recommended by the ESI Hospital. Lastly prayed for dismissal of complaint.  

10.                   It is not disputed that the complainant suffered injuries on his right eye on 23.3.2007 and remained under treatment of private Dr. Arvind Gupta of Arvind Eye Hospital, Yamuna Nagar and thereafter he got treatment from PGI Chandigarh and discharged from the PGI Chandigarh on 4.4.2007 which is evident from Annexure C-26 to C-30 treatment chart alongwith bills of PGI Chandigarh. Arguments advanced by the counsel for the complainant is not tenable. From the contents of complaint and documents filed on the file and arguments advanced by the counsel for the complainant it is clear that amount i.e. all expenses demanded by the complainant in his complaint pertains to the period from 23.3.2007 to 4.4.2007 and the present complaint has been filed on 18.1.2010 i.e. after a gap of more than 2 years 8 months. Further no application for condonation of delay has been filed by the complainant nor any sufficient cause has been explained by the complainant in his complaint for filing the complaint beyond a period of 2 years as per section 24)a) of the Consumer Protection Act 1986. Further the complainant has failed to convince this Forum that how this Forum has jurisdiction to entertain and try the present complaint because as per notification of the State of Haryana applicable to the Yamuna Nagar, The ESI court is  senior most court of Civil Judge, Yamuna Nagar. During the course of arguments counsel for the OPs has placed on file copy of notification. On merit also, the complainant failed to convince this Forum that complainant ever submitted the original bills or treatment chart for the concerned period to the ESI Hospital and get it verified from the concerned doctors, when no claim has been lodged with the ESI Hospital by the complainant then how the complainant is entitled to get the claim amount from the OP No.1. Further the complainant failed to implead the ESI Hospital due to the reasons known best to him and has not filed any cogent documentary evidence that he had submitted the bills and treatment chart for getting verification or approval to the Doctors of ESI Hospital and has also not filed any documents from which we can presume that ESI Hospital has no facilities to treat such type of patient or any letter of referring the complainant/ patient to the private hospital.

 11.                  After going through the above noted facts we are of the considered view that the present complaint of the complainant is hopelessly time barred and without jurisdiction and even devoid of any merit.  So, there is no deficiency in service on the part of OPs. Hence, the present complaint is hereby dismissed with no order as to costs. Copy of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court. 16.11.2015.

                                                                                                ( ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER