Delhi

StateCommission

FA/566/2014

MAHANAGAR TELEPHONE NIGAM LTD. - Complainant(s)

Versus

RAJA RAM YADAV & ANR. - Opp.Party(s)

10 Feb 2016

ORDER

IN THE STATE COMMISSION

(Constituted under section 9 of the Consumer Protection Act, 1986)

 

Date of Decision: 10.02.2016

 

First Appeal – 566/2014

 

        In the Matter of:

                General Manager,

          Mahanagar Telephone Nigam Ltd.

          Head Quarter, Khursheed Lal Bhawan,

          New Delhi

……Appellant     Versus   1. Raja Ram Yadav, Retired Phone Mechanic, R/o RZ-8L(917) Gali No. 5, Main Sagarpur, New Delhi   2. Then Regional Manager, M.D. India Health Care Services, TPA Pvt. Ltd., Regional Office, Plot No. 18/13, WEA, Ground Floor, Ganga Plaza, Pusa Lane, Karol Bagh, New Delhi-110005   3. United India Insurance Co. Ltd. Regional Office, 8th  Floor, Kanchanjunga Building, 18, Barakhamba Road, Connaught Place, Delhi-110001                                                              …….Respondents

CORAM

Justice Veena Birbal, President

Salma Noor, Member

1.   Whether reporters of local newspaper be allowed to see the   judgment? 

2.   To be referred to the reporter or not?

 

Justice Veena Birbal, President

1.             This is an appeal u/s 15 of the Consumer Protection Act against ex-parte order dated 01.10.2013 passed by the Consumer Disputes Redressal Forum-VI (New Delhi) in complaint case no. 828/11.

2.             A complaint u/s 12 of the Act was filed by the respondent no. 1 herein i.e. complainant before the Ld. District Forum alleging therein that he is a retired MTNL employee. It was alleged that for the treatment of its employee either in service or retired, appellant/OP-1 had launched a scheme for medical claim and for the said purpose respondent-2/OP-2 had been authorized by appellant/OP-1. It was alleged that as per collaboration of appellant/OP-1 and respondent-2/OP-2 Medical facility claim had been provided according to which if a person takes treatment from hospital, he could claim from the company and company after examining the claim on the basis of essentiality certificate issued by the concerned hospital, had to pay the medical claim incurred in the treatment. It was alleged that the respondent-1/complainant had opted for the said scheme and became a member of the Health Policy granted by appellant/OP-1 through respondent-2/OP-2. It was alleged that the respondent-1/complainant had suffered a head injury for which he was admitted in Ganga Ram Hospital on 08.03.2009 and was treated as an Indoor patient  till 26.03.2009 and had spent about Rs. 2,90,804/- and 98,730/- respectively. After getting the treatment the complainant applied for reimbursement of Medical claim. However, he received reply from respondent-2/OP-2 asking for certain documents. Even those documents were also provided. However, the amount was not released. Thereafter, the aforesaid Consumer Complaint was filed before the Ld. District Forum.

3.             The appellant/respondent-1 was proceeded ex-parte before the Ld. District Forum.

4.             After considering the ex-parte evidence of the respondent-1/complainant, Ld. District Forum directed appellant/respondent-1 as under:

        “Keeping this in view, OP-1 is directed to pay Rs. 3,89,517/- along with 9% interest from date of claim till realization and we also award Rs. 35,000/- as compensation for harassment and litigation charges OP-1 may take up this matter with OP-2 to whom he has entered in contractual obligation on behalf of his employees”.

5.                     Ld. Counsel for the appellant/OP-1 has submitted that the appellant/OP-1 was never served before the Ld. District Forum with the notice of the complaint. It is also submitted that the even the material facts have been wrongly recorded in the impugned order as there is no contractual relationship or obligation between the appellant/OP-1 and respondent-2/OP-2. It is submitted that the appellant/respondent-1 has contractual obligations only with respondent-3/OP-3. It is further submitted that impugned order is silent with respect to respondent-3/OP-3. It is submitted that it is only respondent-3/OP-3 which is the main party with whom the appellant/OP-1 had taken the policy to provide insurance cover to its retired employees. It is submitted that impugned order is passed without appreciating that respondent-3/OP-3 is the insurer and is under obligation to make payment as per agreement. It is submitted that since impugned order is passed without dealing with the respondent-3/OP-3, it has resulted in causing grave miscarriage of justice to appellant/OP-1. It is submitted that respondent-2/OP-2 is only a TPA/agent of respondent-3/OP-3. It is contended that if there is any deficiency in service, the same is on the part of respondent-3/OP-3 and the same has nothing to do with appellant/OP-1.

6.             It is submitted that the appellant/OP-1 was not served before the Ld. District Forum as such it could not put forth its defence. It is also submitted that since there is no service on the appellant/OP-1, the impugned order has been passed without giving opportunity of hearing to appellant/OP-1 and the same is liable to be set aside.

7.             The respondent-3/OP-3 has also filed reply to the appeal wherein it is stated that the impugned order has been passed without any service on the parties and it will be appropriate if the matter is remanded back to the Ld. District Forum for deciding afresh  on merits after giving opportunity of hearing to the parties.

8.             Nothing has been stated in the impugned order as in what manner appellant/OP-1 was served before the Ld. District Forum. Ld. counsel for respondent-1/complainant has also not been able to state anything as to what was the mode of service of appellant/OP before the Ld. District Forum. Ld. counsel for appellant/OP-1 has stated that record from the District Forum would clarify the position as such the same be summoned.

9.             However, after some arguments, Ld. counsel for the respondent-1/complainant has submitted that to cut short further delay in the matter respondent-1/complainant has no objection if the matter be heard and decided on merits after giving opportunity of hearing to the appellant. However, it is stated that since delay has been caused in the matter, the costs be imposed upon appellant/OP-1.

10.            Considering the material on record, stand of appellant/OP-1 on merits as well as no objection given by the respondent-1/complainant, ends of justice will be served if appellant/OP-1 is given chance to contest the case on merits. For the delay caused, respondent-1/complainant can be compensated with costs. Accordingly, we allow this appeal and set aside the impugned ex-parte judgment, subject to costs of Rs. 5000/- and remand back the case to the District Forum for deciding afresh in accordance with law.

11.            The parties shall appear before the District Forum on 10.03.2016. On the said date appellant/OP-1 shall pay costs of Rs. 5000/- to the respondent-1/complainant. Thereafter, the District Forum shall proceed further in the matter in accordance with law.

12.            Respondent-1/complainant is stated to be of 75 years of age. The District Forum shall make all endeavour to dispose of the case within 4 months from the date of the receipt of order.

                FDR, if any, deposited by the appellant be released in its favour as per rules.

                File be consigned to record room.

(Justice Veena Birbal)

President

 

(Salma Noor)

Member