BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

VAZHUTHACAUD : THIRUVANANTHAPURAM

PRESENT:

SHRI. G. SIVAPRASAD : PRESIDENT

SMT. BEENA KUMARI. A : MEMBER

SMT. S.K. SREELA : MEMBER

C.C. No: 184/2006 Filed on 1/7/2006

Dated: 31..03..2010

Complainants:

1. Consumer Protection Council of Kerala, Represented by its General Secretary, Smt. Annie Jacob No.153, A.K.G Nagar, Peroorkada, Thiruvananthapuram – 695 005.

   (By Adv. K.G.M Nair)

    

2. Employees Provident Fund Pensioners Association Kerala (Reg.No.T.210/97) Represented by its Secretary, C.V. Gopinathan Nair, Sarojabhavan, Devaswam Lane, Kesavadasapuram, Pattom Palace – P.O., Thiruvananthapuram – 695 004.

(By Adv. Narayan. R)

Opposite parties:

1. Oriental Insurance Company Ltd., Represented by its Senior Divisional Manager, Divisional Office No.1, Jeevan Vihar Buildings, 4^th Floor, Sansad Marg, New Delhi – 110 001.

   (By Adv. G.S. Kalkura)

2. The Central Provident Fund Commissioner, EPFO Head Quarters, Bhavishya Nidhi Bhavan, 14 Bhikaji Cama Place, New Delhi – 110 066.

3. The Regional Provident Fund Commissioner, Pattom, Thiruvananthapuram – 695 004.

(By Sri. K. Ramachandran Nair)

This O.P having been heard on 24..12..2009, the Forum on 31..03..2010 delivered the following:

ORDER

SMT. S.K.SREELA, MEMBER:

The allegations in the complaint are the following: The 2^nd complainant – Employees Provident Fund Pensioners Association Kerala, is a registered organisation, of retired employees of the Employees Provident Fund Organisation, with registration No.T.210/1997. This complaint is filed on behalf of 5 pensioners, who like other retired Employees Provident Fund Organisation (herein after called the EPFO), are beneficiaries of the Mediclaim Scheme of 1^st opposite party. The Central Provident Fund Commissioner, New Delhi, 2^nd opposite party has got legal responsibility to arrange for competent health care to the Pensioners of the EPFO. To discharge that responsibility 2^nd opposite party accepted the said Mediclaim scheme proposed by the 1^st opposite party paying substantial amount as premium. Under the said scheme Regional Provident Fund Commissioner, Thiruvananthapuram, 3^rd opposite party is having the responsibility of obtaining and forwarding to 1^st opposite party, the particulars of the Pensioners eligible to avail the benefits under the scheme. The subject matter of dispute involves the deficiency in service of the opposite parties in not completing the formality for enrolling the pensioners and allotting them Personnel Identification Numbers.

2. The 1^st opposite party remains exparte.

3. Opposite parties 2 & 3 have filed their detailed version contending as follows: The Employees’ Provident Fund Organisation is a Statutory Organisation created under the Employees’ Provident Fund and Miscellaneous Provisions Act, 1952. The Organisation is administered by the Central Board of Trustees. The Mediclaim Scheme was introduced by the Oranisation as a welfare measure with a view to extend post retirement medical cover to its retired employees. All retired employees had to submit enrolment form within a period of one month of retirement for availing, the benefits under the scheme. All retired employees were supplied with the required enrolment form by the 3^rd opposite party. The enrolment forms submitted by the retired employees were forwarded to the 1^st opposite party for enrolment and allotment of PIN soon after the receipt of the same. Some of the pensioners have not submitted the enrolment form till now. A notice dated 21/11/2005 has been received from Sri. C.S.G Nair IRS (Retd). Advocate furnishing a list of 45 pensioners who were not in receipt of PIN. On verification it is seen that 5 pensioners are already in receipt of PIN and 10 pensioners have not applied for enrolment so far and the rest of 30 pensioners had applied belatedly. Their failure to submit the enrolment form in time cannot be treated as a failure on the part of the organisation. Being such a class of employees their failure cannot be thrust up on the organisation. Moreover, as requested by the Pensioners’ Association, the 2^nd opposite party has sanctioned the medical reimbursement of the pensioners of EPFO as per CS(MA) Rules 1944 and the existing medi claim scheme under 1^st opposite party has stopped with effect from 24/10/2006. As such the question of allotment of PIN to the pensioners does not arise at all. They are not entitled for any kind of compensation from the Organisation. However, the Medical Insurance Scheme has ceased to operate on expiry of the current term on 23/10/2006. The retired employees of the organisation are now eligible for medical benefits under CS(MA) Rules – 1944 with effect from 24/10/2006. Hence the petitioners are not eligible for any relief as sought for by them in the petition. Hence opposite parties 2 & 3 pray for cost and compensation from the complainant.

4. PW1 has been examined on behalf of the complainant and Exts. P1 to P7 were marked on their side. On the part of the opposite parties 2 & 3, DW1 has been examined and marked Exts. D1 & D2.

From the contentions raised following issues arise for consideration:

1. Whether there is any deficiency in service on the part of opposite parties?

    

2. If the above is in affirmative, from whom the complainants are entitled for the relief claimed in the complaint?

3. Reliefs and costs?

5. Points (i) to (iii) : The main contention of the complainants is that, all the papers required to obtain the PIN were submitted by the pensioners to the 3^rd opposite party immediately before their date of retirement and inspite of that, PIN has not been allotted even after several years of their retirement. The opposite parties 2 & 3 have taken out a contention in their version that all the retired employees were supplied with required enrollment form by the 3^rd opposite party and on verification it is seen that 10 pensioners have not applied for enrollment so far, 5 pensioners are already in receipt of PIN and the rest of 30 pensioners had applied belatedly and further contend that the failure on the part of the pensioners in not submitting the enrollment form in time cannot be treated as a failure on the part of the organisation. The complainants have pleaded that 3^rd opposite party failed to forward the enrollment form of the affected pensioner to 1^st opposite party in time and relied on Ext. P7 in support of their contention. As per Ext.P7, the Employees’ Provident Fund Organisation, New Delhi has stated that ’it is noted with great concern that in spite of repeated directions from the Headquarters Office from time to time, some of the Regions are not submitting Enrolment form of eligble Pensioners/Retired/Retiring Employees of their respective Regions well before One/Two month from the date of their retirement resulting difficulty for getting PIN/Medical reimbursement benefits by the pensioners besides creating lot of administrative difficulties. Some Regions are still forwarding the Enrolment forms at the old address of the Oriental Insurance Company Ltd resulting misplacing/non-receipt of the Enrolment forms of the beneficiary concerned by the Oriental Insurance Company Ltd. It will be the responsibility of the Regional Provident Fund Commissioner of the Region to ensure that Enrolment forms in respect of all the eligible pensioners/retired/retiring employees along with their spouses of their respective Regions duly completed in all respect are sent to the Senior Divisional Manager, Oriental Insurance Company Ltd., Divisional Office No. 1, Jeevan Vihar Building, 4^th Floor (Rear Portion), Sansad Marg, New Delhi – 110 001 well before two month from the date of retirement as per the instructions issued by the Headquartes Office. All concerned officials of the Region be cautioned accordingly. Despite the contention of the opposite parties 2 & 3, they have not furnished any documents to support their contention in the version. DW1, the witness for opposite parties 2 & 3, had deposed that PIN യഥാസമയം കിട്ടുന്നില്ല എന്ന ccomplaints pensioners-ല്‍ നിന്നും ഞങ്ങള്‍ക്ക് കിട്ടിയിട്ടുണ്ട്. ഈ സാഹചര്യത്തിലാണോ 1^st opposite part -യെ discharge ചെയ്തത് (Q) 1^st opposite party യുടെ serviceമോശമായതിനാലാണ് 2^nd & 3^rd opposite parties 1^st opposite partyയുടെ service discharge ചെയ്യുകയും 24/10/2006 മുതല്‍ CSMA Rules ന്‍െറ കീഴില്‍ കൊണ്ടു വന്നു. (A).

6. The learned counsel for the complainant had argued that as per Ext. P6 it is evident that the 3^rd opposite party failed to forward the list of the affected pensioners to 1^st opposite party in time. The learned counsel had further argued that the affected pensioners had submitted the prescribed form duly filled with the required details within the prescribed period to the 3^rd opposite party but the opposite parties failed to provide them with PIN even after repeated reminders and the 1^st opposite party has received premium amount without discharging their services and hence is liable to refund the premium amount received on behalf of the affected pensioners for every year after their retirement along with interest on that amount. The learned counsel for the opposite parties 2 & 3 had argued that the complainant has produced the names, date of retirement, designation etc purposely hiding the date of submission of the form and premium as agreed upon and the list contains names of deceased persons. The opposite parties 2 & 3 have not furnished any documents to show that the applications were not given in time as contended in the version. When the complainants plead that they have submitted the prescribed forms in time, then opposite parties 2 & 3 also have the burden to prove otherwise when they contend that the forms have not been submitted in time.

7. In Annexure 1 attached to the complaint, only 5 persons names have been mentioned. But along with the Annexure attached to Ext. P2, names of 45 pensioners have been mentioned. Furthermore the complainant’s counsel had filed an argument note wherein names of 28 pensioners have been mentioned whose names have also been mentioned in the Annexure attached to P2. Out of the above, the learned counsel for the complainant had submitted that one Smt. K. Kamalamma and Sri. S.S.W. Stephen have passed away and the claims for getting PIN as against these claimants have been relinquished by the complainants.

8. The opposite parties 2 & 3 have submitted that out of the 45 retired pensioners 5 has been allotted PIN and request has been sent to 10 employees for furnishing emolument form for which they did not respond and remaining 30 pensioners had submitted their application belatedly and hence their applications were rejected.

9. The 1^st opposite party has neither filed any version nor has contested the case. Hence the allegations levelled against the 1^st opposite party stands uncontroverted. The opposite parties 2 & 3 contend that it is the liability of the 1^st opposite party to reimburse the expenses for treatment and these opposite parties 2 & 3 have no role in it. From the foregoing discussions we are of the view that the act of the 1^st opposite party in denial of service even after acceptance of premium amount to deficiency in service on their part. Hence the affected pensioners are found entitled for refund of the premium amount from the 1^st opposite party.

10. Hence it is found that the pensioners mentioned in the Annexure attached to Ext. P2 except the 2 persons mentioned Supra who are no more, are eligible for refund of the premium amount paid by each of them from the 1^st opposite party and each of them are found entitled for a compensation of Rs.2,000/- from the opposite parties. The opposite parties shall also pay Rs.2,500/- to the complainants towards costs of the proceedings.

In the result, the complaint is allowed. The 1^st opposite party shall refund the premium paid by the pensioners and also provide PIN to the pensioners referred Supra. The opposite parties shall pay Rs.2,000/- each to the above referred persons towards compensation. The opposite parties 1 to 3 shall also pay an amount of Rs.2,500/- to the complainants towards costs of the proceedings. Time for compliance 2 months from the date of receipt of the order, failing which the entire amount shall carry interest @ 9% from the date of the Order.

A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room.

Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the open Forum, this the 31^st day March, 2010.

S.K. SREELA, MEMBER.

G. SIVAPRASAD,

PRESIDENT.

BEENA KUMARI.A, MEMBER.

ad.

C.C.No. 184/2006

APPENDIX

I. Complainants’ witness:

PW1 : C.V. Gopinathan Nair

II. Complainants’ documents:

P1 : Copy of Mediclaim Scheme for the pensioners of Employees Provident Fund Organisation (EPFO) and their spouses.

P2 : Copy of advocate notice dated 21//11/2005

P3 : Copy of letter dated 1/1/2006 addressed to 1^st opp. Party.

P4 : Copy of letter dated 1/1/2006 addressed to 2^nd opp. Party.

P5 : Copy of letter dated 1/1/2006 addressed to 3^rd opp. Party.

P6 : Copy of letter dated 30/1/2006 addressed to 1^st complainant.

P7 : Copy of proceedings dated 23/2/06

III. Opposite parties’ witness:

DW1 : K. Parameswaran

IV. Opposite parties’ documents:

D1 : Copy of letter dated 30/1/06 addressed to 1^st complainant.

D2 : Copy of letter dated 30/1/06 issued by 3^rd opp. Party.

PRESIDENT

ad.

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

VAZHUTHACAUD : THIRUVANANTHAPURAM

PRESENT:

SHRI. G. SIVAPRASAD : PRESIDENT

SMT. BEENA KUMARI. A : MEMBER

SMT. S.K. SREELA : MEMBER

C.C. No: 184/2006 Filed on 1/7/2006

Dated: 31..03..2010

Complainants:

1. Consumer Protection Council of Kerala, Represented by its General Secretary, Smt. Annie Jacob No.153, A.K.G Nagar, Peroorkada, Thiruvananthapuram – 695 005.

   (By Adv. K.G.M Nair)

    

2. Employees Provident Fund Pensioners Association Kerala (Reg.No.T.210/97) Represented by its Secretary, C.V. Gopinathan Nair, Sarojabhavan, Devaswam Lane, Kesavadasapuram, Pattom Palace – P.O., Thiruvananthapuram – 695 004.

(By Adv. Narayan. R)

Opposite parties:

1. Oriental Insurance Company Ltd., Represented by its Senior Divisional Manager, Divisional Office No.1, Jeevan Vihar Buildings, 4^th Floor, Sansad Marg, New Delhi – 110 001.

   (By Adv. G.S. Kalkura)

2. The Central Provident Fund Commissioner, EPFO Head Quarters, Bhavishya Nidhi Bhavan, 14 Bhikaji Cama Place, New Delhi – 110 066.

3. The Regional Provident Fund Commissioner, Pattom, Thiruvananthapuram – 695 004.

(By Sri. K. Ramachandran Nair)

This O.P having been heard on 24..12..2009, the Forum on 31..03..2010 delivered the following:

ORDER

SMT. S.K.SREELA, MEMBER:

The allegations in the complaint are the following: The 2^nd complainant – Employees Provident Fund Pensioners Association Kerala, is a registered organisation, of retired employees of the Employees Provident Fund Organisation, with registration No.T.210/1997. This complaint is filed on behalf of 5 pensioners, who like other retired Employees Provident Fund Organisation (herein after called the EPFO), are beneficiaries of the Mediclaim Scheme of 1^st opposite party. The Central Provident Fund Commissioner, New Delhi, 2^nd opposite party has got legal responsibility to arrange for competent health care to the Pensioners of the EPFO. To discharge that responsibility 2^nd opposite party accepted the said Mediclaim scheme proposed by the 1^st opposite party paying substantial amount as premium. Under the said scheme Regional Provident Fund Commissioner, Thiruvananthapuram, 3^rd opposite party is having the responsibility of obtaining and forwarding to 1^st opposite party, the particulars of the Pensioners eligible to avail the benefits under the scheme. The subject matter of dispute involves the deficiency in service of the opposite parties in not completing the formality for enrolling the pensioners and allotting them Personnel Identification Numbers.

2. The 1^st opposite party remains exparte.

3. Opposite parties 2 & 3 have filed their detailed version contending as follows: The Employees’ Provident Fund Organisation is a Statutory Organisation created under the Employees’ Provident Fund and Miscellaneous Provisions Act, 1952. The Organisation is administered by the Central Board of Trustees. The Mediclaim Scheme was introduced by the Oranisation as a welfare measure with a view to extend post retirement medical cover to its retired employees. All retired employees had to submit enrolment form within a period of one month of retirement for availing, the benefits under the scheme. All retired employees were supplied with the required enrolment form by the 3^rd opposite party. The enrolment forms submitted by the retired employees were forwarded to the 1^st opposite party for enrolment and allotment of PIN soon after the receipt of the same. Some of the pensioners have not submitted the enrolment form till now. A notice dated 21/11/2005 has been received from Sri. C.S.G Nair IRS (Retd). Advocate furnishing a list of 45 pensioners who were not in receipt of PIN. On verification it is seen that 5 pensioners are already in receipt of PIN and 10 pensioners have not applied for enrolment so far and the rest of 30 pensioners had applied belatedly. Their failure to submit the enrolment form in time cannot be treated as a failure on the part of the organisation. Being such a class of employees their failure cannot be thrust up on the organisation. Moreover, as requested by the Pensioners’ Association, the 2^nd opposite party has sanctioned the medical reimbursement of the pensioners of EPFO as per CS(MA) Rules 1944 and the existing medi claim scheme under 1^st opposite party has stopped with effect from 24/10/2006. As such the question of allotment of PIN to the pensioners does not arise at all. They are not entitled for any kind of compensation from the Organisation. However, the Medical Insurance Scheme has ceased to operate on expiry of the current term on 23/10/2006. The retired employees of the organisation are now eligible for medical benefits under CS(MA) Rules – 1944 with effect from 24/10/2006. Hence the petitioners are not eligible for any relief as sought for by them in the petition. Hence opposite parties 2 & 3 pray for cost and compensation from the complainant.

4. PW1 has been examined on behalf of the complainant and Exts. P1 to P7 were marked on their side. On the part of the opposite parties 2 & 3, DW1 has been examined and marked Exts. D1 & D2.

From the contentions raised following issues arise for consideration:

1. Whether there is any deficiency in service on the part of opposite parties?

    

2. If the above is in affirmative, from whom the complainants are entitled for the relief claimed in the complaint?

3. Reliefs and costs?

5. Points (i) to (iii) : The main contention of the complainants is that, all the papers required to obtain the PIN were submitted by the pensioners to the 3^rd opposite party immediately before their date of retirement and inspite of that, PIN has not been allotted even after several years of their retirement. The opposite parties 2 & 3 have taken out a contention in their version that all the retired employees were supplied with required enrollment form by the 3^rd opposite party and on verification it is seen that 10 pensioners have not applied for enrollment so far, 5 pensioners are already in receipt of PIN and the rest of 30 pensioners had applied belatedly and further contend that the failure on the part of the pensioners in not submitting the enrollment form in time cannot be treated as a failure on the part of the organisation. The complainants have pleaded that 3^rd opposite party failed to forward the enrollment form of the affected pensioner to 1^st opposite party in time and relied on Ext. P7 in support of their contention. As per Ext.P7, the Employees’ Provident Fund Organisation, New Delhi has stated that ’it is noted with great concern that in spite of repeated directions from the Headquarters Office from time to time, some of the Regions are not submitting Enrolment form of eligble Pensioners/Retired/Retiring Employees of their respective Regions well before One/Two month from the date of their retirement resulting difficulty for getting PIN/Medical reimbursement benefits by the pensioners besides creating lot of administrative difficulties. Some Regions are still forwarding the Enrolment forms at the old address of the Oriental Insurance Company Ltd resulting misplacing/non-receipt of the Enrolment forms of the beneficiary concerned by the Oriental Insurance Company Ltd. It will be the responsibility of the Regional Provident Fund Commissioner of the Region to ensure that Enrolment forms in respect of all the eligible pensioners/retired/retiring employees along with their spouses of their respective Regions duly completed in all respect are sent to the Senior Divisional Manager, Oriental Insurance Company Ltd., Divisional Office No. 1, Jeevan Vihar Building, 4^th Floor (Rear Portion), Sansad Marg, New Delhi – 110 001 well before two month from the date of retirement as per the instructions issued by the Headquartes Office. All concerned officials of the Region be cautioned accordingly. Despite the contention of the opposite parties 2 & 3, they have not furnished any documents to support their contention in the version. DW1, the witness for opposite parties 2 & 3, had deposed that PIN യഥാസമയം കിട്ടുന്നില്ല എന്ന ccomplaints pensioners-ല്‍ നിന്നും ഞങ്ങള്‍ക്ക് കിട്ടിയിട്ടുണ്ട്. ഈ സാഹചര്യത്തിലാണോ 1^st opposite part -യെ discharge ചെയ്തത് (Q) 1^st opposite party യുടെ serviceമോശമായതിനാലാണ് 2^nd & 3^rd opposite parties 1^st opposite partyയുടെ service discharge ചെയ്യുകയും 24/10/2006 മുതല്‍ CSMA Rules ന്‍െറ കീഴില്‍ കൊണ്ടു വന്നു. (A).

6. The learned counsel for the complainant had argued that as per Ext. P6 it is evident that the 3^rd opposite party failed to forward the list of the affected pensioners to 1^st opposite party in time. The learned counsel had further argued that the affected pensioners had submitted the prescribed form duly filled with the required details within the prescribed period to the 3^rd opposite party but the opposite parties failed to provide them with PIN even after repeated reminders and the 1^st opposite party has received premium amount without discharging their services and hence is liable to refund the premium amount received on behalf of the affected pensioners for every year after their retirement along with interest on that amount. The learned counsel for the opposite parties 2 & 3 had argued that the complainant has produced the names, date of retirement, designation etc purposely hiding the date of submission of the form and premium as agreed upon and the list contains names of deceased persons. The opposite parties 2 & 3 have not furnished any documents to show that the applications were not given in time as contended in the version. When the complainants plead that they have submitted the prescribed forms in time, then opposite parties 2 & 3 also have the burden to prove otherwise when they contend that the forms have not been submitted in time.

7. In Annexure 1 attached to the complaint, only 5 persons names have been mentioned. But along with the Annexure attached to Ext. P2, names of 45 pensioners have been mentioned. Furthermore the complainant’s counsel had filed an argument note wherein names of 28 pensioners have been mentioned whose names have also been mentioned in the Annexure attached to P2. Out of the above, the learned counsel for the complainant had submitted that one Smt. K. Kamalamma and Sri. S.S.W. Stephen have passed away and the claims for getting PIN as against these claimants have been relinquished by the complainants.

8. The opposite parties 2 & 3 have submitted that out of the 45 retired pensioners 5 has been allotted PIN and request has been sent to 10 employees for furnishing emolument form for which they did not respond and remaining 30 pensioners had submitted their application belatedly and hence their applications were rejected.

9. The 1^st opposite party has neither filed any version nor has contested the case. Hence the allegations levelled against the 1^st opposite party stands uncontroverted. The opposite parties 2 & 3 contend that it is the liability of the 1^st opposite party to reimburse the expenses for treatment and these opposite parties 2 & 3 have no role in it. From the foregoing discussions we are of the view that the act of the 1^st opposite party in denial of service even after acceptance of premium amount to deficiency in service on their part. Hence the affected pensioners are found entitled for refund of the premium amount from the 1^st opposite party.

10. Hence it is found that the pensioners mentioned in the Annexure attached to Ext. P2 except the 2 persons mentioned Supra who are no more, are eligible for refund of the premium amount paid by each of them from the 1^st opposite party and each of them are found entitled for a compensation of Rs.2,000/- from the opposite parties. The opposite parties shall also pay Rs.2,500/- to the complainants towards costs of the proceedings.

In the result, the complaint is allowed. The 1^st opposite party shall refund the premium paid by the pensioners and also provide PIN to the pensioners referred Supra. The opposite parties shall pay Rs.2,000/- each to the above referred persons towards compensation. The opposite parties 1 to 3 shall also pay an amount of Rs.2,500/- to the complainants towards costs of the proceedings. Time for compliance 2 months from the date of receipt of the order, failing which the entire amount shall carry interest @ 9% from the date of the Order.

A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room.

Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the open Forum, this the 31^st day March, 2010.

S.K. SREELA, MEMBER.

G. SIVAPRASAD,

PRESIDENT.

BEENA KUMARI.A, MEMBER.

ad.

C.C.No. 184/2006

APPENDIX

I. Complainants’ witness:

PW1 : C.V. Gopinathan Nair

II. Complainants’ documents:

P1 : Copy of Mediclaim Scheme for the pensioners of Employees Provident Fund Organisation (EPFO) and their spouses.

P2 : Copy of advocate notice dated 21//11/2005

P3 : Copy of letter dated 1/1/2006 addressed to 1^st opp. Party.

P4 : Copy of letter dated 1/1/2006 addressed to 2^nd opp. Party.

P5 : Copy of letter dated 1/1/2006 addressed to 3^rd opp. Party.

P6 : Copy of letter dated 30/1/2006 addressed to 1^st complainant.

P7 : Copy of proceedings dated 23/2/06

III. Opposite parties’ witness:

DW1 : K. Parameswaran

IV. Opposite parties’ documents:

D1 : Copy of letter dated 30/1/06 addressed to 1^st complainant.

D2 : Copy of letter dated 30/1/06 issued by 3^rd opp. Party.

PRESIDENT