IN THE KODAGU DISTRICT CONSUMER DISPUTES REDRESSAL FORUM MADIKERI

SRI. C.V. MARGOOR,PRESIDENT

O R D E R

1. This complaint filed by Sri. C.B. Raju s/o. late Basappa, aged 59 years, resident of Chikkakunda Village, Besoor Post, Somwarpet Taluk, Kodagu District with a prayer to direct the opponents to pay the Yashasvini Health Card amount as incurred by him to the tune of Rs.1,06,730/-  with interest from the date of complaint till realization.  Further the complainant has asked compensation a sum of Rs.50,000/- towards shock and mental agony and cost of this proceedings.

2. The opponent no.1 is the President of Besoor Primary Agricultural Credit Co-operative Society Limited Besoor and opponent no.2 is the Chief Executive Officer of opponent no.1.  The complainant being an agriculturalist used to borrow loan from the opponents for raising crops.  While borrowing the loan the complainant being member of the opponents’ society has obtained the Yashasvini Health card in the name of him, his wife, son and daughter in law by paying necessary premium amount.

3. It is averred in the complaint that the complainant has spent Rs.66,730/- towards medical expenses as his left leg was fractured and got treatment at Tejaswini Hospital, Kadri,Mangalore.  The daughter in law of complainant by name Shalini Dharshan was admitted at Cauvery Hospital, Mysore for delivery and the hospital authority has issued bill for Rs.40,000/-.  The complainant has approached the opponents for reimbursement of the medical expenses a sum of Rs.1,06,730/- on the basis of Yashaswini card, but the opponents did not respond to his repeated request.  Hence, this complaint.

4. The opponent nos.1 and 2 appeared through their learned counsel but opponent no.2 filed version admitting that the complainant being member of their society and used to borrow loan for agricultural purpose by offering his landed property as security.  The opponent no.2 denied that the complainant while borrowing loan as member of the society has obtained the Yeshasvini Health Card in his and in his family members name.  The complainant had applied for the Yashasvini card in his name and in the name of his wife, son and daughter in law but he has not full filled the primary condition for issue of card.  Hence the same was not issued to the complainant.

5. The opponent no.2 admitted that they have received Yashasvini premium amount from the complainant but not issued Yashasvini cards as the complainant has failed to provide photos of all his family members.  The opponent no.2 contended that it is not aware that the complainant has took treatment for his left leg fracture and incurred a sum of Rs.66,730/- as medical expenses and his daughter in law was admitted at Cauvery Heart and Multi Speciality Hospital, Mysore for a delivery of a child and she has also incurred a sum of Rs.40,000/-.  The opponent denied that by not responding to the request of complainant have cheated him by not making the reimbursement of medical expenses on the basis of Yashasvini Health card. 

6. It is the case of opponent that while giving an application the complainant has not given Adhaar card and photograph of his daughter in law as such the opponents could not forward the application to the Assistant Registrar of Co-operative Society, Madikeri.  As per the Yashasvini Scheme the card holder shall approach the hospital and hand over the card to the hospital to claim the medical expenses and inturn the hospital shall claim the amount which was incurred for the card holder from the Government.  The complainant cannot claim the amount directly from the opponents. The last contention of opponent no.2 is that the complainant should have filed an application before the Assistant Registrar of Co-operative Society, Madikeri to decide the dispute between him and the opponents as per the provisions of Section 70 of the Co-operative Society Act, 1959.  Therefore, this Forum has no jurisdiction to entertain the complaint.  The opponents have not committed any breach of duty or shown deficiency of service towards the complainant.  On the above grounds, the opponent no.2 prays to dismiss the complaint.

7. The opponent no.1 by filing a memo adopted the version of opponent no.2.

8. The complainant filed his affidavit in lieu of evidence and got marked exhibits P1 to P6 documents.  On behalf of opponents  Sri.C.R. Murthy s/o. Rangashetty, the Chief Executive Officer filed affidavit evidence and  got marked exhibit R1.

9. Heard the arguments advanced by the complainant and learned counsel for the opponents and the points that would arise for determination are as under;

1. Whether the complainant proves that the act of opponents not forwarding the application for issue of Yeshasvini card amounts to deficiency in service?
2. Whether the opponents prove that this Forum does not have jurisdiction to entertain the complaint?
3. Is complainant entitled to the relief sought for ?
4. What order?

10. Our findings on the above points is as under;

• Point No.1:- In the affirmative
• Point No.2:- In the Negative
• Point No.3:- In the partly affirmative
• Point No.4:-  As per final order for the below

R E A S O N S

11. Point No.1 to 4 :- The  complainant submitted that he has paid the premium for issue of Yashasvini Health Scheme Card and produced medical bills of him and his daughter in law.  The learned counsel for the opponents submitted that the complainant has not provided photo and adhaar card of his daughter in law as such the opponents could not forward the application to the Assistant Registrar of Co-operative Societies for issue of Yeashaswini Health Card to the complainant and his family members. 

12. The opponents have not disputed payment of premium amount for issue of Yeshavini Health Card. The complainant produced exhibit P1 receipt dated 25/06/2017 issued by the opponents for payment of application fee and premium amount towards Yeshavini Health Scheme total sum of Rs.1,200/-.  Exhibit P2 is copy of application dated 28/03/2018 written by opponent no.2 to the ARCS  Madikeri, Kodagu District stating that vide exhibit P1 receipt the complainant has paid Rs.1,200/-for Yeshasvini Health Policy for the complainant, his wife Smt. Kamalamma, son Dharshan and daughter in law Shalini.  The opponents contention is that the complainant has submitted applications along with photos and adhaar card of him, his wife and son but not submitted the photo and copy of adhaar card of his daughter in law as such the applications could not be forwarded to the ARCS for issue of Yeshasvini Health Card.  The opponents have not issued a letter to the complainant after issue of exhibit P1 receipt that his application is not accompanied by the photo and copy of adhaar card of his daughter in law Smt.Shalini.  In exhibit P1 we can see the names of all the four family members, their age and adhaar card numbers. 

13. The opponents have written exhibit P2 letter dated 28/03/2018 to the ARCS Madikeri stating that the complainant has paid premium of Rs.1,200/- for issue of Yeshasvini Health Card to the complainant and his family members including daughter in law.  In fact, the complainant had not furnished photo and copy of adhaar card of his daughter in law certainly the opponents should have mentioned in exhibit P2 stating that on account of this reason only they have not forwarded the application of complainant and his family members.   The opponents have not forwarded the applications of the complainant and his family members thought they received the premium amount on 25/06/2017 now they have come up with false defence that the complainant has not fulfilled the conditions of Yeshasvini Health Scheme by not furnishing the photo and copy of adhaar card of Smt.Shalini w/o. Dharshan.  Immediately after issue of exhibit P1 receipt for receiving premium amount the opponents would have issued letter to the complainant to furnish the photo and copy of adhaar card of Smt. Shalini if not accompanied with the application.  The opponents have not taken any action even after issue of exhibit P1 receipt but now they have come up with false defecne that the complainant has not produced photo and adhaar card of Smt. Shalini.  The defence set up by opponents is false and not acceptable.

14. The complainant produced exhibit P3 medical bill of his daughter in law Smt. Shalini Dharshan dated 09/04/2018 issued by Kaveri Heart and Multi Specialty Hospital, Mysore for Rs.43,950/- and Exhibit P4 medical bill of complainant dated 22/01/2018 issued by Tejaswini Hospital, Mangalore for Rs.66,730/-.  The opponents marked exhibit R1 which is in the name of C.A. Meenakshi dated 31/05/2009 which issued to the member of Yeshasvini Co-operative Farmers Health Care Scheme.  Exhibit R1 contained the terms and conditions for issue of Yeshasvini Health Card and how to get medical benefit.  According to instruction No.1 any farmer shall become member of a co-operative society six months prior to the first of June to eligible for the scheme.   The member shall get reimbursement of the medical bill by submitting the Yeshasvini card in the hospital where he and his family members have taken treatment. 

15. The complainant’s son written exhibit P5 and P6 letters dated 20/05/2018 to the opponents for issue of Yeshavini Cards since his father has made payment vide receipt No.1365 dated 25/06/2017 a sum of Rs.1,200/- and they shall pay the medical expenses of his father and his wife Smt. Shalini a sum of Rs.1,00,000/-.  The opponents inspite of collecting premium amount on 25/06/2017 for Yeshasvini Health Scheme for the complainant and his family members have not taken any action by forwarding the applications to the ARCS for issue of Heath cards and thereby neglected to discharge their service.  Therefore, the act of opponents amounts to deficiency in service.

16. The learned counsel for the opponents urged that this Forum has no jurisdiction as there is a bar under Section 70 of the Karnataka Co-operative Societies Act, 1959. The present claim is not in respect of the affairs of the society but it pertains to deficiency in service by the opponents.  That apart Section 3 of the Consumer Protection Act, 1986 says that the provisions of this Act shall be in addition to and not in derogation of the provisions of any other law for the time being in force.  The provisions of this Act grant additional remedy to the consumers.  In the case on hand the opponents though they have received premium amount from the complainant towards the Yeshasvini Health Scheme on 25/06/2017 but failed to forward the applications to ARCS for issue of health cards.  Therefore, the act of opponents amounts to deficiency in service as such this Forum is having jurisdiction to grant remedy. 

17. The complainant has claimed the medical expenses a sum of Rs.1,06,740/- which supported by exhibits P3 and P4 hospital bills.  The complainant has not produced any material to grant Rs.50,000/- plus 40,000/- towards the damages, mental shock and agony.  However due to the negligence on the part of the opponents the complainant has paid the medical expenses and he was compelled to approach this Forum inspite of writing exhibits P5 and 6 letters to the opponents on 20/05/2018.  Therefore, the complainant is entitled a sum of Rs.10,000/- as compensation towards mental agony and Rs.5,000/- as cost of this proceedings.  Accordingly, we proceed to pass the following;

O R D E R

1. The complaint filed by Sri.C.B. Raju s/o.late Basappa is partly allowed directing the opponents 1 and 2 jointly and severally liable to pay a sum of Rs.1,06,730/- to the complainant within two months from the date of order.  In case the opponents fails to comply with the order within two months then the amount carries interest at the rate of 12% per annum from 01/04/2018 till payment.
2. The opponent shall pay Rs.15,000/- as compensation and cost of the proceedings to the complainant within two months from the date of order otherwise it carries interest at the rate of 12% interest per annum till its payment.
3. Furnish the copy of the order to the complainant and opponents at free of cost.

(Dictated to the Stenographer, got it transcribed, corrected and pronounced in the open Forum on this 29^th day of DECEMBER, 2018)

                                                  (C.V. MARGOOR)

                                                      PRESIDENT 

                                                (M.C. DEVAKUMAR)

                                                        MEMBER