Employees State Insurance Corporation & Anr vs Ram Saran

V.K. Jain, Presiding Member

The complainant / respondent is working with Delhi Transport Corporation and was issued an ESI Card by the petitioner - Employees State Insurance Corporation. His wife being seriously ill and in need of treatment, he approached the ESI Hospital for treatment of his wife. The ESI Hospital, however, refused to entertain him on the ground that his particulars did not match the IP Number shown on the Card. The complainant, therefore, had no option but to take his wife to a private hospital for immediate treatment. He took his wife to Tyagi Hospital which referred her to Fortis Hospital where she was treated and the complainant had to incur expenditure of Rs.216727/- on the treatment of his wife. Since the said expenses were not reimbursed to him, he approached the concerned District Forum by way of a consumer complaint seeking reimbursement to the aforesaid extent alongwith compensation etc.

The petitioner did not appear before the District Forum despite service and, therefore, an exparte order was passed by the District Forum allowing the consumer complaint. The said Forum directed reimbursement of the expenditure incurred by the complainant alongwith compensation quantified at Rs.12,000/- for the mental agony and harassment caused to him and the cost of litigation quantified at Rs.8,000/-.

Being aggrieved from the order passed by the District Forum, the petitioner approached the concerned State Commission by way of an appeal. Since there was a delay of more than one year in filing the said appeal, they also preferred an application seeking condonation of the said delay. The State Commission found no justification for condonation of such an abnormal delay in preferring the appeal and consequently, dismissed the same as barred by limitation. Being aggrieved from the order passed by the State Commission, the petitioner Corporation is before this Commission by way this revision petition. Since there is a delay in filing the revision petition, the petitioner has also preferred an application seeking condonation of the said delay.

In my opinion, the merits of the case do not justify interference by this Commission in exercise of its revisional jurisdiction under Section 21 of the C.P. Act. The complainant was an employee of Delhi Transport Corporation which is set up by none other than Govt. of NCT of Delhi. He was given an ESI Card which contained correct particulars of the complainant and his family members. However, in the computer system of ESIC, the particulars filled against the IP Number given on the ESI Card of the complainant were different from the particulars given on the Card. This was a mistake which in any manner cannot be attributed to the complainant. The submission of the learned counsel for the petitioner is that the particulars are filled up by the employer and not by ESIC. Even if this is so, the complainant cannot be penalized for such a mistake, he admittedly being a beneficiary of the health scheme of ESIC and having been issued a valid ESI Card. If the mistake was on the part of Delhi Transport Corporation and not on the part of the ESIC, nothing prevents ESIC for taking up the matter with Delhi Transport Corporation and asking it to reimburse them to the extent they have to pay to the complainant in compliance of the orders passed by the Fora below. But, the complainant , who paid way back in the year 2015 cannot be made to wait indefinitely to receive the reimbursement. The District Forum instead of awarding interest w.e.f. the date on which payment was made by the complainant to the Hospital has awarded the same only w.e.f. the date of the order. That is one more reason why the said order does not call for any interference by this Commission at the behest of the petitioner Corporation.

Since in find no merit in the case of the petitioner Corporation, I need not go into the question as to whether there was any sufficient cause shown by the petitioner for condonation of the delay of more than one year in filing the appeal before the State Commission, though the said Commission after examining the grounds given in the application seeking condonation of delay found no merit in the said grounds.

For the reasons stated hereinabove, the revision petition is dismissed with no order as to cost.