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2018 Supreme(Bom) 1285

IN THE HIGH COURT OF JUDICATURE AT BOMBAY
S.C. DHARMADHIKARI, B.P. COLABAWALLA, JJ.
The Commissioner of Income Tax-1 - Appellant
Versus
M/s Dedicated Healthcare Services (TPA) India Pvt. Ltd. - Respondent
Income Tax Appeal No. 1315 of 2015 With Income Tax Appeal No. 1313 of 2015
Decided On : 17-09-2018

Advocates Appeared:
For the Appellant : Mr. Prakash C. Chhotaray.
For the Respondent: Mr. F.V. Irani i/by Mr. Atul K. Jasani.

Headnote:

Income Tax Act, 1961 - Section 260A, 143(1), 194J, 273B, 271C, 201(1) ,119, 145 - Income Tax Appeal - Revenue challenges - Insurance companies to disburse amounts - Assessee before this Court is a Private Limited Company - It is carrying on business as a Third Party Administrator - Assessee is holding a licence from Insurance Regulatory and Development Authority - Revenue claims that assessee is appointed by various insurance companies to disburse amounts under what is styled as Mediclaim Insurance Policy - Insurance companies issue these policies which are serviced by TPAs like assessee - Revenues case is that these TPAs act as facilitators and charge a fee - They provide services, inter alia, like hospitalisation, cashless access, billing and call centre services - All claims payable by insurance companies for these services are routed through TPA - Amounts are paid from an account styled as Claim Float Account provided by insurance companies - Under cashless scheme, amounts received from insurance companies are disbursed directly to recognized hospitals/clinics towards payments to various individuals receiving medical treatment - In case of reimbursement, payments are made by TPA to insured – Held, Court cannot deviate or depart from view taken by Division Bench of this Court in Health India TPA Services - Not right in relying upon certain other decisions to which we will make a reference. Mr. Chhotaray would submit that the questions raised in these appeals have not been discussed earlier by Division Bench - Court can understand then a departure from rule of consistency - Court do not think that we are applying principle of res judicata or estoppels – Court have also not found any occasion to apply Judgment of Honble Supreme Court which is to be found in Five Judge Bench Judgment - Argument of Revenue was considered and equally that of assessee but Supreme Court found from same that challenge is entertainable because there is a substantial question of law or issue impacting public interest or same has potential of recurring in future - Rule of consistency or practice and particularly of accounting adopted by assessee and its acceptance by Revenue possess no bar - It requires no reiteration that legal provisions would take precedence over all such practices and therefore when it comes to a pure legal question and demanding interpretation in larger public interest, Courts would have to keep out rule of consistency - Court do not find that Revenue can be permitted to raise same questions as have been earlier dealt with in Division Bench Judgments and Orders of this Court - Necessarily does not lead to any different conclusion for, on facts Court have not found situation to be any different - Both these appeals do not raise any substantial question of law - Appeal Dismissed.

ORDER :

S.C. DHARMADHIKARI, J.

1. By these appeals, the Revenue has proposed common questions and stated to be substantial questions of law.

2. These questions are set out at pages 14 and 15 of the paper-book in Income Tax Appeal No.1315 of 2015.

3. These questions and the additional question stated to be of law are common to both these appeals.

4. It would be convenient to take the facts from Income Tax Appeal No.1315 of 2015. Therein the Revenue challenges the order passed on 10-12-2014 by the Income Tax Appellate Tribunal, Mumbai for the Assessment Year 2008-09. The Tribunal has dismissed the Revenue's appeal.

5. This Court's jurisdiction under Section 260A of the Income Tax Act, 1961 ("the I.T. Act" for short) is invoked in the following facts and circumstances.

6. The assessee before this Court is a Private Limited Company. It is carrying on business as a Third Party Administrator ("TPA" for short). The assessee is holding a licence from the Insurance Regulatory and Development Authority ("IRDA" for short). The Revenue claims that the assessee is appointed by various insurance companies to disburse amounts under what is styled as Mediclaim Insurance Policy. The insurance companies issue these policies which are serviced by TPAs like the assessee. The Revenue's case is that these TPAs act as facilitators and charge a fee. They provide services, inter alia, like hospitalisation, cashless access, billing and call centre services. All claims payable by the insurance companies for these services are routed through the TPA. The amounts are paid from an account styled as Claim Float Account ("CFA" for short) provided by the insurance companies. Under the cashless scheme, the amounts received from the insurance companies are disbursed directly to the recognized hospitals/clinics towards payments to various individuals receiving medical treatment. In the case of reimbursement, the payments are made by the TPA to the insured.

7. In para 3.2 of the memo of this appeal the Revenue says that, the arrangement is that the initial amount is paid by the insurance company to the assessee. This amount is deposited in the FA (Float Account). The payment for insurance claim is made from this account. Once the FA is utilised by the assessee, it presents the detailed information on disbursement to the insurance company and which is verified by the insurance company. Thereupon, the assessee is reimbursed the sums/amounts disbursed. This is a continuous process and throughout the assessment year. As stated above, the receipts and disbursements are routed through the bank account of the assessee for which the assessee passes certain book entries. It is stated that on receipt of the amount, the bank account is debited and the account of the insurance company is credited. On payment of claims to the hospitals/insured, the account of the insurance company is debited and the bank account is credited. It is in these circumstances that the Revenue alleges that the assessee prepares the Profit and Loss Account by taking only the service charges received as receipt, and administrative and operating charges as expenses. The claims receivable from the insurance companies and payable to hospitals are not routed through the Profit and Loss Account and are directly taken to the Balance Sheet and are reflected as assets and liabilities in the Balance Sheet.

8. In the instant case, the assessee filed a return of income on 28-9-2008 declaring total income of Rs.68,85,850/-. The return was processed under Section 143(1) of the I.T. Act. Later, a survey under Section 133A of the I.T. Act was conducted by the TDS Wing of the Department on 17-9-2009. It was noticed that the assessee had made payments to various hospitals during the year totalling to Rs.11,89,18,600/-, without deducting tax at source. It was claimed that this was required under Section 194J of the I.T. Act and that invited a disallowance under Section 40(a)(ia) of the I.T. Act. The Assessing Officer, therefore


































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