JUDGMENT :

Pankaj Mithal, J.

1. In this Miscellaneous Appeal filed under Section 17 of the Jammu & Kashmir Consumer Protection Act, 1987, the challenge is to the order dated 22.12.2017 passed by the Jammu & Kashmir State Consumer Disputes Redressal Commission, Jammu, hereinafter referred to as ‘Commission’, in the complaint filed by the respondent-Bhupinder Singh claiming reimbursement of medical charges in respect of his liver transplant surgery at the Mendanta Hospital Gurgaon.

2. The Commission by the impugned order has permitted reimbursement of the medical claim to the tune of Rs.29,28,435.96/- as the amount spent on treatment as aforesaid with 12% interest on the said amount with effect from the date of filing of the complaint i.e. 10.11.2015 till its payment and a sum of Rs.01 lakh as compensation for the mental agony and harassment suffered by the respondent. The aforesaid amount was directed to be paid within a period of six weeks from the date of the award failing which interest at the rate of 18% was also awarded on the entire amount awarded.

3. The brief facts which gave rise to the above complaint are that the respondent was an employee of the Neptune Plastics, Phase-I S.I.C. Bari Brahamina, Jammu. He was insured with the Employees State Insurance Corporation and had made all required contributions for the relevant period. He fell seriously ill on June 10, 2012 and was taken to the Emergency Ward of Government Medical College (GMC), Jammu. On the advice of doctors, he was shifted to Dayanand Medical College (DMC), Ludhiana, Punjab for specialized treatment where he remained admitted from 11.06.2012 to 17.06.2012. He was advised liver transplant. It was alleged that the senior specialists at D.M.C. Ludhiana, verbally advised the family members of the respondent for emergency treatment and liver transplant which was not possible in that hospital. Accordingly, they advised them to take the respondent to Medanta City Hospital, Gurgaon, which is one of the best in Asia in private sector for such treatment. On the advice of the doctors, the respondent was immediately shifted to the Medanta Hospital, Gurgaon, on 19.06.2012. The doctors there declared his condition to be very serious and advised that he needs immediate liver transplant and surgery of kidney to save his life. Both the surgeries i.e., in connection with the liver transplant and kidney were simultaneously performed in the Medanta Hospital, wherefrom he was finally discharged on 18.08.2012.

4. The respondent in connection with his above treatment and operation at Medanta Hospital, Gurgaon, incurred expenses of Rs.29,28,435.96. Accordingly, he submitted an application for reimbursement of the above amount on 23rd January, 2013 with all necessary details and documents. The respondent, however, did not claim any medical reimbursement in respect of his treatment at G.M.C, Jammu, and D. M. C. Ludhiana. The entire papers relating to the above claim were also submitted to the Medical Officer, ESI Dispensary, Bari Brahamna, but no action whatsoever was taken to consider his claim.

5. The respondent was thus forced to make a complaint to the Commission regarding the deficiency in service of the ESI in considering his medical reimbursement claim (MRC) claiming the said amount with 14% interest and a compensation of Rs. 20 lakhs for deficient services.

6. The complaint was contested by the ESI. It was pleaded that the Commission has no jurisdiction to hear the matter in view of bar under Section 75(3) of the Employees Insurance Act, 1948. It was admitted that MRC from the respondent was received on 31st December, 2013 and the same was placed before the State Medical Commissioner, Baddi (HP), and the claim was rejected. The new State Medical Commissioner who took charge with effect from March, 2014, vide letter dated 24th July, 2014, referred the case of the respondent to the Medical Commissioner, ESIC Headquarters, New Delhi, for consideration of relaxation, if any, and for pl