The obligation for reimbursement of medical expenses under the ESI Act primarily lies with the State Government, while the ESI Corporation has a limited role.

JUDGMENT

ESI Corporation has come up in appeal aggrieved by order dated 13.05.2022 in Insurance Case No.12 of 2014 passed by the Employees Insurance Court, Kollam.

2. 1st respondent filed the case under Section 75 , 76 and 78 of the ESI Act, claiming that he is an insured person and was working at contract site of LAPPA in the premises of the Kerala minerals and metals Ltd., Chavara. On 22.05.2007, while he was climbing a ladder it broke down. He fell down and sustained fracture to his left arm and injury to lower part of an eye. He was initially taken to Taluk Hospital, Karunagapally and was then referred to District Hospital, Kollam. He was further treated at Medical College Hospital, Thiruvananthapuram. He underwent a surgery at Sanker’s Hospital, Kollam and was treated up to 25.08.2007. After obtaining treatment at ESI Hospital at Asramam, he applied for reimbursement of medical expenses for an amount of Rs.40,000/- (Rupees Forty Thousand only). The ESI Corporation granted an amount of Rs.12,000/- (Rupees Twelve Thousand only). Dissatisfied with the amount sanctioned by the ESI Corporation, the 1^st respondent approached the Court claiming that he was entitled for an amount of Rs.40,000/- (Rupees Forty Thousand only) along with interest at the rate of 12% per annum.

3. The ESI Corporation filed written objection and resisted the claim of the 1^st respondent. The Corporation contended that an amount of Rs.13,766/- (Rupees Thirteen Thousand Seven Hundred and Sixty Six only) was paid towards Temporary Disablement benefit for the period from 23.05.2007 to 17.08.2007. The medical board examined the 1^st respondent on 19.06.2008 and awarded 7% permanent disability provisionally upto 31.12.2008, for which disability benefit of Rs.1107.40 was paid. A total amount of Rs.5,561/- (Rupees Five Thousand Five Hundred and Sixty One only) was paid to the 1^st respondent as permanent disablement benefit from 18.08.2007 to 31.12.2008. Corporation denied the contention of the 1^st respondent that it had reimbursed an amount of Rs.12,000/- (Rupees Twelve Thousand only). Corporation specifically contended that it has no obligation to reimburse the medical expenses incurred and relied on Section 58 of the Act stating that the responsibility of reimbursement of medical expenses is of the State Government. Though notice was served, the 2^nd respondent herein did not enter appearance and was set exparte.

4. The applicant was examined as AW1 and on the side of the ESI Corporation RW1 and RW2 were examined. Exhibits A1 to A4 were marked on the side of the applicant and Exhibits B1 to B10 were marked on the side of the ESI Corporation. Exhibit X1 disability certificate was also marked.

5. The Insurance Court concluded that the 1^st respondent was eligible for reimbursement of the entire medical expenses incurred for his treatment and that the ESI Corporation as well as the State Government were jointly and severally liable to reimburse the medical expenses.

6. The Corporation contends that in view of Section

58 of the Employees State Insurance Act , the liability to reimburse medical expenses lies solely with the State Government.

7. Heard the learned Standing Counsel for the appellant and the learned Senior Government Pleader for the 2^nd respondent. The learned Standing Counsel referred to provisions of Section 58 of the ESI Act and contended that in view of (1) the obligation to reimburse the medical expenses is that of the State Government alone and that the ESI Corporation cannot be mulcted with the liability to reimburse the medical expenses. He pointed out that the Corporation has already made all eligible payments apart