The Consumer Protection Act applies to insurance claims for employee medical reimbursements under comprehensive policies, viewing the employer as a consumer.

JUDGEMENT

AVM JONNALAGADDA RAJENDRA, AVSM, VSM (Retd), MEMBER

1. By this common order, we shall dispose of Revision Petitions No. 19, 77, 78 and 79 of 2021 arising from a common order dated 25.09.2019 passed by the Karnataka State Consumer Disputes Redressal Commission, Bangaluru (“State Commission”) in F.A. Nos.849 to 852 of 2019, affirming the District Consumer Disputes Redressal Forum at Bangalore Urban (“District Forum”) order dated 25.10.2016 in Complaint Nos. 518 to 521 of 2016 respectively.

2. For the sake of convenience, parties shall be referred to as they were arrayed in the original complaint before the District Forum.

3. Since the facts and questions of law involved in all the Revision Petitions are substantially similar, they are being disposed of by this common order.

4. The complainant is a State Transport Corporation established under the Road Transport Corporations Act, 1950, for providing public passenger transport services in the State of Karnataka. The complainant functions on a “no profit, no loss” basis and renders essential public services. It owns and operates a fleet of buses for public transportation purposes. One such Corona Bus bearing Registration No. KA-40 F-833, owned by the Corporation, was insured under comprehensive insurance policy No. 67210031120100003550 issued by the Opposite Party (OP). The policy was valid from 30.03.2013 to 29.03.2014, for which premium of Rs.72,570 along with an additional premium of Rs.19,447 towards third-party coverage including crew/employees was paid by the Complainant to the OP. The said bus met with a road traffic accident on 28.06.2013 at Neeraloor Gate, Attibele, Bengaluru, while proceeding from Bengaluru to Tiruchirappalli. In the said accident, the driver, Sri MR Ramesh, sustained grievous injuries and was admitted to Manipal Hospital for treatment. The Complainant incurred medical expenses amounting to Rs.12,62,890, which was reimbursed to the driver. An FIR was registered on the same day vide Crime No.188/2013. A claim for reimbursement was submitted to OP on 20.02.2014 with all necessary documents. However, OP failed to indemnify the said amount. Also, Volvo Bus Regn No.KA-01 F-8514, owned by them was insured under comprehensive policy No. 67210031120100003652 from 30.03.2013 to 29.03.2014. OP collected premium of Rs.68,166 along with an additional premium of Rs.24,235 towards third-party coverage including crew/ employees. The said bus met with an accident on 02.08.2013 at Panchal Village near Tiruvannamalai, TN, while proceeding from Bengaluru to Neyveli. The driver, Sri Mari Gowda, sustained grievous injuries and was treated at St. John’s Hospital, Bengaluru, incurring medical expenses of Rs.23,544. An FIR was registered in Crime No.116/2013. Despite submission of all documents and claim forms, the OP failed to reimburse the due. Consequently, a legal notice dated 18.11.2015 was issued. With OP failing to take requisite action, they approached the District Forum. Further, Corona Bus Registration No.KA-40 F-815 insured under comprehensive policy No. 67210031120100003545 from 30.03.2013 to 29.03.2014, for which premium of Rs.72,570 and additional premium of Rs.19,447 was paid towards third-party coverage including employees/ crew had met with an accident on 30.03.2013 at Penukonda, AP while proceeding from Bengaluru to Hyderabad. The driver, Smt. P. Renuka, sustained grievous injuries and underwent treatment at Hosmat Hospital, Bengaluru, incurring medical expenses amounting to Rs.5,22,144, which was reimbursed by them. An FIR was registered in Crime No.35/2013. Despite submission of the claim with all supporting documents and issue of legal notice dated 18.11.2015, the OP failed to reimburse