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2007 Supreme(SC) 666

DALVEER BHANDARI, B.N.AGARWAL, P.P.NAOLEKAR
Kishore Lal – Appellant
Versus
Chairman, Employees State Insurance Corporation – Respondent


Judgement Key Points

The legal document establishes that the services provided by the Employees’ State Insurance (ESI) hospital or dispensary fall within the definition of ‘service’ under Section 2(1)(o) of the Consumer Protection Act (CP Act). Since the medical treatment under the ESI scheme is not gratuitous but is funded through contributions made by both the employer and the employee, it constitutes a service for consideration, thereby bringing it under the scope of ‘service’ as defined in the Act (!) (!) .

Furthermore, the document clarifies that the jurisdiction of the consumer forum is not barred by the provisions of the Employees’ State Insurance Act, particularly Sections 74 and 75, which establish the Employees’ Insurance Court for specific disputes related to the implementation and benefits of the ESI scheme (!) (!) . Disputes concerning medical negligence or damages arising from alleged negligence do not fall within the scope of the jurisdiction of the Employees’ Insurance Court, as the Act explicitly limits its jurisdiction to certain claims such as contributions, benefits, and related disputes (!) (!) .

The definition of ‘consumer’ under the CP Act encompasses individuals who hire or avail of services for consideration, including those provided under an insurance scheme like the ESI, when such services are not free of charge (!) (!) . Since the services are rendered under a statutory insurance scheme where the costs are borne through contributions, the recipient qualifies as a ‘consumer’ (!) (!) .

Additionally, the legal principles outlined affirm that claims for damages due to medical negligence, which involve establishing duty of care, breach, and damages, are beyond the jurisdiction of the Employees’ Insurance Court and are more appropriately adjudicated by a civil or consumer forum (!) (!) . The jurisdiction of the consumer forum is to be interpreted broadly to include cases involving services rendered under insurance schemes, provided the services are not gratuitous (!) (!) .

In summary, services provided by the ESI hospital or dispensary are covered under the Consumer Protection Act as ‘services’ obtained for consideration, and the consumer forum has jurisdiction to hear cases related to medical negligence or deficiencies in such services. The statutory provisions of the ESI Act do not exclude or oust this jurisdiction, especially in cases involving alleged negligence or damages (!) (!) (!) (!) (!) .


JUDGMENT

P.P. NAOLEKAR, J.—

1.The appellant was insured with the respondent-Employees’ State Insurance Corporation (for short “the Corporation”) with Insurance No. 913644. The employee’s/appellant’s contribution towards the insurance scheme under the Employees’ State Insurance Act, 1948 (hereinafter referred to as “the ESI Act”) was being deducted regularly from his salary and deposited by his employer with the Corporation. In 1993, the appellant’s wife was admitted in the ESI dispensary at Sonepat for her treatment for diabetes. However, the condition of his wife continued to deteriorate. As alleged by the appellant, there were instances when the doctors were not available even during emergencies. Later, the appellant got his wife medically examined in a private hospital. The tests done revealed that his wife had been diagnosed incorrectly in the ESI dispensary; and that the deterioration in the condition of the appellant’s wife was a direct result of the wrong diagnosis. The appellant filed a complaint under the Consumer Protection Act, 1986 (hereinafter referred to as “the CP Act”) before the District Consumer Disputes Redressal Forum seeking (i) compensation towards mental agony,




























































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