(1.) THIS order shall decide the above mentioned 11 revision petitions. The facts and law points involved in all these cases are same and consequently, they are being disposed of by this common order. We are taking the facts from RP No. 1786/2012. In this case, the complainants became Members of Yeshaswini Co -op. Farmers Health Care Scheme. As per the medical Insurance Scheme, the petitioner/OP was to reimburse the medical expenses of its Members. This is an indisputable fact that Manager, Health Family Plan Ltd., received the premium from each of the complainants and he also issued the policies. The petitioner/OP refused to pay the medical bills of the complainants on the ground that they did not undergo treatment in the network hospitals. There is no dispute that all the complainants took treatment in Dhanvanthari Hospital, Puttur. The petitioner refused to reimburse the said bills.
(2.) THE complainants filed the complaints before the District Forum which were partly allowed by it. C.E.O, Yeshaswini Co -op. Farmers Health Care Scheme, petitioner/OP 1 and Manager, Family Health Limited Plan, Respondent No.2/OP2 were directed to reimburse the medical expenses of the complainants and were further directed to pay Rs.5,000/ - each as compensation and Rs.1,000/ - as costs of litigation expenses, within a period of 30 days. Aggrieved by that order, the petitioner/OP filed appeals before the State Commission. The State Commission also dismissed the appeals. We have heard the counsel for the parties. It is interesting to note that both the counsel have filed two divergent judgments of the same Bench. The first judgment is with reference to the authority in Yeshashwini Bima Yojna Vs. Shahinbanu and Yeshashwini Bima Yojna Vs. Mumtaz Begum (RP Nos. 1172 and 1173 of 2007). In these cases, it was held that :
(3.) THE second judgment is also by the same Bench in the cases, C.E.O, Yeshaswini Co -operative Farmers Health Care Scheme Vs. Hemanth Kumar and C.E.O, Yeshaswini Co -operative Farmers Health Care Scheme Vs. Smt. Susheela Rai K.S. (RP Nos. 3873 and 3875 of 2012), wherein it was held that :