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2011 DIGILAW 527 (JK)

State of J&K v. Chairman/M. D. National Insurance Co. & Ors

2011-09-29

J.P.SINGH

body2011
1. Desirous of providing good quality medical health care to serving Government Employees/Legislators and their dependents, the Government of Jammu and Kashmir was entered into a Memorandum of Understanding with the National Insurance Company Limited, in terms whereof, a Policy namely "Jammu and Kashmir Government Employees Health Insurance Scheme" came to be conceived. According to the Policy, a premium of Rs. 1400/- inclusive of Third Party Administrator (TPA) charges was fixed for a Family Unit of four and the Group size of 1.5 Lac employees were to be covered in the First Phase of the commencement of the Policy. Since the policy was optional, the Employees' Union are started to have showed reservation. 2. The Government, therefore, held discussions with the National Insurance Company for modifications in the terms and conditions of Memorandum of Understanding, pursuant whereto, the Insurance Company agreed that premium of seventy five thousand employees amounting to Rs. 10.50 Crore would be paid by the State on account and it would be adjusted against the actual enrolment number. The additional premium is stated to have been agreed to be refunded by the National Insurance Company. Accordingly, the State Government paid Rs. 10.50 Crore to National Insurance Company covering seventy five thousand employees. Only 19,985 employees opted for the Scheme and the State Government, therefore, demanded refund of excess premium of Rs.7,70,21,000/, as premium for 19,985 employees would be only Rs.2,79,79,000/-. 3. The State Government's Claim for refund was not, however, entertained by the Insurance Company. The Insurance Company was, therefore, approached by the State Government for settlement of dispute regarding refund of excess premium by an Arbitrator in terms of Clause 4 of the Miscellaneous Clauses of the Memorandum of Understanding. Finding no Response from the Insurance Company to its request for appointment of Arbitrator, the State of Jammu and Kashmir has approached this Court seeking appointment of a retired Judge of this Court as Arbitrator to settle the existing dispute between the Government and the Insurance Company. The respondent-Insurance Company opposes the appointment of Arbitrator urging that the petitioner's Claim was barred by time and even otherwise there was no arbitral dispute between the parties that may require its adjudication by an Arbitrator. The respondent-Insurance Company opposes the appointment of Arbitrator urging that the petitioner's Claim was barred by time and even otherwise there was no arbitral dispute between the parties that may require its adjudication by an Arbitrator. The execution of the Memorandum of Understanding and existence of Arbitration Clause is, however, not disputed. 4. Heard learned counsel for the parties and considered their submissions. Clause 4 of the Memorandum of Understanding appearing under Caption "Miscellaneous" reads thus: "4.Disputes: Any dispute that may arise between the parties shall be decided by having a recourse to Arbitration in accordance with the Provisions of J&K Arbitration and Conciliation Act, 1997 and/or other laws in force regarding in the State." The respondent-Insurance Company's plea that there was no Arbitration dispute between the parties, is found without merit in view of National Insurance Company Limited's Communication dated 12.08.2003 to the Director Finance Department, Jammu and Kashmir Government, Srinagar, in terms whereof, the Insurance Company is stated to have, inter alia, confirmed that "the premium paid (on account) will be adjusted against the actual enrollment number and accordingly, additional Premium or Refund Premium whichever is applicable will be made", and additionally, in view of the terms and conditions of the Memorandum of Understanding, which had given rise to the dispute between the parties pertaining to the refund of extra premium paid by the State Government to the Insurance Company. 5. This apart, the tenor, tone, text and contour of the Arbitration Clause which is demonstrated by the expression 'Any dispute' that may arise between the parties" is wide enough to cover the dispute raised by the petitioner against the respondent. Respondent Insurance Company's next plea that the petitioner's Claim was barred by time, as no proceedings had been initiated within twelve months of the repudiation of the State Government's Claim, is a plea which needs consideration by the Arbitrator and not by the Court at this stage. The State Government claims refund of the extra premium paid by it to the Insurance Company in terms of the Memorandum of Understanding and Insurance Company's Communication dated 12.8.2003. The respondent-Insurance Company denies the petitioner's entitlement and its liability to refund the premium received by it to the Government. The State Government claims refund of the extra premium paid by it to the Insurance Company in terms of the Memorandum of Understanding and Insurance Company's Communication dated 12.8.2003. The respondent-Insurance Company denies the petitioner's entitlement and its liability to refund the premium received by it to the Government. A dispute, in terms of the Memorandum of Understanding, therefore, exists between the parties which in terms of Clause 4 thereof, is required to be settled by an Arbitrator. 6. The petitioner's request for appointment of Arbitrator, having not been responded to by the respondent within thirty days' of the receipt of request in this behalf, a Arbitrator needs to be appointed in terms of Section 11 of the Jammu and Kashmir Arbitration and Conciliation Act, 1997. During the course of consideration of the Petition, learned counsel for the parties were asked as to whether they had any objection, in case a designated Senior Advocate of the Court was appointed as Arbitrator to adjudicate upon the dispute, to which they offered their "No Objection" for appointment of Sh. D. C. Raina, Senior Advocate, as Arbitrator. 7. Looking to the nature of dispute between the parties and to appoint an independent and impartial Arbitrator, Sh. D.C. Raina, Senior Advocate, is appointed as Arbitrator to adjudicate upon the dispute raised by the petitioner-State of Jammu and Kashmir. The Fee of the learned Arbitrator is fixed at Rs.5, 000/- per sitting, which the parties shall pay in equal shares. This shall be in addition to the secretarial expenses, as determined by the Arbitrator, which too shall be paid by the parties in equal proportion.