MANU/KE/0842/2021

True Court CopyTM

IN THE HIGH COURT OF KERALA AT ERNAKULAM

WP(C) No. 2938 of 2021 (N)

Decided On: 29.03.2021

Appellants: Reliance General Insurance Company Ltd. Vs. Respondent: State of Kerala

Hon'ble Judges/Coram:
P.V. Asha

JUDGMENT

P.V. Asha, J.

1. Ext. P23 order of Government revoking the award of contract to the petitioner is under challenge in this Writ Petition. The petitioner has sought for a declaration also to the effect that the conditions stipulated by the Government in Ext. P27 invitation for request for proposal (RFP) for implementing Medical Insurance Scheme for State Employees and Pensioners (MEDISEP) would not apply to it.

2. The Government had as per Ext. P1 notification dated 01.01.2019 invited RFP for implementation of MEDISEP for State Government employees and pensioners. The scheme was envisaged for providing cashless treatment facility to the State Government employees, pensioners and family pensioners, etc., through an insurance company and a network of empanelled hospitals in accordance with the criteria fixed by the Government. It was provided that the proposal shall remain valid for 180 days after the deadline for submission. It was also provided that the successful participant shall enter into an agreement within seven days of receipt of the order of acceptance of proposal. Annexure II provided for the empanelment guidelines. As per Ext. P2 letter dated 27.02.2019 the Government accepted the bid submitted by the petitioner at an annual premium of Rs. 2992.48 per family. Thereupon, the petitioner as per Ext. P3 letter dated 06.03.2019 accepted the award and requested for confirmation on the start of the policy, finalisation of package rates, etc., at the earliest, stating that the petitioner would be turning down other opportunities. Thereafter, in the meeting held on 14.03.2019 as per Ext. P4 minutes, a time line was fixed for each steps to be undertaken by the petitioner as well as the respondent for the period from 23.03.2019 to 10.04.2019. As per Ext. P6 letter dated 27.04.2019, the Government awarded the contract to the petitioner. It is stated that, in the meanwhile, the respondent had approved the logos prepared by the petitioner for the scheme and the petitioner had sought for clarifications over the discrepancies found in the data shared by the respondent with respect to the details of the beneficiaries: there had been various correspondence between the petitioner and the respondent through emails like Exts. P7 to P9 and that the respondent had, while acknowledging the discrepancies as per Ext. P8 email dated 21.05.2019, requested the petitioner to upload the data in the portal created by it for the scheme, for updation of the details of beneficiaries and the petitioner had uploaded the same accordingly. As per Ext. P10 proceedings, the Government decided to constitute a committee with the Additional Secretary, Finance (Health Insurance) Department, Joint Director, State Nodal Cell (MEDISEP) and Medical Officer, State Nodal Cell (MEDISEP), for taking decisions on the utilisation of the funds from the corpus and laying down the procedure to be followed for implementation of the scheme. It is stated that the petitioner had been diligently working on empanelment of hospitals for implementing the MEDISEP. According to the petitioner, the difference in package rate approved by the respondent under the scheme and the rate demanded by several of the hospitals it approached were almost double and therefore the petitioner was unable to empanel certain super specialty hospitals. It is stated that in the meeting held with both the parties on 11.07.2019, as per Ext. P11 minutes, the respondent had acknowledged the existence of the discrepancies and had assured to hand over the rectified data to the petitioner on 15.07.2019 and it had acknowledged the difference in the packages approved in the tender and the rate prescribed by certain hospitals. It is stated that even after the petitioner furnished the details regarding the portal established by it, the respondent had not furnished the rectified data despite repeated requests; even then the petitioner continued to work on implementation of ........