BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: AT HYDERABAD.
FA.No.503/2010 against CC.No.41/2005
District Forum, MEDAK AT SANGAREDDY.
Between
The Regional Manager, The New India
Assurance Company Ltd., 5th floor,
Surya Towers, S.P.Road, Secunderabad. ..Appellant/
Opp.party No.5
And
1. Smt.Anishamma W/o.late Vittal Reddy
Aged 55 years, Occupation: Household
R/o.Bellapur Village, Mannor Mandal, now
Residing at H.No.170, MIG, Phase III,
Zahirabad, Medak District. ..Respondent/
Complainant
2. Dr.Ajay Sarda S/o. not known to appellant
Aged Major. Proprietor of Gajanan Hospital, Block
Road, Zahirabad Town, Medak District.
3. Dr.Naval Kishore Sarda S/o.Govind Prasad Sarda
Aged major. Proprietor of Gajanan Hospital, Block
Road, Zahirabad Town, Medak District.
4. Dr.Milind Kandawar S/o.not known to appellant
Aged Major, Occupation:Consultant doctor at
Gajanana Hospital at Zahirabad and Vasavi Hospital
At Lakdikapool, Hyderabad.
5. The Chairman, Indian Medical Association
A.P.State Branch at Hyderabad. Respondents/
Opp.parties
Counsel for the Appellant: Mrs.S.N.Padmini
Counsel for the Respondents: Mr.P.Venkat Reddy-R1
Mr.A.Alavender Gound-R2 & R3
R4-served
M/s.V.Sankara Rao-R5
FA.No.525/2010 against CC.No.41/2005
District Forum, MEDAK AT SANGAREDDY.
Between
1. Dr.Ajay Sarda S/o. Shivaprasad,
Aged 54 years, Occu:Doctor.
2. Dr.Naval Kishore Sarda S/o.Govind Prasad Sarda
Aged about 46 years. Occu: doctor.
Both are proprietors of Gajanan Hospital, Block
Road, Zahirabad Town, Medak District. Appellants/
Opp.parties 1 & 2
And
1. Smt.Anishamma W/o.late Vittal Reddy
Aged 55 years, Occupation: Household
R/o.Bellapur Village, Mannor Mandal, now
Residing at H.No.170, MIG, Phase III,
Zahirabad, Medak District. ..Respondent/
Complainant
2. Dr.Milind Kandawar S/o.not known to appellant
Aged Major, Occupation:Consultant doctor at
Gajanana Hospital at Zahirabad and Vasavi Hospital
At Lakdikapool, Hyderabad.
3. Regional Manager, The New India
Assurance Company Ltd., 5th floor,
Surya Towers, S.P.Road, Secunderabad.
4. The Chairman, Indian Medical Association
A.P.State Branch at Hyderabad. Respondents/
Opp.parties
(Opp.parties 2 to 4 are not necessary parties)
Counsel for the Appellants: M/s.A.Alavender Gound
Counsel for the Respondent: M/s.P.Venkat Reddy-R1
FA.No.275/2011 against CC.No.41/2005
District Forum, MEDAK AT SANGAREDDY.
Between
Smt.Anishamma W/o.late Vittal Reddy
Aged 55 years, Occupation:Household
R/o.Bellapur Village, Mannor Mandal, now
Residing at H.No.170, MIG, Phase III,
Zahirabad, Medak District. ..Appellant/
Complainant
And
1. Dr.Ajay Sarda S/o. not known to appellant
Aged Major.
2. Dr.Naval Kishore Sarda S/o.Govind Prasad Sarda
Aged about 46 years.
Both are proprietors of Gajanan Hospital, Block
Road, Zahirabad Town, Medak District.
3. Dr.Milind Kandawar S/o.not known to appellant
Aged Major, Occupation:Consultant doctor at
Gajanana Hospital at Zahirabad and Vasavi Hospital
At Lakdikapool, Hyderabad.
4. The Chairman, Indian Medical Association
A.P.State Branch at Hyderabad.
5. The Regional Manager, New India
Assurance Company Ltd., 5th floor,
Surya Towers, S.P.Road, Secunderabad. Respondents/
Opp.parties
Counsel for the Appellant : M/s.P.Venkat Reddy
Counsel for the Respondents : M/s.A.Alavender Goud-R1&R2
Mr.M.Sudheer Kumar-R3
Smt.S.N.Padmini-R5
(Mr.V.Sankara Rao-R4)
FA.No.277/2011 against CC.No.41/2005
District Forum, MEDAK AT SANGAREDDY.
Between
Dr.Milind Kandawar S/o.Gangadhar
Aged Major, Occupation: Medical doctor
Flat No.114, Ameen Eshok
R/o.Sanjeevareddynagar, Hyderabad. ..Appellant/
O.P.No.3
And
1. Smt.Anishamma W/o.late Vittal Reddy
Aged 55 years, Occupation: Household
R/o.Bellapur Village, Mannor Mandal, now
Residing at H.No.170, MIG, Phase III,
Zahirabad, Medak District. ..Respondent/
Complainant
2. Dr.Ajay Sarda S/o. Shiva Prasad
Aged 54 years, Occ:Doctor, Gajanan Hospital, Block
Road, Zahirabad Town, Medak District.
3. Dr.Naval Kishore Sarda S/o.Govind Prasad Sarda
Aged about 45 years. Occ:Doctor, Gajanan Hospital, Block
Road, Zahirabad Town, Medak District.
4. The Chairman, Indian Medical Association
A.P.State Branch at Hyderabad.
3. The Regional Manager, New India
Assurance Company Ltd., 5th floor,
Surya Towers, S.P.Road, Secunderabad. Respondents/
Opp.parties
(Opp.parties 2 to 5 are not necessary parties)
Counsel for the Appellant: M/s.M.Sudheer Kumar
Counsel for the Respondents: (M/s.P.Venkat Reddy-R1)
QUORUM: THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT,
AND
SMT.M.SHREESHA, HON’BLE MEMBER,
MONDAY, THE NINETEENTH DAY OF MARCH,
TWO THOUSAND TWELVE
Oral Order (Per Smt.M.Shreesha, Hon’ble Member )
***
Aggrieved by the order in C.C.No.41/2005 on the file of District Forum, Medak at Sangareddy, the complainant preferred F.A.No.275/2011, opposite parties 1 and 2 preferred F.A.No.525/2010, opposite party No.3 preferred F.A.No.277/2011 and opposite party No.5 preferred F.A.No.503/2010. Since all these appeals arise out of common C.D., they are being disposed of by a common order.
The brief facts as set out in the complaint are that the complainant’s son, one Mukunda Reddy, aged 23 years suffered from severe stomach pain and was taken to Gajanan hospital on 18-2-2004 and opposite parties 1 and 2 examined the patient and advised x-ray and blood test reports. After examining the x-ray and blood test reports, opposite parties 1 and 2 called opposite party No.3 who is consulting doctor and opposite party No.3 conducted the surgery on the patient without examining x-ray report. The complainant submits that the surgery was performed for appendicitis but the patient’s intestine became septic and he was admitted in the hospital for a period of 10 days. Opposite party No.3 performed another operation at Vasavi hospital on 03-3-2004 and he was treated in the said hospital till 18-3-2004. Thereafter the patient developed multi palfaceal-fistula in the abdomen and was passing stools from multiple holes in the stomach. On 18-3-2004, opposite party No.3 referred the patient to Vivekananda hospital and while undergoing treatment, the patient died on 27-4-2004.
It is the complainant’s case that the patient was never having any appendicitis problem and opposite parties 1 to 3 wrongly diagnosed appendicitis and did not advise Ultrasound scan of the abdomen and opposite party No.3 performed the surgery without examining the x-ray. The patient’s problem was that there were obstructions in his intestine and even chest x-ray revealed T.B. but the opposite parties did not give any treatment for T.B. and also did not remove the obstructions of the intestine because of which the intestine became septic which lead to multiple operations. The complainant submits that they incurred expenses of more than Rs.2 lakhs for the treatment in these hospitals and it is only because of the negligence of the opposite parties 1 to 3 that the complainant had lost her only son and she also registered a case in Crime No.456/2004 against the said opposite parties, which is pending. Hence the complaint seeking directions to the opposite parties to pay the amount incurred towards medical expenses together with compensation of Rs.10,00.000/- and costs.
Opposite parties 1 and 2 filed their written version admitting that the patient, Mukund Reddy was seen on 21-2-2004 by opposite parties 1 and 2 and after thorough clinical examination, he was diagnosed to be having acute appendicitis and therefore x-ray KUB was taken to rule out any problem which may mimic appendicitis. On 22-2-2004 the patient was seen by opposite party No.3 doctor and after thorough medical examination and also seeing x-ray KUB, he was diagnosed of acute appendicitis and performed appendectomy on the same day i.e. 22-2-1994. The specimen was sent for histo pathological examination and for the initial four post operative days, the patient was fine but on 26-2-2004, the patient developed distention of abdomen with fever. Plain x-ray of abdomen in erect position was taken which showed multiple fluid levels, suggestive of Paralyic Ileus which is a post operative complication. He was managed by surgeons consultation with sufficient I.V. fluids, Higher antibiotics and R.T.aspiration and ‘strict NBM’ and patient showed remarkable recovery in the first 48 hours. From 28-2-2004 morning, he became Afebrile and distension of abdomen reduced and patient was discharged from the hospital on 01-3-2004 asymtomatic. Opposite parties 1 and 2 submit that on 02-3-2004 when the patient came for follow up treatment, he was found to have pus discharged from his abdomen and therefore he was referred to opposite party No.3 at Vasavi hospital at Hyderabad. Opposite parties 1 and 2 submit that the complainant paid only Rs.8,000/- but not Rs.12,500/- as alleged in the complaint. Ultra sound scan examination is not mandatory and the diagnosis of appendicitis was confirmed by histo pathological examination. Opposite parties 1 and 2 further contend that the complainant harassed opposite parties 1 and 2 by staging Dharnas in front of the hospital and registered a false complaint in Crime No.456/2004. Opposite parties 1 and 2 are Members of Indian Medical Association and they are protected under Welfare and Protection scheme valid from 11-7-2001 to 10-6-2006 and submit that there is no deficiency in service on their behalf.
Opposite party No.3 filed counter admitting that he is consultant of opposite parties 1 and 2 hospital and also in Vasavi hospital, Hyderabad and submits that he clinically examined the patient on 22-2-2004 at 8.30 a.m. and pointed out that the clinical history is suggestive of classical appendicitis where abdominal pain was migratory in nature getting localized in right lower abdomen associated with fever. The patient also passed motion on the same day before examination and if there is any intestinal obstruction, the patient will not be able to pass motion. Opposite party No.3 noticed absence of any major disease in the past like T.B., diabetes and Hypertension. The patient was having fever and the abdomen was soft, there was severe pain in the right lower abdomen which indicates that the appendix is infected and he also noticed that they were normal pitched bowel sounds suggesting no intestinal obstruction. Opposite party no.3 examined the KUB x-ray and performed operation on 22-2-2004 and the specimen of appendix was sent for histo pathological examination and the report dated 29-2-2004 shows that it is appendicitis, distelileum found for 3 feet – traced, normal, suggesting that while conducting operation, opposite party No.3 confirmed again that there was no intestinal obstruction. Since he is only a consultant, he performed operation and left for Hyderabad. On 02-3-2004, he once again saw the patient at Vasavi hospital and on clinical and radiological examination show that the patient was suffering from intestinal obstruction and on 03-3-2004, he performed operation along with a senior consultant at Apollo hospital and the patient stayed in the hospital till 18-3-2004.
Opposite party No.3 submitted that he gave option to the complainant to take the patient to another hospital due to poor prognosis which was explained to the complainant on the day of operation. The development of multiple facal fistula is known complication of internal obstruction. Opposite party No.3 referred the patient to Vivekananda Hospital for enteral nutrition which was not available at Vasavi hospital. This surgery was a major surgery in which large amount of pus and gangrenous intestine was noted in the abdominal cavity. In such types of surgeries because of septic complications like fecal fistula, the patient will become thin and lean. The diagnosis of appendicitis was made by all the opposite parties based on clinical examination and radiological tests and ultra sound sonography is not used to diagnose appendicitis. The histo pathological examination showed appendicitis and it is not true that he did not examine the x-ray prior to the operation. He submits that he was not paid any amount for carrying out operation in Vasavi hospital. He submits that he was covered by New India Assurance Company policy and that there was no negligence in conducting the operation as well in diagnosing the condition of the patient and prayed for dismissal of the complaint with costs.
The President of the District Forum based on the evidence adduced i.e Exs.A1 to A28 and also evidence of P.Ws.1 to 3, B1 to B4, R.Ws.1 to 4 dismissed the complaint whereas the Members by way of majority order allowed the complaint directing opposite parties 4 and 5 who are insurers of opposite parties 1 to 3 to jointly and severally pay Rs.2 lakhs towards compensation together with costs of Rs.1,000/-.
Aggrieved by the said order, the complainant preferred F.A.No.275/2011, opposite parties 1 and 2 preferred F.A.No.525/2010, opposite party No.3 preferred F.A.No.277/2011 and opposite party No.5 preferred F.A.No.503/2010.
Opposite parties 3 and 5 filed written arguments.
The facts not in dispute are that the complainant’s son one Mr.Mukund Reddy was brought to Gajanan Hospital run by opposite parties 1 and 2 with stomach pain on 21-2-2004. Opposite parties 1 and 2 advised some blood test and also x-ray of the patient and opined that it was appendicitis. On 22-2-2004 opposite party no.3 who is the consultant doctor of opposite parties 1 and 2 hospital examined the patient and opined that it was acute appendicitis and operated upon the patient on the same day and left to Hyderabad. It is the complainant’s case that opposite party No.3 without examining the x-ray performed the operation. Thereafter the patient’s intestine became septic and the patient was taken to opposite party No.3 at Vasavi hospital on 02-3-2004 where he conducted a major operation on 03-3-2004 and advised him to stay till 18-3-2004. Thereafter the patient was shifted to Vivekananda Hospital where he died on 27-4-2004. It is the complainant’s case that it was because of intestinal obstruction in the abdomen that the intestine became septic and this was detected by opposite party no.3 only 10 days after the first operation. A perusal of Ex.B1 case sheet shows that the patient was of 24 years of age and was seen by opposite parties 1 to 3 on 21-2-2004 and the case sheet shows history of abdominal pain and that an KUB x-ray was taken and blood tests were also conducted. On 22-2-2004 in the operation notes, it is stated that the abdomen was opened and appendicitis was done and there is a note to send the specimen for histo pathology examination. The patient complained of pain at the operation site at about 9.00 p.m. and the same treatment was continued. On 22-2-2004 , it is noted that the abdomen was soft and that the patient passed stool and the same treatment was continued on 25-2-2004. On 26-2-2004 in the case sheet it is clearly stated that there is rigid distension in the abdomen and there is a question mark along with a note ’paralytic ilens’. The condition of the patient was also discussed with the surgeon on the phone and the treatment was continued. An x-ray of the erect abdomen was taken at about 4.00 p.m. which showed multiple fluid levels and the patient also had abdominal distension. On 26-2-2004, 27-2-2004 28-2-2004 and 29-2-2004 the same treatment was continued as shown in the progress notes. The patient was discharged at 6.00 p.m. on 01-3-2004. It is the case of the opposite parties 1 to 3 that the patient was suffering from appendicitis which is evidenced under Ex.B2, histo pathology report which states that the specimen shows acute appendicitis. It is evident form this case sheet that the patient was undergoing treatment in the opposite parties hospital from 21-2-2004 till his discharge on 01-3-2004.
It is also not in dispute that opposite parties 1 and 2 referred the patient to go to Vasavi hospital and meet opposite party No.3. The complainants in their cross-examination before the District Forum submitted that their son did not pass any motion and contend that opposite parties 1 and 2 gave only one x-ray which she filed before this court and the x-rays taken subsequent to the operation were not given to her. It is the main contention of the complainant that without KUB x-ray, opposite party no.3 conducted the operation without observing the intestinal obstruction which resulted in faecal fistula as evidenced under Ex.A18, issued by Vivekananda hospital. Ex.A18 is the medical report given by Vivekananda hospital which states that the patient had intestinal obstruction after undergoing appendectomy. On Laporatomy, distal Ileum was found gangrenous and there was faecal discharge from the wound and after initial assessment the patient was found to be having septicaemia and renal failure with multiple faecal fistula. It is the contention of the opposite parties that this Ex.A18 is unsigned. However, it is not in dispute that the patient was treated in Vivekananda hospital from 18-3-2004 onwards. Ex.A1 is the x-ray of erect abdomen dated 21-2-2004 and signed by Dr.N.V.N.Rao, Radiologist which shows intestinal obstruction. The patient’s name is given clearly as Mukund Reddy and though KUB x-ray is mentioned in the case sheet, Ex.A1, the result of that x-ray have not been noted. As per Ex.A2, it is evident that the patient had intestinal obstruction. In the discharge summary, Ex.A6, opposite parties 1 to 3 did not mention anything about Ex.A1. They only mentioned acute appendicitis but no where stated about intestinal obstruction. Though in Ex.B1 case sheet, x-ray taken in erect position was mentioned still the radiologist opinion has not been noted. Ex.A10 is the x-ray report dated 2-3-2004 once again signed by Dr.N.V.N.Rao, Radiologist, depicting intestinal obstruction. Ex.A15 is dated 10-3-2004 and reports as following:
MICROSCOPIC EXAMINATION:
Multiple sections studied from the specimen show small intestine
(all the three layers) with papillary mucosal folds. The serosal surface
and underlying soft tissues shows an inflammatory mass filled with extensive
collections of neutrophils, fibrinous material. There is granulation tissue
in the wall consisting of many small congested blood vessels and dense
diffuse infiltrate of lymphotcytes, plasma cells, neutrophils and
histiocytes. There are focal areas of foreign body of giant cells and
microabcesses with vegetable material in side. The adjacent serosal
surface also shows similar inflammatory changes, areas of hemorrhage
and congestion. The muscular layer show focal infiltration by these
inflammatory cells and leukocyte margination.
IMPRESSION
Features are suggestive of chronic inflammatory Mass (Abscess)
with foreign body giant cell reaction, serosal soft tissues of small intestine
and mesentry.
Ex.A17 is dated 18-3-2004 is the letter written by Dr.Milind Consultant Surgeon i.e. opposite party No.3 to the DMO Vivekananda hospital that he is referring the patient who is suffering from postal intestinal obstruction with faecal fistula for further care. In the light of this letter, dated 18-3-2004 there is no reason to disbelieve, Ex.A18 medical report. Even otherwise, the documentary evidence establishes that the patient was suffering from intestinal obstruction even at the time of admission i.e. 21-2-2004 at opposite parties 1 and 2 hospital. The death report given by Vivekananda Hospital i.e. Ex.A24 dated 27—4-2004 clearly shows that the cause of death is cardio respiratory arrest secondary to septicaemia and multiple faecal fistula. It is an admitted fact that the patient is not a high risk patient at the time of admission into opposite parties 1 and 2 hospital as on 21-2-2004. He was only 24 years old and was neither diabetic nor hypertensive. The patient stayed for 10 days in opposite parties 1 and 2 hospital and even if intestinal obstruction was not present prior to the operation but had developed as a post operative complication, it does not appear to be treated during the period of 10 days as Ex.B1 case sheet does not evidence anywhere about either the diagnosis of intestinal obstruction or the subsequent treatment thereafter for which opposite parties 1 to 3 are liable to explain. It was only after the crucial 10 days has passed that the patient was once again taken to O.P.3 surgeon and another operation was performed by which time faecal fistula developed along with other post operative complications which is evident in Ex.A18 referral letter given by O.P. 3 himself to Vivekananda hospital. The contention of opposite parties 1 to 3 that the patient was suffering from acute appendicitis alone at the time of admission and did not have intestinal obstruction is unsustainable in the light of Ex.A2, Radiologist report. As the KUB x-ray was not filed before the District Forum or the State Commission, we rely on the notings of opposite parties 1 to 3 hospital in the case sheet. We rely on the decision of the apex court in (2004) 8 SUPREME COURT CASES 56 in SAVITA GARG (SMT) v. DIRECTOR, NATIONAL HEART INSTITUTE wherein the apex court held that when there is a prima facie case, as in the instant case, the burden of proof shifts on the hospital and the doctors to establish that they have undertaken the correct line of treatment as per standards of normal medical parlance. We observe from the record, i.e. Ex.B1 case sheet that neither the results of KUB x-ray was written nor was the intestinal obstruction mentioned anywhere in the case sheet though x-ray of the abdomen erect was supposed to be taken on 26-2-2004 at about 4.00 p.m. It only says it showed multiple levels fluid. It is the main contention of opposite party no.3 that intestinal obstruction developed after the operation done on 22-2-2004. But then there are no substantial reasons as to why this post operative complication was not mentioned anywhere in the case sheet and the same treatment was continued throughout till the patient’s discharge after 10 days on 01-3-2004. It is the burden of opposite parties to establish that they have diagnosed the post operative complication and given treatment as per standards of normal medical parlance which in the instant case the opposite parties failed to establish. It is evident on the face of the record that the patient was undergoing treatment for a period of 10 days in opposite parties 1 and 2 hospital but no steps were taken to either to diagnose or treat the post operative complication resulting in sepsis being formed and it is an admitted fact that the patient died of Septicaemia.
We also observe from the record that consent was taken from the complainant whereas as per the judgement of the apex court in Samira Kohli Vs. Dr. Prabha Manchanda & Another reported in (2008) 2 SCC 1 Informed Consent should be taken from the patient himself unless he is in a state of comatose and unless he is not in a position to comprehend the doctors statements. In the instant case Ex.B1 case sheet shows that the patient was in a coherent condition and the consent was taken from the mother, which is against the provisions of law as observed by the apex court in the aforementioned judgement. To reiterate, all the documentary evidenced filed, establishes that opposite parties 1 to 3 did not follow Standards of Normal Medical Parlance and did not diagnose intestinal obstruction even as a post operative complication from 21-2-2004 to 01-3-2004 which led to the patient developing Sepsis and this is in contradiction to the duty of care and caution that is supposed to be taken by the doctor as laid down in In Bolam v. Friern Hospital Management Committee, WLR at p.586 it is held as follows:
“Where you get a situation which involves the use of some special skill or competence, then the test as to whether there has been negligence or not is not the test of the man on the top of a Clapham omnibus, because he has not got this special skill. The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill….It is well established law that it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art”
In Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. reported in (1969) I SCR 206 is another Landmark judgment on medical negligence. In this case the death of patient was caused due to shock resulting from reduction of the fracture attempted by doctor without taking the elementary caution of giving anaesthesia to the patient. In this case the court discussed the duty of care a doctor should undertake
a) A duty of care in deciding whether to undertake the case
b) A duty of care in deciding what treatment to be given
c) A duty of care in the administration of that treatment
For the aforementioned reasons, we are of the considered view that the duty of care and caution as envisaged in Bolam v. Friern and Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. Has not been followed by opposite party and therefore the in Appeal F.A.No.525/2011 preferred by opposite parties 1 and 2 and FA No.277/20011 3 are dismissed. We also observe from the record that opposite party No.3 is insured by opposite party No.5 and has filed the copy of policy evidenced under Ex.B4 which shows that opposite party is insured for an amount of Rs.10,00,000/- and the period of insurance being 16-7-2003 to 15-7-2004. We find no substantial reasons to interfere with the order of the District Forum with respect to opposite party No.5 indemnifying opposite party no.3 and being liable to jointly and severally pay the amounts awarded by the District Forum and therefore the appeal, FA 503/2011 preferred by the insurance company is dismissed. However, we are of the considered view that opposite party No.4, which is the Indian Medical Association cannot be saddled with the liability of paying the amount as it is only a facilitator and the insurance policy was issued by opposite party No.5 only. Therefore the order of the District Forum is modified setting aside the liability of opposite party no.4. The appeal, FA 275/2011 preferred by the complainant is allowed in part and we find force in the contention of the complainant that her son was only 24 years old and she being a widow was dependant on the son both in terms of monetary and emotional support and also incurred expenses incurred and has filed medical bills in support of her case. Keeping in view that the patient had gone in for an appendicitis operation but ended up dying within two months from the date of operation after a prolonged battle against Sepsis, the complainant is entitled to an amount of Rs.3,00,000/- i.e. the compensation is being enhanced from Rs.2,00,000/- to Rs.3,00,000/- to be paid by opposite parties 1 to 3 and 5. We also observe that the District Forum did not award any interest. Case against opposite party no.4 is dismissed.
In the result, the appeals, FA 525/2010, FA 277/2011 and F.A.No.503/2010 preferred by opposite parties 1, 2 and 3 and 5, the insurance company are dismissed with costs of Rs.5,000/- in each appeal. F.A.No.275/2011 preferred by the complainant is allowed in part and the majority order of the District Forum is modified by enhancing the compensation from Rs.2,00,000/- to Rs.3,00,000/- payable by opposite parties 1 to 3 and 5 jointly and severally. Case against opposite party no.4 is dismissed without costs. Time for compliance four weeks.
Sd/-PRESIDENT.
Sd/-MEMBER.
jm 19-3-2012
