Haryana

Kurukshetra

CC/275/2020

Anju Rani Wd/o Rahul Nain - Complainant(s)

Versus

Axis Bank - Opp.Party(s)

Ajay k Sharma

18 Nov 2021

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL COMMISSION  KURUKSHETRA.

 

Complaint no.275 OF 2020.

Date of instt.19.08.2020. 

                                                                Date of Decision: 18.11.2021.

 

1.Anju Rani aged about 31 years, wd/o Sh.Rahul Nain son of Sh.Kuldeep Nain.

2.Tajasveer Nain aged about 7 years (minor) s/o Sh.Rahul Nain through his mother Anju Rani being his guardian cum next friend.

3.Kusum Lata aged about 55 years, wd/o Sh.Kuldeep Nain, all residents of village Nandu Khera, Bibipur Kalan, P.O.Murtzapur District Kurukshetra.

 

                                                                  …Complainant. 

                        Versus

 

1.Axis Bank Ltd. Kaithal Road, Pehowa through its Branch Manager.

 

2.New India Assurance Co. Sawhney Nursing Home, Pipli Road, Kurukshetra through its Branch Manager.

 

…Opposite parties.

 

                          Complaint under section 35 of Consumer Protection Act. 

 

Before               Smt. Neelam Kashyap, President.    

                        Ms. Neelam……… Member.

                        Sh.Issam Singh Sagwal…..Member.

 

Present :            Sh. Dinesh  Sharma, Adv. for complainant.

Sh. Rohtash Jangam, Advocate for OP No.1.

Sh.Taroon Sethi Advocate for OP No.2.

ORDER

 

                    This is a complaint under Section 35 of the Consumer Protection Act, 1986 moved by Anju Rani and others, complainant against Axis Bank etc. the opposite parties.

2.             It is stated in the complaint that Rahul Nain met with an accident on 19.5.2029 in which he received multiple serious and grievous injuries on various parts of his body. He was taken to Healing  touch Hospital, Ambala but due to serious condition he was referred to Paras Hospital, Panchkula where he was treated. As the condition of injured was deteriorating and the complainant and her family members were not satisfied with the treatment given by the concerned hospital, the family of complainants consulted with the doctors of  Arvind Hospital, Karnal and after consultation , on 26.5.2019 the injured was shifted to Arvind Hospital,  Karnal with all necessary life support system and precautions. The patient was treated for two days in Arvind Hospital, Karnal but unfortunately he could not be recovered and he succumbed to his injuries on 27.5.2019.  It is further stated that every endeavour was made on behalf of family of the deceased to give him the best treatment but inspite of all the efforts his life could not be saved and huge amount  was spent on his treatment.

 

                It is submitted that said Sh.Rahul Nain was having bank account bearing No.916010081915043 with the OP No.1 and an ATM card  i.e. debit card had also been issued to him against that account.  As per the policy of OP No.1 all the ATM card/Debit Card holders had been given a cover of accidental insurance for a sum of Rs.5.00 lacs.The said insurance cover was given by OP No.2 as there was a tie up between both the Ops. As Sh.Rahul Nain died in a road accident, so the complainant no.1 had applied for insurance claim with the Ops on 10.7.2019 and provided all the documents which were demanded by the Ops.   The  officials of Ops sent the case to the higher authorities for consideration under claim reference No.UIBAXIS-1920-15464  but the  claim of the complainants was rejected by the Ops and the OP No.1 vide letter dated 13.08.2020 informed that claim applied on 10.7.2019 which stands rejected by the OP no.1 which have  tie up with the Axis BanK Limited. For debit card personal accident claim. New India Assurance Co.stated as per the discharge summary  the patient was made to leave against the Medical Advice (LAMA  Certificate) in spite of poor prognosis & expired in the absence of proper medical treatment, but the true facts are  other way around, as the condition of the injured was deteriorating and the family members  of Rahul Nain since deceased were not satisfied with the treatment given by the concerned Hospital and on consultation he was admitted to Arvind Hospital, Karnal and died on 27.5.2019. On  receipt of letter dated 13.8.2020, the complainants approached the officials of the OP and requested them to pay the claim but nothing was paid, which amounts to deficiency in services on the part of the Ops. Thus, the complainants have filed the present complaint alleging deficiency in services on the part of the Ops and prayed that the Ops be directed to pay the claim amount to the complainants alongwith compensation for the mental agony and harassment caused to them and the litigation expenses.

 

3.             Notice of the complaint was given to the Ops. OP No.1 appeared and filed its written statement disputing the claim of the complainant. It has been submitted that the bank has no legal liability to pay any claim to the complainants. However, the insurance company has liability to pay the claim if any and for that bank has forwarded all the claim related documents to the OP No.1 on 10.7.2019. It is also submitted that intricate questions of law and facts are involved in the present complaint which requires comprehensive evidence and thus cannot be decided in summary manner by way of tendering affidavits and also on this ground also this forum has no jurisdiction to decide the present complaint. Issuance of ATM card and having of bank account with the OP No.1 has been admitted and the insurance cover of Rs. 5 lacs was provided by the insurance company. Thus, it is submitted that the OP No.1 has no deficiency in services  and prayed for dismissal of the present complaint.

 

4.             The OP No.2 also filed written statement and disputed the claim of the complainant. It is submitted that  the complainants have admitted in the written statement that the patient was taken away without the medical advice of the treating doctors and was shifted to an another hospital, where he did not get recovered and died. Had the complainant not taken away the patient without the medical advice of the treating doctors, the patient would not have died. The complainants consulted the treating doctors to refer the patient but the doctors  at PARAS  Hospital denied and in this regard they had issued a summary dated 26.5.2019 in which it has been stated in the last para that “The patient needs further care and management in ICU but the patient’s attendants have requested to take LAMA to another medical setup.  The patient’s attendants  have been explained about the risk of transfer which includes risk to life during the transport. The attendants understand the disease process and the current critical condition. They have been explained the need for continuation of care in an intensive care unit with facility for nursing support and lifesaving equipment. The patient is being shifted to ambulance on bains circuit with 100% oxygen. The ventilation and hemodynamic status is expected to worsen during the transport. Thus, the patient’s condition was very critical and he died due to the negligent act of the complainants. The complainants have not attached any document  regarding consultation with the doctors of Arvind Hospital Karnal for the betterment  of the patient. Thus, it is submitted that the patient died due to act and risk of the complainants and there is no deficiency in services on the part of the answering OP No.1 and prayed for dismissal of the present complaint.

 

5.             The complainant in support of  their case have filed affidavit  Ex.CW1/A and tendered documents Ex.C-1 to Ex.C-7 and closed their evidence.

 

6.             On the other hand, OP no.1 in support of its case has filed documents Ex.R-1 to Ex.R-7 and closed its evidence.

 

                The OP No.2 in support of its case has filed affidavit Ex.RW1/A and tendered documents Ex.R-1 to Ex.R-8 and closed its evidence.

 

7.             We have heard the learned counsel for the parties and gone through the case file very carefully.

 

8.             The learned counsel for the complainant has argued that that Rahul Nain met with an accident on 19.5.2029 in which he received multiple serious and grievous injuries on various parts of his body. He was taken to Healing  touch Hospital, Ambala but due to serious condition he was referred to Paras Hospital, Panchkula where he was treated. As the condition of injured was deteriorating and the complainant and her family members were not satisfied with the treatment given by the concerned hospital, the family of complainants consulted with the doctors of  Arvind Hospital, Karnal and after consultation , on 26.5.2019 the injured was shifted to Arvind Hospital,  Karnal with all necessary life support system and precautions. The patient was treated for two days in Arvind Hospital, Karnal but unfortunately he could not be recovered and he succumbed to his injuries on 27.5.2019. 

9.             It is  further argued that said Sh.Rahul Nain was having bank account bearing No.916010081915043 with the OP No.1 and an ATM card  i.e. debit card had also been issued to him against that account.  As per the policy of OP No.1 all the ATM card/Debit Card holders had been given a cover of accidental insurance for a sum of Rs.5.00 lacs.The said insurance cover was given by OP No.2 as there was a tie up between both the Ops. As Sh.Rahul Nain died in a road accident, so the complainant no.1 had applied for insurance claim with the Ops on 10.7.2019 and provided all the documents which were demanded by the Ops.   The  officials of Ops sent the case to the higher authorities for consideration under claim reference No.UIBAXIS-1920-15464  but the  claim of the complainants was rejected by the Ops and the OP No.1 vide letter dated 13.08.2020 informed that claim applied on 10.7.2019 which stands rejected by the OP no.1 which have  tie up with the Axis BanK Limited for debit card personal accident claim. New India Assurance Co.stated as per the discharge summary  the patient was made to leave against the Medical Advice (LAMA  Certificate) in spite of poor prognosis & expired in the absence of proper medical treatment, but the true facts are  other way around, as the condition of the injured was deteriorating and the family members  of Rahul Nain since deceased were not satisfied with the treatment given by the concerned Hospital and on consultation he was admitted to Arvind Hospital, Karnal and died on 27.5.2019 but the claim was not paid by the Ops. It is also argued on behalf of complainants that the complainants had applied for claim as per Ex.C-1 within time.

10.            On the other hand, learned counsel for the OP No.1 has argued that the bank has no legal liability to pay any claim to the complainants. However, the insurance company has liability to pay the claim if any and for that bank has forwarded all the claim related documents to the OP No.1 on 10.7.2019. It is also submitted that intricate questions of law and facts are involved in the present complaint which requires comprehensive evidence and thus cannot be decided in summary manner by way of tendering affidavits and also on this ground also this forum has no jurisdiction to decide the present complaint.

 

11.            The learned counsel for the OP No.2  while reiterating the contentions made in the written statement has argued that  the patient was taken away without the medical advice of the treating doctors and was shifted to an another hospital, where he did not get recovered and died. Had the complainant not taken away the patient without the medical advice of the treating doctors, the patient would not have died. The complainants consulted the treating doctors to refer the patient but the doctors  at PARAS  Hospital denied and in this regard they had issued a summary dated 26.5.2019 in which it has been stated in the last para that “ As mentioned in Ex.R-8, The patient needs further care and management in ICU but the patient’s attendants have requested to take LAMA to another medical setup.  The patient’s attendants  have been explained about the risk of transfer which includes risk to life during the transport. The attendants understand the disease process and the current critical condition. They have been explained the need for continuation of care in an intensive care unit with facility for nursing support and lifesaving equipment. The patient is being shifted to ambulance on bains circuit with 100% oxygen. The ventilation and hemodynamic status is expected to worsen during the transport. Thus, the patient’s condition was very critical and he died due to the negligent act of the  complainants.

 

12.            After hearing the learned counsel for  the parties, we see that the  patient Rahul Nain was shifted from Paras hospital  Panchkula to Arvind Hospital Karnal on 26.5.2019 and he remained admitted in Arvind Hospital, Karnal for two days.  The doctors of Paras Hospital Panchkula in the discharge summary Ex.R-8 has mentioned  that the patient was discharged in LAMA and that there was risk during the transit but nothing happened during transit and the patient remained alive for two days in the Arvind Hospital, Karnal, therefore, it cannot be said that the patient Rahul Nain died due to  negligent act of the attendants of the patient.  Insurance cover for Rs.5.00 lacs is not in dispute. As per Ex.C-2, the complainants applied for claim within time  i.e. on 13.08.2020 within two months. Therefore, claim of the complainants is bonafide and for not paying the claim there is deficiency in services on the part of the OP No.2. However, no deficiency in services is made out against the OP No.1 and the complaint deserves to be dismissed against the OP No.1.

 

13.            In view of our above discussion, we accept the present complaint and direct the OP no.2 to make the payment of the claim amount of Rs.5.00 lacs to the complainants in the following manner:

 

i)              To make the payment of Rs.2.00 lacs to the complainant no.1 Anju Rani wife of Rahul Nain alongwith interest @ 6% per annum from the date of filing of the present complaint i.e. 19.08.2020 till its actual realization.

 

ii)              To make the payment of Rs.2.00 lacs to the complainant No.2 Tejasveer Nain, son of the Rahul deceased, alongwith interest @ 6% from the date of filing of the present complaint i.e. 19.08.2020 till its realization. It is made clear that the claim amount payable to the complainant no.2 be deposited in the shape of FDR in some nationalized bank and be given to the complainant no.2 Minor Tajasveer Nain on attaining of  majority.

 

iii)             To make the payment of Rs.1.00 lacs to Smt. Kusum Lata mother of the deceased Rahul, alongwith interest @ 6% per annum from the date of filing of the present complaint i.e. 19.8.2020 till its actual realization.

 

iv)             To make the payment of Rs.10,000/- as compensation on account of mental harassment and agony caused to the complainants and R%s.5000/- as litigation expenses. The amount of the compensation and litigation expenses shall be shared by the complainant No.1 and 3 in equal shares.

                The OP No.2 is further directed to make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order, failing which the complainants shall be at liberty to initiate proceedings u/s 71 of the Consumer Protection Act.  The complaint qua OP No.1 stands dismissed. The file be indexed and consigned to the record room after due compliance.

 

Announced in open Commission.

Dated: 18.11.2021.                                              President.

 

 

                                Member             Member.