JUDGEMENT

          Complainant by filing this complaint has submitted that the husband of the complainant Sarbeswar Barik was an employee of General Post Office, Kolkata – 700001 under Central Government and he was a permanent Card Holder of Central Govt. Health Scheme Calcutta vide Permanent Card No. P050877 and Dispensary No. IX mint building and Registration No. 73 and Sarbeswar Barik had been suffering from various diseases and on 07.11.2010 under serious condition the said Sarbeswar Barik was taken to the Calcutta National Medical College Hospital of 24 Gorachand Road, Kolkata – 700014 and being dissatisfied with the treatment of concerned doctors of the said hospital, complainant shifted her husband to Ruby General Hospital Ltd. on 09.11.2010 and after full treatment the said Sarbeswar Barik died on 25.11.2010 leaving behind his wife Smt Gita Barik and four daughters namely Smt Shanti Das, Smt Ashalata Sarkar, Smt Ushalata Mondal and Smt Monilata Khamaru as his only legal heirs and representatives in respect of his movable and immovable properties.

On the death of Sarbeswar Barik on 22.01.2011 complainant in order to get medical reimbursement, submitted a letter of reimbursement of medical claim for hospital expenses for Rs. 2,19,086/- only by virtue of CGHS Card No. P050877 by annexing all the relevant documents for settlement of the said claim towards medical expenses to the op and complainant also submitted a claim form to the op for obtaining a total claim amount of Rs. 2,19,086/- on the self same day and the said claim Form and Documents were duly received by the op by putting its seal and signature.

          After lapse of two months from the receipt of the said claim Form, op sent a letter to the complainant stating that the said claim could not be honoured because of non-furnishing of Medical Bill, Discharge Certificate and Bed Head Ticket and original Money Receipt of Hospital.  In this regard complainant has stated that it is unfortunate to state that due to said tragic incident complainant could not find the medical papers for submitting the same to the op no.1 day after day the complainant being an old lady attended the hospitals for the required document but failed to get the same.  Thereafter complainant requested the op no.1 to enquire and get the said documents from the accountant of op nos. 2 & 3 but op no.1 is bent upon to get the said document from the complainant despite of knowing the incidents of lost of the said documents.  Thereafter the complainant requested the op no.1 with her folded hand for payment of the medical expenses as she has burden for huge loan amount for the treatment of her husband but op ruthlessly refused the complainant for want of the said bed head ticket and separate bill.  Thereafter complainant showed the final bill of op no. 3 amounting to Rs. 1,41,692/- and other bill of medicine and pathological center before the concerned officer of op no.1 but all are in vain.  So it is crystal clear that the op refused to pay any coin to the complainant in order to deprive the complainant from her legitimate right.

          In the above circumstances, complainant sent legal notice on 21.03.2012 through her Ld. Lawyer with a prayer for make payment of Rs. 2,19,086/- towards medical treatment expenses of Permanent Card Holder Sarbeswar Barik on receipt of the said legal notice the op no.1 on 11.04.2012 sent a reply to the Ld. Advocate of the complainant requesting to re-submit the claim papers with necessary correction through proper channel, but complainant did not know in which channel op no.1 will pay the medical expenses.  On 01.04.2013 complainant personally met with the op no.1 with a demand of compensation but op no.1 advised the complainant to bring an order from Ld. Court, hence the present complaint is filed for relief and for redressal.

On the other hand ops appeared before this Forum by filing written version and op by filing written statement admitted that late Sarbeswar Barik the husband of the complainant has retired employee and was a beneficiary of C.G.H.S. and he was also a Card Holder of C.G.H.S. and it is also submitted that complainant being wife of Sarbeswar Barik since Medical Reimbursement Claim of Rs. 2,19,086/- of CGHS of op and after scrutinizing the claim (MRC) Section of CGHS it has been found that the proper requisite was not submitted by the complainant for the said claim and it had been returned to the complainant.  Further it is submitted that complainant failed to follow and maintain the proper rules and regulations as there was some procedure of loss which was required to be fulfilled by the complainant and op also stated in the said return memo dated 25.03.3011 in Column-7 (i), (ii) & (iii) and further complainant did not submit the original money receipt as required for processing the said bill and it is also to be noted that instant case two separate period of admission in two separate hospital but MRC was placed in one consolidated bill.  Further it is submitted that complainant was informed to submit requisite documents stated in the returned Memo dated 25.03.2011 but complainant for the reason best known of her did not submit required documents till date and op further submitted that following documents for processing the MRC Bill i) two sets of bills, one original and one photocopy for the period of hospital admission, (ii) the Govt. hospital bills (period 07.11.2010 to 09.11.2010) got the discharge certificate/DORB Certificate, (iii) for treatment in private hospital (Ruby Hospital) complete clinical and treatment record which is called Bed head ticket in Medical parlance and (iv) original money receipt.  Further op states that MRC could not settle as the complainant yet not submitted the MRC with required documents as per rule after duly rectifying the lapses and there was no negligence on the part of the op, so question of compensation by paying interest to the complainant does not arise at any point of time and prayed for final dismissal of the complaint.

                                                     Decision with reasons

            On in depth study of the complaint including the written version filed by the ops, it is clear that admitted position is that Sarbeswar Barik (since deceased) was a retired employee of the op at Kolkata and was a beneficiary of CGHS and he is also a card holder of CGHS.  It is also admitted fact that complainant being the wife of Sarbeswar Barik legally claimed for Rs. 2,19,086/- at CGHS alongwith all documents.

          Truth is that Sarbeswar Barik was hospitalized on 01.07.2010 at National Medical College Kolkata of 24 Gorachand Road, Kolkata – 700014 with various disease.  Thereafter he was shifted to Ruby General Hospital Ltd. on 09.11.2010  where he was treated up to 25.11.2010 and on that date he died.  It is also admitted fact that the complainant as per claim all allegations with all papers on 22.11.2010 submitted and since then this matter has not been disposed by the ops. But we are not unmindful of the fact that op has tried to convince that complainant did not file any certificate and documents as per their requirement that is two sets of bills, one original and one photocopy for the period of hospital admission, (ii) the Govt. hospital bills (period 07.11.2010 to 09.11.2010) got the discharge certificate/DORB Certificate, (iii) for treatment in private hospital (Ruby Hospital) complete clinical and treatment record which is called Bed head ticket in Medical parlance and (iv) original money receipt.  But fact remains complainant submitted most of the documents including doctor’s certificate etc.  But it is our long experience that CGHS has not been disposing of the matter for releasing medical bill of any ex-employee and it is an example in respect of that fact but fact remains CGHS or the present authority ops are not disbursing the medical expenses as per said claim to the beneficiaries on the death of retired employees in most of the cases and it is not an exception but when the case is being filed they are telling that some documents are not found.  But it is to be kept in our mind that the authority has his scope to verify the same after sending the letter to the hospital authority but they are not doing that.

          On the other hand they are harassing the beneficiaries in such a manner and in the present case complainant is being harassed for last 3 years as widow of late Sarbeswar Barik.  What we have gathered from the present case also that CGHS authorities are aware of the fact though they shall have to return in future such sort of claim.  Practically so long ops shall be in service and they are very powerful man and also can reject any person’s prayer and they can harass anyone but they do not think for a moment that what would be their position when they shall be out of their service and position.  Practically everywhere morality has no place in rendering such service by the Government Employees of any status.  Here and there only for the purpose of attending office and to draw their salary per month they are their duties and that is the situation of the entire administration whether Central Government or State Government.  So, ultimately day by day the work load of the court is being increased for giving relief to the relief seeker and it is only for the very callous attitude of the administration and its department to decide any dispute of any relief seeker with morality and showing dignity to the relief seeker and in the present case it is found that the ill fated widow has not been entertained by the ops and practically CGHS authority are not in a mood to settle such dispute in respect of any claim in most of the cases and it is one of the example. 

          Now it is undisputed fact that the complainant is entitled to such disbursement which is admitted.  But they want documents.  Now we have gone through the entire matters and it is found that it is the intention of the ops not to disburse the said claim.  Anyhow in this case Medical Superintendent of Calcutta National Medical College and Hospital submitted in writing that no other documents are available in their hospital at present but details in short can be supplied and they have mentioned that details as follows- P.M. Report of Sarbeswar Barik, age-80 years, sex-male, date of admission 07.11.2010 at 20:41hours with CVA along with Falciperum malaria, bed no. RF-2 paying bed-222, R.G. No. 10316961, PA no. 10042780 and DORB on 09.11.2010 by Subhas Khamaru and in spite of this no other documents are available in their hospital.

          Then question is wherefrom the complainant shall have to produce all those documents?  Then it was the duty of the op to collect it by sending a letter but that has not been done and it is proved that deficiency and dereliction of duty is on the part of the op and in the office of ops’ employees and officers are enjoying different type of songs by fixing hearing cod in the ears so they are not in a mood to hear the prayer and relief seekers’ prayer at all  as they are engaged in hearing songs of modern style through their mobile or handset and this is the picture is normal picture in most of the offices and now it is true also.  So it is proved that op’s office and employees, officers are not in a mood to hear any other cry because they are always engaged in hearing the songs by closing their ears through head phone.

          But we have realized that the lady has been harassed by the employees and officers and the very simple procedure was there to justify the claim of the complainant only by sending the letters to the hospital for verification, but that has not been done.  So it is clear that ops did not attend the complainant’s cry or prayer at all and practically she has been harassed and for which we are convinced to hold that negligence, callousness, deficiency, dereliction of the duty on the part of the op are well proved.  So, in the circumstances we find that an widow like complainant must have to get relief because she has been harassed in all respect and she has also proved the deficiency, negligence, dereliction of the duty on the part of the ops for which the complaint succeeds.

          Moreover from the letter of Dr. A. C. Additional Director of CGHS dated 11.03.2014 addressed to this Forum it is found that they are not in a position to produce any paper to show that complainant’s claim was refused and there is no trace of any such paper or claim of the complainant.  But he has tried to say that when original application is returned no record is available and in fact that Additional Director has also failed to produce such sort of materials and moreover there is a negative attitude for which complainant was asked to file all those documents and it is no doubt condemnable activities of the CGHS for which complaint succeeds.

Hence, it is

                                                            ORDERED

          That the complaint be and the same is allowed on contest with cost of Rs. 5,000/- against the op no.1 and same is also allowed against op nos. 2 & 3 but without any cost.

          Op no.1 is hereby directed to settled the claim of the complainant after collecting further application from the complainant and all such documents from the Calcutta National Medical College & Hospital and Ruby General Hospital to dispose of the same within 45 days positively and handed over a bank draft in the name of the complainant in respect of settlement of the claim and if op no.1 does not comply this part of the order in that case after lapse of 45 days op no.1 shall have to hand over a bank draft of Rs. 2,19,000/- in the name of Mrs. Gita Barik within 15 days (after expiry of the said 45 days).  If op no.1 fails to comply that order in that case for each day’s delay and non-compliance of the Forum’s order, op no.1 shall have to pay punitive damages @ Rs. 250/- per day till full satisfaction of the decree and punitive damages shall be paid to this Forum.

          Op no.2 & 3 are hereby directed to supply all material documents as required by op no.1 on receipt of the letter from op no.1 if it is found that op nos. 2 & 3 are not complying the present order of this Forum in that case they shall be imposed penalty for dereliction of duty and deficiency of service.

          Ops are directed to comply the order very strictly within stipulated period as per spirit of this order failing which penal action shall be started proceeding against op u/s 27 of C.P. Act 1986 for which they shall be to imposed further fine and penalty also.

          Complainant is directed to file a fresh application at once along with available documents in her custody and receive a copy from the authority and parties are directed to report after lapse of 60 days about compliance of the order otherwise for implementation of this order penal proceeding shall be started.