Delhi

North

CC/346/2024

DR NITESH KUMAR TRIPATHI - Complainant(s)

Versus

DIRECTOR GENERAL OFFICE OF DIRECTORATE GENERAL OF HEALTH SERVICES - Opp.Party(s)

27 Aug 2024

ORDER

District Consumer Disputes Redressal Commission-I (North District)

[Govt. of NCT of Delhi]

Ground Floor, Court Annexe -2 Building, Tis Hazari Court Complex, Delhi- 110054

 

Consumer Complaint No.346/2024

Date of filing: 14.08.2024

Date of disposal: 27.08.2024

In the matter of

Dr. Nitesh Kumar Tripathi

S/o Sh. S.B. Tiwari

General Duty Medical Officer

Health & Family Welfare Department

GNCTD-Delhi

‘Group A-Gazetted Officer’

Posted as Medical Officer Incharge

Delhi Government Dispensary

Jharoda Majra, Delhi-110084

 

Resident of:

House No.B-241, Street No.11,

B-Block, Sant Nagar Burari

Police Station-Burari

Delhi-110084                                              …      Complainant

VERSUS

Director General

Directorate General of Health Services,

Police Station-Anand Vihar

F-17, Karkardooma, Delhi-110032             …      Opposite Party No. 1

 

Dr. Anita Chawla

Chief District Medical Officer,

Central District

Gali No.4, Bagichi Allaudin, Nabi Karim,

Police Station- Nabi Karim

Paharganj, New Delhi-110005           …      Opposite Party No. 2

 

ORDER

27.08.2024

 

Present:  Shri Parikhsit Mahipal, Ld. Advocate and DLSA LAC for the Complainant

(Divya Jyoti Jaipuriar)

1. We have heard the arguments of Shri Parikshit Mahipal, Ld. Advocate (DLSA LAC) and Complainant in person on last date of hearing. We have also perused the complaint and its annexures.
2. The Complainant herein is a General Duty Medical Officer of GNCTD cadre, posted in Delhi Government Dispensary, Jharoda Majra, Delhi. He is a beneficiary of “Delhi Government Employees Health Scheme” (DGEHS). It is stated that the Complainant herein makes the monthly contribution to the said scheme for availing the medical facility in the GNCTD empaneled hospitals. The grievance of the Complainant herein is that the Directorate of Health Services represented by its Director General (OP-1 herein) and Chief District Medical Officer (OP-2 herein) are not reimbursing the medical expenses incurred by him for treatment of his mother, who is a dependent beneficiary of the Complainant herein. The bills were submitted to the OPs on 27.02.2023 for claim of Rs. 4,26,940/-.
3. At the very onset, it is noted that although the Complainant is making monthly contribution to DGEHS, but such contribution does not make the Complainant herein a consumer within the provisions of Consumer Protection Act, 2019. DGEHS is not a health insurance, but a scheme which is exclusively available to the government employees of GNCTD. The Complainant and his dependent parents are getting the benefit of the scheme only because of the fact that the Complainant is a government servant. Such benefit of health services is part of the service condition of the employees of GNCTD, which is out of purview of Consumer Protection Act.
4. In this context, Hon’ble Supreme Court in the matter of Jagmittar Sain vs Health Services, Haryana, (2013) 10 SCC 136, Hon’ble Supreme Court has held that a government servant does not fall within the definition of “consumer” and he cannot raise any dispute before Consumer Commissions regarding his service conditions.
5. Hence, we are of the opinion that in view of clear pronouncement of Hon’ble Supreme Court in Jagmittar Sain Bjhagat (supra) case, this complaint is not maintainable before this Commission as the Complainant herein is not a consumer qua OPs herein.
6. Further, on perusal of the complaint and its annexures, it has been observed that the Complainant has filed complaint on account of non-reimbursement of the medical claim filed by him being beneficiary of Delhi Government Employees Health Scheme. The communication exchanged between the Complainant/ Applicant and the employer has revealed that certain clarifications were being sought from the treating hospital to examine the claim but the clarifications have not been received. It has also been seen that the Complainant instead of cooperating with its employer to satisfy the requirements/ formalities to settle the claim, has preferred to communicate with employer through email stating that necessary clarifications be obtained from the treating hospital i.e. Indian Spinal Injury Hospital. It appears that the Complainant herein is not cooperating with the OPs in examination of his claim under DGEHS.
7. Hence, for the reasons explained above, we are not inclined to entertain this complaint primarily on the ground that the Complainant herein is not a consumer within the meaning of provisions of Consumer Protection Act, 2019. Accordingly, this complaint is dismissed at admission stage itself.
8. Office is directed to supply a copy of this order to the parties in accordance with the rules. Thereafter file be consigned to the record room. A copy of this order be supplied free of cost to Ld. LAC, DLSA as well.

 

 

                                                                                     

___________________________

Divya Jyoti Jaipuriar, President

 

 

___________________________

Ashwani Kumar Mehta, Member

 

 

___________________________

Harpreet Kaur Charya, Member