PER  JAGROOP  SINGH   MAHAL, MEMBER

                        This is complainant’s appeal under Section 15 of the Consumer Protection Act, 1986 (hereinafter referred to as the Act) directed against the order dated 16.5.2011, rendered by the ld. District Consumer Disputes Redressal Forum-II, UT, Chandigarh (hereinafter referred to as the District Forum) vide which the complaint filed by the complainant/appellant was dismissed.

2.                             According to the complainant after retiring from Central Government Department on 30.4.2003, with last basic pay of Rs.12,400/- per month and pension sanctioned @ Rs.6,145/- per month, he joined Central Government Health Scheme (CGHS) w.e.f. 1.5.2003 and contributed Rs.100/- per month based on his last basic pay of Rs.12,400/- and, as such, he was entitled to avail Private/Deluxe Ward accommodation in case of admission in Hospital for self and for dependent family members. He paid the contribution, as per the prescribed limit, upto 31.12.2007 and requested OP-1 on 20.12.2007 to convert his CGHS Card No.P-2569 into Permanent Card.  However, OP No.1 converted the payment of Rs.4600/- made by him into enhanced rate of contribution at the rate of Rs.150/- per month w.e.f. 1.4.2004, without any notice, whereas the enhanced rate of contribution was applicable only to the pensioners joining CGHS w.e.f. 1.4.2004 or subsequently and therefore, it was not applicable to the complainant as he had joined the said scheme on 1.5.2003.  However, the card was renewed by the OPs upto 30.6.2010.  The OPs stressed that he has to pay the subscription at the rates prevailing at the time of renewal of the card from time to time.   The matter was taken up with OPs but all in vain.  When the grievance of the complainant was not settled, a complaint under Section 12 of the Act was filed.

3.                             In their joint reply the OPs admitted the factual matrix of the case and submitted that the complainant was registered as a CGHS beneficiary for a period of 8 months in the first instance upto 31.12.2003 which was got extended upto 31.12.2004 on 4.12.2003 with the subscription charges for this period @Rs.100/- per month, matching with his basic pay with entitlement of Private Ward.  It was stated that the Government of India enhanced the subscription/contribution rates w.e.f. 1.4.2004 vide O.M. dated 28.10.2005 in view of merger of 50% DA/DR with basic pay/basic pension of government employees/pensioners. The complainant opted for contribution/ward entitlement matching with his last basic pay which after merger of 50% DA rose from 12400/- to Rs.18600/-. Therefore, for renewal of his card beyond 31.12.2004, he was liable to pay the subscription/contribution at the enhanced rate of Rs.150/- per month instead of Rs.100/- per month and accordingly, while renewing his CGHS card for another 36 months i.e. upto 31.12.2007, he was rightly charged @150/- per month.  His card was further extended by the Department upto 30.6.2010 for 30 months on 16.1.2008 by charging the same rate of contribution.  Remaining averments were denied being wrong.

4.                             Parties led evidence in support of their case.

5.                             After hearing the complainant in person, ld. Counsel for the OPs and on going through the evidence on record, the ld. District Forum dismissed the complaint, as stated above.

6.                             Feeling aggrieved, the instant appeal has been filed by the appellant/complainant.

7.                             We have heard the appellant in person, ld. Counsel for the respondents and have gone through the evidence on record of the case carefully. 

8.                             The contention of the complainant is that he had retired before 1.4.2004 on which date 50% of the dearness allowance was merged in the basic pay. According to him his basic pay remained the same i.e. 12,400/- till his retirement, there was no merger of dearness allowance in his basic pay and therefore, his monthly contribution based on last pay drawn cannot change.  In this respect we may refer to para No.3 of the Central Government Health Scheme, Notification dated 28.10.2005
(Annexure A-1), which reads as follows:-

                        “3.       In view of the merger of 50% of Dearness Allowance/Dearness Relief with Basic Pay/Basic Pension to the Central Govt. Employees/Pensioners with effect from 1.4.2004, the entitlements under the CGHS for free diet, Nursing Home facilities, Ward entitlements in CGHS recognized private hospitals, etc. in respect of CGHS beneficiaries that were governed under Department of Health’s O.M. No.S-11022/1/98- CGHS(P), dt. 4.9.1998 would also get revised with effect from 1.4.2004 as under:-

                        Annexure 7.1:Enhancement of Subscription under the CGHS

                        It is on the basis of this notification that the monthly contribution of Rs.150 per month has been demanded from the complainant/appellant instead of Rs.100/-. The letter makes it clear that the merger of dearness allowance was ordered w.e.f. 1.4.2004. It is not disputed that the complainant/appellant had already retired prior to that date and therefore, he never got benefit of merger of 50% of dearness allowance in his basic pay. His basic pay would therefore, continue to remain the same even after 1.4.2004 and the rate of contribution towards CGHS would not change. In our opinion Annexure A-1 would be applicable to those employees who were in service on 1.4.2004 or thereafter and to those pensioners who had opted on the basis of their basic pension because in their case the dearness relief would be merged in their basic pension w.e.f. 1.4.2004. The case of the complainant is not covered warranting the increase in the contribution. He is therefore, liable to pay Rs.100/- per month as his contribution unless this rate is increased, keeping in view the basic pay irrespective of merger of the dearness pay in his basic pay.

9.                             The learned District Forum referred to decision dated
17.3. 2010  of the Central Administrative Tribunal, Madras bench in case of D. Thiruvateeswaran Vs. Union of India, copy of which is annexed as OP-4.  There is no mention in the order if the applicant had opted for CGHS Scheme on the basis of last pay drawn by him. If contribution is not proved to be on the basis of last pay drawn and if the same is calculated on the basis of pension then certainly the pension is bound to increase with the addition of dearness relief or other factors and the pensioner may be liable to pay increased amount of contribution. This decision therefore, does not apply to the complainant, firstly because he had opted for membership of the scheme on the basis of his basic pay and secondly there was no increase in his basic pay as he had already retired before 1.4.2004.

10.                         The learned District Forum proceeded with the assumptions that circular Annexure A-1 is applicable to him and the obvious conclusion was that he is liable to pay enhanced contribution. The learned District Forum did not examine the aspect whether this notification was applicable to those pensioners who had retired before 1.4.2004 and who had opted for membership of CGHS Scheme on the basis of the last pay drawn by them, which in any case would remain the same because the merger of dearness pay took place long after his retirement on 30.4.2003.

11.                           There is no dispute about it that if part contribution had already been made for some period, the complainant/appellant can pay the remaining amount at any time and by paying the same he can get   membership for whole life. According to the complainant he had paid the entire amount of 10 years contribution and is therefore, entitled to a permanent CGHS Card, valid for the whole life. The total amount paid by him is not disputed by the OPs. Their decision to appropriate the same at @Rs.150/- p.a. cannot sustain. In this manner the complainant/appellant would be entitled to a Life Membership Card for getting the facilities under CGHS Scheme.  

12.                         Para 4 of the notification Annexure A-1 makes it clear that for the existing CGHS card holders (both serving and pensioners), there would be no change in their ward entitlements consequent upon the grant of dearness pay/dearness pension with effect from 1.4.2004.

13.                          In view of the above, discussion, we are of the opinion that the complaint filed by the complainant was liable to succeed but has been wrongly dismissed by the learned District Forum. The impugned order therefore, cannot sustain and is accordingly set aside. The appeal is allowed and the OPs are directed to issue the complainant a permanent CGHS Card, valid for the whole life and give him all medical facilities and benefits as a member for his whole life in accordance with scheme formulated by the OPs.

14.                         Since the complainant has been unnecessarily harassed, his membership has been wrongly terminated and he has been left without medical cover/facilities which caused him physical and mental tension, the OP/respondents shall pay him Rs.10,000/-as compensation. The complainant would also be entitled to Rs.5,000/- as costs of litigation. This order shall be complied by the respondents/OPs within 15 days of the receipt of its certified copy. If the order is not complied with, within the above said period  the OPs would be liable to pay interest @12% p.a. on the aforesaid amount w.e.f. today till the order is fully complied with.

            Copies of the order be sent to the parties free of costs