DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD
Dated this the 28th day of February 2015
Present : Smt.Shiny.P.R. President
: Smt.Suma.K.P. Member Date of filing: 17/05/2014
(C.C.No.45/2014)
Mohanan.V.
S/o.Ramakrishnan,
Velanmarthodi House,
Koonathara Post,
Shoranur, Palakkad - Complainant
(By Adv.V.Rajan)
Vs
1.Dr.Abdulla Cherayakkat,
Managing Director,
Malabar Institute of Medical Sceience Ltd.,
Calicut
(By Adv.P.G.Anoop Narayanan)
2.Superintendent of Postal Department
Ottapalam – 679 101 - Opposite parties
(Authorised Person)
O R D E R
By Smt.Suma.K.P. Member
The complaint was filed for the damages for loss of medical reimbursement (for pre and post hospitalization expenses) documents due to the negligent act of respondents.
The complainant’s case is that he undergone a surgery on 17/9/2013 at the first opposite party’s hospital under the terms of IOB Health care policy. The treatment was cashless (but not free). During admission time as the bills were paid by insurance company on behalf of complainant as per the policy. The complainant has also the right to reimburse 30 days pre and sixty days post hospitalization expenses from the insurance company. On 26/10/2013 the complainant submitted reimbursement documents alongwith bills and receipts to the insurance desk of the respondents hospital vide slip no. 8744. The total bill amount as per the bill and receipts is Rs.17,003/- only. The first opposite party had not returned back the reimbursement documents to the complainant till date and the time for reimbursement had expired. Hence the complainant had incurred a loss of Rs.17,003/- due to the negligent act of the first opposite parties. Insurance desk of the first opposite party hospital first informed the complainant that the documents are misplaced. Then they informed the complainant that the documents were despatched through courier service and the complainant enquired about the details of courier first opposite party further informed that the documents are despatched to the residential address of the complainant through ordinary post. But the complainant had not received the above documents till date. Complainant had spent a lot of time and suffered mental agony in this regard. The act of opposite parties amounts to gross negligence and deficiency in service. Hence the complainant had approached before the Forum seeking an amount of Rs.1,50,000/- as damages for the mental agony and inconvenience caused to him.
Notice was issued to the opposite party for appearance. Opposite party entered appearance and filed version denying the allegation in the complaint. The first opposite party admits that the complainant had undergone a surgery on 17/9/2013 at the first opposite party hospital and the treatment was under the coverage of the above mentioned insurance policy. The practice followed in similar case was prior and post admission charges will have to be submitted to TPA and obtained the amount of the bill from the insurance company by the patient himself. The hospital authorities submit the inpatient bills of the beneficiary to the TPA and subject to their approval they will receive the amount from the TPA. Getting signature of the doctor concerned for submitting pre and post admission bills are to be done by the patients themselves. The hospital authorities usually interfere in getting the signatures of doctors concerned for TPA patient only for patients from long distance and that too for helping them to avoid travelling and that too without charging them. Since the complaint is a person from far away place i.e. Shornur, he instructed the first opposite party to forward the said bills after obtaining the signature from the treating doctor and send the same to his house address at Shornur. The first opposite party’s office forwarded the bills to the complainant’s address as early on 30/10/2013 through post in the given address of the complainant. This was intimated through a mail sent to the complainant on 11/11/2013, when the first opposite party received a mail from the complainant on the same day in the morning, after enquiring about it at the insurance desk of the first opposite party. It was confirmed that the signed bills have already been despatched to the complainant as per the records maintained by the hospital authorities. The complainant was asked to enquire about it at his post office. The first opposite party has performed all the responsibilities to the best of their abilities well within time enabling the complainant to get reimbursement of the post admission expense from the insurance company. The amount of Rs.17,003/-was also denied by the first opposite party. The actual amount for which bills were handed over to the hospital authorities by the complainant was only for Rs.6,075/-.
The first opposite party had also contended that the above complaint is not maintainable since no part of cause of action arose before the revenue district of Palakkad and as per the allegation made in the complaint. The entire transaction had allegedly took place between the complainant and the opposite party within the jurisdiction of revenue district of Kozhikkode and first opposite party had no branch office situated within the jurisdiction of revenue District of Palakkad and as such this Forum lacks territorial jurisdiction to entertain the complaint. They had also contended that the complainant is not a consumer of the first opposite party. The complainant approached the first opposite party as beneficiary of TTK Health care for treatment. The services that had been given to the complainant are free of charges and as such the deficiency of service attributed against the first opposite party will not come under the provisions of the Consumer Protection Act.
Complainant had filed an application to implead Superintendent of Postal Department as supplemental second opposite party. Since the first opposite party had raised no objection, petition was allowed.
Second opposite party entered appearance and filed their version contending the following:
The complainant is not consumer to the second opposite party in the strict sense as specified in the provisions of the consumer protection act Section 2. There is no service availed of by complainant by having paid or partly paid. There is no direct transaction between the complainant and second opposite party. This is a case of dispute between the complainant and first opposite party. The second opposite party is unnecessarily dragged into this case as such there is no consumer grievance as contemplated under the Consumer Protection Act. Complainant does not perceive under the precincts of the law accordingly the complaint is not sustainable under this act and not maintainable. They further contended that since the complainant had stated that he had not received back his medical reimbursement bills from the first opposite party they enquired about the matter. It was stated by the first opposite party that the said documents were misplaced later it was stated that they have despatched the said document through courier. Again they have changed the stand and stated that they have despatched as ordinary post. The second opposite party states that department of posts handles lacks of ordinary postal articles daily. No record is maintained for receipt of despatch and delivery of ordinary articles passing through the post. The first opposite party cleverly made use of this aspect so as to evade from his responsibilities even without posting the articles by ordinary post. According to section 171 of Post Office Guide Part I (Published by Department of Post for the information of general public) all valuable articles should be sent through “Registered Post” only. In the present case medical reimbursement documents including bills and receipts amounting to Rs.17,003/- is meticulously considered to be valuable and irreplaceable documents. Despatching these valuable documents through ordinary post by the opposite party seem to be quite unbelievable and astonishing. It was also submitted that under section 6 of Post Office Act, 1898 the Department of Post is absolved from its responsibilities in the event of any loss/misdelivery of any postal article if it was not done willfully or fraudulently. The enquiry conducted by the second opposite party at the delivery post office of complainant at Koonathara revealed that all the postal article addressed to the complainant are correctly delivered from there. Hence in this case there is no willful or fraudulent act on the part of any of the employees of the department and hence second opposite party is not liable to pay any compensation. They had also stated that second opposite party had not entered any contract with the complainant. They had not received any money from the complainant for offering any service. Hence complainant is not a consumer to the second opposite party and is therefore liable to be dismissed.
The evidence in this case consists of chief affidavits of complainant as well as opposite parties. OP1 filed a petition to cross examine the complainant and complainant was cross examined as PW1. Opposite party 2 also filed petition to cross examine the complainant. Ext.A1 to A6 was marked on the side of complainant. Complainant also filed petition to cross examine the opposite party and opposite party was cross examined as DW1. Opposite party 2 also filed petition to cross examine opposite party NO.1 Opposite party was cross examined as DW1. Ext.B1 & B2 marked on the side of opposite party.
Issues that arise for consideration are
- Whether there is any deficiency in service on the part of opposite parties ?
- If so, what is the relief ?
Heard both parties.
Issues 1 & 2
We have perused the documents on record. First opposite party stated in their version that they had forwarded the bills to the complainant’s address as early on 30/10/2013 through post in the given address of the complainant. But the complainant had not received the said bill till date. The first opposite party has marked the despatch register kept by the hospital showing the outward despatch as Ext.B1 and the e mail sent by first opposite party by the insurance desk as marked as Ext.B2. As per Ext.B1 it is revealed that the documents are sent to the complainant on three occasions. This document is only a register maintained at the first opposite party’s office and not a valid proof for having handed over the articles to the post office. Moreover many corrections are seen in this register. The name of Shri.Mohanan, the complainant is seen recorded in three places on different dates on 30/10/2013 and 31/10/2013 . Towards all the entries it has been remarked as registered post / courier. But towards the entry of Mohanan on 31/10/2013 it has only noted as “post”. Hence conspiracy is involved in the entries made in this register on both dates. Register is not a genuine documents. Hence its evidentiary value cannot be taken into consideration. The first respondent during cross examination has given evidence that the medical reimbursement documents are valuable irreplaceable documents. According to the second opposite party all valuable articles should be sent through registered post only. During cross examination the first opposite party gave evidence to the effect that he is aware of the fact that all valuables should be sent by “registered post” only. This is also a well known to a common man approaching the post office. The 1st opposite party ought to have sent the medical reimbursement bills through registered post without doing so, the 1st opposite party has committed gross deficiency of service.
Hence we are of the view that there is deficiency in service only from the part of first opposite party. The second opposite party is not at all a necessary party to this complaint since there is no contract between the complainant and the second opposite party. The first opposite party had stated that the amount of Rs.17,003/ as the bill amount is wrong. The actual amount for which the bills were handed over to the hospital authorities by the complainant was only for Rs.6075/-. The complainant had also not produced any evidence to prove the allegation that the medical bills amounts to the tune of Rs.17,003/-. Since the first opposite party had disputed the same it is the bounden duty of the complainant to prove that the amount shown in the bill amounts to Rs.17,003/- The evidence produced by the complainant on that aspect is not a authenticated document. In this context, we direct the first opposite party to compensate the loss to the tune of Rs.6,075/- to the complainant due to the negligent act committed by the first opposite party. We also direct the first opposite party to pay an amount of Rs.3,000/- as compensation for mental agony suffered by the complainant due to the negligent act of the first opposite party. Second opposite party is exonerated from their liability since there exist no contract between complainant and second opposite party.
In the result complaint is allowed and we direct the first opposite party to pay Rs.6,075/- (Rupees Six thousand and seventy five only) as damages to the complainant alongwith Rs.3,000/- (Rupees Three thousand only) as compensation for mental agony suffered by him and also direct first opposite party to pay Rs.1,000/- (Rupees One thousand only) as cost of the proceedings. Order shall be complied within one month from the date of receipt of order, failing which the compensation amount shall carry interest @9% per annum from the date of order till realization.
Pronounced in the open court on this the 28th day of February 2015.
Sd/-
Shiny.P.R.
President
Sd/-
Suma.K.P.
Member
Appendix
Exhibits marked on the side of complainant
Ext.A1 – Reimbursement Desk – document receipt slip - original
Ext.A2 – Copy of notice sent by the complainant’s counsel to the opposite
party dated 7/12/2013.
Ext.A3 – Reply notice sent by the respondent’s counsel to the complainant’s
counsel dated 28/2/2014
Ext.A4 – Cash bill dated 19/2/2014 for Rs.250/- issued by opposite party
Ext.A5 –E mail dated 11/11/2013 issued by opposite party to the complainant
Ext.A6 - Medical bill amount incurred by the complainant.(subject to proof)
Exhibits marked on the side of opposite party
Ext.B1 – True copy of Outward register of MIMS Ltd.
Ext.B2 – Copy of E mail sent to the complainant by the opposite party dated
11/11/2013
Witness examined on the side of complainant
PW1 – Mohanan.V
Witness examined on the side of opposite party
DW1 – Udayakumar.T.P
Cost (Allowed)
Rs.1,000/- allowed as cost of the proceedings.
