DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PALAKKAD
Dated this the 29th day of July 2011
Present : Smt. Preetha G Nair, Member
: Smt.Bhanumathi.A.K. Member Date of filing: 30/11/2010
(C.C.No.160/2010)
Chandrika Sreenivas
W/o.Sreenivas,
Amrutha Kripa,
Adakkaputhur Post,
Cherupulassery, Vellinezhi,
Palakkad - Complainant
(By T.V.Pratheesh)
V/s
E.M.S.Memorial Co-operative Hospital &
Research Centre Ltd.
No.M.549,
Perinthalmanna Post,
Malappuram
Rep.by its Chairman
(By Adv.Sureshlal) - Opposite party
O R D E R
By Smt.PREETHA G NAIR, MEMBER
The complainant was lured to purchase the shares of the hospital due to the schemes and benefits that the opposite party had offered and agreed to provide the share holders. The agents of the opposite party have came to the home of the complainant and canvassed for the same. The opposite party had given wide publicity to those offer also. One such benefit offered by the opposite party was that a share holder of Rs.1,00,000/- will be provided with free medical treatment with other four persons upto an amount of Rs.20,000/- The complainant was thus lured to purchase 20 fully paid up shares of Rs.5,000/- per share having a total value of Rs.1,00,000/- in the share capital of the opposite party. Another benefit offered by the opposite party was that free treatment will be provided for the illness and accidents, which occurs after purchasing the shares. The opposite party had also offered to pay bonus to the share holders. Having being attracted by these offers the complainant had purchased shares on 11/2/2009 by making a payment of Rs.1,00,000/- to the opposite party. The husband of the complainant Sreenivasan was admitted in the hospital of the opposite party on 9/5/2009 for treatment of Abscess in his left leg. He was treated in the hospital as an inpatient and on 9/5/2009 itself a surgery was done. Thereafter he was discharged on 11/5/2009 with advice to have a review. The treatment of the husband of the complainant was Rs.12,500/- Though the opposite party had collected all the original bills from the complainant, she was compelled to pay the amount inspite of the fact that the complainant is legally entitled for free treatment of her husband as share holder. Inspite of requests made by the complainant the opposite party has not provided free medical treatment to the complainant's husband. The complainant is legally entitled for and the opposite party is legally liable to provide free medical treatment to the complainant and 4 other persons as per the terms and conditions as agreed by the opposite party. The opposite party has clearly caused deficiency of service in repudiating the genuine claims made by the complainant and that to without offering any explanation. The complainant has submitted all the necessary papers and bills. There is a clear unfair trade practice on the side of opposite party. The complainant had sent lawyer notice on 18/8/2010 to the opposite party. Subsequent to the receipt of notice, the opposite party has sent a reply on 31/8/2010 informing the complainant to reimbursement of medi-claim as Rs.4,338/-. The opposite party is bound to reimburse the entire medi claim of the husband of the complainant and the failure to do so is gross deficiency in service and an unfair trade practice. Hence the complaint prays an order directing the opposite party to
Pay an amount of Rs.8162/- towards the amount collected by the opposite party towards the medical treatment
Pay an amount of Rs.50,000/- as compensation for the mental agony and suffering.
Pay Rs.1,000/- as the cost of the proceedings.
Opposite party filed version stating the following contentions. Opposite party stated that they had not appointed anybody as agent of the hospital for canvasing any business. It is true that the opposite party had given publicity regarding the offer of shares and the benefits offered to the share holders and their beneficiaries. The opposite party stated that on 11/2/2009 the complainant had came to the office of the opposite party alongwith her relatives and requested for share of the hospital for a total share value of Rs.1,00,000/- that offer accepted on the same day subject to the decision of the Board of Directors and the amount paid by the complainant had kept in share suspense account. The meeting of the Board of Directors held on 30/3/2009 accorded permission for issuance of 20 shares of the hospital to complainant. As per the offer given by the opposite party a share holder who is having shares worth Rs.1,00,000/- is entitled for free medical treatment to the share holders as well as four other persons nominated by the share holder upto an amount of Rs.20,000/- per year. Under the said scheme the opposite party has to pay an yearly premium to the Insurance company for and on behalf of the share holder. After the admission of the complainant as a share holder the opposite party had paid Rs.2,000/- as premium for and on behalf of the complainant during the year 2009 in the insurance company.
Under the above scheme whenever a share holder admits in the hospital of the opposite party, if they are eligible for the free medical treatment they have to inform the opposite party that they are share holders and they are eligible for free medical treatment. Then the opposite party issued a credit card to that person and then no direct payment is required for any of the facilities or medicines given by the hospital. Only when the credit exceeds the limits, the opposite party directs the party to make payment in excess of the limit. The opposite party stated that the husband of the complainant came to the hospital on 9/5/09 and admitted with the complaint of abscess left leg with history of penetrating trauma to left leg. At the time of the admission or any day thereafter the complainant had not informed the opposite party that she is a share holder. Thereafter the husband of the complainant had made direct payments during the period of treatment for the services and the medicines supplied. The husband of the complainant was discharged on 11/5/09. After settling the bill it is reported by the complainant that she is a share holder of the hospital and she is entitled for the benefit of the medical treatment. Hence she was asked to submit all the bills by which she made payments for the services given by the hospital. At that time she had produced bills for an amount of Rs.4,338.32 alone. On a perusal of the records it was found by the opposite party that the husband of the complainant had paid Rs.11,025/- towards the charges and taken computer prints of the bills. Thereafter the opposite party made a claim before the Insurance Company for the said amount of Rs.11,025/- alongwith some other share holders. During the pendancy of the claim the complainant issued a lawyer notice to the opposite party. Immediately the opposite party contacted with the husband of the complainant over phone and informed to the pendancy of the claim. He was satisfied with the explanation given by the opposite party. Then the insurance company had allowed the claim in respect of the complainant for an amount of Rs.4,538/- Then the opposite party taken up the matter and objections were raised before the Insurance company. The insurance company granted the balance amount within a short time. On 25/9/10 the complainant had accepted Rs.4338/- from the opposite party as per voucher No.13181 without any protest. The opposite party had not collected all the original bills from the complainant for an amount of Rs.12,500/- The opposite party has not denied any of the benefits for which the complainant is entitled for. There is absolutely no deficiency in services given and offered by the opposite party either to the complainant or to his beneficiaries. The opposite party admitted that the complainant issued a lawyer notice on 18/8/10. The opposite party stated that New India Assurance Company, near Catholic Syrian Center, UP Hill, Malappuram is a necessary party. Hence the opposite party prayed that the complaint may be dismissed with cost of the opposite party.
Both parties field affidavit and documents. Ext.A1 to A5 marked on the side of the complainant. Ext.B1 to B7 marked on the side of the opposite party. Ext.B2, B3 & B4 marked with objection. Complainant and opposite party was examined. Argument notes filed by both parties.
Issues to be considered are
Whether there is any deficiency in service on the part of opposite party ?
If so, what is the relief and cost ?
Issue I & II
We perused relevant documents on record. In Ext.A1 shows that the application forms are available at Co-operative bank in Malappuram and Palakkad. But the opposite party had stated that they had not appointed anybody as agent of the hospital for canvassing any business. The laison officer was examined as DW1. At the time of cross examination the laison officer deposed that no agent in Palakkad District. Admittedly the complainant is the share holder of the opposite party are entitled to avail free treatment for herself and 4 members of her family upto an amount of Rs.20000/- The laison officer of the opposite party has filed affidavit and was cross examined. The evidence would show that he has only received information from his subordinate staff and has no first hand information of the same. The opposite party stated that boards are put up at relevant places to mentioned that the share holders are entitled to free treatment. At the time of examination of complainant deposed that at the time of admission informed to the opposite party that she was a share holder. No contradictory evidence was produced by the opposite party. In Ext.B3 the insurance company stated that cheque No.440968 dated 27th August 2010 for Rs.4538/- drawn on Catholic Syrian Bank Ltd. towards the claim preferred in respect of the share holder. But the opposite party had paid only Rs.4338/- to complainant as per voucher NO.13181. Further the opposite party stated that the complainant had produced bills for an amount of Rs.4,338.32 alone. No evidence was produced by the opposite party to show that the complainant had produced bills for an amount of Rs.4338/- alone. The opposite party stated that after settling the bill it is reported by the complainant that she is a share holder of the hospital. The complainant stated that on 11/5/09 discharged from the hospital. The opposite party stated that on 25/9/10 the complainant had accepted Rs.4,338/- In Ext.B3 the insurance company stated that the cheque dated 27th August 2010 towards the claim preferred in respect of the share holder. In the above discussions we are of the view that the opposite party has not tried to pay the bill amount at the earliest time to the complainant. In Ext.A1 the offer is between the complainant and the opposite party. Therefore the Insurance Company is not necessary as a party to this complaint. In Ext.A1 the complainant is legally entitled for medical treatment with other 4 persons upto an amount of Rs.20,000/- Thereafter at the time of evidence the opposite party produced cheque as a share amount of Rs.6687/- dated 21/1/11 and marked as Ext.B7. Then the complainant filed application seeking permission to release the cheque produced by opposite party. On verification it is seen that the cheque is produced by opposite party as a document. Hence we are not in a position to allow the application. Hence, the application dismissed. The complainant stated that the treatment of the husband of the complainant was paid Rs.12,500/- No evidence was produced by the complainant to prove that the bill amount was Rs.12,500/- In Ext.B2 the opposite party informed to M/s.New India Assurance Company for claim amount on 13/6/2009. The complainant's husband was discharged on 11/5/2009. Therefore in Ext.A1 the complainant has not paid the bill amount as a share holder. The opposite party stated that the complainant was informed as a share holder after paying the bill amount. Thereafter the complainant issued a lawyer notice dated 18/8/2010. Then the opposite party has paid only Rs.4338/- to the complainant on 25/9/2010. After admitting the complaint the opposite party has produced the cheque for the balance amount. The acts of the opposite party amounts to clear deficiency in service. It is a fit case for awarding compensation. The opposite party has not taken steps to pay insurance amount as early as possible. No evidence was produced by the opposite party to prove that the complainant informed as a share holder after paying the bill amount.
In the above discussions we are of the view that there is deficiency in service on the part of opposite party. In the result the complaint is allowed.
We direct the opposite party to pay Rs.6687/- (Rupees Six thousand six hundred and eighty seven only) and pay an amount of Rs.3,000/- (Rupees Three thousand only) as compensation and 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 complainant is entitled for 9% interest per annum for the whole amount from the date of order till realization.
Pronounced in the open court on this the 29th day of July 2011. Sd/- Smt.Preetha G Nair
Member
Sd/-
Smt. Bhanumathi.A.K.
Member
APPENDIX
Exhibits marked on the side of the complainant
Ext.A1 – Brochure of EMS Hospital
Ext.A2 – Photocopy of share certificate
Ext.A3 series – Bills issued by Opposite party
Ext.A4 – Copy of Lawyer notice dated 18/8/2010 sent to opposite party
Ext.A5 – Photocopy of intimation sent to complainant dt.31/8/10 by OP.
Exhibits marked on the side of the opposite parties
Ext.B1 - Brochure of EMS Hospital
Ext.B2 – Photocopy of letter sent to The Manager, LIC Malappuram dated
13/6/09 by the oppostie party
Ext.B3 – Photocopy of letter sent to opposite party dated 27/8/10 by the New
India Insurance Co.Ltd. Malappuram
Ext.B4 – Photocopy of intimation letter to the complainant by opposite party
dt.31/8/2010
Ext.B5 – Photocopy of letter sent to New India Assurance Co. Malappuram
dated 31/8/10 by the opposite party
Ext.B6 – Photocopy of letter sent to opposite party by the New India Insurance
Co. dated 19/1/11
Ext.B7 – Cheque bearing No.29832 for Rs.6687/ dtd.21/1/11 of Urban
Co-Op.bank, Perinthalmanna issued in the name of the complainant.
Complainant cross examined
PW1 - Chandrika Sreenivasan
Cross examination on the side of opposite party
DW1 – C.Ramachandran
Cost Allowed
Rs.1,000/- allowed as cost of the proceedings
