Punjab

Ludhiana

CC/13/941

Bhajanik Singh - Complainant(s)

Versus

Indian Railway - Opp.Party(s)

09 Jan 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

 

Consumer Complaint No. 941 of 23.12.2013

Date of Decision          :   09.01.2017

 

Bhajnik Singh s/o Late Babu Singh, r/o 609/44-B, St. No.7, Sham Nagar, Ludhiana.

….. Complainant

Versus 

1.Union of India, Northern Railway, Baroda House, New Delhi, through its General Manager.

2.Divisional Railway Manager, Northern Railway, Firozpur Cantt.

3.Chief Medical Supdt. Northern Railway, Firozpur Cantt.

..…Opposite parties

 

 (COMPLAINT U/S 12 OF THE CONSUMER PROTECTION ACT, 1986)

 

QUORUM:

SH.G.K.DHIR, PRESIDENT

SH.PARAM JIT SINGH BEWLI, MEMBER

 

COUNSEL FOR THE PARTIES:

For Complainant                     :       Sh.M.S.Toor, Advocate

For OPs                         :       Sh.Iqbal Singh, Advocate

 

PER G.K DHIR, PRESIDENT

 

1.                          Complainant, a retired railway employee and a senior citizen filed complaint under Section 12 of the Consumer Protection Act, 1986(hereinafter in short referred to as ‘Act’) by claiming that he retired as Railway Guard on 31.3.2013. Complainant claims to have paid one time payment at the time of retirement as per Departmental policy for getting eligibility for total medical treatment facility. In March 2012, the complainant  got admitted in Railway Hospital, Ludhiana, where he could not got proper treatment owing to deputing of negligent medical staff there. Condition of complainant became serious and he was  referred (after many requests) to Mediciti (Mediwave) Hospital, Near Octroi    Post, Ferozepur Road, Ludhiana on 20.3.2012 at about 11:00 PM. There complainant remained admitted for the period from 20.3.2012 to 28.3.2012(wrongly mentioned in the complaint as 20.3.2013 to 28.3.2013). Complainant was advised for further treatment and he was called for review after 7 days. After such review, the complainant was again advised for further treatment, prescribed diagnosis. Even he was called for review after 7 days. On 11.4.2012, complainant reached at Mediciti Hospital, Ludhiana for review and there he was again admitted for treatment for the period from 11.4.2012 to 14.4.2012. An amount of Rs.16,166/- were spent on medical treatment. Reimbursement of the same has not taken place and that is why, after serving legal notice dated 15.6.2013,  this complaint filed for issuing directions to Ops to reimburse the amount of Rs.16,166/- and even pay compensation of Rs.80,000/- for mental harassment and agony. Said amount claimed with interest @24%.

2.                In written statement filed by Ops, it is pleaded interalia as if complaint is not maintainable in the present form; Ops have not committed any deficiency in service and nor adopted any unfair trade practice; complainant has not approached this Forum with clean hands because he has suppressed the material facts; complainant is estopped by his own act and conduct from filing this complaint and moreover, false and frivolous complaint alleged to be filed for abusing the process of law. Ops duly sent two letters dated 1.10.2009 and 17.6.2010. In letter No.139-Mad/MR/BS/CMS/FzR dated 1.10.2009 issued by the Chief Medical Superintendent, Northern Railway, Ferozepur Cantt, the deficiencies in his medical reimbursement case were depicted and brought to the notice of the complainant, but with direction to him to rectify the same. Prescription was without proper signatures and seal of the doctor, despite the fact that as per requirement, the prescription should be issued by the Head of the Department of the concerned hospital. Through second letter, complainant was apprised for appearance before the medical board for assessing the urgency of requirement of the equipment. In the present case till the sanction for the purchase of equipment from the Head Quarter is obtained, reimbursement for the same cannot be processed. It is claimed that purchase of the equipment is the decision of the complainant at his own without taking into confidence the Railway Department and obtaining the sanction and as such, complainant is not entitled for reimbursement. Admittedly, the complainant was employed in Northern Railway, Ludhiana as Passenger Guard and he retired there-from. As per record available with Ops, complainant remained admitted in Satguru Partap Apollo Hospital, Ludhiana, where he got treatment as per documents submitted by him. Complainant applied for medical reimbursement expenses, but after scrutinizing of the claim, he was informed through letters qua the deficiencies. The deficiencies pointed out alleged to be that the equipment already purchased by the complainant without advise of the doctor as an OPD case as depicted at S.No.09. That purchase alleged to be without proper prescription and without proper signatures and seal of the doctor. Prescription was required to be counter signed by the HOD of the hospital concerned, but the same was not counter signed as such. Besides, bill/voucher of the purchased equipment alleged to be placed at SM-15, but without counter signatures of the HOD of the hospital. It is claimed that if there is any lapse, then the same is on the part of the complainant and Ops cannot be blamed for the same. Present complaint alleged to be filed just for extorting the money from Ops. Service of notice dated 13.5.2010 is not denied, but allegations contained in the notice alleged to be false and frivolous. Complaint failed to remove   the deficiencies despite being pointed out through above referred letters. Each and every other averment of the complaint denied by claiming that the complainant is not entitled to a single penny because cause of action has even not accrued to the complainant against Ops. It is claimed that this Forum has no jurisdiction to entertain and decide the present complaint.

3                 Complainant to prove his case tendered in evidence his affidavit Ex.CA along with documents Ex.CW1/A to Ex.CW1/F and thereafter, his counsel closed the evidence.

4.                On the other hand, counsel for Ops filed an application for amendment of the written statement, but the same was dismissed vide orders dated 17.3.2015. Thereafter, review application was filed and the same was also dismissed vide orders dated 7.9.2015. It was stated at bar by the counsel for Ops that appeal preferred against those orders even has been dismissed by the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh. Statement of Sh.Iqbal Singh, Advocate for Ops was recorded on 12.7.2016 to the effect that he does not wish to lead any evidence on behalf of Ops because amendment in the written statement was declined by this Forum and even appeal preferred against those orders was dismissed  by the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh. So, virtually no evidence was adduced by Ops.

5.                Written arguments submitted in this case by the complainant, but not by Ops. Oral arguments of counsel for the parties even heard. Records gone through minutely. 

6.                Complainant in support of the contents of the complaint has submitted his affidavit Ex.CA along with documents Ex.CW1/A for establishing that he was referred for further management to Mediciti Hospital, Ludhiana. This reference was made on the basis of telephonic permission received from CMS/Ferozepur. This permission is of date 20.3.2012 as reflected by the contents of Ex.CW1/A and in pursuance to this permission, the complainant got treatment from the Mediciti Hospital, Ludhiana for the period from 20.3.2012 to 28.3.2012 as revealed by the contents of copy of discharge summary Ex.CW1/B. It is contended by counsel for the Ops that claim for this treatment was allowed by way of reimbursement of the medical expenses, but no documentary evidence in that respect has been produced by the complainant or by Ops even. Even plea regarding such reimbursement is not taken in the complaint or in the written statement filed by Ops. However, claim in this case is put forth for reimbursement of the medical expenses of Rs.16,166/- incurred by the complainant for treatment for the period from 11.4.2012 to 14.4.2012 in Mediciti Hospital, Ludhiana.

7.                Copy of discharge summary of treatment of complainant for the period from 11.4.2012 to 14.4.2012 produced on record as Ex.CW1/C. Earlier treatment was got by the complainant for the period from 20.3.2012 to 28.3.2012 for complaints of breathlessness, drowsy, increasing BP and not taking orally as revealed by contents of Ex.CW1/B. In Ex.CW1/B itself, it is mentioned that condition of the complainant became serious during his admission in the Railway Hospital and that is why, he was referred to LMC for further management. So, plea taken in the complaint as well as in the affidavit Ex.CA is correct that the complainant on being referred by the Department got treatment from the Mediciti Hospital, Ludhiana during period from 20.3.2012 to 28.3.2012. As in Ex.CW1/B itself, it is mentioned that the patient was referred to LMC for further management and as such, in case complainant for subsequent treatment of fever with chills, swelling B/L Lower limbs and scrotum, itching over both legs and Hypoglycemia(as reflected in Ex.CW1/C) got treatment again from the Mediciti Hospital, Ludhiana, then the same was in view of the reference for such treatment. In Ex.CW1/C itself, it is mentioned that earlier the complainant was admitted in Mediciti Hospital, Ludhiana in  LMC on 20.3.2012 and was discharged in satisfactory condition, but thereafter, he has suffered with the problems mentioned in Ex.CW1/C and that is why he has come to LMC for further management. So, it is obvious that contents of Ex.CW1/B and Ex.CW1/C itself establishes that the complainant was referred to LMC for further management. Earlier the complainant was referred to this Mediciti Hospital, Ludhiana on 20.3.2012 for treatment after telephonic permission from the CMS/Ferozepur as reflected from Ex.CW1/A and as such, it is obvious that treatment from the Mediciti Hospital, Ludhiana got by the complainant on above referred dates. However, it is vehemently contended by Sh. Iqbal Singh, Advocate representing Ops that subsequent treatment for the period from 11.4.2012 to 14.4.2012 got by the complainant without being referred by the department and as such, Ops not liable to reimburse the expenses borne on this medical treatment. Evidence in that respect has not been produced and nor copy of letter No.205/H/6-4/ policy dated 31.1.2007 has been produced on record, despite the fact that repudiation of claim took place on the basis of this letter of Railway Board through letter Ex.CW1/D dated 17.4.2013. Plea taken in the written statement speaks of the deficiencies of non purchase of the equipment without prescription or counter signatures of the HOD. However, present is not a case of purchase of the equipment, but it is a case of getting of treatment by the complainant from Mediciti Hospital, Ludhiana in respect of which, reimbursement of the medical expenses claimed. So, plea taken  in the written statement is a plea not related to this case at all. In view of this vague plea taken in the written statement, there is no escape from the conclusion that Ops either have not supported their claim properly or they have been negligent in not defending their case. In any eventuality, the advantage to go to the complainant, particularly when evidence even  not adduced by the Ops. However, claim of the complainant cannot be ordered to be passed as put forth for amount of Rs.16,166/-, particularly when he has not produced on record any document to prove that he bore expenses of Rs.16,166/- on such treatment during the period from 11.4.2012 to 14.4.2012. Genuine claim of the parties alone can be allowed by the Consumer Forum, but as and when verification of the reimbursement amount required, then the same can be done by the Department, particularly when documentary proof of medical expenses not produced. Ex.CW1/F is the identity card showing as if the complainant retired from the Railway Department as a Guard and dispute in that respect is not raised in the written statement even. It is a case, in which, no evidence adduced by the Ops and as such, claim of the complainant is believable that he on account of purchase of policy and after payment of one time policy premium, entitled for medical treatment facility.

8.                Deficiency in service on the part of Ops is to the extent that they had rejected the claim for medical reimbursement without appreciating the facts and that is why the plea taken in the written statement raised not with respect to this case, but to some other case. For such negligent act on the part of Ops, complainant deserves to be compensated with costs and also to compensation for mental harassment and agony.

9.                Therefore, as a sequel of the above discussion, complaint allowed in terms that Ops will reimburse the medical expenses borne by the complainant on his treatment for the period from 11.4.2012 to 14.4.2012 in Mediciti Hospital, Ludhiana, but amount will be adjudged by them on production of proof by the complainant with Ops or any of them qua such expenses. This documentary proof be produced by the complainant with Ops within 30 days from the date of receipt of copy of this order and thereafter, on receipt of this documentary proof by Ops or any of them, they will get the amount verified from the competent authority and pay the same. Such exercise of verification and payment must be carried out by the Ops within 60 days from the date of receipt of copies of documents by any of them from the complainant. Compensation for mental harassment and agony of Rs.5000/- and litigation expenses of Rs.3000/- more allowed in favour of complainant and against Ops. Liability of Ops to pay these compensation amount and litigation expenses will be joint and several. Payment of these compensation amount and litigation expenses be made within 45 days from the date of receipt of copy of this order. Copies of order be supplied to the parties free of costs as per rules.

10.                        File be indexed and consigned to record room.

 

                      (Param Jit Singh Bewli)                        (G.K.Dhir)

                                  Member                                        President

Announced in Open Forum

Dated:09.01.2017

Gurpreet Sharma.