Sri Partha Kumar Basu, Hon’ble Member :

The complaint case on deficiency in service and unfair trade practices has been filed against the O.P. Nos. 1 and 2 hospital and O.P. Nos. 3 to 7 (incorrectly numbered as OP 3 to OP6) officials of government authorities. While O.P. Nos. 1 and 2 have filed W/V, the case has been running ex-parte against the O.P. nos.  3 to 7 for not filing W/V within the statutory period and were declared ex-parte as per Order No. 4 dated 11.07.2022. Subsequently O.P. Nos. 3 to 7 appeared through Ld. Advocate on 17.01.2023 but as the case had already been running ex-parte hence the petition to set aside the ex-parte order was rejected as per Order No. 9 dated 17.01.2023. The matter was heard for final argument on 20.02.2024 when the contesting O.P. Nos. 1 and 2 and the Ld. Advocate for the complainant filed BNA and advanced their respective arguments.

The case of the complainant in a capsulated form is that the complainant being an Advocate by profession got admitted at O.P. hospital on 01.05.2021 for cough and cold related problem. The family members of the complainant visited the Swastha Sathi Desk of that hospital which was found unmanned. They approached reception of the hospital and presented the original the original Swastha Sathi card of the complainant who refused to accept the same. Further it is alleged that although the complainant was admitted in general bed but only with one oxygen plug on the head but no other salient equipment was found although the complainant was admitted at ICCU as per admission document. Hence there was neither ICCU infrastructure available nor any monitor seen besides the bed of the patient. Thereafter the patient was shifted from one general bed to another but the daily bill was raised stating ICCU facility which the patient alleges as unfair trade practices and deficiency in services. On 24.01.2022 complainant reported to O.P. nos. 2 to 6 about the attitude and activity of O.P. no. 1 hospital but without any respite. This was followed by a legal demand notice dated 21.02.2022 from the complainant. It is the case of the complainant that O.P. no. 1 hospital deliberately and intentionally refused admission through Swastha Sathi card wherein cash less facility is available and the mediclaim insurance coverage lost it’s purpose although having sufficient entitlement for the patient cum complainant during admission. The complainant paid the hospital bills upfront and applied for reimbursement of the cost of medical treatment before the authority of O.P. Nos. 2 to 6 after release from hospital but of no effect which amounts to unfair trade practice and deficiency in services. The complainant exhibited the documents with copies of Swastha Sathi card, medical bills, representation dated 24.01.2022 and legal notice dated 21.02.2022 in support of his contention in the complaint petition and prayed before this District Commission for a direction on the O.P. nos. 1 and 2 or reimbursement of the medical bill to the extent of Rs. 2 lakh along with a compensation of Rs. 1 lakh and cost thereof

The O.P. Nos. 1 and 2 hospital resisted the complaint petition by fling W.V. wherein all the allegations were denied stating that no Swastha Sathi Card was produced before the hospital as alleged. It is also contended by the contesting O.Ps. that in case of refusal to get admitted through Swastha Sathi card, the complainant ought to have lodged complaint to O.P. no. 2 and local police station instead of which he paid final bill amount on 17.05.2021 without any objection whatsoever at the time of discharge or at the time of payment of dues. The OPs contended that the complainant delayed to take remedial steps to put undue pressure on the hospital authority and sent a letter on 21.02.2022 to O.P. nos. 3 to 7.

The records and documents were perused and arguments of both sides were heard in full.

It appears that the complainant cum patient was admitted on 01.05.2021 and was discharged from the O.P. No. 1 hospital on 06.05.2021 diagnosed for sufferance from COVID 19 as per clinical note cum final diagnosis in the discharge certificate dated 06.05.2021. It appears from discharge summary that the patient was presented with fever and pneumonia and diagnosed as Covid positive. The patient was released with an advice for a home isolation of 10 days and medication thereof for post Covid 19 treatment. From the final bill and receipt dated 17.05.2021 for Rs. 2 lakh it appears that the bed/room number is quoted as “ICCU-2 -44”. The complainant filed complaint before the Govt. authorities cum O.P.no. 3 about the allegations centring around refusal to accept Swastha Sathi card duly supported by track report from postal department and legal notice was sent dated 21.02.2022.

The Swastha Sathi scheme is a state sponsored welfare scheme on health services. The benefit of the schemes are hosted in the public domain wherein the beneficiary can escalate their grievances including admission or refusal issues through various Whatsapp and toll free numbers for immediate redressal details of which are also printed on the back side of the Swastha Sathi smart card and hosted in public domain. No document is found exhibited about lodging any complaint on the alleged date of refusal on 01.05.2021 on nearby till after more than 9 months  either to any of the authorities or the hospital administration or the district/state grievances redressal committee instituted by the govt. authority. Hence it has not been possible to ascertain the legitimacy of the facts which should have been on real time basis. The only document in support of the claim of the complainant having reported for the social security card is his evidence but on the same issue the OP1 and OP2 have also filed counter affidavit denying the same leading to shortfall of cogent proof through some record or documents with adequate evidentiary value. As per various declared policies of the DGHS and authorities, the general beds and facilities had to be converted to ICCUs / ICUs for higher coverage towards patients and emergencies to combat the pandemic. But in this complaint case there is no much reflection of inadequacy of ICU/ICCU facilities, specially read with  the itemised medical bills, element of which reflects that most of the IVs were administered which are normally used in an ICU/ICCU/ITU/PICU/NICU set ups only.

Hence, the case of the complainant is not sustainable in want of cogent proof in support of his contention and the complainant has failed to make out the case prima facie.  

As such, it is

                                                          ORDERED

That the instant complaint case fails to get proved and thus dismissed on contest against the O.P. Nos. 1 & 2 and ex-parte against the rest.

There shall be no order as to cost.    

Let a copy of the order be supplied free of cost to the parties concerned. 

That the final order will be available in the following website www.confonet.in.

Dictated and corrected by me.  

           Member