Punjab

Fatehgarh Sahib

RBT/CC/1140/2018

Paramjit Singh - Complainant(s)

Versus

Max Super Speciality Hospital - Opp.Party(s)

Vipin Kaushal

04 Jul 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL

                                    COMMISSION

                                FATEHGARH SAHIB

RBT No.	:	CC/1140/2018
Complaint No.	:	RBT/CC/1140 of 2018
Date of Institution	:	01/11/2018
Date of Decision	:	04/07/2023

               

Paramjit Singh son of Sh. Sahib Singh R/o H. No.2192, Sector-9, Ambala City. .

                                                                                                        ………....Complainant

                                        Versus

1.  Max Super Specialty Hospital (Mohali), A Unit of Hometrail Estates Private Limited, near Civil Hospital Mohali, Phase-6, Mohali (Pb.). through its Managing Director.
2. Northen Railways, Rail Vihar, DRM office, Near Ambala Bus Stand, Ambala Cantt. District Ambala, Haryana Pin:-134003 through its Divisional Manager Railways.

                                                                …………..opposite Parties

 

Complaint under Section 12 of Consumer Protection Act 1986(Old)

Quorum

Sh. S.K.Aggarwal, President

Ms. Shivani Bhargava, Member

Sh. Manjit Singh Bhinder, Member

Present: Sh.Vipin Kaushal , counsel   for complainant.

      Sh. Amit Gupta, counsel for OP no.1.

      Sh. Subash Chander Lutava, counsel for OP2.

          

 

Order by

SHIVANI BHARGAVA, MEMBER

 

The complaint has been filed against the OPs (opposite parties)  under Section 12 of Consumer Protection Act-1986(old) alleging deficiency in service with the prayer to give directions to the OPs to refund  Rs.1,11,884/- alongwith interest @ 12% P.A , to pay Rs.5,00,000/- for harassment and  to pay Rs.22,000/- as litigation expenses.  

2.  The brief facts of the complaint are that the  complainant is a employee of Northern Railways i.e Central Govt. Employee. He is member of the central Govt. Health Scheme (CGHS) and has a health card. On 27.4.2018 , wife of complainant felt some uneasiness  and complainant took his wife to Max super specialty Hospital Mohali i.e OP1 , which is empanelled hospital under the CGHS scheme .  On the advise of Dr.Vinay Sakhuja  complainant admitted his wife to emergency ward due to breathing problem,  vomiting, CKD, HYPERTENSION.   The wife of the complainant remained admitted from 27.4.2018 to 4.5.2018 but they charged base price charges not  CGHS on admission. Her registration from the very inception is as Northern Railways NABH(MHLI) i.e of OP no.2. The complainant spentRs.11,1,884/- as medical expenses on the treatment of his wife. Hence this complaint.
3. Notice of the complaint was given to the OPs through registered Post. OPs1,2 appeared  through their Counsel. OP2 filed  written version.
4. The OP2 contested the complaint and  filed written version raising various legal  objections that  the complainant is an employee of the Northern Railway.  OP no.1 is empanelled under the CGHS through  Northern Railway Divisional Hospital Ambala Cantt  under the OP no.2 for a period of two years, which was  revised & substituted by unified MOU no.140-Med/Max Hospital/UMB/17 dated 30.3.2017.   No order of dempanelment of Max Super Specilaty Hospital, Mohali was issued from this office  during the period of 27.4.2018 to 4.5.2018,when the patient Smt.Parmjeet Kaur  wife of complainant remained admitted in the above said Hospital. As per the revised unified MOU between the OP Department (OP2)  and  OP1, as also considering the letter of additional Director C.F.H.S, Chandigarh no.AD/CGHS/CHD/EPHHDC/E-tendering/2018/135-136 dated 4.4.2018, the OP1 was under legal obligation to make the bill as per CGHS rate  to the beneficiary of CGHS. Thus, dispute is between OP1 and complainant. OP2 has no role to play in the matter,    Hence OP no.2 prayed for  dismissal of complaint.
5.                The complainant in support of his complaint produced his affidavit along with documents i.e Ex.C1 copy of  OPd ticket and  payment receipt, Ex.C2 & Ex.C3 admission charges and medical card, Ex.C4  Railway medical card,  Ex.C5 discharge summary, Ex.C6 LAMA, Ex.C7 No due clearance , Ex.C8 bill clearance from dated 4.5.2018 to 19.5.2018, Ex.C9 representation, Ex.C10  reply, Ex/C11  and ex.C12 Legal notice. 
6. In rebuttal the OP2 produced the documents along with affidavit of Dr. Chaattar Singh in evidence i.e. annexure R2/1 Memorandum, annexure  Ex.R2/2 MOU dated 4.7.2016, annexure R2/3 revised & substituted by unified MOU dated 30.3.2017, annexure R2/4 Railway Board Letter, annexure R2/5 agreement with Hospital ,  annexure R2/6  letter dated 4.4.2018, and closed the evidence of Ops.
7. Heard. Entire record has been perused.
8.  Admittedly, the complainant being the Central Govt. Employee is  beneficiary under CGHS and his family is also  beneficiary under  this. Complainant on 27.4.2018 along with his wife visited the O.P.D of Max Hospital , Mohali.  They paid the O.P.D. fees of Rs.135 in the name of Smt. Parmajit Kaur under CGHS through company name northern Railways NABH (MHLI) to OP1 as per Ex.C1 because hospital was empanelled under CGHS. On  the advice of doctors, complainant got his wife admitted to hospital on  28.4.2018 but he  was denied the admission of his wife under CGHS.  OP1 charged the base price charges from complainant as per Ex.C7.
9. From the perusal of the record , it emerges out that after filing of the present complaint on 1.11.2018, the  OP1 have partially reimbursed the amount of Rs.1,10,000/- through cheque no.070947 drawn at Axis Bank, Mohali dated 9.3.2019 on 1.5.2019 in the name of Parmjeet Kaur as per Ex.C1 . Complainant received this amount under protest because it is less than the claim amount. Now the complainant has requested for grant of interest on claim amount along with compensation for harassment and mental tension.
10. OP1 reimbursed the claim during the pendency of the complaint partially. OP1 charged the   base price not CGHS though complainant is beneficiary under this. More so OP1 was empanelled under CGHS during  at that time  vide Ex.R5.  If the OP1 charged  the O.P.D fees under CGHS as per Ex.C1 then how can they deny the admission & other medical expenses under CGHS. The complainant was compelled to pay the base hospitalization charges despite  being beneficiary of CGHS.     Therefore OP1 is held liable for deficiency in service.
11. As a corollary of our above discussion  and keeping in view the facts & Circumstances  of   the present complaint, the same  is partly allowed. OP2 is proforma party. The OP1 is directed as under:-

[a] To pay Rs. 1884/- to the complainant along with interest @ 9% P. A from the date of filing of compliant within 30 days, failing which interest @ 12% shall be payable.

[b] To pay Rs. 25000/- as compensation and litigation expenses.

Compliance of the order be made by the OPs within a period of 30 days of receipt of certified copy of this order . Failing which the complainant shall be entitled to recover the above said amount through legalprocess. The complaint could not be decided within the statutory period dueto pandemic of Covid-19 and paucity of staff. File be cosigned to record Room.

Pronounced 04 July 2023.

                               

                                        (S.K. Aggarwal)

                                                 President

                                                                     

    

                                               (Shivani Bhargava)

                                                   Member

 

                                               ( Manjit Singh Bhinder )                                                                                                                           

                                                               Member