BEFORE THE DISTRICT CONSUMER FORUM : WARANGAL
Present: Sri D.Chiranjeevi Babu
President.
Sri N.J.Mohan Rao,
Member.
AND
Smt. V.J. Praveena,
Member.
Monday the 05th May, 2008.
CONSUMER DISPUTE NO. 67/2002
Between:
M/s.Jaya Hospitals, represented by
Its Managing Director T.Narasinga Reddy,
S/o.narasimha Reddy,
C/o.Jaya Hospitals,
Chowrastha Hanamkonda,
Warangal District.
… Complainant
AND
The Oriental Insurance Company Limited,
Represented by its Divisional Manager,
Near Radhika Talkies, Warangal. … Opposite Party
Counsel for the Complainant : Sri.G.V.Brahmananda Rao, Advocate
Counsel for the Opposite Party : Sri. Y.Manohar Rao, Advocate
This complaint coming for final hearing before this Forum, the Forum pronounced the following Order.
:: ORDER ::
Sri D.Chirajeevi Babu, President
This is a complaint filed by the complainant M/s.Jaya Hospitals i.e. rep.by its Managing Director Dr.T.Narasinga Reddy against the Opposite party under section 12 of Consumer Protection Act, 1986 for a direction to pay an amount of Rs.4,00,000 to us together with future interest @ 24% p.a. and costs.
The brief averments contained in the complaint filed by the complainant are as follows:
The complainant submit that Sri E.Sudhakar & Smt.E.Hymavathy have filed a complaint vide CD No.238/97 before the Hon’ble Forum on the ground that the reports of the blood test given by us regarding HIV was found to be otherwise, when they got the HIV confirmation test and Directorate of Preventive Medicine Hyderabad. I submit that we have contested the said case through a Senior Advocate stating the Tri Dot test. During the course of contesting the CD, we have informed the opposite party about the case. We have filed written version to the said case, examined two witnesses on our behalf, cross-examined the witness of the complainant in that case at length filed the scientific literature about the procedure of Tri Dot test contemplated by the Medical Science and also filed written arguments in the said case. Our hospital is liable to pay Rs.61,133/- in all order dated 11-01-2001. Subsequently after receiving the copy of the Award on 16-04-2001, we have sent a letter to the opposite party requesting them to settle the claim, while enclosing the copy of the award. We have paid Rs.61,133/- to the Hon’ble Court on 18-04-2001 towards the full satisfaction of the Award dated 11-01-2001. Further we incurred an amount of Rs.10,000/- for contesting CD No.238/97 and also incurred heavy expenditure in pursuing the reimbursement with the opposite party in fact we learnt that the complainant No.1 in CD 238/97 died after receiving the award amount due to the consequential effects of HIV positive and further learnt that the other complaint is also suffering with consequential effects of HIV positive thus our test reports proved to have been correct than the reports of other laboratory. We entitled to get reimbursement of Rs.61,133/- together with interest @ 24% p.a. from 18.04.2001 Rs.3,38,867/- expenses and damages for mental agony. In all we are entitled for Rs.4,00,000/-.
We pray the Hon’ble Forum to direct the opposite party to pay an amount of Rs.4,00,000/- to us together with future interest @ 24% per annum and costs.
Opposite Party filed the Written Version contending in brief as follows:
The complainant has made a claim without following and complying the conditions of the policy as such, there is no deficiency is service on the part of the opposite party. Dr.T.Narsinga Reddy filed his Affidavit on behalf of complainant. He had no knowledge about the CD No.238/97 alleged to have been filed by Sri E.Sudhakar and E.Hymavathi against the complainant on the ground of defect in reports of Blood Tests of HIV, when compared to that of given by Directorate, preventive medicine, Hyderabad. The opposite party submits that the complainant has not informed the opposite party about filing of CD No.238/97 against him. It is an absolute false statement to mis-guide the Hon’ble Forum to fill up the Lacunae. The opposite party is not a party to the said C.D. The contents of letter of the complainant dt.:26-04-2002, it can be observed that Dr.T.Kalpana Devi is not the Proprietor of Jaya Hospital and that she did not conduct the test or other treatment was given. As such, there is no liability on the opposite party, which had insured the professional risks of Dr.T.Kalpana Devi. After submitting the claim dt.:16-04-2001, the complainant was asked to supply the relevant records and material to the opposite party to come to a reasonable conclusion but he did not take any action. As per the record produced by the complainant, himself, this opposite party had to come to a conclusion that there is violation of conditions of the policy. In spite of several requests they have not supplied the relevant material to substantiate the claim. The opposite party is not aware whether the complainant No.1 in CD No.238/97 died due to the effects of HIV and that the other one is suffering with HIV, as such the reports given by the complainant herein are not defective. So the complainant would have filed an appeal before the State Forum to set aside the orders of the Hon’ble Forum dt.:11-01-2001. The opposite party submits that the claim for Rs.61,133/- and consequential relief of interest @ 24% P.A. is not tenable in law. No basis is made for claim of the Rs.4,00,000/- towards damages. At any rate the claim is speculative and exorbitant.
The opposite party prayed that the Hon’ble Court may be pleased to dismiss with costs.
The complainant in support of his claim filed his Affidavit in the form of chief examination and marked Exs.A-01 to A-08. On behalf of opposite party Sri Y.Manohar Rao filed his Affidavit in the form of chief examination and marked Ex.B-1 & B-2.
05. Now the point for consideration whether the complainant is entitled to get reimbursement of Rs.61,133 together with interest i.e. Rs.24,000/- per annum from 18-04-2001 Rs.3,38,867/- expenses and damages for mental agony. After he requested this Forum to direct the opposite party to pay an amount of Rs.4,00,000/- to them together future interest 24% per annum and costs.
06. The complainant filed this case against the Oriental Insurance Company Limited for getting amount what I have stated supra. He stated that Sri E.Sudhakar and Smt.E.Hymavathy filed a complaint vide CD 238/1997 before this Forum on the ground that the reports of the blood test given by them i.e. hospital authorities herein regarding HIV was found to be otherwise, when they got the HIV confirmation test at Directorate of Preventive Medicine, Hyderabad and further they have contested the said case stating that Tri Dot test, which they have conducted regarding HIV is only a preliminary test and the same is necessarily to be get it confirmed by the test at Directorate of Preventive Medicine, Hyderabad and that there is every likely hood of getting varying report in the confirmation test. Further during the course of contesting the C.D. they have informed that the opposite party about the case and also this complaint preliminary contested the above CD No.238/97. But this Forum directed the complainant to pay an amount of Rs.61,166/- in its order dated 11-01-2001, subsequently they have paid the same. Thereafter the complainant made so many efforts and so many representations to the opposite party for reimbursement of Rs.61,133/- because the complainant in C.D. they got issued policy with the opposite party. Now the complainant in this case is asked the opposite party to reimburse the amount of Rs.61,133/- for the something, the opposite party is denying and refused to pay, thereafter the complainant filed this complaint before this Forum for the entitlement of amount of Rs.61,133/- with interest @ 24% per annum from 18-04-2001 Rs.3,38,867/- expenses and damages for mental agony in all Rs.4,00,000/-.
07. The Counter Version filed by the other side is clear that without add the Oriental Insurance Company as a party in CD No.238/97 now the complainant is asked the amount of Rs.4,00,000/- is same in bad-in-law and the Oriental Insurance Company is not liable to pay the amount prayed by the complainant.
08. After arguments of the both counsels our reason are like this. No doubt there is a insurance policy covered to the E.Sudhakar and Smt.E.Hymavathi but in respect of filing of this case against the opposite party in this case if he add the opposite party in the main CD 238/97 certainly this complainant is entitled to get amount from the opposite party but the complainant has not added the opposite party in CD 238/97 and he himself not added the opposite party he is entitled to get amount from him. More over after long time he filed this case against the opposite party the main C.D.238/98 has been disposed on 11-01-2001. So certainly it is pre mature one since the complainant has not added the opposite party in main C.D.238/97 it is only pre mature one, since the case is a pre mature one the opposite party is not liable to pay any amount to the complainant.
In the result there are no merits in the complaint filed by the complainant and accordingly the same is dismissed but without costs.
05th May, 2008).
Sd/- Sd/- Sd/-
Member Member President,
District Consumer Forum, Warangal.
APPENDIX OF EVIDNECE
WITNESSES EXAMINED
ON BEHALF OF O.P.
Affidavit of Complainant Affidavit on behalf of OP filed
EXHIBITS MARKED
ON BEHALFOF COMPLAINANT
1. Ex.A-1 True copy of Receipt issued by District Consumer Forum,
Warangal dated, 18-04-2001.
2. Ex.A-2 Copy of Oriental Insurance, Hyderabad Region,
dated: 25-04-2002.
3. Ex.A-3 & A-4 Receipt of Jaya Hospitals Hanamkonda,
dated.: 26-04-2002.
4. Ex.A-5 Letter of Divisional Manager, The Oriental Insurance Co.,
Ltd., Warangal, dated.: 19-04-2001.
5. Ex.A-6 Letter of Senior Divisional Manager, Oriental Insurance
Company Ltd., Warangal, dated.: 26-04-2002.
6. Ex.A-7 Receipt of Jaya Hospitals, Hanamkonda, dated: 16-04-2001.
7. Ex.A-8 Receipt of Jaya Hospitals, Hanamkonda, dated: 19-04-2001.
EXHIBIT MARKED ON
BEHALF OF OPPOISTE PARTY
1. Ex.B-1 Medical Establishment professional negligence errors &
Omissions insurance rules & conditions.
2. Ex.B-2 policy schedule issued by Opposite Party.
Sd/-
PRESIDENT.
