Rajasthan

StateCommission

A/1068/2015

Rajeev Maharshi Chief Secretary Govt. of Rajasthan - Complainant(s)

Versus

Padam Chand jain s/o Late Sh. Tikaram Jain - Opp.Party(s)

Ratnesh Yadav

13 Jan 2016

ORDER

BEFORE THE CONSUMER DISPUTES REDRESSAL COMMISSION,RAJASTHAN,JAIPUR BENCH NO.1

 

 

FIRST APPEAL NO: 1068 /2015

 

Rajeev Maharshi,Chief Secretary,Govt. Of Rajasthan as President,Board of Trustees, Rajasthan Pensioners Medical Relief Fund, Secretariat, Jaipur (retd.) & ors.

 

Vs.

 

Padam Chand Jain s/o Late Tikaram r/o20/13 Mansarovar, Jaipur.

 

 

Date of Order 13.1.2016

 

Before:

Hon'ble Mrs. Justice Nisha Gupta- President

Mr. Kailash Soyal -Member

 

Mr.Shiv Vyas counsel for the appellants

Mr.Padam Chand Jain respondent in-person

 

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BY THE STATE COMMISSION ( PER HON'BLE MRS. JUSTICE NISHA GUPTA,PRESIDENT):

 

This appeal has been preferred against the order dated 10.8.2015 of the court below whereby u/s 27 of the Consumer Protection Act the court has ordered for compliance of the original order and amount has been calculated as Rs.1,09,970/-.

 

The contention of the counsel for the appellant is that as per their circular the charges for consultation, surgery and miscellaneous charges are not allowed and they have complied with as per the circular dated 6.2.2009.

 

Per contra the contention of the respondent is that in hospital charges consultation, surgery and miscellaneous charges were also made admissible hence, they are payable.

 

Heard the counsel for the parties and perused the order of the court below.

 

Para No.3 of the relevant circular reads as under:

 

“Hospital charges ( inclusive of consultation, surgery and

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all other miscellaneous charges ) at the rate of cottage charges admissible in Government hospitals as per entitlement of the employee.”

 

The plain reading of the same goes to show that in hospital charges consultation, surgery and miscellaneous charges were also made inclusive, meaning thereby that in hospital charges on the above counts, reimbursement is admissible but it has been denied to the respondent unnecessarily and no reason has been assigned.

 

The contention of the appellant is that in cottage charges surgeon fee, consultation fee and miscellaneous charges are inclusive but he could not show any such document which could support his contention. Hence, the court below has rightly ordered for the reimbursement of surgeon fee, OT charges and anesthestic fees etc. For CCU and room rent no objection has been raised by the appellant hence, these are admissible.

 

The respondent has relied upon 2004 (2) CPR 62 (SC) United India Insurance Co. Ltd. Vs. M/s.Pushpalaya Printers where it has been held that there is any ambiguity or a term is capable of two possible interpretations one beneficial should be

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accepted to the insured consistent with the purpose of the act. Here in the present case also in hospital charges consultancy, surgery and miscellaneous charges are made admissible hence, beneficial interpretation should have been taken in favour of the respondent and these charges are admissible.

 

Furthermore the contention of the appellant is that for medicine and consumable articles Rs. 45,000/- has been allowed where no details have been submitted. It is true that for

medicines 100% reimbursement is admissible as per the circular of the Government but for consumable articles it has to be decided that whether it is admissible or not hence, the respondent is not entitled for Rs. 45,000/-. He has been given liberty to file details of the same before the court below and has agitate it again.

 

With this contention this appeal is disposed of accordingly.

 

(Kailash Soyal) (Nisha Gupta )

Member President

 

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