Haryana

StateCommission

A/579/2018

BSNL - Complainant(s)

Versus

PURAN MAL - Opp.Party(s)

ANITA SHARMA

02 Jul 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

 

                                                Date of Institution: 07.05.2018

                                                          Date of final hearing: 20.05.2024

                                                     Date of Pronouncement: 02.07.2024

 

First Appeal No.579 of 2018

 

Bharat Sanchar Nigam Limited through Asstt. G. Manager (Legal Cell) BSNL.                                                                      ...Appellant

•  

Puran Mal S/o Sh. Tota Ram, Resident of village Bamnikhera, Tehsil & District-Palwal-121102

CORAM:             Mr.Naresh Katyal, Judicial Member

                             Mrs. Manjula Sharma, Member

 

Argued by:-       Mrs. Anita Sharma, counsel for the appellant.

Mr. Ashok Kaushik, counsel for the respondent.

 

                                                ORDER

NARESH KATYAL, JUDICIAL MEMBER:-

          Delay of 04 day in filing of this appeal is condoned for reasons stated in application for condonation of delay.

2.      Challenge in this Appeal No.579 of 2018 of appellant/OP has been invited to legality of order dated 22.03.2018 passed by District Consumer Disputes Redressal Forum, Palwal (In short “District Consumer Commission”) in Consumer Complaint No.243 of 2017, vide which complainant’s complaint has been allowed.

3.      Factual matrix:Complainant, after serving department of opposite party had retired from service vide HRMS No.197302706. He is ESI Card Holder which covers his wife Smt. Ramwati. His wife was suffering from severe abdomen pain, vomiting and difficulty in breathing, so he took her for treatment in nearby hospital i.e. Om Premia Hospital at Palwal in emergency and doctor admitted her in emergency condition and advised for her operation at the earliest. After operation on 07.08.2015, of abdomen, she was discharged on 14.08.2015. As per complainant, he could have thought of taking patient to best possible hospital at Faridabad which was 35 KM away from his residence or at any other specialist hospital and empanelledhospital, he would have lost her wife/patient. He spent Rs.49710/- on consultation, diagnostics and Rs.67,813/- on medicines etc. He spent total amount of Rs.1,17,523/-. He moved application to opposite party no.2 for reimbursement of medical claim of his wife, upon which, opposite party no.2 raised objections vide dated 12.01.2016 that he has mentioned that he admitted his wife in emergency ward and not in emergency condition and also not attached visiting report. As per complainant; it is/was a strange objection; can a normal patient is also admitted in emergency ward and whose duty was it to visit hospital when he has already informed department through an application and asked for permission to get his wife treated in Om Premia Hospital at Palwal and permission was duly sanctioned by opposite party. Further, he also submitted Emergency Certificate of Medical Officer of concerned hospital (which is neither forged nor declared as illegal by opposite party) and not objected. His reimbursement of medical claim was withheld in an illegal way by opposite party to reject his claim. He met officers of opposite parties and requested them to see reasons of his medical bill but in vain. Even, legal notice slapped on 24.08.2017 through counsel did not bring desired result. Opposite parties did not provide sufficient services to him and were negligent in repudiating his claim i.e. reimbursement of medical bills in an arbitrary fashion.It has caused mental agony, harassment to him. He has alleged unfair trade practice of OPs.On these allegations; he filed complaint for issuance of directions to OPs to pay Rs.1,17,523/- spent by him on treatment of his wife; to pay damages of Rs.50,000/- for deficient intentional services and to pay Rs.21,000/- on account of litigation expenses along with interest on above amount @12% per annum.

4.      Upon notice, OPs-appellant raised contest. In its written version, in preliminary objections thereof, it is asserted that complaint is misconceived, groundless and unsustainable in law;forum has no jurisdiction; complainant has no locus standi; it is flagrant abuse of process of law. While replying on merits, it is asserted that complainant is not a consumer. It is denied that there was deficiency in service of OPs or there was mental agony and harassment to complainant. It is pleaded that complainant’s wife is not covered under medical policy and under definition of consumer.

5.      Parties to this lisled their respective evidence (oral as well as, documentary). On analysingit; learned District Consumer Commission-Palwal vide order dated 22.03.2018 has allowedthe complaint. It has directed OPs to pay Rs.1,17,523/- spent by complainant on treatment of his wife;it also awarded compensation of Rs.20,000/- on account of negligent and deficiency services and awarded Rs.5100/- to complainant towards litigation costs.

6.      Feeling dissatisfied; unfazed and unsuccessful OP/BSNL has filed instant appeal.

7.      We have heard learned counsel for parties at length and examined record with their able assistance.

8.      Learned counsel for OP-appellant, while urging for acceptance of this appeal, has contended that; impugned order dated 22.03.2018 passed by Learned District Consumer Commission-Palwal is illegal. Learned District Consumer Commission has no jurisdiction to entertain and adjudicate the dispute involved. It has erroneously considered complainant as an ESI card holder, whereas he was just a medical card holder which was just a facility provided by BSNL to its employees free of cost. Wife of complainant was admitted in non-empanelled hospital for treatment on 07.08.2015 rather to admit her in nearby in BSNL empanelled hospital, where medical treatment of BSNL employees (working and retired both) and to the dependents are provided on cashless scheme at CGHS rates or at AIIMS rates, whichever is less. It is further contended that complainant firstly admitted appellant regarding admission of his wife on 13.08.2015 and not on 07.08.2015.

9.      Per-Contra: learned counsel for complainant has supported the impugned order dated 22.03.2018 by urging that, it is the outcome of proper appreciation of material facts by learned District Consumer Commission-Palwal and no interference in same is warranted.

10.    Undisputedly, complainant is retired employee of appellant. He got admitted his wife who was suffering from severe abandon pain, vomiting and difficulty in breathing, in an emergent situation, in non-empanelled hospital (Om Premia Hospital at Palwal) on 07.08.2015. She was discharged from said hospital on 14.08.2015. Complainant has spent Rs.1,17,523/- on her treatment. He submitted his claim to his employer for reimbursement of amount of Rs.1,17,523/- vide his application Annexure C-3 which was declined. Emergency Medical Certificate dated 07.08.2015 signed by Dr. Manish Chauhan of Om Premia Hospital-Palwal certifies with recitals that: “complainant’s wife has been operated for appendicular perforation with lump with pyoperiteneum with bowel obstruction and she was still admitted in hospital and is undergoing treatment”. This document, clearly substantiate that complainant was confronted in an emergent medical situation regarding ailment of his wife on 07.08.2015 which compelled him, under constrained circumstances, to took her for treatment in nearby non-empanelled hospital, instead of taking her at BSNL empanelled hospital. He represented BSNL vide his application Annexure C-4 by stating that: in emergent situation he had to took his wife in Om Premia Hospital on 07.08.2015. He has requested for according necessary permission for the purpose of treatment of his wife, so that he should not face any hinderance and difficulty in the process of reimbursement of amount of bills as per BSNL rules.

11.    There is a letter dated 16.01.2016-Annexure C-5, of appellant with regard to case of complainant. Phraseology of this letter is really astonishing. It recites that:“in the emergency certificate admission of complainant’s wife has been stated to be in emergency ward, and not in an emergent situation”. Apparently, authorities at the helm of affair of appellant have not adopted a realistic approach to the text and recitals of Emergency Medical Certificate dated 07.08.2015.  This certificate, in its earlier part, unambiguously recites that:“Ramwati age-65 years/F, W/o Sh. Puran Mal, R/o Village Bamnikhera, Teh. & Distt. Palwal was admitted in our hospital in emergency as a case of severe pain in abdomen, vomiting, difficulty in breathing on 07.08.2015 vide IPD No. 15/1148”. This quality recital, in no manner of doubt, would prove that situation before complainant regarding ailment of his wife was grave and serious, warranting medical treatment for her, in emergency. Even, discharge summary Annexure C-2, corelates with text of Emergency Medical Certificate Annexure C-6. Appellant herein should have adopted a considerate and justice oriented approach by according requisite sanction to complainant so requested by him in his letter Annexure C-4. Instead, approach of appellant, belies the tall claim raised by it, in its capacity of being a Government of India Undertaking towards the concept of welfare State.

12.    In wake of above facts, complainant has no other option but to act as per ground reality of situation confronted to him, in order to save precious life of his wife who was battling with severe abandon pain, vomiting and difficulty in breathing. Learned counsel for the appellant has relied upon judgment of Hon’ble Apex Court in case titled as Jagmittar Sain Bhagat and others Vs. Director, Health Services Haryana and others Civil Appeal No. 5476 of 2013 decided on11.07.2013 to contend that Consumer Forum has no jurisdiction and impugned order dated 22.03.2018 is a nullity. This contention has no credence in view of paras No. 16 & 17 of above quoted judgment which reads as under:-

“16. In view of the above, it is evident that by no stretch of imagination a government servant can raise any dispute regarding his service conditions or for payment of gratuity or GPF or any of his retiral benefits before any of the Forum under the Act. The government servant does not fall under the definition of a “consumer” as defined under Section 2(1)(d)(ii) of the Act. Such government servant is entitled to claim his retiral benefits strictly in accordance with his service conditions and regulations or statutory rules framed for that purpose. The appropriate forum, for redressal of any his grievance, may be the State Administrative Tribunal, if any, or Civil Court but certainly not a Forum under the Act.

17. In view of the above, we hold that the government servant cannot approach any of the Forum under the Act for any of the retiral benefits.”

13.    Thus, it is clear that claim for reimbursement of medical expenses of Rs.1,17,523/- raised by complainant in relation to treatment of his wife, cannot be termed as a retiral benefit.  In wake of above subjective and critical discussion; this Commission has arrived at an inescapable conclusion that there is no illegality or any fallacy committed by learned District Consumer Commission-Palwal while non-suiting appellant herein by allowing the complaint of complainant through impugned order dated 22.03.2018. Impugned order dated 22.03.2018 is not perverse, instead it is the outcome of meticulous appreciation of all relevant facets of this case, which is hereby affirmed, maintained and upheld. Present appeal being devoid of merits is hereby dismissed. 

14.    Statutory amount of Rs.25,000/- deposited by appellant at the time of filing of this appeal is now ordered to be refunded to it (appellant) against proper receipt, identification and verification as per rules and regulations.

15.  

16.    A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgment be uploaded forthwith on the website of the Commission for the perusal of the parties.

17.    File be consigned to record room.

                                    

Date of pronouncement: 2^nd July, 2024

 

 

 

                             Manjula Sharma                            Naresh Katyal                                          Member                                 Judicial Member

Addl. Bench-I                       Addl. Bench-I