DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD

Dated this the 27th day of July 2010 .

Present : Smt. Seena.H, President

: Smt. Preetha.G. Nair, Member

: Smt. Bhanumathi.A.K, Member

C.C.No.77/2009

Manju.C.G

Gayathri

Ram Nagar

Vadakkanthara (P.O)

Palakkad – 678 012. - Complainant

Vs

1. R V Clinic & Hospital

Orthopeaddic Super Speciality Centre

West Fort Road

Palakkad – 678 001.

(Rep. By Dr. Vaidyalingam)

(Adv .L. Namassivayan)

2. The Manager

The New India Assurance Co Ltd

P.O. Box No.43, N.S. Tower

Near Stadium Bus Stand

Coimbatore Road

Palakkad – 678 013. - Opposite parties

(Adv.T. Giri)

O R D E R

By Smt. Bhanumathi.A.K, Member

The case of the complainant is as follows.

The complainant met an accident at Puthur Road, Palakkad on November 26^th of 2007. Her right shoulder bone was fractured very badly and underwent a major surgery as a part of treatment. The complainant filed a case for Insurance claim. On the discharge date that is on 7^th December 2007, they got the hospital bill. When the complainant go through the bill provided by the hospital authorities, it is noted that the implant material cost was not mentioned . When she approached the hospital authorities to mention the implant material cost in the consolidated bill, they told that they cannot mention the same in the bill

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because of the tax related issue. On further request, the hospital authorities provided a letter mentioning that “Received from Manju 24/ Female, the cost of implants as mentioned in the attached invoice bought and used for her surgery” signed and sealed by Mr. Parameswaran on 7^th December, 2007 along with the Invoice provided by the material vendor to the hospital. The complainant made the payment to R V Clinic but the hospital authorities did not give any proper bill which is very essential for claiming compensation. During the out of court settlement with the Insurance firm, they informed that the complainant is not eligible to make a claim for the amount of Rs.37,346.88 as the hospital authorities neither included the implant material cost in their consolidated bill nor they provided any proper bill for the payment towards the implant material cost. The loss incurred the complainant happened due to the deficiency of service on the part of 1^st Opposite party. Hence the complaint seeking an order directing the opposite parties to pay an amount of Rs.1,50,220/- as compensation and cost from the opposite parties .

Complaint was admitted and the opposite parties entered appearance through counsels. They filed their respective version with the following contentions.

It is true that the complainant was admitted in the 1^st opposite party hospital on 26/11/2007 for the treatment of fracture on her right shoulder. A surgery was duly done as required medically in such cases and an imported Titanium Metal locking Plate was implanted and the patient was discharged on 07/12/2007. The complaint of the complainant is that a separate bill for this imported Titanium metal plate was not issued in her name. For not issuing the seperate bill for the imported Titanium metal plate the 1^st opposite party submitted the details of the method of procuring the imported Titanium metal locking plates. 1^st opposite party is not stocking and selling imported Titanium metal locking plates. They are not easily available in the market. Such metal plates for a particular surgery cannot be procurred single and used as the exact nature of the fracture of the bone and the wound can be seen for certain only on opening the wound. The size of the metal locking plate, the number of the holes therein, the number of particular screws

required etc are decided and used only during the process and progress of the surgery. So a full set with wide range of locking metal plates and screws are required in order to carry

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out the surgery. The patients are unable to procure the process and bear the cost of the entire sets of the implant material and the required particular surgical instruments. So the 1^st Opposite party procuring the entire set of implant materials from the next immediate available medical sources or suppliers. After the completion of the surgery 1^st opposite party informed the surgical instrumental suppliers and the supplier comes with the bill for the same and takes back the non used metal plate and the surgical instruments supplied for the use of surgery. 1^st opposite party is not dealer having the license to sell the metal locking plates. 1^st opposite party has issued bill and also certificate with copy of the bill by the medical supplier as was possible in this case. And there is no deficiency of service on their part.

The 2^nd opposite party stated in their version that the complainant had filed a petition under Section 166 of Motor Vehicle Act before the MACT, Palakkad as OPMV 200/08 for getting compensation for the injuries sustained to her in a motor vehicle accident. In the above OPMV the 2^nd opposite party was impleaded as insurer of vehicle involved in the accident. The said petition was included in the Lok Adalath. After considering the injuries and original documents produced before the Tribunal the complainant and the 2^nd opposite party arrived for a settlement for Rs.75,000/- as a full and final settlement. So the complainant cannot adjudicate another claim against 2^nd opposite Party. Even if she settled the matter and she has got any grievance against the said settlement the complainant has to file an appeal against the settlement award before the proper forum. It is not correct to say that the 2^nd opposite party has not accepted Rs.37,346.88 . If the said invoice was produced before the M A C T and the opposite party has not accepted, the complainant can very well file an application before the M A C T and call upon the said original documents from 1^st opposite party hospital before the settling the case. The complainant has accepted the settlement and Lok Adalath passed an award as final and accepted the amount as a final settlement. So the 2^nd opposite party is not liable to compensate the complainant.

Both parties filed their affidavits and Exhibits A1 to A4 marked on the side of complainant. Exhibit B1 to B5 were marked in the side of the opposite parties.

Matter was heard.

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The issues for consideration are

1. Whether the complainant is entitled to get any compensation from the opposite parties?

The case of the complainant is that she met with an accident while travelling on two wheeler on 26/11/2007 and admitted in the 1^st opposite party hospital. An amount of Rs.37,346.88 was paid as cost of the implant material used for surgery. That amount was not included in the consolidated bill of the hospital which is very essential for claiming the compensation. Non issuing of the proper bill caused to reject the insurance claim amount of Rs.37,346.88. 1^st opposite party submits that they have not holding any agency of such medical instrument or metal locking plates and is not having the license or registration under the taxation laws to sell the same. So the 1^st opposite party is giving order to the immediate available medical source on suppliers. The required bill amount is collected by the 1^st opposite party from the patient and paid directly to the supplier of medical instruments. Thus 1^st opposite party issued certificate with copy of the bill by the medical supplier.

When the supplimentary 2^nd opposite party was impleaded it is revealed that the same complainant has filed a petition under Section 166 of Motor Vehicle Act before the Motor Accident Claims Tribunal, Palakkad as OPM V 200/2008 for getting compensation for the injuries sustained to her in a Motor Vehicle accident. The said petition was included in the Lok Adalath. After considering the injuries and original documents produced before the Motor Accident Claims Tribunal, the complainant and 2^nd opposite party arrived for a settlement for Rs.75,000/- as a full and final settlement.

1^st opposite party called for the certified copy of the settlement of OP MV 200/2008 and the document list from the complainant. But it has not produced by the complainant. Exhibit B5 produced by the supplimentary 2^nd opposite party shows that OPMV 200/2008 in Motor Accident Claims Tribunal was included in Lok Adalath and settled the matter for an amount of Rs.75,000/-. The complainant has not raised any objection at the time of settlement regarding the disputed bill. On the other hand has accepted the award. Hence complainant is not entitled to get any compensation for the same.

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So we are of the view that the complainant is not entitled to get compensation from the opposite parties.

In result complaint dismissed. No order as to cost.

Pronounced in the open court on this the 27th day of July , 2010

PRESIDENT (SD)

MEMBER (SD)

MEMBER (SD)

APPENDIX

Date of filing: 19/06/2009

Witness examined on the side of Complainant

Nil

Witness examined on the side of Opposite party

Nil

Exhibits marked on the side of the complainant

1. Ext. A1 – Copy of Bill No.702 of R V Clinic and Hospital

2. Ext. A2 – Copy of receipt dated 07/12/2007 of R V Clinic & Hospital

3. Ext. A3 – Copy of Tax Invoice Form 8A of Trichur Dental Depot

4. Ext. A4 - Copy of invoice on discharge

xhibits marked on the side of the Opposite Party

1. Ext. B1 – Copy of OP No.11556 dated 26/11/2007

2. Ext. B2 – Copy of Tax Invoice Form 8 A dated 30/11/2007

3. Ext. B3 – Copy of receipt of R V Clinic & Hospital dated 07/12/2007

4. Ext. B4 - Copy of bill dated 07/12/2007

5. Ext. B5 – Copy of Award of Lok Adalath dated 14^th March 2009.

Forums Exhibits

Nil