Haryana

StateCommission

A/816/2014

United India Insurance Company Ltd - Complainant(s)

Versus

Smt. Amar Jeet Kaur - Opp.Party(s)

22 Nov 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA PANCHKULA

 

 

First Appeal No.816 of 2014

Date of the Institution:02.09.2014

Date of Decision: 22.11.2016

 

United India Insurance Company Ltd., Branch Office at Mini Zoo Road, Red Cross, Bhiwani through its Deputy Manager, United India Insurance Company Ltd., Regional office, Chandigarh, SCO-123-124, Sector-17 B, Chandigarh.

                                                                             .….Appellant

Versus

1.      Smt. Amar Jeet Kaur wife of Shri Avtar Singh son of Sh. Sohan Singh, resident of Hosue No.46, Ball Nagar, Tehsil and District Palwal.

                                                                             …..Respondent

2.      Dr. Kamal Aggarwal, M.D. Sunflag Hospital & Research Centre, Sector-16-A, Faridabad, District Faridabad.

3.      Sunflag Hospital & Research Centre, Sector-16-A, Faridabad, District Faridabad through its Managing Director.

4.      National Insurance Co. Ltd., through its Branch Office, II, situated at SCO No.96, First Floor, Sector-16, Faridabad, vide Policy No.36102/46/07/87700000771 valid from 04.03.2008 to 03.03.2009.

                                                                   .….Performa Respondents

CORAM:    Mr.R.K.Bishnoi, Judicial Member

                    Mrs. Urvashi Agnihotri, Member

 

Present:-    Mr.Satpal Dhamija, Advocate counsel for the appellant.

                    Mr. Ammish Goel, Advocate counsel for the respondent.

O R D E R

URVASHI AGNIHOTRI, MEMBER:

 

1.      United India Insurance Company Ltd. OP is in appeal against the Order dated 18.02.2014 passed by the learned District Consumer Disputes Redressal Forum, Palwal (for short ‘District Forum’), whereby the complaint of Amar Jeet Kaur has been allowed, directing the OPs to pay Rs.1,00,000/- towards her treatment, alongwith interest @9% per annum with Rs.5500/- as litigation expenses.

2.      Briefly stated, on 05.05.2008, the complainant felt pain in her abdomen and she got herself checked from Able Hospital, Palwal where doctors advised her to get C.E.C.T. lower abdomn from OP No.2 (Sunflag Hospital, Faridabad). The complainant went to OP No2 where said examination was conducted by OP No.1 (Dr. Kamal Aggarwal) on 05.05.2008 and the report dated 05.05.2008 was given by OP No.1 stating that a large lobulated isodnse mass lesion in the lower abdomen and pelvis in relation to the fundus of uterus, likely to be benign itiology was found in the abdomen of the complainant. The complainant went to Prem Jeewan Hospital, Palwal where doctor believing the said CECT report, advised operation of uterus for treating the complainant but doctors upon opening the abdomen of the complainant found that there was a large multi lobulated mass in sigmold mesocolon sigmoid. Sigmoid colon was stretched over mass. The problem was not in uterus as reported by said CECT  report, therefore, doctors  stitched abdomen of the complainant and referred her to AIIMS. The OP had given a false and wrong report of said CECT of the complainant due to which she had suffered a great mental pain and agony. The complainant approached the District Forum to direct the OP to pay a sum of Rs.1,00,000/- as compensation on account of expenditure and mental harassment.

3.      According to the OPs 1 & 2, the findings of doctors of AIIMS indicated that there was nothing wrong in C.T. Scan report  prepared by OP No.1. It was wrong that on account of said report the complainant  underwent and incomplete surgery at Palwal. If there was any problem in surgery at Palwal, medical negligence, if any, was on the part of the doctors of Prem Jeevan Hospital, Palwal, who had not been impleaded as party.  Thus there being no deficiency in service on the part of the OPs 1 & 2, they prayed for the dismissal of the complaint.

4.      OP-3 – National Insurance company pleaded that the treating doctor of M/s Prem Jeevan Hospital, Palwal had failed to go through the findings of said CECT report of the complainant and further failed to correlate Clinico Pathologically. If the treating doctor had been vigilant, he would not have operated the complainant. Therefore, the treating doctors were negligent in operating the complainant and OPs No.1 & 2 had not given false and wrong report of CECT.

5.      OP-4 – M/s United India Insurance company however pleaded that   OP-1 was insured with OP No.4 and accepted the written statement of OP No.1 in totality and prayed for the dismissal of the complaint. But, the learned District Forum rejected their pleas and accepted the complaint vide order dated 18.02.2014 by granting the relief to the complainant has mentioned above.

6.      Against the impugned Order, the OP-4 has filed Appeal before us contending that the learned District Forum has accepted the complaint without any legal justification. The appellant reiterating the same submissions as made by it before the District Forum has stressed that there was no deficiency in service on the part of the OP-1, hence, OP-4 was not liable at all.

7.      We have heard the learned counsel for the parties and have also gone through the record. From a perusal of record, it is evident that the complainant – Smt. Amar Jeet Kaur no doubt got herself treated by Dr. Kamal Aggarwal,  Sunflag Hospital, Faridabad, who was insured by the appellant – insurance company, but before that she had already got checked from Able Hospital, Palwal. She was advised to get C.E.C.T of lower abdomen, but she of her own accord went to Prem Jeewan Hospital,  Palwal, who advised for operation of the uterus. The doctors attending her at that place opened the abdomen of the complainant and found that there was large multi lobulated mass in sigmoid mesocolon sigmoid.   The mass was inseparable from mesocolon two vessels. So the doctors during operation advised the complainant that the problem was not in the uterus as suggested in the C.E.C.T. report. Despite that the doctors straightway proceeded towards surgery without any FNAC/Biopsy or any attempt at correlating the report dated 05.05.2008. But, it is surprising that neither the Prem Jeewan Hospital, Palwal nor any of their doctors who treated the complainant was impleaded as parties to the complaint. Further, when the complainant ultimately approached the AIIMS, Delhi, the doctors attending her advised a wholly different treatment and a different diagnosis i.e. other than the one adopted by doctors in the Prem Jeewan Hospital, Palwal. Therefore, it at all there was any negligence or any deficiency in the medical treatment provided to the complainant it was only at the level of Prem Jeewan  Hospital, Palwal and not the doctors of Sunflag Hospital, Faridabad, who came on the scene subsequently. Therefore, the insurance company – appellant and OP-1 can not be held liable for any negligence or deficiency in service etc.

8.      So far as the delay in filing the present appeal is concerned, notice was issued to the OP at the time of entertaining the appeal, but there was opposition to condone the delay. Otherwise also, in the affidavit filed by the appellant with the application for the condonation of delay, it has been asserted that the papers regarding the filing of the appeal had to be sent by the appellant from place to place at various levels. Infact  the law has been settled by the Hon’ble Supreme Court with regard to the condonation of delay by holding that in the case of the public bodies & companies etc., the delay in filing the appeal should be condoned liberally otherwise it will result in grave mis-carriage of justice. Therefore, we condone the delay of 159 days in filing the appeal. Consequently, we allow the appeal and dismiss the complaint with no other as costs. 

9.      The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the appellant against proper receipt and identification in accordance with rules.

November 22nd, 2016

Urvashi Agnihotri, Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench