Delhi

West Delhi

CC/14/28

Sanjana - Complainant(s)

Versus

Sri Balalji Action Medical Insttitute - Opp.Party(s)

09 Jun 2017

ORDER

CONSUMER DISPUTES REDRESSAL FORUM (WEST)

GOVERNMENT OF NCT OF DELHI

150-151 Community Centre, C-Block, JanakPuri, New Delhi – 110058

                                                                                                Date of institution: 10.01.2014

Complaint Case. No. 28/14                                                   Date of order:09.06.2017

IN  MATTER OF

Mrs. SanjanaTrehanW/o Mr. UtpalTrehan  R/o  D1/12JanakPuri, New Delhi­110058.

                                                                                                                        Complainant

VERSUS

Medical Superintendent, Sri Balaji Action  Medical Institute A-4, PashchimVihar, New Delhi -110058.

Opposite  party

ORDER

R.S. BAGRI,PRESIDENT

            Mrs. SanjanaTrehan named above  here in the complainant has filed the present complaint  under section 12 of  Consumer Protection Act for directions to  Medical Superintendent  Sri Balaji  Action  Medical Institutehere in after in short referred as the opposite party  for directions to the opposite party to pay Rs. 43512/- excess amount charged from the complainant  with interest @ 18% ,  Rs 2,00,000/-  towards  physical  strain  and mental agony  suffered by the  complainant and her family , Rs. 1,000/-  towards cost of  petition and Rs. 21,000/-  towards litigation expenses.

            The brief  relevant facts necessary for disposal of  the present complaint as stated are that the complainant   is working  as  Dietician  in DeenDayalHospital,New Delhi therefore, entitled  for DGEHS facility. She  was in family  way and her treatment was going on in the opposite party  under supervision of Dr.Ekta Sharma, who is on penal of  the opposite party.  The complainant during  check up in the opposite party was told that the opposite  party is in the  empanelment of the DGEHS   and she is entitled for DGEHS facility being a government  employee.

            That on 12.05.2013 the complainant  was admitted  in emergency of the opposite party for  C- section  treatment and husband of the complainant gave a copy of the DGEHS card  of the complainant.  Thereupon   staff  of the  opposite party told that they are no longer on penal of DGEHS  and asked husband of the complainant  to pay the bill . The condition of the complainant was complicated, therefore, family of the complainant was left with no other option except to bear expenses  of her treatment.

            That  accounts department of office of the complainant  told her that she was charged wrongly  by the opposite party as they were never removed from  DGEHS penal.  Therefore, the complainant  several times visited  and requested the opposite party to consider her case  and return excess money charged.  She also made correspondence with the opposite party.But to  no effect.  The opposite party hadcharged  Rs.43,512excess amount in total charges of Rs. 60,762/-  as she received a  reimbursement of Rs. 17,250 only.  The complainant also sent a legal notice to the opposite party to refund the excess  amount of Rs.  43,512/- charged from the complainant but the opposite party did not  respond.   Hence the present complaint for directions to the opposite party  to refund Rs. 43512/- excess amount charged from the complainant  with interest @ 18%,  Rs 2,00,000/-  towards  physical  strain  and mental agony  suffered by the  complainant and her family , Rs. 1,000/-  towards cost of  petition and Rs. 21,000/-  towards litigation expenses.

              After notice the opposite  party  appeared and filed  reply while  contesting the complaint and raising preliminary objections including  that the complaint is without cause of action false and frivolous, based on wrong and concocted  version as the opposite party was not on  penal  of  DGEHS   and prayed for  dismissal of the complaint with cost.

However on merits the opposite  party  admitted that the complainant was  under treatment of   doctor of the opposite party.She was admitted on 12.05.2013 for C-section treatment  and after complete treatment  to the  satisfaction of the complainant  was discharged  on 14.05.2013.  The opposite party was not  on penal of  DGEHS from  12.05.2013  to 15.05.2013 , therefore, the  opposite party  rightly charged Rs. 60,762/- for her treatment.  All other allegations of the complaint are vehemently denied and prayed for dismissal of the complaint with exemplary cost.

The complainant did not file rejoinder to the reply of the opposite party despite opportunity..

When Mrs.SanjanaTrehan  complainant was asked  to lead evidence by way of affidavit she tendered  her affidavit  narrating  facts of the complaint .   The complainant  also relied  upon Exhibit CW 1/1 DGEHS card of the complainant, Exhibit CW 1/2 undated letter  written by Additional Director, DGEHS  to Medical Superintendent  Sri Balaji Action Medical Institute ,  Exhibit CW1/3  bill dated 14.05.2013 ,  Exhibit CW1/4  e-mail dated 22.08.2013, ,   Exhibit CW1/5 e-mail dated 29.08.2013 ,   Exhibit CW1/6 e-mail dated 10.09.2013, Exhibit CW1/7 email dated19.09.2013 , Exhibit CW1/8 legal notice  dated 11.11.2013, Exhibit CW1/9 and Exhibit CW1/10  postal receipts.

When opposite party was asked to lead evidence by way of  affidavit they

tendered  in evidence affidavit  of Sh. K.N. Gulati GM Administration narrating the facts of the reply.The opposite party relied upon  AnnexureR-I letter dated 01.03.2013 written by opposite party  to Director (Health Services) for  discontinuation of  their  empanelment from 01.04.2013  onwards, Annexure R-2 letter dated 16.04.2013  written  by Additional Director DGEHS  to Medical Superintendent  in response to the letter dated 01.03.2013 received on 20.03.2013 with request to continue  in the panel of DGEHS, Annexure R-3 letter dated 20.05.2013 written by Medical Superintendent  to Additional Director CGEHS for confirming continuation of on  panel of DGEHS with immediate effect, AnnexuresR-4 to  R-7 request for admission , admission form, undertaking,  list of room rent charges and bills.

The parties  also submitted written arguments in support of their respective contentions.

We have heard   Ms KomalTrehan advocate learned counsel for the Complainant and Sh. R.P. Pahwa advocate learned counsel for the  opposite party and  have gone  through the material available  on the record carefully and thoroughly.

After having  heard  both the sides  and going through the recordcarefully and thoroughly the issue between the parties is :-

“Whether opposite party was on panel of DGEHS from 12.05.2013 to14.05.2013”

The burden to prove that the opposite party was on panel of DGEHS from

12.05.2013 to 14.05.2013 is heavily on the complainant.  The complainant  in support of her case has tendered her affidavit  and Exhibit CW1/2 undated letter written by  Additional Director DGEHS to the Medical Superintendent Sri Balaji  Medical  Institute.  Before proceeding further  it  is worth while  to re-write  letter Exhibit  CW 1/2  :-

“ Please  refer to you letter no SBAMU/MS/DG/2013  dated 29.07.2013 on  the  subject cited above.  In this regard it is informed  that:-

1.        Your letter for discontinuation of empanelment  w.e.f 01.04.2013  was received in this office  on dated 17.04.2013.

2.        The empanelment cannot  be discontinued  with retrospective  effect.

3.        As per provisions under the scheme  one month notice, from  the date of  receipt   of letter in this Office , should have been provided for discontinuation  of the empanelment.

4.        Your Hospital  agreed to continue empanelment  under DGEHSw.e.f. 21.05.2013.  Therefore,  there was practically no period when  you were not on panel of DGEHS , if your request   received on dated 17.04.2013  was considered  as Notice.

In view  of the above mentioned   facts, since your hospital  was very much on the panel of DGEHS on  dated  12.05.2013  to 14.05.2013  during the period of admission of Mrs.SanjanaTrehan.  Therefore,  your hospital should  have  charged as per DGEHS rates during the said period. .

As such you are requested to sort out the problem of overcharging with the beneficiary at your end at the earliest under intimation to this office.”

            First of all the letter Exhibit CW 1/2 is undated.   This letter is written in reference to continuation of empanelment  letter dated 01.04.2013 received in the office of Director DGEHS on 17.04.2013.

            The opposite party  to rebut  evidence of the  complainant  tendered in evidence affidavit  of Sh. K.NGulati  GM, Administration  and Annexure R-2  letter dated 16.04.2013 showing that the letter dated  01.03.2013 of the  opposite party  for cancelation  of empanelment  of DGEHS  was received in the office of Director DGEHS on 20.03.2013.  There are affidavits  of Mrs.  SanjanaTrehan  complainant  and letters Exhibit  CW1/2 and Annexure R-2 .  The  affidavit  of Mrs. SanjanaTrehanisrebutted by the affidavit of Sh. K.N. Gulati.  The  letter  Exhibit CW1/2  is falsified from  the letter  Annexure R-2 firstly on the ground that the letter Exhibit  CW 1/2  is un dated.  Secondly, according to Exhibit CW 1/2 ,Annexure  R-1 letter dated 01.03.2013 for cancelation empanelment  of DGEHS written by opposite party to the Director DGEHS was received on 17.04.2013.  Whereas  as per annexure R-2 letter dated 16.04.2013,   the letter  dated 01.03.2013 was  received  in the office of  DGEHS on 20.03.2013 and  even  if  forsake of  arguments it is presumed that one month  notice was required for cancelation of empanelment with DGEHS though there is no such agreement on the record, the empanelment of the opposite party was cancelled on 19.04.2013. Whereas the opposite party in Annexure R-1 letter dated 01.03.2013 has specifically mentioned that their hospital will not remain on panel  of DGEHS from 01.04.2013 onwards.Empanelment  ofthe opposite party  again came into existence  from 20.05.2013  according to Annexure R-3 letter dated 20.05.2013 of the opposite party. Therefore, from 19.04.2013 to 20.05.2013  the opposite  party was not on panel  of DGEHS.Resultantly was also not on panel of DGEHS from 12.05.2013  to 14.05.2013  during hospitalization of the complainant. Therefore,  the  opposite party  rightly  chargedRs.60,762/-expenses of treatment  from the complainant.

            Therefore, there is no unfair trade practice  and deficiency in service on the part of the opposite party.  Hence, there is no merit in the complaint.  The same fails and is hereby dismissed.

Order pronounced on : 09.06.2017

• Copy of order be sent to the concerned parties free of cost.
• Thereafter, file be consigned to record.

                       

(PUNEET LAMBA)                                                              ( R.S.  BAGRI )

                   MEMBER                                                                    PRESIDENT