D.o.F;7/1/06D.o.O:9/12/08 IN THE CONSUMER DISPUTES REDRESSAL FORUM KASARAGOD CC. NO.32/06 Dated this, the 9th day of December 2008 PRESENT: SRI.K.T.SIDHIQ : PRESIDENT SMT.P.RAMADEVI : MEMBER SMT.P.P.SYAMALADEVI : MEMBER 1.Amina, W/o K.A.Moidu, 2. Pallichikunhi, w/o late Aboobacker, both are R/at Moojimudi House, : Complainants Koipady Kadappuram, Po.Kumbla, Kasaragod. (Adv.Rajesh.K, Kasaragod) The Commissioner, Kerala Fisherman Welfare Fund Board, : Opposite party Matsya Board, Trichur Po. (Adv. C.Damodaran,Kasaragod) ORDER SRI.K.T.SIDHIQ : PRESIDENT Whether the treatment from a private hospital without reference from a government hospital/ dispensary will disqualify a fisherman/ or his legal representatives to claim the benefits stipulated under the Kerala Fisherman’s Welfare Fund Board is the question posed before us in this complaint. Amina, the complainant herein is the wife of Moideen alias K.A.Moidu alias Moideen kunhi. He was a fisherman entitled to get the benefits of the Kerala Fishermans Welfare Fund. He was suffering from chronic increstitial nephritis, chronic renal failure and fluid overload with pulmonary oedema and he died on 24/7/05. As per the scheme Moidu is entitled to get the entire medical reimbursement but the same was rejected on flimsy grounds. Hence he died for want of funds. The application submitted by the mother of K.A.Moidu ie, the 2nd complainant herein to opposite party for the benefits as per the scheme was rejected on 28/2/04 arbitrarily. More than rupees two lakhs were spent for the treatment and medicine of the deceased fisherman. The rejection of the claim amounts to deficiency in service. Hence the complaint. 2. Opposite party filed version contending that the claim of the mother of K.A.Moideen that is the second complainant herein was repudiated as the claim was not as per the terms and conditions of the scheme of the opposite party. The treatment was done in a private hospital without any reference by a government doctor. In the absence of a reference by the government doctor the opposite party is not liable to grant any medical assistance as per the guide lines. By way of an additional version opposite party further contended that as per the scheme their liability is limited to Rs.50,000/-. 3. Complainant No.1 Amina , the wife of deceased fisherman filed affidavit in support of their claim and Exts.A1 to A15 marked. Ext.B1 is marked on the side of the opposite party. Both sides were heard and the documents perused. 4. The treatment records and medical bills marked as Ext.A15 series shows that deceased fisherman has undergone expensive treatments. The only contention of the opposite party is that as per the guide lines issued to them( a copy of the guidelines is produced and marked as Ext.B1), the treatment aid will be provided to a patient if his treatment at private hospitals were as per the reference from a government hospital. Against this contention, the complainant No.1 in her affidavit stated that initially the deceased fisherman has taken to Public Health Centre,Kumbla and as there are no facilities at PHC Kumbla, he was referred to Kasaragod Nursing Home and thereafter he was referred to Mangalore for better management. 5. The contention of the opposite party is too technical and flimsy. They have no case that the deceased fisherman has not undergone any treatment. Therefore merely for availing the benefits of the scheme it could not be presumed that one will restrict his treatment to government hospital even if there are no facilities available for his treatment. 6. The counsel for complainant invited our attention to the decision reported in 2005(2) KTT 610 in the case of Kerala Fishermans Welfare Fund Board vs. Kunjan Divakaran. In the said decision the Hon’ble High Court has held as below: “ The scheme framed by the Kerala Fisherman Welfare Fund Board is a laudable welfare measure. Any provision or clause in a welfare legislation or scheme as the case may be, has to be construed and interpreted liberally. The attempt should never be to deprive the needy and eligible the benefit of benevolent legislation or scheme. An earnest endeavor should be made to reach out to the victim and wipe the tears of sufferings. The intent and purport of the legislation must be borne in mind while dealing with the provisions contained in any welfare legislation or scheme. There is no room for a pedantic view while interpreting the provisions contained in a welfare statute.” Considering the principle enunciated in the above judgment, we are of the view that the repudiation of the claim preferred by the mother of the deceased fisherman amounts to deficiency in service and our answer to the question posed is affirmative and the complainants Nos 1&2 being the legal heirs of the deceased fisherman are entitled for the benefits as per the scheme of opposite party. 7. Relief and costs: The deceased fisherman was suffering from chronic renal failure . He had undergone hemo dialysis many times . He was disabled to do his work completely. Definitely he was entitled for the benefits as per the scheme of the opposite party. The liability of the opposite party as per the scheme is Rs.50,000/-. The complainants being the legal heirs of the deceased fisherman are eligible for that amount. Therefore, we allow the complaint and the opposite party is directed to pay Rs.50,000/- to the complainants along with a cost of Rs.2000/-. Time for compliance is 30 days from the date of receipt of copy of order. MEMBER MEMBER PRESIDENT Exts. A1-Copy of death certificate A2-copy of rejection application A3-dt.10/10/05-copy of lawyer notice A4&A5-postal acknowledgments A6-pass book A7-identity card A8-subscription receipt. A9-copy of sonography of abdomen & pelvis report A10- copy ofUltrasound report A11-copy of medical report issued by Fr.Mullers MC & hospital Mangalore A12-Medical certificate issued by ‘ ,, ,,, A13-Case summary and discharge record A14-Certificate issued by Village Officer,Koipady A15 series- cash receipts issued by Fr.Mullers Hospital, Mangalore. B1- copy of the Guide lines issued by OP MEMBER MEMBER PRESIDENT eva/
......................K.T.Sidhiq ......................P.P.Shymaladevi ......................P.Ramadevi | |