BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM<br /> VAZHUTHACAUD, THIRUVANANTHAPURAM.<br /> PRESENT<br /> SRI. G. SIVAPRASAD : PRESIDENT<br /> SMT. BEENAKUMARI. A : MEMBER<br /> SMT. S.K.SREELA : MEMBER<br /> O.P.No. 369/2001 Filed on 13.09.2001<br /> Dated : 30.09.2008<br /> Complainant:<br /> <br /> Annamma Kuriakose, Marukam Moottil, Perumpanachy P.O, Changanassery, Perumpanachy P.O. <br /> <br /> (By adv. N. Krishnankutty)<br /> <br /> Opposite party:<br /> <br /> The Director, Regional Cancer Centre, Medical College P.O, Thiruvananthapuram. <br /> <br /> (By adv. C.S. Sukumaran Nair)<br /> <br /> This complaint is disposed of after the period so specified under the Consumer Protection Act, 1986. Though the case was taken up for orders by the predecessors of this Forum on 01.03.2005, the order was not prepared accordingly. This Forum assumed office on 08.02.2008. This O.P having been taken as heard on 13.08.2008, the Forum on 30.09.2008 delivered the following:<br /> ORDER <br /> SRI. G. SIVAPRASAD: PRESIDENT<br /> The facts leading to the filing of the complaint are that the husband of the complainant was a member of the Cancer Care for Life Scheme instituted by the opposite party with member card No. K-0007093. The CCL Scheme provides cancer diagnostic and treatment facilities in the RCC, Thiruvananthapuram in the unfortunate event of the member getting cancer at any time during his life time after two years from the date of enrollment. The opposite party had agreed to meet the expenses for investigation and treatment for cancer including X-rays, scanning, radiation, therapy, surgery, cost of drugs for chemotherapy, charges for accommodation of the member in the hospital ward including charges for diet as long as the member remains in RCC as an inpatient. The husband of the complainant had undergone treatment at S.H. Medical Centre, Kottayam for some ailments, where he was diagnosed as having lung cancer and he was registered as a patient in the opposite party centre with registration No. 007001. Opposite party Centre accepted the card. The husband of the complainant was directed by the opposite party to pay for the treatment provided to him. He was also directed to pay the registration charge of Rs. 300/-. The action of the opposite party is in violation of the terms and conditions of the schemes instituted by the opposite party. The husband of the complainant expired on 12.12.2000 while undergoing treatment in the opposite party centre. The total expenses incurred for the treatment was Rs. 60000/-. Opposite party is liable to pay the said amount to the complainant. Complainant issued advocate notice to opposite party on 30.04.2001. Opposite party received the notice and issue a reply letter denying their liability on flimsy reasons. Hence this complaint claiming an amount of Rs. 60000/- towards expenses for the treatment of late Kuriakose and compensation of Rs. 100000/-. <br /> Opposite party entered appearance and filed version contending that the complaint is not maintainable either in law or on facts. There is no deficiency in service on the part of opposite party. The husband of the complainant was referred to the opposite party from S.H. Medical Centre, Kottayam. The husband of the complainant insisted to register in Pay Clinic when he came to RCC and he was registered in Pay Clinic. The patient was a retired Professor and furnished a consent letter to register him in Pay Clinic. Complainant never claims concession as provided under CCL policy at any point of time prior to the advocate notice. The patient as well as the complainant were well aware of the fact that they are not entitled to the concession as registration was in the Pay Clinic and payments were effected without raising any objection. Patient had no complaints with regard to the medical attention and other services rendered to him in R.C.C. It is at his request he was treated under Dr. V.P.Gangadharan. Therefore the alleged deficiency of service on the part of the opposite party is unsustainable. CCL patients are not required to register in the Pay Clinic. Patients are having every right to register in the O.P of RCC producing the CCL Certificate and no registration fee is being realised from him for registration and they will be given the best treatment by the doctors. Such patients covered by C.C.L scheme are entitled to all the benefits envisaged under the scheme. The patient as well as the person accompanied him gave written consent while registering in the Pay Clinic itself. Therefore the claim is illegal, ill-motivated and is lacking bonafides. Complainant is having no case that there is deficiency of service in the matter of treatment. The dispute relates only with regard to the concession offered in the CCL Scheme. Complainant is not entitled to any of the reliefs prayed for. Hence opposite party prayed for dismissal of the complaint with costs. <br /> The points that would arise for consideration are:-<br /> (i)Whether complainant is entitled to the payment of expenses of Rs. 60000/-?<br /> (ii)Whether there has been deficiency in service on the part of opposite party?<br /> (iii)Reliefs and costs. <br /> To support the contention in the complaint, complainant has filed an affidavit of herself as PW1 in lieu of examination in chief and marked Exts. P1 to P3. To support the contention in version Dr. M. Krishnan Nair, Director, RCC, Thiruvananthapuram has filed a counter affidavit as DW1 and marked Exts. D1 to D3. <br /> Points (i) to (iii):- Admittedly, the husband of the complainant was a member of the Cancer Care for Life scheme instituted by the opposite party with membership card No. K 0007093 dated 29.12.1990. It has been the case of the complainant that as per the above said scheme opposite party has agreed to provide cancer diagnostic and treatment facilities in the RCC in the unfortunate event of the member getting cancer at any time during his life time after two years from the date of enrollment. It has also been the case of the complainant that the husband of the complainant had undergone treatment at S.H. Medical Centre, Kottayam where he was diagnosed as having lung cancer and referred to opposite party's hospital where he was registered as a patient. Complainant has never furnished the said membership card so as to comprehend the terms and conditions of the said scheme. It has been submitted by the complainant that though her husband was a member of the scheme he was directed to pay for the treatment, purchase certain medicines from outside, thereby incurred total expenses of Rs. 60000/-. Neither the complainant nor the opposite party did furnish the terms and conditions of the cancer care for life scheme. It is pointed out by the opposite party that the husband of the complainant insisted to register in pay Clinic when he came to RCC on 29.09.2000 and thus he was registered in Pay Clinic. Ext. D1 is the copy of reference letter dated 21.09.2000 from S.H. Medical Centre. Ext. D2 is the copy of the Patient Registration document. Ext. D3 is the copy of the consent letter executed by the patient opting to register in Pay Clinic under treatment of Dr. V.P. Gangadharan. It is pointed out by the opposite party that all patients registered under the Pay Clinic are bound to make all payments including registration fee, service charges, treatment charges, cost of drugs, investigation etc. and that the opposite party is not empowered to grant exemption to any patient from the purview of the said provision. The said Pay Clinics were evolved as the alternate Forum for patients to consult the doctors whom they desire to see and to stop the private practice of all doctors in RCC. Further submitted by opposite party that the CCL patients are not required to register in the Pay Clinic and that they are having every right to register in the opposite party of RCC producing the CCL Certificate and no registration fee is being realised from them for registration and they will be given the best treatment by the doctors. Such patients covered by CCL Scheme are entitled to all the benefits envisaged under the scheme. It is pertinent to point out that the Ext. D3 consent letter is seen executed by the patient as well as the person accompanied the patient. Complainant did not object the marking of Ext. D3 consent letter nor did cross examine the opposite party to controvert the affidavit of the opposite party, nor did furnish the copy of CCL certificate so as to comprehend the terms and conditions of the certificate. Submission by the opposite party is that the complainant as well as her late husband were aware of the fact they were not entitled to claim any benefit envisaged under CCL Scheme as they opted to register in Pay Clinic of RCC and that is why no claim was lodged by the complainant prior to the serving of Ext. P1 advocate notice to the opposite party. Ext. P2 is the copy of reply notice dated 18.05.2001 issued by the complainant. It has been stated in Ext. P2 that Mr. Kuriakose was registered under CR 111 and since the patient himself insisted to be examined by Dr. V.P. Gangadharan the case was referred to Pay Clinic with the patient's consent and treatment started under medical oncology. In the pay clinic the charges for diagnostic and treatment modalities are 25% more than the ordinary category patients ................ CCL patients are not eligible for reimbursement of such expenses. On going through Exts. D2 and D3 that the patient is a retired Professor and supposed to be in wealthy circumstances and opted for treatment in the Pay Clinic of Dr. V.P. Gangadharan, and such registration forfeits complainant's claim for reimbursement as ordinary patient in the RCC. In view of the above, the plea of the opposite party is to be accepted and the claim is to be rejected. In view of the above, complainant is not entitled to payment of expenses. Deficiency in service on the part of opposite party is not proved. Complaint has no merit at all which deserves to be dismissed. <br /> In the result, complaint is dismissed. No order as to cost. <br /> A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room.<br /> Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the Open Forum, this the day of 30th September 2008.<br /> G. SIVAPRASAD,<br /> President.<br /> <br /> BEENAKUMARI. A : MEMBER<br /> <br /> S.K. SREELA : MEMBER <br /> <br /> <br /> <br /> <br /> O.P.No. 369/2001<br /> APPENDIX<br /> I COMPLAINANT'S WITNESS : <br /> NIL<br /> II COMPLAINANT'S DOCUMENTS :<br /> <br /> P1 - Photocopy of advocate notice dated 30.04.2001.<br /> P2 - Photocopy of reply letter dated 18.05.2001.<br /> P3 - Original of bills totalling to Rs. 48942.24<br /> <br /> III OPPOSITE PARTIES' WITNESS :<br /> NIL <br /> IV OPPOSITE PARTIES' DOCUMENTS :<br /> D1 - Photocopy of letter dated 21.09.2000.<br /> D2 - Photocopy of patient registration document of RCC, Tvpm.<br /> D3 - Photocopy of consent letter dated 23.09.2000.<br /> <br /> <br /> <br /> PRESIDENT<br /> <br /> <br /> <br /> <br /> <br />