This Complaint coming up before us for hearing on 19-12-11 in the presence of Sri P.V. Ramana, advocate for the complainant and opposite party remained absent and set exparte, upon perusing the material on record and having stood over till this day for consideration this Forum made the following:-

O R D E R

Per Sri A. Hazarath Rao,  President:-

The complainant filed this complaint under section 12 of the Consumer Protection Act seeking a direction to the opposite party to submit his medical bills to the Medical and Health Department, Government of AP for reimbursement, Rs.10,000/- towards mental agony, Rs.10,000/- towards compensation, Rs.10,000/- towards legal expenses.

2.   In brief the averments of the complaint are these:

        The complainant retired as a head master in Repalle Municipality long back.    The complainant took treatment in M/s Sai Krishna Super Speciality Neuro Hospital at Kachiguda, Hyderabad for the complaint of UNSCIOUS condition as inpatient on 19-11-10 and 20-11-10 and incurred Rs.28,196/-.   The doctors at M/s Sai Krishna Super Speciality Neuro Hospital advised the complainant to undergo treatment at M/s Care Hospitals, Hyderabad.   The doctors at M/s Care Hospitals, Hyderabad diagnosed that the complainant was suffering with heart ailment.   The complainant underwent surgery for his ailment at M/s Care Hospitals, Hyderabad and pace maker was implanted.   The complainant was treated as inpatient for the said surgery from                20-11-10 to 24-11-10 and incurred Rs.2,26,246/-.  In all the complainant paid Rs.2,54,442/- to the above hospitals.   In view of         G.O. Ms.No.74,  dated 09-04-07 of Health, Medical and Family Welfare (K-1) Department the complainant is entitled for medical reimbursement. The above hospitals were included in the panel recognized by Government of Andhra Pradesh.    The complainant on 07-02-01 submitted his medical bills along with necessary certificates to the opposite party.  The opposite party failed to respond positively and even to give reply.  Due to non payment of reimbursement of medical bills the complainant suffered mentally, physically and financially.  The conduct of opposite party amounted to deficiency of service.     

3.   Sri Umamaheswara Rao, Junior Assistant of opposite party on          18-10-11 appeared before this Forum and requested time to file version.   As the opposite party failed to file its version though sufficient time was granted it was set exparte.

4.   Exs.A-1 to A-16 were marked on behalf of the complainant. 

5.  Now the points that arose for consideration in this complaint are:

1. Whether the complainant is a consumer within the purview    of Consumer Protection Act?

        2.  Whether the opposite party committed deficiency of service?

        3. Whether the complainant is entitled to compensation?

        4. To what relief?

6.  POINT No.1:-   In South Western Railway, Keshawapur, Hubli vs D.J. Manuel 2011 (3) CPJ 22 (NC) it was held

          “7. Reverting to the issue raised by the petitioner in this revision petition, so far as the question of the present dispute being covered by the Consumer Protection Act, 1986 is concerned, it is well-settled by now that service in question even though freely provided by the opposite party Authority to its employees including retired employees would be service within the definition of Section 2(1) (o) of the C.P.Act.   Following its earlier decision in the case of Indian Medical Association vs. V.P. Shantha, III (1995) CPJ 1 (SC) = I (1996) CLT 81 (SC)=(1995) 6 SCC 651, the Hon’ble Supreme Court has reiterated same in the case of Laxman Thamappa Kotgiri vs. G.M., Central Railway, III (2006) CPJ 6 (SC)=I (2005) SLT 387 = (2007) 4 SCC 596, and held as under:

          “B. Consumer Protection – Services –Service rendered “free of charge” – Meaning of – Held, any service which is rendered as part of the terms of service of an employee and the employer bears the expenses, is not a service rendered “free of charge” and falls within definition of “service” in section 2(1) (o) – Thus medical services provided by a hospital run and funded by the employer as a part of the terms of service of employees, are not rendered “free of charge” and fall within the definition of service in Section 2(1)(o) – Consumer Protection Act, 1986, Section 2(1)(o)”.

          8.  Applying the aforesaid ratio to the present case, we have no doubt in our mind that the For a below were absolutely right in categorizing the present dispute between the complainant and the opposite party Authority as a consumer dispute and hence falling within the ambit of definition of service as envisaged under the Consumer Protection Act”. 

In Jagdish Kumar Bajpai vs. Union Bank of India 2005 (V) CPJ 197 (NC) it was held

          “It is also to be stated that under the law, consideration can be in cash or kind.  The definition of the word ‘consumer’ under section 2(1)(d)(ii) provides that a person would, inter alia, be a consumer if he hires or avails of the services for consideration paid (paid in past or agreed to be paid in future including deferred payment).   In consideration of service rendered to the Government till the age of superannuation, if right is conferred upon an employee to get pension as well as other benefits including medical treatment prescribed by various rules or the schemes framed by the Government, it cannot be held that it is a free service.  Such employee would be a consumer as defined in Section 2(1)(d)(ii) of the Consumer Protection Act.  Service rendered by the Government employees before retirement would be ‘consideration’ for providing medical facilities to him or his family members”.   

        Taking a clue from the above decisions, we are of the opinion that the complainant is a consumer within the purview of Consumer Protection Act. Hence we answer this point in favour of the complainant.

7.  POINTS 2 & 3:- The opposite party received copy/original of      Ex.A-1 application on 07-02-11 as seen from the seal of the office of the opposite party.   In the 1^st instance the complainant filed this complaint seeking a direction to the opposite party for reimbursement of Rs.2,84,442/-.   The prayer was subsequently altered seeking a direction to the opposite party to forward his medical bills to the concerned authority.   But the prayer portion in the affidavit filed on 13-12-11 reads as follows:

                “I therefore prays that the Hon’ble Dist. Forum may be pleased to pass an award of Rs.2,84,442/- in my favour and against the opposite party, with interest @12% p.a., from the date of complaint, till the date of realisation to meet the ends of justice”. 

8.     The opposite party has to process the medical bills to the concerned authority but it cannot pay the amount unless sanctioned by the competent authority.   In Ex.A-1 requisition the complainant mentioned the following:

“I request earnestly to re-imburse the total amount Rs.2,54,442-16ps (Two lakh fifty four thousand four hundred and forty two paise sixteen only) and oblise”.

9.     The opposite party as required by the complainant in Ex.A-1 cannot reimburse the amount unless sanctioned by the competent authority.   Instead of keeping quite the opposite party ought to have process the papers submitted by the complainant to the competent authority which it failed to do so.   That is not the case of the complainant as seen from the averments of complaint.   Under those circumstances it cannot be said that the opposite party committed deficiency of service and as such the complainant is not entitled to any compensation.   We therefore answer these points against the complainant.

10.  POINT No.4:-    In view of above findings disposing off this complaint with a direction to the opposite party to forward the papers to the competent authority for sanctioning reimbursement will meet ends of justice. 

        In the result the complaint is disposed off

1. Directing the opposite party to forward the papers submitted to it by the complainant under Ex.A-1 to the competent authority within four weeks from the date of receipt of the order.
2. There is no order as to costs. 

Typed to my dictation by Junior Stenographer, corrected by us and pronounced in the open Forum dated this the 20^th day of December, 2011.

MEMBER                                  MEMBER                           PRESIDENT

APPENDIX OF EVIDENCE

DOCUMENTS MARKED

For Complainant:

For opposite party :   NIL

                                                                                                PRESIDENT