Section 21 in Employees' State Insurance (Punjab Medical Benefit) Rules, 1953
21. Investigations by Medical Service Committee.
(1)Any question arising between an insurance Medical practitioner and a person who is or has been, or who claims to be or to have been, entitled to obtain treatment from that practitioner or between the representative of any such person, if deceased, and the Insurance Medical Practitioner in respect of the treatment rendered by the Insurance Medical practitioner or any alleged failure to render treatment or other breach by the Insurance Medical Practitioner of his duties under the terms of service or in respect of the conduct of the person while receiving treatment, shall be investigated by the Medical Service Committee.The person desiring to raise any question under this rule shall within twelve weeks after the event which gave rise to the question give written notice to the Secretary of the Committee stating the substance of the matter which it is desired to have investigated; provided that notwithstanding failure to give notice within the said period the Committee may investigate the matter if they are satisfied that such failure was occasioned by illness or other reasonable cause and the Insurance Medical practitioner consents to the investigation taking place.For the purpose of this rule the representative of a deceased person shall include a member of the deceased person's family or any person who satisfies the Medical Service Committee that he is acting on behalf of the deceased person's family.[he should not be a paid Counsel, Solicitor or Advocate.] [Added by Punjab Government Notification No. 6-S-LP-55/7429, dated 14.2.1955.](2)the Director health Services, Punjab may, and if the Medical Committee so desires shall, refer for investigation by the Medical Service Committee any matter relating to the administration of medical benefit or to the discharge by any insurance Medical practitioner of his duties under the terms of service whether such matter has been raised by or on behalf of an insured person under the preceding paragraph of this rule or not, and the Medical Service Committee shall investigate it accordingly :Provided that no question which involves an allegation against an Insurance Medical Practitioner of a breach of the terms of service shall without the approval of the State Government be referred for investigation under this paragraph except within a period of three months after the occurrence of the event on which such allegation is based.
