State Consumer Disputes Redressal Commission
Shila vs Lic on 8 January, 2010
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thou chek fuxe] Hkjfr;k vLirky ds lkeus] pw: tfj;s 'kk[kk izcU/kdA 3- Hkkjrh;
thou chek fuxe] iksnkj xsLV gkml ds ikl] jrux< ftyk&pw: tfj;s 'kk[kk izcU/kdA jsLiksMsaVl&foi{khx.k fnukad%8@1@2010 le{k ekuuh;
U;k;kf/kifr Jh lquhy dqekj xxZ] v/;{k ekuuh;k Jherh foeyk lsfB;k] lnL;k mifLFkr%& vihykaV& ifjokfn;k dh vksj ls Jh vlxj [kku] vf/koDrkA jsLiksMsaVl&L.I.C. dh vksj ls Jh v'kksd prqosZnh] vf/koDrkA jkT;
vk;ksx }kjk%& 1- fo}ku odhy i{kdkjku dh cgl xzg.kkFkZ LVst ij lquh xbZA 2- ;g vihy vihykaV tks fd ewy ifjokn esa ifjokfn;k Fkh] us ftyk eap] pw: ds vkns'k fnukad 16-2-2008 tks mUgksaus ifjokn la[;k 5@2007 esa fuEu :i esa vihykaV&ifjokfn;k ds fo:) vkns'k ikfjr fd;k%& ^^izkFkhZ;k dk ifjokn vizkFkhZx.k ds fo:) vLohdkj fd;k tkrk gSA i{kdkjku viuk&viuk [kpkZ ogu djsaxsA ** ds fo:) is'k dh gSaA 3- ;g bu ifjfLFkfr;ksa esa lkeus vk;k gS fd vihykaV&ifjokfn;k us ,d ifjokn jsLiksMsaVl&L.I.C. ds fo:) ftyk eap] pw: esa fnukad 24-5-2007 dks ;g dgdj is'k fd;k fd vihykaV&ifjokfn;k ds Lo-ifr Jh galdqekj tk[kM ftldks Hkfo"; esa e`rd ds uke ls lEcksf/kr fd;k tk;sxk] us vius thoudky esa ,d Policy jsLiksMsaVl&L.I.C. ls fnukad 31-5-2005 dks 100]000@&:i;s dh yh Fkh ftldk uEcj 501623582 Fkk mudk ;g Hkh dguk gS fd fnukad 31-1-22006 dks e`rd dh e`R;q gks xbZ vkSj fQj vihykaV&ifjokfn;k us crkSj iRuh ,oa ukWfeuh viuk Dyse jsLiksMsaVl&L.I.C. ds ;gkaW is'k fd;k] ftls jsLiksMsaVl&L.I.C. us vius jsiwfM;s'ku i=k fnukafdr 31-3-2007 ds }kjk ;g dgdj jn~n dj fn;k fd%& ^^e`rd us fnukad 30-5-2005 dks vius LokLF; ijh{k.k ds le; ;g dgk Fkk fd mlds dksbZ chekjh ugha gS uk gh mlus fdlh vLirky esa HkrhZ jgdj viuk bZykt djok;k gS ysfdu jsLiksMsaVl&L.I.C. ds ikl bl ckr ds iq[rk lcwr gS fd mijksDr ikWfylh esa chek/kkjh izLrko frfFk ds iwoZ ls gh 'kjkc dkvR;f/kd lsou djrk Fkk rFkk vknru 'kjkch Fkk ysfdu e`rd us bu rF;ksa dks chek djkrs le; izdV ugha fd;k mlds LFkku ij vlR; mRrj fn;sA ** mlds ckn ifjokn i=k is'k fd;k x;kA 4- jsLiksMsaVl&L.I.C. us viuk tokc fnukad 29-10-2007 dks is'k dj eq[; :i ls ogh Pleas yh tks vius jsiwfM;s'ku i=k fnukafdr 31-3-2007 esa yh FkhA blds vykok mudk ;g Hkh dguk gS fd e`rd lQnjtax vLirky] ubZ fnYyh esa fnukad 30-1-2006 dks HkrhZ gqvk Fkk vkSj nkSjkus bZykt fnukad 31-1-2006 dks e`rd dh e`R;q gks xbZ Fkh vkSj mDr vLirky ds Bed Head Ticket fnukad 30-1-2006 esa ;g fy[kk gqvk gS fd e`rd Chronic Alcholic Fkk tcfd e`rd }kjk viu sLokLF; ijh{k.k dh fnukad 30-5-2005 dks mDr rF; dks Nqik;k x;k Fkk blfy;s ;g ekeyk chekjh Nqikus dk gSA blfy;s jsLiksMsaVl&L.I.C. }kjk viusa jsiwfM;s'ku i=k fnukafdr 31-3-2007 ds }kjk tks Dyse vihykaV&ifjokfn;k dk jn~n fd;k x;k Fkk] og lgh jn~n fd;k x;k FkkA ifjokn [kkfjt fd;s tkus dk fuosnu fd;kA 5- ftyk eap] pw: us vius vkns'k fnukad 16-2-2008 ds }kjk vihykaV&ifjokfn;k dk ifjokn ;g ekurs gq, [kkfjt dj fn;k fd%& 1- i=kkoyh ds voyksdu ls ;g rF; Li"V gks tkrk gS fd chfer chek djrs le; 'kjkc ihus dk vkfn Fkk og bl rF; dks tkurk Fkk rFkk tkucw>dj bu rF;ksa dks fNikrs gq, mlds }kjk chek izLrko fd;k x;k 2- chek izLrko ds 8 ekg dh vof/k esa gh mldh e`R;q gks xbZ Fkh vkSj vf/kd 'kjkc dk lsou gh mldh e`R;q dk dkj.k jgk gSA bl izdkj ikWfylh NyiwoZd ysuk ekuh tk;sxhA 6- mDr vkns'k fnukad 16-2-2008 ls vlarq"V gksdj vihykaV~&ifjokfn;k dh vksj ls ;g vihy is'k dh xbZ gSA 7- nkSjkus cgl fo}ku odhy vihykaV~&ifjokfn;k dk eq[; eqn~nk ;g jgk gS fd ftyk eap dh QkbZfMax xyr gS D;ksafd jsLiksMsaVl&L.I.C. }kjk ,sls dksbZ nLrkost izLrqr ugha fd;s x;s gS ftlls ;g lkfcr gks fd e`rd us LokLF; ijh{k.k dh fnukad 30-5-2005 ls iwoZ fdlh vLirky esa jgdj viuh fdlh chekjh dk bZykt djok;k gks vkSj uk gh jsLiksMsaVl&L.I.C. bl ckr dks lkfcr djus esa lQy jgs gS fd e`rd dh e`R;q 'kjkc ds lsou ds dkj.k gh gqbZ gks blfy;s ftyk eap ds vkns'k fnukad 16-2-2008 dks vikLr fd;k tkdj vihykaV&ifjokfn;k dh vihy Lohdkj fd;s tkus dk fuosnu fd;kA 8- blds foifjr fo}ku vf/koDrk jsLiksMsaVl&L.I.C. us ftyk eap ds vkns'k fnukad 16-2-2008 dks lgh crk;k vkSj vihykaV&ifjokfn;k dh vihy [kkfjt fd;s tkus dk fuosnu fd;kA 9- bl lUnHkZ esa fopkj fd;k x;kA 1- bl dsl esa blesa fookn ugha gS fd e`rd us fnukad 31-1-06 dks ,d Policy rknknh 100]000@&:i;s dh vihykaVl&L.I.C. ls yh Fkh A 2- bl dsl esa blesa Hkh dksbZ fookn ugha gS fd fnukad 30-5-2005 dks vius LokLF; ijh{k.k ds le; e`rd us dgk Fkk fd mlds dksbZ chekjh ugha gS uk gh mlus fdlh chekjh dk dksbZ bZykt fdlh vLirky esa HkrhZ jgdj djok;k gSA 3- bl dsl esa blesa Hkh fookn ugha gS fd e`rd dh e`R;q mDr ikWfylh ysus dh fnukad 31-5-2005 ds yxHkx 8 eghus ckn gh fnukad 31-1-2006 dks gks xbZ FkhA 4- blesa Hkh dksbZ fookn ugha gS fd vihykaV&ifjokfn;k dk Dyse jsLiksMsaVl&L.I.C. us vius jsiwfM;s'ku i=k fnukafdr 31-3-2007 esa of.kZr dkj.kksa ds vk/kkj ij jn~n dj fn;k FkkA 5- i=kkoyh esa layXu fjdkMZ ds vuqlkj e`rd lQnjtax vLirky] ubZ fnYyh esa fnukad 30-1-2006 dks HkrhZ gqvk Fkk vkSj nkSjkus bZykt fnukad 31-1-2006 dks e`rd dh e`R;q gks xbZ Fkh vkSj mDr vLirky ds Bed Head Ticket esa ;g fy[kk gqvk gS fd e`rd Cronic Alcoholic Fkk A 6- i=kkoyh esa layXu fjdkMZ ds vuqlkj e`rd us LokLF; ijh{k.k dh fnukad 30-5-2005 ls iwoZ fnukad 9-5-2005 ls 7-6-2005 rd dh vof/k ds fy;s Domestic vk/kkj ij vius dk;ZLFky ls vodk'k fy;k Fkk A 7- bl dsl esa blesa dksbZ fookn ugha gS fd jsLiksMsaVl&L.I.C. dh vksj ls e`rd ds LokLF; ijh{k.k dh fnukad 30-5-05 ls iwoZ dk e`rd ds fdlh vLirky esa HkrhZ gksus vkSj viuh fdlh chekjh dk bZykt djokus dk dksbZ lcwr is'k ugha fd;k x;k gSA 8- bl dsl esa blesa dksbZ fookn ugha gS fd lQnjtax vLirky] ubZ fnYyh ds Bed Head Ticket fnukad 30-1-2006 esa e`rd ds Enuresis dh chekjh fy[kh gqbZ gSA 10- vc iz'u ;g gS fd mijksDr ifjfLFkfr;ksa esa D;k ftyk eap dh QkbZfMax fnukafdr 16-2-2008 lgh gS ;k ugha ;k jsLiksMsaVl&L.I.C. }kjk vius jsiwfM;s'ku i=k fnukafdr 31-3-2007 ds }kjk vihykaV&ifjokfn;k dk tks Dyse jn~n fd;k x;k Fkk oks lgh gS ;k ughaA 11- gekjh jk; esa tgka rd lQnjtax vLirky] ubZ fnYyh ds Bed Head Ticket fnukad 30-1-2006 esa ;g fy[kk gksuk fd e`rd Chronic Alcholic Fkk] dk lEcU/k gS bl lEcU/k esa gekjh jk; gS fd ek=k Bed Head Ticket fnukad 30-1-2006 ds vk/kkj ij ;g ugha dgk tk ldrk gS fd e`rd 'kjkc ihus dk vkfn Fkk vkSj 'kjkc ihus ds dkj.k gh e`rd dh e`R;q gqbZ Fkh vkSj mDr Bed Head Ticket fnukad 30-1-2006 ij rc rd fo'okl ugha fd;k tk ldrk gS tc rd fd mDr Bed Head Ticket fnukad 30-1-2006 dks fy[kus okys MkaDVj dk 'kiFk&i=k is'k ugha fd;k tkrk gSA blds vykok ;gka ;g Hkh dguk mfpr gksxk fd jsLiksMsaVl&L.I.C. dh vksj ls e`rd ds LokLF; ijh{k.k dh fnukad 30-5-2005 ls iwoZ dk e`rd ds fdlh vLirky esa HkrhZ gksus vkSj viuh fdlh chekjh dk bZykt djokus ds lEcU/k esa dksbZ nLrkost izLrqr ugha fd;s x;s gS vkSj tks mDr nLrkost Bed Head Ticket fnukad 30-1-2006 is'k fd;k x;k gS og LokLF; ijh{k.k dh fnukad 30-5-2005 ds ckn dk gSA blds vykok ;gka ;g Hkh dguk mfpr gksxk fd bl vk;ksx }kjk vius fu.kZ; fnukad 27-3-2008 Smt. Indermani Gautam Vs. LIC esa ekuuh; jk"Vªh; vk;ksx] ubZ fnYyh ds fu.kZ; LIC Vs. Dr. P.S. Agarwal reported in NCJ 2205 181 (NC) ij fo'okl djrs gq, ;g fl)kUr izfrikfnr fd;k Fkk fd%& "It may be stated here that the past history recordedin the bed head ticket of the hospital could not be trated as primary piece of evidence to prove any fact unless and until the doctorwho had recorded that history had been produced and primary evidence would be of the doctor who had recorded the information in the bed head ticke . "
blfy;s ,slh fLFkfr esa mDr Bed Head Ticket fnukad 30-1-2006 ij fo'okl fd;k tkuk mfpr ugha gSA 12- blds vykok tgka rd lQnjtax vLirky] ubZ fnYyh ds Bed Head Ticket fnukad 30-1-2006 esa e`rd ds Enuresis dh chekjh ls ihfMr gksus dk mYys[k fd;s tkus dk lEcU/k gS bl lEcU/k esa gekjh jk; gS fd Enuresis chekjh dk vFkZ ;g gksrk gS%& ^^Enuresis:Urinary incomtinence during thenight. Involuntary discharge of urineafter the age at which bladder control should have beeb established."
;kfu Enuresis chekjh dk lEcU/k yhoj ls ugha gksrk gS cfYd ;s chekjh fdMuh ls lEcfU/kr gS blfy;s jsLiksMsaVl&L.I.C. dk ;g dguk fd 'kjkc vR;f/kd ek=kk esa ihus ds dkj.k gh e`rd dks yhoj dh mDr chekjh Enuresis gks xbZ Fkh ] xyr lkfcr gks tkrk gSA 13- blds vykok ;gka ;g Hkh dguk mfpr gksxk fd ;fn e`rd FkksMh cgqr 'kjkc ihrk Hkh Fkk vkSj mDr 'kjkc ihus ds rF; dks e`rd }kjk vius LokLF; ijh{k.k dh fnukad 30-5-2005 dks ugha crk;k x;k rks FkksMh cgqr 'kjkc ihus vkSj bl rF; dks vius LokLF; ijh{k.k dh fnukad 30-5-2005 dks ugha crkus ds vk/kkj ij ;g ugha dgk tk ldrk fd e`rd us fdlh egRoiw.kZ rF; ;k chekjh dks tkucw>dj Nqikdj ikWfylh izkIr dh FkhA 14- tgka rd e`rd }kjk LokLF; ijh{k.k dh fnukad 30-5-2005 ls iwoZ fnukad 9-5-2005 ls 7-6-2005 rd dh vof/k ds fy;s vius dk;ZLFky ls vodk'k ysus dk lEcU/k gS bl lEcU/k esa gekjh jk; gS fd mDr vodk'k e`rd }kjk Domestic vk/kkj ij fy;s x;s gS blfy;s ;g dguk fd e`rd us viuh chekjh ds bZykt ds fy;s mDr vodk'k fy;s Fks] mfpr ugha gSA 15- blds vykok ;gka ;g Hkh dguk mfpr gksxk fd e`rd dh e`R;q 'kjkc dk vR;f/kd lsou djus ds dkj.k yhoj dh chekjh ds dkj.k gh gqbZ gks ;g Hkh jsLiksMsaVl&L.I.C. lkfcr djus esa vlQy jgs gSA 16- QyLo:i bl dsl esa ;g r; fd;k tkrk gS fd jsLiksMsaVl&L.I.C. bl rF; dks lkfcr djus esa vlQy jgs gS fd e`rd us tkucw>dj viuh chekjh ds rF;ksa dks tkucw>dj Nqikdj ikWfylh izkIr dh Fkh vkSj e`rd dh e`R;q 'kjkc dk vR;f/kd lsou djus ds dkj.k gh gqbZ Fkh blfy;s ftyk eap] pwa:
dh QkbZfMax fnukad 16-2-2008 dkfcys iqf"V ugha gS D;ksafd og rF;ksa ij vk/kkfjr ugha gS rFkk jsLiksMsaVl&L.I.C. }kjk vius jsiwfM;s'ku i=k fnukafdr 31-3-2007 ds }kjk vihykaV&ifjokfn;k dk jn~n fd;k x;k Dyse xyr Fkk vkSj vihykaV&ifjokfn;k dh vihy Lohdkj fd;s tkus ;ksX; gSA mijksDr dkj.kksa ds dkj.k vihykaV&ifjokfn;k dh ;g vihy xzg.kkFkZ LVst ij gh Lohdkj dh tkrh gS rFkk ftyk eap] pwa: ds fookfnr vkns'k fnukad 16-2-2008 dks vikLr fd;k tkrk gS ,oa vihykaV&ifjokfn;k dk ifjokn Lohdkj fd;k tkrk gS rFkk jsLiksMsaVl&L.I.C. dks funsZ'k fn;k tkrk gS fd jsLiksMsaVl&L.I.C.] vihykaV&ifjokfn;k dks chek Dyse dh jkf'k 100]000@&:i;s ¼v{kjs ,d yk[k :i;s½ e; ifjokn is'k djus dh fnukad 24-5-2007 ls rkvnk;xh rd 9 izfr'kr okf"kZd dh nj ls C;kt lfgr Hkqxrku djs] blds vykok jsLiksMsaVl&L.I.C.] vihykaV&ifjokfn;k dks Cost of Litigation ds Hkh 3000@&:i;s ¼v{kjs rhu gtkj :i;s½ vnk djsA ¼Jherh foeyk lsfB;k½ ¼U;k;kf/kifr Jh lquhy dqekj xxZ½ lnL;k v/;{k lat;