State Consumer Disputes Redressal Commission
Smt. Anita Arora vs Manager, Apollo B.S.R Hospital & Ors. on 28 December, 2022
Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
NRrhlx<+ jkT;
miHkksDrk fookn Áfrrks"k vk;ksx] iaMjh] jk;iqj lafLFkr fnukad&01-10-2021 vafre rdZ fnukad&20-12-2022 vkns'k fnukad& 28@12@2022- vihy Øekad%&FA/2021/123 Jherh vfurk vjksjk ifr Lo- Jh "kjn vjksjk] mez djhc&47 o'kZ] fuoklh&e- ua-&,y- vkbZ- th-&255] in~eukHkiqj] nqxZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼}kjk Jherh izrh{kk flag] vf/koDrk okLrs vihykfFkZuh½
---------------------- vihykfFkZuh@ifjokfnuh-
fo:)
1- izca/kd] viksyks ch- ,l- vkj- gkWfLiVy]
Le`fr uxj] tquokuh] fHkykbZ]
Rkglhy o ftyk&nqxZ ¼N-x-½
¼,di{kh;½
------------mRrjoknh dzz-&1@fo:} i{kdkj dz-&1-
2- MkW- vkj- t;jke v;~;j]
g`n; jksx fo"ks'kK]
viksyks ch- ,l- vkj- gkWfLiVy]
Le`fr uxj] tquokuh] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼,di{kh;½
------------mRrjoknh dzz-&2@fo:} i{kdkj dz-&2-
3- MkW- fnyhi jRukuh]
g`n; jksx fo"ks'kK]
fuoklh&,&2@392] lw;kZ fogkj dkWyksuh]
Le`fr uxj] tquokuh] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼,di{kh;½
------------mRrjoknh dzz-&3@fo:} i{kdkj dz-&3- 4- ;qukbZVsM bafM;k ba";ksjsal daiuh fyfeVsM] vkWfQl uacj&7] th- ,Q&150 ch- ch- lh- dkEiysDl] fdyksdjh fjax jksM] egkjkuh ckx ds ikl ubZ fnYyh] LFkkuh; dk;kZy;&rkjk dkEiysDl] ikWoj gkÅl] Tkh- bZ- jksM] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼}kjk Jh ih- ds- ikWy] vf/koDrk okLrs mRrjoknh dzekad&4½
------------mRrjoknh dzz-&4@fo:} i{kdkj dz-&4-
-
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 1 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors. lafLFkr fnukad&18-10-2021 vafre rdZ fnukad&20-12-2022 vkns'k fnukad& 28@12@2022- vihy Øekad%&FA/2021/130 ;qukbZVsM bafM;k ba";ksjsal daiuh fyfeVsM]
vkWfQl uacj&7] th- ,Q&150 ch- ch- lh- dkEiysDl] fdyksdjh fjax jksM] egkjkuh ckx ds ikl] ubZ fnYyh] irk&rkjk dkEiysDl] ikWoj gkÅl] Tkh- bZ- jksM] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ }kjk&ofj'B eaMy izca/kd] e.My dk;kZy; dzekad&01] d`'.kk dkEiysDl] iksLV] rglhy o ftyk&jk;iqj ¼N-x-½ ¼}kjk Jh ih- ds- ikWy] vf/koDrk okLrs vihykFkhZ½
------------ vihykFkhZ@fo:} i{kdkj dz-&4-
fo:)
1- Jherh vfurk vjksjk ifr Lo- Jh "kjn vjksjk]
mez&54 o'kZ] fuoklh&e- ua-&,y-vkbZ-th-&255] in~eukHkiqj] nqxZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼}kjk Jherh izrh{kk flag] vf/koDrk okLrs mRrjokfnuh dzekad&1½
------------------- mRrjokfnuh dz-&1@ifjokfnuh-
2- izca/kd] viksyks ch- ,l- vkj- gkWfLiVy] Le`fr uxj] tquokuh] fHkykbZ] Rkglhy o ftyk&nqxZ ¼N-x-½ ¼,di{kh;½
------------mRrjoknh dzz-&1@fo:} i{kdkj dz-&1-
3- MkW- vkj- t;jke v;~;j] g`n; jksx fo"ks'kK] viksyks ch- ,l- vkj- gkWfLiVy] Le`fr uxj] tquokuh] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼,di{kh;½
------------mRrjoknh dzz-&2@fo:} i{kdkj dz-&2-
4- MkW- fnyhi jRukuh] g`n; jksx fo"ks'kK] fuoklh&,&2@392] lw;kZ fogkj dkWyksuh] Le`fr uxj] tquokuh] fHkykbZ] rglhy o ftyk&nqxZ ¼N-x-½ ¼,di{kh;½
------------mRrjoknh dzz-&3@fo:} i{kdkj dz-&3- le{k% ekuuh; U;k;ewfrZ Jh xkSre pkSjfM+;k] v/;{k-
ekuuh;k Jherh :fp xks;y] lnL;-
ekuuh; Jh xksiky panz "khy] lnL;-
ekuuh; Jh izeksn dqekj oekZ] lnL;-
vafre rdZ esa mifLFkr& ifjokfnuh dh vksj ls Jherh izrh{kk flag] vf/koDrkA fo:} i{kdkj dzekad&1 ls 3 ,di{kh;A fo:} i{kdkj dzekad&4 dh vksj ls Jh ih- ds- ikWy] vf/koDrkA Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 2 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
vkns'k ¼ }kjk& Jherh :fp xks;y] lnL; ½ vihy dzeakd&,Q,@2021@123 ifjokfnuh Jherh vfurk vjksjk ,oa vihy dzekad&,Q,@2021@130 fo:} i{kdkj dzekad&4 ;qukbZVsM bafM;k ba";ksjsal daiuh fyfeVsM us /kkjk&41 miHkksDrk laj{k.k vf/kfu;e] 2019 ds varxZr ftyk miHkksDrk fookn izfrrks"k vk;ksx] nqxZ ¼N-x½ ¼ftls vkxs laf{kIr esa **lacfa /kr ftyk vk;ksx** lacksf/kr fd;k tk,xk½ ds ifjokn izdj.k dzekad&lhlh@2014@35 esa ikfjr ,d gh vkns"k fnukad&04-09-2021 ftlds }kjk ifjokfnuh ds ifjokn dks vkaf"kd :i ls Lohdkj fd;k x;k gS] lss {kqC/k gksdj izLrqr fd, gSA lqfo/kk dh n`f"V ls i{kdkjksa dks mudh ekSfyd izkfLFkfr ls lacksf/kr fd;k tk,xkA 02- ifjokfnuh dk ifjokn ftyk Qksje ds le{k la{ksi esa bl izdkj jgk gS fd ifjokfnuh ds ifr Lo- 'kjn vjksjk N-x- fo|qr e.My esa dk;Zjr FksA fnukad&13-11-2011 dks izkr% 3 cts Lo- 'kjn vjksjk dh Nkrh esa gYdk nnZ eglwl gqvk rc ifjokfnuh vius ifr dks lqcg 6&7 cts yxHkx fo:} i{kdkj Øekad&1 ds vLirky esa ys xbZ Fkh tgka MkW- vks- ih- frokjh }kjk ifjokfnuh ds ifr dk ijh{k.k dj nokbZ vkSj batsD'ku fn;k x;kA fo:} i{kdkj Øekad&3 MkW fnyhi jRukuh 'kgj ls ckgj jgus ds dkj.k fo:} Øekad&2 dks vLirky cqyk;k x;k FkkA MkW- frokjh }kjk ifjokfnuh ds ifr dk ijh{k.k dj tkudkjh nh xbZ fd gkVZ vVSd tSlk y{k.k izrhr gks jgk gS ftldk mipkj nokbZ;ksa vFkok ,u- th- vks- IykLVh ds ek/;e ls fd;k tk ldrk gS vkSj nokbZ;ksa dk ykHk gksus dh laHkkouk de gSA bl ij ifjokfnuh ,oa mlds tsB tks Loa; g`n; jksx fo'ks"kK gSa] ds }kjk fo:} i{kdkj Øekad&2 dks dgk x;k fd ejht ds thou ds fy, tks vPNk gS os djsa rc fo:} i{kdkj Øekad&2 }kjk ,u- th- vks- IykLVh djus dk fu.kZ; fy;k x;kA ifjokfnuh ds ifr dks fnukad&13-11-
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 3 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
2011 dks lqcg 11 cts ,u- th- vks- IykLVh ds fy, ys tk;k x;k tgka ,u- th- vks- IykLVh dh izfØ;k dh tkap ds nkSjku irk pyk fd g`n; esa jDr igqpkusa okyh /keuh iw.kZr% can gS rc fo:} i{kdkj Øekad&2 ds }kjk /keuh dks [kksyus dk iz;kl fd;k x;k fdarq yxHkx 1 ?k.Vk 15 feuV dksf'k'k djus ds ckn fo:} i{kdkj Øekad&2 /keuh [kksyus esa vlQy jgkA blh nkSjku fo:} i{kdkj Øekad&3 MkW- fnyhi jRukuh ogka ij vk x, rc fo:} i{kdkj Øekad&2 dsl chp esa NksM+dj fo:} i{kdkj Øekad&3 dks lkSaidj pys x,A fo:} i{kdkj Øekad&3 }kjk Hkh /keuh [kksyus dk iz;kl fd;k x;k fdUrq izfØ;k ds nkSjku gh ifjokfnuh ds ifr dh e`R;q gks xbZA ifjokfnuh ds ifr ,u- th- vks- IykLVh izfØ;k ds igys lkekU; voLFkk esa Fks vkSj mUgsa gkVZ vVSd ds ejht ds leku ?kcjkgV] cspSuh ,oa ilhuk ugha vk jgk Fkk rFkk mudk CyM izs'kj Hkh ,dne lkekU; Fkk rFkk nnZ nk;sa rjQ dh ilyh esa dkQh uhps dh rjQ gks jgk Fkk vkSj iSny pydj gh dStqvYVh rd x, Fks rFkk ,slh fLFkfr esa gkVZ vVSd gksuk laHko ugha FkkA ,u- th- vks- IykLVh djus ds iwoZ lko/kkuh cjrrs gSa og lko/kkuh ugha cjrk x;k vkSj fo:} i{kdkj Øekad&2 ,u- th- vks- IykLVh djus esa foQy jgk vkSj bl izdkj fo:} i{kdkj Øekad&2 ,oa 3 }kjk fpfdRlh; mis{kk cjrk x;k ftlds ifj.kkeLo:Ik ifjokfnuh ds ifr dh e`R;q gqbZ FkhA ifjokfnuh }kjk vius vf/koDrk ds ek/;e ls fo:} i{kdkjx.k dks fnukad&06-01-2014 dks uksfVl izsf"kr dj {kfriwfrZ dh ekax dh xbZ] fdUrq fo:} i{kdkjx.k }kjk {kfriwfrZ jkf'k dk Hkqxrku ugha fd;k x;k ftlds dkj.k ifjokfnuh dks ;g ifjokn ykus dh vko';drk iM+h gSA vr% ifjokfnuh dks ifjokn&i= esa of.kZr vuqlkj vuqrks"k iznku dh tkos A 03- fo:} i{kdkj dzekad&1 ls 3 dh vksj ls lacaf/kr ftyk vk;ksx ds le{k fyf[kr dFku izLrqr dj ;g vfHkopu fd;k x;k gS fd nokbZ;ksa ,oa vkWijs'ku Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 4 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors. djus ij gkbZ fjLd dsl esa ykHk gksrk gS] dsoy nokbZ;ksa ls ykHk ugha gksxkA vkWijs'ku djus ij gkbZ fjLd ij ykHk gksrk gS rFkk MkW t;jke v;~;j ds fizfLØI'ku ls Li"V gS fd ejht dks fujarj izd`fr dk Nkrh esa nnZ FkkA fiNys 2&3 o"kksZa esa 2&3 ckj Nkrh esa nnZ mB pqdk Fkk] rackdw dk lsou djrk Fkk ,oa og 10 o"kksZa ls e/kqesg dk jksxh Fkk vkSj ejht dh gkyr ns[kdj gkbZ fjLd dk izdj.k gS vkSj ftls e`rd ds HkkbZ MkW th- ds- vjksjk dks voxr djk;k x;k Fkk vkSj e`rd vuqoknd ,oa ifjokfnuh us lgefr QkeZ esa nLr[kr fd;k Fkk vkSj vkWijs'ku ds fy, lgefr iznku fd;k FkkA MkW- jRukuh ds }kjk CyM DykV dks gVkdj ejht ds HkkbZ dks fn[kk;k Fkk blds i'pkr~ iqu% [kwu esa FkDdk cu jgk gS] mls Hkh ejht ds HkkbZ dks fn[kk;k x;k vkSj ,u- th- vks- IykLVh dh xbZA ,u- th- vks- IykLVh ds iwoZ ejht ds [kwu esa 'kdZjk dh ek=k 303 Fkh ,oa iYl jsV 140 FkkA ejht dh bZ- lh- th- Hkh fudkyh xbZ ftlesa 12 fyM esa ls 8 fyM jhfMax ls g`n; esa xaHkhj leL;k nf'kZr dj jgk Fkk rFkk ejht dh fLFkfr uktqd FkhA uktqd fLFkfr esa vafre fodYi ds :i esa izk;ejh ,u-th-vks- IykLVh lko/kkuh iwoZd fd;k x;k] fdarq CyM DykfVax@[kwu dk FkDdk fujarj curk tk jgk Fkk bl dkj.k ls /keuh lkQ ugha gks ik;h] urhtk e`rd 'kjn vjksjk dh nqHkkZX;tud e`R;q gks xbZ gSA fo:} i{kdkjx.k }kjk fdlh izdkj dh dksbZ fpfdRlh; mis{kk ugha cjrk x;k gS rFkk fu;ekuqlkj ,u- th- vks IykLVh djus ds i'pkr~ gh g`n; dh /keuh 10 feuV ds vanj [kksyk x;k Fkk vkSj FkDdk fudkyk x;k rFkk mlds HkkbZ dks fn[kk;k x;k FkkA ejht dks vR;f/kd e/kqesg dh chekjh Fkh vkSj rackdw lsou ls FzkksEckstsfud LVsV esa Fkss blfy, Hkh vR;f/kd lko/kuh dh xbZ Fkh mls xaHkhj izd`fr dk g`n;k?kkr gqvk FkkA bu lc ifjfLFkfr;ksa ds dkj.k ifjokfnuh ds ifr dh e`R;q gqbZ gSA fo:} i{kdkj dzekad&1 ls 3 }kjk fdlh izdkj dh fpfdRlh; mis{kk ugha cjrh xbZ gSA Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 5 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors. ifjokfnuh fdlh izdkj dk vuqrks"k ikus dh vf/kdkjh ugha gSA vr% ifjokn fujLr fd;k tkosA 04- fo:}+ i{kdkj dzekad&4 dh vksj ls lacaf/kr ftyk vk;ksx ds le{k fyf[kr dFku izLrqr dj ifjokn&i= ds lHkh vfHkopuksa dks badkj fd;k x;k gS vkSj ;g vfHkopu fd;k x;k gS fd ifjokfnuh dk ifjokn le; ckf/kr gSA lacfa /kr gkWfLiVy ,oa MkWDVj }kjk ?kVuk dh dksbZ tkudkjh ugha nh xbZ gS vkSj u gh ifjokfnuh }kjk ;g of.kZr fd;k x;k fd fo:} i{kdkj dzekad&4 }kjk fdl rjg ls lsok esa deh ,oa ykijokgh fd;k x;k gSA fo:} i{kdkj dzekad&4 }kjk ,slk dksbZ d`R; ugha fd;k x;k gS tks lsok esa deh ,oa ykijokgh dh Js.kh esa vkrk gksA ifjokfnuh ,oa fo:} i{kdkj dzekad&4 ds e/; **miHkksDrk** ,oa **lsok iznkrk** dk dksbZ lac/a k ugha gSA izdj.k esa ;fn ;g ik;k tkrk gS fd lacfa /kr fpfdRld us fpfdRlk esa mis{kk ,oa ykijokgh cjrdj ejht dks {kfr dkfjr fd;k gS rks ,slh n"kk esa {kfriwfrZ vnk;xh gsrq izkFkfed nkf;Ro lacfa /kr fpfdRld dk gksxk vkSj lacaf/kr fpfdRld {kfriwfrZ vnk;xh ds Ik"pkr~ chek daiuh ds le{k nkok izLrqr dj chek ikWfylh esa of.kZr fu;e ,oa "krksZa ds rgr Hkqxrku dh tkus okyh jkf"k dh izfriwfrZ ys ldrk gSA chek daiuh dks lh/ks rkSj ij i{kdkj ugha cuk;k tk ldrkA vr% ifjokfnuh dk ifjokn lO;; fujLr fd;k tkosA 05- iwoZ esa lacaf/kr ftyk vk;ksx }kjk fnukad&17-12-2014 dks vkns'k ikfjr djrs gq, ;g vkns'k ikfjr fd;k x;k Fkk fd **vukosndx.k la;qDr ,oa vyx&vyx :Ik ls ifjoknh dks 16]76]515@&¼lksyg yk[k fNgRrj gtkj ikap lkS iUnzg :Ik;s½ vnk djsaxs ,oa mDr jkf'k ij ifjokn izLrqfr fnukad&07-02- 2014 ls Hkqxrku fnukad rd 09 izfr'kr okf"kZd dh nj ls C;kt Hkh iznku djs axs rFkk O;; ds :Ik esa 10]000@&¼nl gtkj :Ik;s½ Hkh vnk djsx a sA** Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 6 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
mDr vkns'k ds fo:}] fo:} i{kdkj dzekad&1 ls 3 dh vksj ls bl vk;ksx ds le{k vihy dzekad&,Q,@15@36 lafLFkr fd;k x;k Fkk ftlesa bl vk;ksx }kjk fnukad&30-09-2015 dks ;g vknsf'kr fd;k x;k Fkk fd%& **12- vr% vihykFkhZ }kjk izLrqr vihy Lohdkj fd;k tkrk gS A ftyk Qksje }kjk ikfjr vkyksP; vkns'k fnukad&17-12-2014 vikLr fd;k tkrk gS vkSj ;g izdj.k ftyk Qksje dks bl funsZ'k ds lkFk izfrizsf"kr fd;k tkrk gS fd ftyk Qksje ifjoknh }kjk izLrqr vkosnu&i= /kkjk& 24 A miHkksDrk laj{k.k vf/kfu;e] 1986 ] ij mHk;&i{k dks lquokbZ djus ds i'pkr~ ml ij i`Fkd ls iqu% vkns'k ikfjr djsxa sA mHk;&i{k dks funsZf'kr fd;k x;k fd os fnukad&28-10-2015 dks ftyk Qksje] nqxZ ds le{k mifLFkr jgsxa sA ftyk Qksje dk vfHkys[k vfoyac okil fd;k tkosA** mDr vkns'k ds ifjikyu esa lacfa /kr ftyk vk;ksx }kjk fnukad&17-05- 2016 dks ;g vkns'k ikfjr fd;k x;k fd%& **¼1½ izLrqr vkns'k vukosnd }kjk izLrqr vkosnu&i= vkbZ- ,- ua-&4 dk fujkdj.k 'kkflr djsxk] ftlds vuqlkj mUgksaus esfMdy cksMZ ls vfHker izkIr djus gsrq izkFkZuk dh gSA \ ¼2 ½ izdj.k dk voyksdu dj ge ;g ikrs gSa fd vukosndx.k }kjk iwoZ esa mDr vk'k; dk vkosnu izLrqr fd;k x;k Fkk tks fd Lohdkj fd;k x;k Fkk ftlds laca/k esa vkns'k if=dk fnukad&05-12-2015 vuqlkj vukosndx.k dks ejht ls lacaf/kr leLr csMgsM fVfdV vkSj fpfdRlh; nLrkost rhu izfr;ksa esa iznku djus gsrq vknsf'kr fd;k x;k Fkk ijUrq Ik;kZIr volj fn;s tkus ds Ik'pkr~ Hkh vukosndx.k us mDr nLrkost izLrqr ugha fd;k QyLo:Ik vkns'k if=dk fnukad&29-02-2016 ds vuqlkj vukosndx.k dk cpko dk volj lekIr dj fn;k x;k gS rc bl fLFkfr esa vukosndx.k }kjk izLrqr ;g vkosnu vkbZ - ,- ua- 4 Lohdkj djus dk leqfpr vk/kkj ugha Ikk;k tkrk gS] QyLo:Ik ge vkbZ - ,- ua-&4 [kkfjt djrs gSaA ¼3½ ;g izdj.k ekuuh; NRrhlx<+ jkT; miHkksDrk fookn izfrrks"k.k vk;ksx] jk;iqj ls vihy dz-,Q-,@15@36 vkns'k fnukad&30-09-2015 ds vuqlkj bl funsZ'k ds lkFk fjek.M gqvk gS fd **ftyk Qksje ifjoknh }kjk izLrqr vkosnu&i= /kkjk&24 ¼,½ miHkksDr laj{k.k vf/kfu;e] 1986] ij mHk;i{k dks lquokbZ djus ds Ik'pkr~ ml ij i`Fkd ls iqu% vkns'k Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 7 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
ikfjr djsxa sA** QyLo:Ik pwfa d vkosnu&i= varxZr /kkjk&24 ¼,½ miHkksDRkk laj{k.k vf/kfu;e] 1986] dk fujkdj.k fd;k tk pqdk gS] vr% vc ;g iqu% ekuuh; NRrhlx<+ jkT; miHkksDrk fookn izfrrks"k.k vk;ksx] jk;iqj dks lknj lEizsf"kr gSA** mDr vkns"k ds fo:} fo:} i{kdkj dzekad&1 ls 3 dh vksj ls bl vk;ksx ds le{k vihy dzekad&,Q,@2016@345 lafLFkr fd;k x;k Fkk ftlesa bl vk;ksx }kjk fnukad&18-10-2016 dks ;g vknsf'kr fd;k x;k Fkk fd%& 17- vr% ;g izdj.k ftyk Qksje dks bl funsZ'k ds lkFk izfrizsf"kr fd;k tkrk gS fd ftyk Qksje mHk;i{k dks xq.k&nks"k ds vk/kkj ij lquokbZ djus ds Ik'pkr~ iqu% vkns'k ikfjr djsxa sA mHk;i{k dks funsZf'kr fd;k tkrk gS fd os fnukad&15-11-2016 dks ftyk Qksje] nqxZ ds le{k mifLFkr jgsxa sA ftyk Qksje dk vfHkys[k vfoyac okil Hkstk tkosA mDr vkns'k ds ifjikyu esa lacaf/kr ftyk vk;ksx }kjk izdj.k dh xq.k&nks'kksa ij lquokbZ dj fnukad&04-09-2021 dks ;g vkns"k ikfjr fd;k x;k gS fd **vukosnd dzekad&1] 2] 3 ,oa 4 la;qDr ;k i`Fkd&i`Fkd ifjoknh dks vkns"k fnukad ls ,d ekg dh vof/k ds Hkhrj 10]00]000@&¼nl yk[k :Ik;s½ vnk djsaxs ,oa ,d ekg ds Hkhrj Hkqxrku ugha fd;s tkus ij vkns"k fnukad ls Hkqxrku fnukad rd 06 izfr"kr okf'kZd lk/kkj.k C;kt vnk djus ds fy, mRrjnk;h jgsaxsA vukosnd dzekad&1] 2] 3 ,oa 4 la;qDr ;k i`Fkd&i`Fkd ifjoknh dks okn O;; 2]000@&¼nks gtkj :Ik;s½ Hkh vnk djsaxs** ls {kqC/k gksdj mHk; vihy izLrqr dh xbZ gSA 06- vihy dzekad&,Q,@2021@123 esa ifjokfnuh dh vksj ls milatkr gksus okyh fonq'kh vfHkHkk'kd Jherh izrh{kk flag dk rdZ gS fd ekuuh; ftyk vk;ksx }kjk {kfriwfrZ dk tks fu/kkZj.k fd;k x;k gS og =qfViw.kZ gS] D;ksfa d ifjokfnuh dks gqbZ {kfr dk ewY;kadu fd;k tkuk laHko ugha gSA ifjokfnuh ds ifr lh- ,l- bZ- ch- esa dk;Zjr~ Fks vkSj mudk osru 70]000@&¼lRrj gtkj :Ik;s½ Fkk vkSj 10 o'kZ rd thfor jgdj o'kZ dk 8]40]000@&¼vkB yk[k pkyhl gtkj :Ik;s½ vk;
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 8 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
vtZu djrs vkSj Lo;a ij 21]00]000@&¼bDdhl yk[k :Ik;s½ rFkk ifjokj ij 63]00]000@&¼frjlB yk[k :Ik;s½ O;; djrsA ifjokfnuh ds ifr "kklu ds fu;eksa ds rgr inksUufr o osru o`f} dk ykHk izkIr djrs ftls /;ku esa j[krs gq, ekuuh; ftyk vk;ksx dks vkns"k ikfjr djuk Fkk vkSj iwoZ esa ikfjr vkns"k fnukad&17-12-2014 esa ikfjr {kfriwfrZ jkf"k&16]76]515@&¼lksyg yk[k fNgRrj gtkj ikap lkS iUnzg :Ik;s½ esa deh djrs gq, ek= 10]00]000@&¼nl yk[k :Ik;s½ fnyk;k x;k gS tks dkQh de gSA vr% ifjokfnuh dks ifjokn esa okafNr vuqrks'k fnyk;k tkosA 07- vihy dzekad&,Q,@2021@130 esa fo:} i{kdkj dzekad&4 ;qukbZVsM bafM;k ba";ksjsal daiuh dh vksj ls milatkr gksus okys fo}ku vfHkHkk'kd Jh ih- ds- ikWy dk rdZ gS fd ifjokfnuh ,oa bl fo:} i{kdkj ds e/; **miHkksDrk** ,oa **lsok iznkrk** dk dksbZ lac/a k ugha gS D;ksafd e`rd "kjn vjksjk us chek daiuh ls dksbZ ikWfylh izkIr ugha fd;k gSA blds vykok fo:} i{kdkj dzekad&4 }kjk ,slk dksbZ d`R; ugha fd;k x;k gS tks lsok esa deh ,oa ykijokgh dh Js.kh esa vkrk gksA lacaf/kr fpfdRld us fpfdRlk esa mis{kk ,oa ykijokgh cjrdj ejht dks {kfr dkfjr fd;k gS rks ,slh n"kk esa {kfriwfrZ vnk;xh gsrq izkFkfed nkf;Ro lacfa /kr fpfdRld dk gksxk vkSj lacfa /kr fpfdRld {kfriwfrZ vnk;xh ds Ik"pkr~ chek daiuh ds le{k nkok izLrqr dj chek ikWfylh esa of.kZr fu;e ,oa "krksZa ds rgr Hkqxrku dh tkus okyh jkf"k dh izfriwfrZ ys ldrk gSA chek daiuh dks lh/ks rkSj ij i{kdkj ugha cuk;k tk ldrkA vr% ifjokfnuh dk ifjokn lO;;
fujLr fd;k tkosA
08- fo:} i{kdkj dzekad&1 ls 3 dh vksj ls dksbZ milatkr ugha gq, gS vkSj
muds fo:} ,di{kh; dk;Zokgh dh xbZ gSA
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 9 of 12
Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced
FA/2021/123 & & on 28.12.2022
FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
09- geus mHk;i{k ds fo}ku vfHkHkk'kdx.k ds rdZ Jo.k fd, ,oa muds }kjk
izLrqr fyf[kr rdZ rFkk ewy vfHkys[k dk Hkh voyksdu fd;kA 10- ifjokfnuh ds fo}ku vfHkHkk'kd dk rdZ gS fd ifjokfnuh ds ifr lh- ,l- bZ- ch- easa LFkk;h lsok esa dk;Zjr~ Fks rFkk mudh vk; 70]000@&¼lRrj gtkj :Ik;s½ izfrekg FkhA le; vuqlkj e`rd dks inksUufr ds Ik"pkr~ osru esa o`f} gksrhA bl izdkj fo:} i{kdkjx.kksa ds ykijokghiwoZd d`R; ls ifjokfnuh o mlds cPpksa dks tks {kfr gqbZ gS mldk vkdyu vlhfer vkSj vlaHko gS] fdarq ifjokfnuh ds ifr ds vk; ds vk/kkj ij {kfriwfrZ jkf"k dk vkdyu djrs gq, ifjokn&i= esa {kfriwfrZ jkf"k dh ekax dh xbZ gS ftls ekuuh; ftyk vk;ksx us u ekurs gq, {kfriwfrZ dh jkf"k de vkadfyr djrs gq, vkns"k ikfjr fd;k gS og mfpr ugha gSA vr% ifjokn esa okafNr vuqrks'k fnykbZ tkosA 11- gekjs }kjk izdj.k esa layXu nLrkostksa dk voyksdu fd;k x;kA ifjokfnuh ds }kjk e`rd dh vk; 70]000@&¼lRrj gtkj :Ik;s½ izfrekg crkbZ xbZ gS ftlds vk/kkj ij {kfriwfrZ dk fuosnu fd;k x;k gS] fdarq bl lac/a k esa ifjokfnuh ds }kjk dksbZ Hkh nLrkost izLrqr ugha fd;k x;k gS ftlls ifjokfnuh ds ifr dh ekfld vk; ugha tkuh tk ldrhA lacaf/kr ftyk vk;ksx us vius vkns"k dh dafMdk&30 esa foospuk djrs gq, {kfriwfrZ ds :Ik esa tks 10]00]000@&¼nl yk[k :Ik;s½ fnyk;k x;k gS og izdj.k dh ifjfLFkfr dks ns[krs gq, mfpr izrhr gksrk gS vkSj ifjokfnuh dks ge vU; dksbZ vuqrks'k fnyk;k tkuk mfpr ugha ikrsA 12- fo:} i{kdkj dzekad&4 ds fo}ku vfHkHkk'kd dk rdZ gS fd fo:} i{kdkj dzekad&4 us izksQs"kuy baMfs EuVh ikWfylh fnukad&21-10-2011 ls 20-10- 2012 gsrq fofHkUu "krksZa] viotZuksa ,oa fu;ekasa ds rgr tkjh dh FkhA mDr chek Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 10 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors. ikWfylh dh lHkh fu;e ,oa "krsZa nksuksa i{kdkjksa ij leku :Ik ls ca/kudkjh FkhA ;g ikWfylh viksyks ch- ,l- vkj- gkWfLiVy dks tkjh dh xbZ Fkh blfy, ch- ,l- vkj- gkWfLiVy gh fo:} i{kdkj dzekad&4 dk **miHkksDrk** gS rFkk fo:+} i{kdkj dzekad&4 dk mRrjnkf;Ro ch- ,l- vkj- gkWfLiVy ds izfr gS] u fd ifjokfnuh ds izfrA lacfa /kr fpfdRld us fpfdRlk esa mis{kk ,oa ykijokgh cjrdj ejht dks {kfr dkfjr fd;k gS rks ,slh n"kk esa {kfriwfrZ vnk;xh gsrq izkFkfed nkf;Ro lacfa /kr fpfdRld dk gksxk vkSj lacaf/kr fpfdRld {kfriwfrZ vnk;xh ds Ik"pkr~ chek daiuh ds le{k nkok izLrqr dj chek ikWfylh esa of.kZr fu;e ,oa "krksZa ds rgr Hkqxrku dh tkus okyh jkf"k dh izfriwfrZ ys ldrk gSA 13- geus izdj.k esa izLrqr izksQs"kuy baMfs EuVh ikWfylh ¼i`'B dzekad&174 ½ tks fd fnukad&21-10-2011 ls 20-10-2012 rd dh vof/k ds fy, gS] dk voyksdu fd;kA mDr ikWfylh viksyks ch- ,l- vkj- gkWfLiVy ds uke ij tkjh dh xbZ gS ftlds i`'B Hkkx ij ;g mYysf[kr gS fd "Indemnity Premium: Rs. 15,000.00, In Patient: Rs. 29,700.00, Out Patient: Rs. 37,200.00, Inqual Staff Premium: Rs. 1,125.00". mDr nLrkost ds ifj"khyu ls Li'V gS fd fo:} i{kdkj dzekad&4 us vkarfjd jksxh ,oa ckg~; jksxh gsrq chek izhfe;e Lohdkj fd;k gS rFkk ifjokfnuh ds ifr mDr gkWfLiVy esa HkrhZ gksdj mipkj djk;k Fkk ftlds dkj.k og chek ikWfylh esa fgrxzkgh gSA 14- ekuuh; loksZPp U;k;ky; us Javed Alam Vs. Inderjit Kaur & Anr. 2005 (11) SCC 550 esa ;g fu/kkZfjr fd;k gS fd%& "3. We have been taken through the stand of the Insurance Company before the District Forum. There is no denial of liability under the insurance policy. All that has been decided is the liability of the respondent No. 1 himself. The learned counsel appearing on behalf of the Insurance company readily concedes that the matter is in fact covered by the insurance policy taken out by the appellant in respect of the claim of medical negligence. In that view of the matter, the appeal is disposed of by directing the respondent Insurance.
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 11 of 12 Appeal No. Smt. Anita Arora Vs. Manager, Apollo BSR Hospitals & Anr. Order Pronounced FA/2021/123 & & on 28.12.2022 FA/2021/130 United India Ins. Co. Ltd. Vs. Smt. Anita Arora & Ors.
4. Company to indemnify the appellant to the extent of its liability under the insurance policy.
5. The respondent No. 1 will be entitled to withdraw the amount deposited by the appellant in the district Forum pursuant to the order passed by this Court on 5th September, 203. The Insurance Company, upon proof of such withdrawal shall indemnify the appellant within a period of two weeks thereunder."
15- mDr U;k; n`"Vkar dk voyacu ysrs gq, iatkc jkT; miHkksDrk fookn izfrrks"k vk;ksx us izFke vihy dz-&656@2010 ;qukbZVsM bafM;k ba';ksjsl a daiuh fyfeVsM fo:) jke flag] vkns'k fnukad&19-05-2014 esa chek daiuh dks {kfriwfrZ gsrq mRrjnk;h ekuk gSA vr% ge ;g ikrs gSa fd lacaf/kr ftyk vk;ksx us vius vkns"k dh dafMdk&29 esa fo:} i{kdkj dzekad&4 dks Hkh {kfriwfrZ gsrq mRrjnk;h ekuk gS vkSj fo:} i{kdkj dzekad&1 ls 4 dks la;qDr ,oa i`Fkd&i`Fkd :Ik ls {kfriwfrZ jkf"k vnk djus gsrq vknsf"kr fd;k gS og gekjs er esa mfpr izrhr gksrk gS vkSj mlesa fdlh izdkj dk gLr{ksi fd;k tkuk ge mfpr ugha ikrs gSaA 16- vr% ge ifjokfnuh dh vksj ls izLrqr vihy dzekad&,Q,@2021@123 ,oa fo:} i{kdkj dzekad&4 dh vksj ls izLrqr vihy dzekad&,Q,@2021@130 lkjghu gksus ls vikLr djrs gSa ,oa lacaf/kr ftyk vk;ksx }kjk ikfjr vkns"k fnukad&04-09-2021 tks fd izdj.k dzekad&lhlh@2014@35 esa ikfjr fd;k x;k gS] dh iqf'V dh tkrh gSA mHk; vihy dk okn O;; i{kdkjx.k Lo;a ogu djax sa sA ewy vkns"k vihy dzekad&,Q,@2021@123 esa layXu dh tkos ,oa vihy dzekad&,Q,@2021@130 esa vkns"k dh izekf.kr lR; izfrfyfi layXu dh tkosA ¼ U;k;ewfrZ xkSre pkSjfM+;k ½ ¼ Jherh :fp xks;y ½ v/;{k lnL;
¼ xksikypanz "khy ½ ¼ izeksn dqekj oekZ ½
lnL; lnL;
Pronounced on 28 December 2022
Appeal No. FA/2021/123 & Appeal No. FA/2021/130 Dismissed Page 12 of 12