State Consumer Disputes Redressal Commission
Divisional Railway Manager vs Vinod Kumar Jain on 17 April, 2017
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
First Appeal No.245 of 2017
Date of institution : 03.04.2017
Date of decision : 17.04.2017
1. Divisional Railway Manager, Northern Railways, Ferozepur.
2. Chief Medical Superintendent, Divisional Hospital, Northern
Railways, Ferozepur.
3. Chief Medical Director, Northern Railways, Baroda House,
New Delhi.
....Appellants/Opposite Parties
Versus
Vinod Kumar Jain, Chief Officer Superintendent (Retd.), office of
Divisional Railways Manager, Northern Railways, Ferozepur, son of
Sh. Vijay Kumar Jain, resident of # 25, Street No.25, Basti Tankan
Wali, Ferozepur, Mob. No.95567-90002.
....Respondent/Complainant
First Appeal against the order dated
09.02.2017 of the District Consumer
Disputes Redressal Forum, Ferozepur.
Quorum:-
Hon'ble Mr. Justice Paramjeet Singh Dhaliwal, President
Mr. Harcharan Singh Guram, Member.
Present:-
For the appellants : Sh. Sanjiv Ghai, Advocate JUSTICE PARAMJEET SINGH DHALIWAL, PRESIDENT The instant appeal has been filed by the appellants/opposite parties against the order dated 09.02.2017 passed by District Consumer Disputes Redressal Forum, Ferozepur (in short, "the District Forum"), whereby the complaint filed by respondent/complainant, under Section 12 of the Consumer Protection Act, 1986, was allowed with ₹2,000/- as consolidated compensation and the opposite parties were directed to pay First Appeal No.245 of 2017 2 ₹1,08,808/- spent by the complainant on the treatment of his wife, along with interest at the rate of 9% per annum from the date of repudiation of the claim till realization.
2. It would be apposite to mention that hereinafter the parties will be referred, as have been arrayed before the District Forum.
3. Shorn of unnecessary details, the relevant facts for the disposal of the present appeal are that the complainant retired as Chief Officer Superintendent from Railway Department. He fell under "Retired Employees Liberalized Health Scheme (RELHS), for which a sum of ₹22,820/- was charged. The wife of the complainant, namely Smt. Neelam Jain, being dependent upon the complainant, was also enrolled under the said scheme and Medical/RELHS Identity Card No.028844 was issued to the complainant. The wife of the complainant suffered from severe bleeding and got treatment from Railway Hospital, Ferozepur from October 2013 to December, 2013. The doctors of the said hospital recommended for conducting MRI abdomen and pelvis of his wife from Anil Baghi Hospital, Ferozepur on 13.12.2013, by paying necessary charges to the said hospital. It was reported by the said hospital that she was suffering from Ovarian Cancer. On 20.12.2013, his wife suffered acute pain in abdomen with severe bleeding and she was taken to Railway Hospital, Ferozepur, from where she was referred to PGI, Department of Gynecology, vide letter dated 20.12.2013. The complainant immediately moved his wife towards PGI, Chandigarh, First Appeal No.245 of 2017 3 but on the way her condition became very serious and under compelling circumstances, she was taken to Mediways Hospital, Ludhiana, where she was admitted with acute pain abdomen plus severe bleeding and was operated upon on the same day. She was discharged on 30.12.2013 from there. An amount of ₹1,08,808/- was spent on the treatment of his wife. Intimation in this regard was given to the opposite parties Thereafter, the complainant filled medical reimbursement form for getting the claim amount and complete the necessary formalities, but the same was repudiated by opposite party No.2, vide letter dated 07.06.2014. The complainant moved representation dated 08.07.2014 to the Chief Medical Director, Northern Railways, New Delhi, but to no effect. The act and conduct of the opposite parties amounted to deficiency in service. Accordingly, the complainant approached the District Forum, seeking following directions to the opposite parties:
i) to pay ₹1,08,808/- towards medical reimbursement claim, along with interest at the rate of 2% per mensum from the date of operation i.e. 21.12.2013 till realization;
ii) to pay ₹50,000/-, as damages and compensation for mental agony and harassment suffered by the complainant; and
iii) to pay ₹11,000/-, as litigation expenses.
4. Upon notice, the opposite parties appeared and filed reply to the complaint, taking preliminary objections that the complaint is not maintainable. Opposite party No.1 is neither necessary nor proper party for adjudication of the complaint. On First Appeal No.245 of 2017 4 merits, it was pleaded that the wife of the complainant was sent to Anil Baghi Hospital, Ferozepur for conducting MRI whole ABD and test of T3T4TSH<C-A-125, ALPHA FETO PROTEIN HCG. The bills for those tests were paid by the Railway Department. On 20.12.2013, the wife of the complainant was diagnosed as cancer endometrium (Uterus) and was referred to PGI for further management, as per the reference of the Divisional Medical Officer to Dr. Dinesh Pathak to Professor, HOD, Dr. (Smt.) L. Dhaliwal, Department of Gynecology, PGIMR, Chandigarh, which did not disclose any emergency qua the wife of the complainant. There was Railway Health Unit at Ludhiana for treatment of emergency cases and she could have been attended there for emergency, but the complainant bypassed the same, in order to get treatment from private hospital. The claim of the complainant was rightly repudiated, due to chronic nature of the disease and that there was no acute emergency. It was further pleaded that his wife took treatment from a non-recognized private hospital at Ludhiana, for complaint of bleeding per vagina 3 months and as per clinical finding, her pulse rate was 70; blood pressure was 130/70; and urine output was normal. There was no deficiency in service on the part of the opposite parties and the complainant is not entitled to any relief. Other allegations of the complaint were denied and dismissal thereof was prayed.
5. Both the sides produced evidence in support of their respective averments before the District Forum, which after going First Appeal No.245 of 2017 5 through the same and hearing learned counsel on their behalf, allowed the complaint, vide impugned order. Hence, this appeal.
6. We have heard learned counsel for the appellants and have carefully gone through the record.
7. Learned counsel for the appellants vehemently contended that the District Forum has passed the impugned order, without properly appreciating the evidence produced before it by the parties. The record of PGI does not disclose any emergency in the case of wife of the complainant. There is Railway Health Unit at Ludhiana, but instead of taking his wife to the said hospital, the complainant preferred to take her to a non-recognized private hospital. The claim of the complainant was rightly repudiated on the above referred grounds. The complainant is not entitled to any relief and the complaint has been wrongly allowed. The impugned order is liable to be set aside.
8. We have given thoughtful consideration to the contentions raised by the learned counsel for the appellants.
9. Admittedly, the wife of the complainant, being dependent upon him, was covered under the RELHS. She was suffering from cancer endometrium (Uterus). It is also admitted fact that she was referred to PGI, Chandigarh by the doctors of Railway Hospital, Ferozepur, but the fact remains that in the midway, she suffered acute pain in abdomen, as a result of which she was admitted in the nearby available hospital i.e. Mediway Hospital, Ludhiana. This fact is not denied that she was suffering from acute pain and severe First Appeal No.245 of 2017 6 bleeding and she was admitted in the above hospital with the aforesaid complaints. It was due to acute emergency at that time that she was taken to nearest hospital by the complainant, specifically when the age of the wife of the complainant was in the last phase of the life span. In such a situation, the first and the foremost anxiety of the person, who is taking the patient in serious condition, is always to approach the nearest hospital to save the life of the patient. It would have taken considerable time to reach Chandigarh. The emergency occurred midway somewhere near Ludhiana and accordingly, she was admitted in Mediway Hospital, Ludhiana on 21.12.2013, due to acute pain and severe bleeding and was operated upon there on the same day. She was discharged therefrom on 30.12.2013. The complainant spent ₹1,08,808/- on her treatment. However, the opposite parties, vide letter dated 07.06.2014, rejected the claim of the complainant, on the ground that there was no emergency in treating his wife. To counter the same, the complainant produced copy of certificate of Mediway Hospital, Ex.C-5, vide which it was certified that patient Neelam Jain was admitted on 21.12.2013 in emergency in Mediway Hospital, Ludhiana, with acute pain abdomen and severe bleeding. She was having gall bladder 2cm size+uterine enlargement and underwent cholecystectomy + TAH with BSO+RPLND under G.A. From the evidence produced before the District Forum, it is clear that the operation of the wife of the complainant was conducted on the same day i.e. 21.12.2013. It is a matter of common knowledge that First Appeal No.245 of 2017 7 operation/surgery is conducted, only if the same is urgently required to completely remove the disease from the body of the patient to save his/her life. In our view, certainly the admission of the wife of the complainant in Mediways Hospital, Ludhiana was in emergency conditions. Moreover, once the factum of the disease is not disputed, then it cannot be said that the claim is false or otherwise. In these circumstances, the claim of the complainant was wrongly rejected by the opposite parties, without any valid ground. The District Forum has passed a well reasoned order, after properly appreciating the evidence produced by the parties before it and we do not find any ground to interfere with the same.
10. In view of above discussion, the appeal is dismissed in limine and the impugned order is upheld.
11. The appellants had deposited a sum of ₹25,000/- at the time of filing of the appeal. This amount, along with interest which has accrued thereon, if any, shall be remitted by the registry to the respondent/complainant, by way of a crossed cheque/demand draft after the expiry of 45 days of the sending of certified copy of the order to them.
(JUSTICE PARAMJEET SINGH DHALIWAL) PRESIDENT (HARCHARAN SINGH GURAM) MEMBER April 17, 2017.
(Gurmeet S)