State Consumer Disputes Redressal Commission
Managing Dir.,Central ... vs Lt.Col.Om Prakash Swami on 31 March, 2009
BEFORE
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CIRCUIT BENCH,
RAJASTHAN, JAIPUR
APPEAL
No. 1483/2007
Managing
Director, Central Organisation, ECHS Mode lines, Army Headquarters,
Delhi Cantt.110010.
Regional
Director, ECHS Station Headquarters Cell, Military Station, Jaipur.
..Appellants-OPs
VS
Lt.
Col. Om Prakash Swami, S/o Late Shri G.L. Swami, R/o 186, Govind
Nagar East, Amer Road, Jaipur.
..Respondent-Complainant
Before:
Mr,
G.S. Hora, Presiding Member
Mr. Sikandar Punjabi, Member Present:
Smt. Anupama Chaturvedi, counsel for the Appellants Mr. S.B.Singh, counsel for the Respondent ORDER Dated:31/03/2009 PER Mr. G.S. HORA, PRESIDING MEMBER This appeal has been filed against the order dated 6.8.2007 passed by the learned District Forum, Jaipur-I, Jaipur whereby the Appellants were directed to pay to the Complainant the amount spent by him on his treatment after 20.1.2005 and to pay interest @ 8% per annum from the date when the claim was rejected by the Appellants along with Rs. 2,500/- as cost of litigation.
The Complainant filed the complaint stating that he retired from Defence Service on 30.9.1989. From 1.4.1991, the Army Group Medical Benefit Scheme (AGMBS) was made applicable to defence personnel according to which there is a provision for free treatment of by-pass surgery. It was further stated that an amendment was introduced and a scheme called 'Ex-servicemen Contributory Health Scheme (ECHS) came into effect from 30.9.2002 according to which Pensioners and retired servicemen were eligible to become its Members for availing of the benefits of treatment in civil/private hospitals. It was also stated that the Complainant met with an accident on 26.12.2004 and when he was recovering from the injuries, he had a heart attack on 16.1.2005. He was admitted in Tongia Hospital. On 20.1.2005, an angiography was done and on 22.1.2005 2 by-pass surgery was performed for which he spent Rs. 1,20,000/-. The Complainant further stated that he became Member of the above Scheme w.e.f. 20.1.2005. He raised a claim before the Appellants for the expenses made during the course of treatment which was not accepted and thus filed the complaint claiming a sum of Rs. 1,20,000/- and compensation on account of physical and mental agony.
A reply was filed by the Appellants wherein it was stated that the Complainant is not a consumer under the Consumer Protection Act, 1986 and therefore the complaint does not lie before the learned District Forum. It was also stated that the emergency occurred on 16.1.2005 when the Complainant was not a Member. He deposited the membership fee after occurrence of emergency and therefore the Complainant was not entitled to get reimbursement.
The learned District Forum was of the view that the Complainant had become a Member of the Scheme w.e.f. 20.1.2005 and therefore all expenditure incurred by him on his treatment has to be reimbursed by the Appellants.
We have heard both the counsels and gone through the file.
The facts of the case are more or less admitted by both the parties. It is clear from the record that the Complainant suffered a heart attack on 16.1.2005 when he was under treatment for the injuries sustained in an accident. He was taken to Tongia Hospital where angiography was done on 20.1.2005 and by-pass surgery was performed on 22.1.2005. From record, it is also clear that the Complainant wanted to become the Member of the Scheme got an affidavit attested on 15.1.2005 by the Notary Public which was later submitted by the Complainant to the Appellants. Unfortunately, he suffered heart attack on 16.1.2005. The other aspect of the case is that he was made Member of the Scheme when he was in the hospital. The provisions of the scheme go to show that for becoming the Member of the Scheme, application form is filled up, affidavit is to be notarised, contribution is to be deposited in Government treasury and then to personally report to Station Headquarters with the complete application form along with documents such as PPO, two pass-port size photographs and ex-servicemen identity card, etc. We fail to understand when the Complainant was in the hospital, why his personal attendance was not impressed upon? Why he was made Member of the Scheme when he was already under treatment in the Tongia Hospital? After becoming Member of the Scheme, he could not avail of benefits under AGMBS. We feel that the Complainant was justified in claiming the reimbursement of the treatment taken after 20.1.2005.
3Consequently, we find no force in this appeal and the same is dismissed.
Member Presiding Member /Hira Lal/