State Consumer Disputes Redressal Commission
Smt. Beena Devi W/O Late Radhey Shyam ... vs Hdcf Ergo General Insurance on 8 October, 2020
1 jkT; miHkksDrk fookn izfrrks"k vk;ksx] cSap la- 1] jktLFkku] t;iqj vihy la[;k %& 1229@2019 Jherh chuk nsoh vihykFkhZZ cuke ,p-Mh-,Q-lh- bjxks tujy ba';ksjsal daiuh fyfeVsM izR;FkhZ le{k % ekuuh; dk;Zokgd v/;{k ekuuh; Jherh 'kksHkk flag] lnL;
mifLFkr %& vihykFkhZ vf/koDRkk Jh uwj eksgEen [kku tfj;s ohfM;ksdkWQzsfa lax izR;FkhZ vf/koDrk jh iz'kkaUr ea=h tfj;s ohfM;ksdkWQzsflax vkns'k fnukad 08 vDVqcj] 2020 jkT; vk;ksx jktLFkku t;iqj }kjk Jh dey dqekj ckxM+h ;g vihy Jherh chuk nsoh dh vksj ls ,p-Mh-,Q-lh- bjxks tujy ba';ksjsal daiuh fyfeVsM ds fo:) ftyk miHkksDrk fookn izfrrks"k eap] t;iqj prqFkZ] t;iqj ds fu.kZ; fnukad 16 vDVwcj] 2019 ls O;fFkr gksdj is'k dhA izdj.k ds rF; bl izdkj gS fd ifjokfnuh us mlds ifr Jh jk/ks';ke lSuh }kjk viuh leLr izdkj dh tksf[keksa dh lqj{kk ds fy, okafNr izhfe;e jkf'k vnk dj chek /ku 19]53]500@&:i;s ds fy, foi{khx.k chek dEiuh ls fnuakd 07-11-2014 ls 06-11-2017 rd dh vof/k ds fy, izkIr dh xbZ 2 loZ lqj{kk Iyl chek ikWfylh la[;k 2950200897851800000 dh vof/k esa fnuakd 20-10-2015 dks ifjokfnuh ds ifr jk/ks';ke lSuh ds nq?kZVukxzLr gks tkus ij mldh nkSjkus bZykt fnuakd 01-11-2015 dks 'kqHkkjrh gkWfLiVy] esjB esa e`R;q gks tkus ij ifjokfnuh }kjk iz'uxr chek ikWfylh ds rgr ukfeuh fu;qDr gksus ds ukrs chfer dh e`R;q gksus ij ns; chek jkf'k dk Dyse leLr vkSipkfjdrk,sa iw.kZ djrs gq, e; vko';d nLrkostkr foi{khx.k chek dEiuh ds le{k is'k djus ij foi{khx.k chek dEiuh }kjk ifjokfnuh ds chek nkos dks fnuakd 29-02-2016 dks iz'uxr chek ikWfylh ds rgr doj ugha gksuk crkdj jsiqfM,V dj nsus ds d`R; dks foi{khx.k chek dEiuh dh euekuh] vuqfpr O;kikj O;ogkj ,oa lsoknks"k crkrs gq, rFkk {ks=kf/kdkj dk rF; of.kZr djrs gq, foi{khx.k chek dEiuh ls chek Dyse jkf'k 19]53]500@&:i;s] ekufld larki o 'kkjhfjd ,oa vkfFkZd uqdlku dh {kfriwfrZ isVs 15]000@&:i;s ,oa ifjokn O;; isVs 21]000@&:i;s e; C;kt pkgs gSa A foi{khx.k chek dEiuh us vius tokc ifjokn esa jk/ks';ke lSuh }kjk viuh leLr izdkj dh tksf[keksa dh lqj{kk ds fy, okafNr izhfe;e jkf'k vnk dj chek /ku 19]53]500@&:i;s ds fy, foi{khx.k chek dEiuh ls fnuakd 07-11-2014 ls 06-11-2017 rd dh vof/k ds fy, loZ lqj{kk Iyl chek ikWfylh la[;k 2950200897851800000 izkIr djuk] bl chek ikWfylh esa ifjokfnuh dk uksfeuh fu;qDr gksuk ,oa fnukad 20-10-2015 dks chfer jk/ks';ke lSuh dh e`R;q gks tkus ds vk/kkj ij ifjokfnuh }kjk iz'xur chek ikWfylh ds rgr izLrqr chek Dyse dks i= fnukafdr 29-02-2016 ds ek/;e ls *uks Dyse* djuk Lohdkj djrs gq, tokc ifjokn esa vkxs O;Dr fd;k gSa fd ifjokfnuh }kjk Dyse ds lkFk miyC/k djok;s x;s nLrkostksa ls ;g Li"V Fkk fd chfer jk/ks';ke lSuh dh e`R;q dk dkj.k "Lower limb gangrene, Severe Speticemia, Septic Shock, Acute Kidney Injury, Hepatic Encephalopathlry, Respiratory failure" u fd chek ikWfylh esa mYysf[kr fØfVdy Js.kh dh chekjhA fØfVdy byuSl ds laca/k esa chek dEiuh dk vf/kdre nkf;Ro ,d yk[k :Ik;s rd ds fy, Fkk ysfdu chfer dh e`R;q chek ikWfylh ds lsD'ku 1 esa mYysf[kr fØfVdy Js.kh dh chekjh ds dkj.k ugha gksus ds dkj.k ifjokfnuh ds chek Dyse dks uks Dyse dj i= fnuakfdr 29-02-2016 ds ek/;e ls lwfpr dj fn;k x;kA foi{khx.k chek dEiuh us ifjokfnuh dk chek Dyse fu;ekuqlkj jsiqfM,V djus] ifjokfnuh dks dksbZ Dyse 3 jkf'k izkIr djus dh vf/kdkfj.kh ugha gksus o ifjokfnuh ds izfr dksbZ lsoknks"k dkfjr ugha djus ds rF; of.kZr djrs gq, ifjokn [kkfjt djus dh izkFkZuk dh gSA cgl tfj;s ohfM;ksdkWQzsflax lquh ,oa i=koyh dk voyksdu fd;kA ifjokfnuh ds ifr jk/ks';ke lSuh us fizfe;e nsdj 19]53]500@&:- dk chek fnukad 07-11-2014 ls 06-11-2017 rd dk djok;kA fnukad 20-10-2015 dks jk/ks';ke lSuh nq?kZVukxzLr gks x;k vkSj nkSjkus bZykt fnukad 01-11-2015 dks mldh e`R;q gks x;hA ifjokfnuh us Dyse QkbZy fd;k ijUrq fnukad 29-02-2016 dks Dyse [kkfjt dj fn;kA tokc esa chek djuk Lohdkj fd;k x;k rFkk dgk fd chek 'krksZ ds vk/kkj ij Dyse ugha vkrk gSA blfy, [kkfjt fd;k gSA fnukad 29-02-2016 dks lwfpr dj fn;k FkkA bl izdj.k esa ifjoknh dh tks gkWfLiVy ds Doctor Note at Discharge dh fjiksVZ fuEu izdkj gS%& --as a cone of S. Speticemia, Septic Shock, AFR type I Respiratory failure Hepatic Encephalopathlry Lower limb gangrene he was manage conuse be --- got gangrene & tracheoltomy now pt. Refer to Subharti medical college on pt. Attendent request.
bl izdkj chek/kkjd Speticemia, Septic Shock, ls xzflr Fkk ftlds fy, fuEu fpfdRlh; fl)kUr gSA lsIVhflfe;k ds ckjs esa Black Medical Dictionary ds ist uacj 557 ij crk;k x;k gS %& Septicaemia A serious condition caused by the presence of micro-organisms in the blood stream. A very high temperature may be the only sign but there is often associated shivering (rigor) profuse sweating and pains in the joints and muscles.
The introduction of aseptic surgery by Lister immensely reduced the frequency of septicaemia and the problem was further ameliorated by the introduction of antibiotics.
Septic shock A dangerous disorder characterized by a severe fall in blood pressure and damage to the body tissues as a result of Septicaemia. The toxins from the septicaemia cause widespread damage to tissue, provoke clotting in small blood vessels and seriously disturb the circulation. The kidneys, lungs and heart are particularly affected. The condition occurs most commonly in people who already have a chronic disease such as cancer, cirrhosis of the liver or diabetes mellitus. Septic shock may also develop in 4 patients with immunodeficiency illnesses such as AIDS. The symptoms are those of septicaemia, coupled with those of shock, cold, cyanotic limbs, fast thready pulse and a lowered blood pressure. Septic shock requires urgent treatment with antibiotics, intravenous fluids and oxygen.
bl izdkj chek/kkjd Speticemia, Septic Shock, ls xzflr Fkk blls vksxZu Qsy gks tkrs gSA ,D;wV fdMuh fMtht rFkk Respiratory failure Hkh gqvk tks gkVZ QSY;ksj dh Js.kh esa vkrk gSA chek ikfylh esa Critical illness ds fy, 1]00]000@&:- {kfriwfrZ dk izko/kku gSA Critical illness ds fy, vko';d gSA
1. First Attack of Specified severity
2. open chest CABG
3. Stroke resulting in permanent symptoms
4. cancer of specified severity
5. Kidney Failure Requiring regular Dialysis
6. Major organ/ Bone Marrow Transplant blesa ls dze la[;k 1] 5 o 6 chek/kkjd ds gq, chek/kkjd dh e`R;q gqbZA fLFkfr esa chek/kkjd Critical illness dh {kfriwfrZ izkIr djus dk vf/kdkjh gSA tgkWa rd nq?kZVuk dk loky gSA bl lac/a k esa ifjoknh dh vksj ls dksbZ nLrkost is'k ugha gqvk gS ftlls ;g lkfcr gks fd nq? kZVuk ds ifj.kkeLo:i chek/kkjd dh nkSjkus bZykt e`R;q gks x;hA fo)ku ftyk eap tks iw.kZr;k ifjokn [kkfjt fd;k gS og lgh ugha gSA ifjokn vkaf'kd :i ls Lohdkj ;ksX; gSA vr% ftyk eap dk vkns'k vikLr djds vkns'k fn;k tkrk gS fd foi{khx.k] ifjokfnuh dks 1]00]000@&:- ¼ v{kjs ,d yk[k :- ½ ifjokn izLrqfr fnukad 27 vDVwcj] 2016 ls vnk;xh rd 9 izfr'kr okf"kZd dh nj ls C;kt lfgr vnk djsa ,oa ekufld larki dh {kfriwfrZ Lo:i 10]000@&:- ¼ v{kjs nl gtkj :- ½ rFkk ifjokn O;; 5000@&:- ¼ v{kjs ikWap gtkj :- ½ vkns'k dh rkjh[k ls nks ekg esa vnk djsAa nks ekg esa vnk u djus ij mijksDr jkf'k ij Hkh 9 izfr'kr okf"kZd dh nj ls C;kt ns; gksxkA ¼ 'kksHkk flag ½ ¼ dey dqekj ckxMh ½ lnL;
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