Thread: State Commission Appeal Order - claim granted

BEFORE THE KARNATAKA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, BANGALORE.

DATED 23/07/2008
PRESENT
THE HON’BLE MR. JUSTICE CHANDRASHEKARAIAH : PRESIDENT
SRI T. HARIAPPA GOWDA : MEMBER
SMT. RAMA ANANTH : MEMBER

Appeal No. 306/2008
1. Smt. Leelamma
W/o Puttaswamappa C.
Sulibele,
Hosakote Taluk
Bangalore Rural Dist.
……..Complainant before the DF
Appellant/s
(By Shri/ Smt. G. B. Srinath)

-Versus-

1. The Chairman/ CEO,
Yashaswini Co-operative Farmers Health Care Scheme
Department of Co-operation,
Government of Karnataka,
6th Floor, 2nd Gate,
M. S. Building,
Bangalore – 560 001

2. The Chief Executive Officer,
Wockhardt Hospital Private Limited
154/9, Opp. IIM-Bangalore
Bilekana Halli, Bannerghatta Road,
Bangalore.
…….OPs Before the DF
….Respondant/s
(ByShri/ Smt. R-I svd, R-II in person)

ORDER

JUSTICE CHANDRASHEKARAIAH, PRESIDENT

This appeal is by the Complainant challenging the Order dated 16-1-2008 passed by the DF, Bangalore Urban III Additional in complaint No. 1886/07 dismissing her complaint.

The facts in this case are as follows:

The Complainant had taken treatment relating to heart in the OP-2 hospital for the period from 1-11-2006 to 11-11-2006. In respect of the surgery and the treatment the Complainant has paid a sum of Rs.1,76,000/-. This fact is not disputed by OP-2 hospital. Out of this Rs.1,76,000/- the Complainant has already got a sum of Rs.50,000/- from Parekh Health Management. For the treatment taken by the Complainant, Parekh Health Management has paid a sum of Rs.50,000/- to OP -2 Hospital. The remaining amount of Rs. 1,26,000 has been paid by the Complainant to OP-2 Hospital.

The case of the Complainant is that she is a member of the Yashaswini Scheme and therefore under the scheme the trust formed is required to reimburse the medical expenditure. Since the trust has not taken any steps to reimburse the medical expenditure incurred by the Complainant, the Complainant has filed the Complaint before the DF alleging deficiency in Service.

The DF dismissed the Complaint on the ground that the Complainant has not produced any evidence to show that she is the member of any Co-operative Society under the provisions of the Karnataka Co-operative Societies Act so as to get the benefits under the scheme.

The Complainant has produced a letter written by Reshme Belegarara Hagu Raithara Seva Sahakara Bank Nigama, Sulibele which is marked as document No.13, wherein it is clearly stated by the Society that the Complainant is a member of the Society right from
23-8-1983, and her membership no. is 597 and SLF No.419/15. This letter is not disputed by any person.

Along with the appeal memo the Complainant has also produced the extract copy of Member Share Register and Dividend Ledger. This also discloses that the Complainant is a member of the above said society from 1983 onwards.

The Complainant underwent a surgery in the month of Nov. 2006. As on that date, the Complainant is a member of that Society. There is no reason to disbelieve the said document. If that is so, there is no reason for the DF to dismiss the Complaint on the ground that the complainant has not produced any evidence to show that she is a member of any society in order to get the benefit under the scheme.

Under the scheme every member of the society is entitled for medical reimbursement provided they have taken treatment in any one of the Network Hospitals.

It is not in dispute that Wockhardt Hospital is one of the network hospitals. But in the instant case, the Complainant was operated in the hospital run by OP-2, which is located at Bannerghatta Road, Bangalore. Though it is located at Bannerghatta Road, this hospital is also run by the same management. If that were to be the case the Complainant is entitled for reimbursement from the Trust established under the Yashaswini Scheme.

Wockhardt Hospital unnecessarily has been made a party though there is no necessity for the Respondant/ Complainant to implead the said hospital as a party. In the result , we pass the following.

O R D E R
Appeal is allowed.

Impugned order is set aside.

Complaint of the Complainant is allowed directing OP-1 to reimburse a sum of Rs.1,26,000/- to the complainant after drawing the same from the trust within three months from today.

Complaint filed as against OP-2 before the DF is dismissed.

Parities are directed to bear their own costs.


MEMBER MEMBER PRESIDENT