IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, ERNAKULAM

Date of filing : 17.02.2021

Date of order : 30.01.2023

PRESENT:

Shri.D.B.Binu President

Shri. V.Ramachandran Member

Smt. Sreevidhia T.N Member

C.C.No.87/2021

COMPLAINANT

Major.Ranjit H S., S/o.P.T.Harinarayanan, Nandanam, House No.46/2155 H (4) Vaduthala P.O, Pin-682 023

(Party-in-person)
Vs.

OPPOSITE PARTY

Managing Director, Central Organization, ECHS (Ex-Serviceman Contributory Health Scheme), Adjutant General’s Branch, IHQ of MoD (Army), Thimaya marg., Near Gopinath Circle, Delhi Cantt. Pin-110 010

F I N A L O R D E R

Sreevidhia T.N., Member

1) A brief history of the complaint is as stated below:

The complainant is an Ex-short service commissioned Officer of Indian Army, and retired on 27.05.2016 in the Rank ‘Major’ after servicing for 14 years in the Army. Until 07.03.2019 Ex-short service commissioned officers were not entitled to get any medical benefit from service Hospital/ECHS Polyclinic. The central organization, Ex serviceman contributory Health Service Scheme (ECHS) located at Delhi, was launched on 01.04.2003 with the aim of provide medical services to ex-serviceman, pensioner and their dependents staying across the length and breadth of this Nation in service Hospitals and Private Hospitals empanelled with ECHS. Within a short span of time ECHS has acquired a very vast membership. Initially the complainant was released from army without any pensionary benefit and medical benefits due to which neither the complainant nor the dependants of the complainant were eligible to use medical benefit from service hospital.

In the meantime, the complainant’s wife was pregnant and on 16.06.2016. The complainant’s 2^nd daughter was born (by LCSC) in a private hospital, Rajagiri, Aluva at complainant’s own expense. Initially the complainant’s wife was consulted at Lakshmi Hospital Aluva at the complainant’s own expense. The complainant’s wife was consulted at Lakshmi Hospital Aluva by Dr.Zareena Khalid and later she was admitted at Rajagiri Hospital Aluva. The total expenditure towards surgery charges, procedure charges, equipment charges, consultation charges, room rent (single Non Ac), purchase of medicines prescribed by consulted doctors of Rajagiri hospital and Lakshmi Hospital, postal natal care charges and other miscellaneous charges amounts to Rs.73,762/- (Rupees Seventy Three thousand Seven hundred and Sixty Two only). After his retirement, Army Head Quarter vide letter dated 17.02.2017 sanctioned Disability pension @20% for life from the day succeeding the date of retirement. The Principal controller of Defence Accounts (Pensioners), Allahabhad issued Pension Order (PPO) to the complainant on 11.09.2017 which shows contribution of Rs.39,000/- deducted towards Ex-serviceman contributory Health Scheme (ECHS). The Principal Controller of Defence Accounts (Pension) letter No.AT/PSB/x/CPPSC/SBI/Bank/Kerala dated 11.02.2020 clarifies that the date of effect of ECHS facility in respect of the complainant is same as the date of commencement of pension ie., 28.05.2016. The complainant states that thus he and his dependants are entitled to ex-service man contributory health scheme ECHS facility with effect from 28.05.2016. Then the complainant had requested Central Organization (ECHS) vide Registration No. DOPPW/E/2018/00489 and DDESW/E/2018/00219 for reimbursement of expenditure met towards the complainant’s wife’s delivery through online website of centralized Public Grievance Redress and Monitoring system, Department of administrative Reforms and Public Grievance Government of India. But the Central Organization, Ex-serviceman Contributory Health Scheme turned down the complainant’s request vide their letter dated 27.04.2018 saying that there is no provision for reimbursement prior to obtaining ECHS Membership. The complainant alleges that while rejecting the complainant’s request Central Organization, Ex-serviceman Contributory Health Scheme had not considered the fact that the complainant’s ECHS Membership was delayed 8 months by the action of the Personnel of the Army Quarters for finalizing the complainants pensionary and medical entitlement and corresponding time taken by Principal Controller of Defence Accounts, Allahabad for issuing Pension Payment orders, which has to be furnished by the pensioner before ECHS authorities for getting ECHS membership. Hence the complainant approached this Commission for getting orders directing the opposite party to reimburse the complete expenditure of Rs.73,762/-(Rupees Seventy Three thousand Seven hundred and Sixty Two only) towards the delivery of the complainant’s wife and for the post delivery charges for the care of the mother and baby along with cost and compensation.

2) Notice

Notice was issued to the opposite party from this Commission on 16.03.2021 and the opposite party neither appeared nor filed their version.

3) Evidence

The evidence in this case consists of the proof affidavit filed by the complainant and the documentary evidences filed by the complainant which are marked as Exbt.A1 to A72. No oral evidence from the side of the complainant. Evidence closed and Heard the complainant.

5) The issues came up for consideration in this case are as follows:

i) Whether the complainant is a consumer?

ii) Whether any deficiency of service or unfair trade practice is proved towards the complainant from the side of the opposite party?

iii) If so, reliefs and costs?

For the sake of convenience we consider issue No. (i) , (II) and (iii) together.

The complainant is a consumer of the oppoite party as per the Consumer Protection Act, 2019. As per Exbt.A67, the Principal Controller of Defence Accounts (Pension) Allahabad issued Pension Payment orders to the complainant on 11/09/2017 which shows contribution of Rs.39,000/- deducted towards Ex-Serviceman Contributory Health Scheme (ECHS) facility. This Militory person is a consumer of the Department. Since there is a consideration of Rs.39,000/- paid by the complainant to the opposite party towards (ECHS) facility.

We have gone through the complainant and documents filed by the complainant.

As per Exbt.A66, letter dated 17.02.2017, the initial claim of Disability pension of Maj.Ranjit HS 9 GR (Released), @20% for life with effect from the dated of his release. The complainant was retired from the army on 28.05.2016.

As per Exbt.A67, the Principal Controller of Defence Accounts (Pension), Allahabad issued Pension Payment order to the complainant on 11.09.2017 which shows that contribution of Rs.39,000/- deducted towards Ex-serviceman contributory Health Scheme (ECHS) facility. The complainant states that hence he is entitled for ECHS facility. Exbt.A68, dated 11/02/2020 clarifies that the date of effect of ECHS facility in respect of Major Ranjith HS is same as the date of commencement of pension ie., 28/05/2016. The complainant argues that thus he is entitled to Ex-service man contributory Health Scheme (ECHS) facility with effect from 28/05/2016.

Exbt.A69 and A70 are the grievances of the complainant, regarding the reimbursement of the medical bills, which are registered through online website of Centralized Public Grievance Redress and Monitory system, Department of Administrative Reforms and Public Grievance (DARPG) Government of India. As proved from Exbt.A71, the Central Organization (ECHS) Integrated HQ of MoD (Army) Maude Lines, Delhi Cantt-10 denied the complainant’s request vide their letter dated 27.04.2018 stating that there is no provision for reimbursement prior to obtaining ECHS Membership. As per Exbt.A72, in the ECHS Advisory note on reimbursement of individual claims it has been emphasised that individual claims should reviewed in the light of judgments on similar case. The courts have opined that once an ESM is a bonafide member of the scheme, Medical treatment/reimbursement in an emergency cannot be denied to him/her simply because he/she could not follow certain laid down procedure/instructions.

The complainant in his complaint submits that in the case of Sujan Singh Vs. Union of India and others OA 350 of 2010, Hon.Armed Forces Tribunal, Chandigad had observed that the claim of the petitioner for reimbursement of Medical bills could have not been denied, in the peculiar facts of the case on mere technicalities. The complainant states that based on this judgment, the complainant is entitled to get reimbursement of the medical expenses incurred by him towards the treatment of his wife.

The opposite party did not appear in person or through their counsel even after accepting the notice from this Commission. The opposite parties have not turned up and no version was filed by them. Hence the opposite parties are set ex-parte. The opposite parties conscious failure to file their written version inspite of having received the Commission’s notice to that effect amounts to an admission of the allegations levelled against them. Here, the case of the complainant stands unchallenged by the opposite parties. We have no reason to disbelieve the words of the complainant. The Hon’ble National Commission held a similar stance in its order dated 2017 (4) CPR page 590 (NC).

So we are of the opinion that the case of the complainant is to be allowed as undisputed.

In the result, the complaint is allowed as follows:

1) We direct the opposite party to refund Rs.73,762/- to the complainant.

2) We direct the opposite party to pay Rs.5,000/- as compensation to the complainant for the inconvenience caused due to the deficiency in service of the opposite parties.

3) We direct the opposite party to pay Rs.3,000/-as cost of the proceedings to the complainant.

The above orders shall be complied with, within one month from the date of receipt of a copy of this order, failing which the amount ordered vide order No. (1) shall carry interest @5% p.a. from the date of order till realization.

Pronounced in the Open Commission this 30^th day of January 2023.

Sd/-

Sreevidhia T.N., Member

Sd/-

D.B.Binu, President

Sd/-

V.Ramachandran, Member

Forwarded by Order

Assistant Registrar

APPENDIX

Complainants Exhibits

Opposite party’s Exhibits : Nil