Chandigarh

StateCommission

A/219/2019

Grewal Eye Institute Private Limited - Complainant(s)

Versus

M/s Apollo Munich Health Insurance Company Limited - Opp.Party(s)

Priyanka Singla & Rohit Gupta Adv.

11 Feb 2020

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

Grewal Eye Hospital Private Limited, through its Director (Dr.S.P.S. Grewal), at SCO No.166-169, Madhya Marg, Sector 9-C, Chandigarh.

……Grewal Hospital/opposite party no.3

V e r s u s

1. M/s Apollo Munich Health Insurance Company Limited (Through Ms.Deepti Rustagi, Vice President-Legal and Compliance) 2^nd & 3^rd Floor, ILABS Centre, Plot No.4404-405, Udyog Vihar, Phase-III, Gurugram– 122016.

…..Respondent No.1/opposite party no.1

2. M/s Apollo Munich Health Insurance Company Limited (Through its Branch Manager) Branch Office at 4^th Floor, SCO No.50-51, Sector 34-A, Chandigarh.

…..Respondent No.2/opposite party no.2

3. Sandeep Khunger, House No.2201, Sector 38-C, Chandigarh,

…..Respondent no.3/complainant no.1

4. Shabnam Khunger, House No.2201, Sector 38-C, Chandigarh

…..Respondent no.4/complainant no.2

BEFORE:             JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                             MRS. PADMA PANDEY, MEMBER

                             MR. RAJESH K. ARYA, MEMBER

Present:               Sh.Amrinder Singh and Ms.Priyanka Singla, Advocates for the appellant.

                             Sh.Vishal Sharma, Advocate for respondents no.1 and 2.

                             Sh.Sandeep Khunger, respondent no.3 in person and Advocate for respondent no.4

PER JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                   The Grewal Hospital (opposite party no.3 before the District Forum) has come up in this appeal by assailing order dated 29.08.2019, passed by the District Consumer Disputes Redressal Forum-I, U.T., Chandigarh, vide which the consumer complaint filed by complainants no.1 and 2 (complainants herein) was allowed in the following manner:-

16. In view of the above discussion, the present consumer complaint succeeds and we fasten the liability on the OPs in the following manner : -

1. OP-3 to pay the amount of Rs.1,01,000/-to complainant No.2 alongwith interest @ 9% per annum w.e.f. 22.11.2017 till realization.
2. OP-3 to pay an amount of Rs.20,000/- to complainant No.2 as compensation for causing mental agony and harassment;
3. OPs 1 & 2 to pay Rs.15,000/- to complainant No.2 as costs of litigation.

17. In view of the above directions passed by us, in so far as the loss caused to complainant No.2 is concerned, it has been restored.  But, we feel it is an exceptional/appropriate case where some exemplary cost needs to be imposed upon OP-3 who indulged in conscious wrong, unfair trade practice and outrageous conduct by breaching their own package agreed with OPs 1 & 2.  Exemplary cost also needs to be imposed on OP-3 to set an example for his reformation as well as other private hospitals so that they may not indulge in such like practice and deter from conscious wrong doing for personal gains and engaging in similar type of conduct. 
18. OP-3 had admitted, agreed amount was Rs.48,000/- and charged amount was Rs.1,49,000/- and even OPs 1 & 2, a party to the agreement, in their joint reply had also highlighted amount was overcharged.  Therefore, they had the opportunity and were aware of the facts of such like imposition of exemplary cost. 
19. Taking into account that it is appropriate case and having regard to the pros and cons, we proceed to impose exemplary cost of Rs.1,00,000/- on OP-3 and this cost amount be deposited by it with Consumer Legal Aid Fund account head being maintained in the name of Secretary, State Consumer Disputes Redressal Commission, UT, Chandigarh which may be utilized under the orders of the competent authority for the purpose of providing legal aid to the economically poor persons and weaker sections of society as well as making the consumer awareness by holding appropriate programmes.    
20. This order be complied with by the OPs severally within thirty days from the date of receipt of its certified copy, failing which, they shall make the payment of the amounts mentioned at Sr.No.16(i) & (ii) above, with interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.16(iii) & 19 above.

21. The certified copies of this order be sent to the parties free of charge. A certified copy of this order be also sent to the Secretary, Hon’ble State Commission, UT, Chandigarh for filing an execution application for recovery of the aforesaid amount of Rs.1,00,000/-, as and when the order becomes final as the amount is to be deposited in legal aid fund for help of poor consumers.  The file be consigned”.

2. The following facts are not in dispute in this case:-

1. On 26.12.2011 health insurance policy was obtained by the complainants from the Insurance Company, which policy was valid till 25.12.2012.
2. The said policy was renewed from time to time and also renewed from 20.01.2017 to 19.01.2018.
3. On 02.10.2017, Smt.Shabnam Khunger had gone to Grewal Hospital for medical checkup of her eyes. She was advised surgery of cataract and told two kinds of surgeries i.e. Phaco/Robolazr Cataract Surgery, vide letter dated 02.10.2017, relevant contents whereof read as under:-

“Mrs.Shabnam Khunger 47F

2201 Sector 38c

Chandigarh

Diagnosis: Cataract Ou

Rx

Advised Robolazr Cataract Surgery with IOL implant Left Eye

Please get the reports of the following investigations and report at least one day before Robolazor/Phaco cataract surgery with foldable intraocular lens at 9.00 am or 3.30 pm for Biometry and instructions preparatory to surgery:

Please discuss the details with your surgeon to decide which procedure will be best suited for your eyes and needs. For more details please contact the counsellor............”

4.  On 24.10.2017, the complainants sent an email to insurance company informing them that Smt.Shabnam Khunger has been advised by the Grewal Hospital vide letter dated 02.10.2017 (ibid) to undergo Robolazr Cataract Surgery with  IOL ( Implant Left Eye, costing Rs.1.49 lacs.
5. On 25.10.2017, the insurance company vide email responded and stated that the Grewal Hospital is a network hospital and would be entitled to cashless benefit. However, she was asked to submit necessary documents alongwith the claim form and follow procedure set out in the claim procedure. It is noteworthy here that in the first letter dated 25.10.2017 of the insurance company no restriction was imposed on the surgery charges.
6. On 04.11.2017, the complainants again sent email but this time, in the reply, insurance company informed that cashless request has been approved for Rs.48,000/- only. On 04.11.2017 itself the insurance company issued authorization letter as date of surgery on 07.11.2017 with a payment guarantee of Rs.48,000/-.
7. On 23.11.2017, Robolazr Cataract Surgery was carried out by the Grewal Hospital upon Smt.Shabnam Khunger and an amount of Rs.48,000/- was provided by insurance company. The claim in respect of remaining amount of Rs.1,01,000/- has been repudiated by insurance company vide Annexure C-12, which is dated 24.01.2018 and relevant part of the same is reproduced hereunder:-

“Settlement Letter

Dear Mr./Ms. Shabnam Khunger,

Thank you for choosing Apollo Munich as your trusted Health Insurance Partner.

We are happy to inform you that we have processed your claim and the settlement details are mentioned above:-

Please note that the amount mentioned above is the full and final settlement of the claim submitted by you”.

3.           Hence consumer complaint has been filed by complainants before the District Forum.
4.           On notice being issued, insurance company/opposite parties no.1 and 2 filed their joint written statement, wherein while making reference to the terms and conditions of the insurance policy; it was stated that in such like surgeries, the amount of Rs.48,000/- in total was to be charged by the empanelled/approved hospital of the Grewal Hospital, which was paid by them; that there was no need for performing robotic surgery upon Smt.Shabnam Khunger; and that claim for the remaining amount was rightly repudiated by the insurance company. 
5.           Grewal Hospital in its written reply made following averments:-

“On examination she was diagnosed with Cataract in both eyes and advised to undergo cataract surgery with IOL implant in Left Eye first. (Annexure -1)

On patients request hospital have initiated preauthorization for cashless facility for the cataract surgery in left eye on 4^th  November 2017 with Apollo Munich Health Insurance as per the agreed package signed with Apollo Munich Health Insurance with Grewal Eye Institute, after explaining the same to patient Mrs. Shabnam Khunger and her attendant. (Annexure 2,2.1). The date of admission requested for 7^th   November 2017 for Rs.48,000/- as per agreed package with Apollo Munich Health Insurance and the cashless was approved for Rs.48,000/-. (Annexure -3). Since patient could not turn up for surgery the date of admission was extended to 23-11-2017 as per patients request.(Annexure 4). We have also sent bill breakup and the tupr of IOL used as patient opted to go ahead  with Robolazr with Symphony IOL implantation which costs Rs.1,49,000/- to Apollo Munich Health Insurance query as reply. (Annexure 5,6). Apollo Munich Health Insurance had refused for Robotic charges and asked us to send revised break up as per monofocal IOL i.e. for Rs.48,000/- (Annexure -7). We have explained these details to patient attendant and made him to speak to the concerned person who deals with cashless approvals at Apollo Munich Health Insurance, Mr Dheeraj Madaan (9041 229747) and also informed him that the patient wants  to go for Robolazr Symphony IOL package and wants to reimburse the difference amount with Apollo Munich Health Insurance later.

The Robolazr with Symphony IOL surgery was performed on 23-11-2017 and we have sent final bill and discharge certificate after surgery as a protocol to get final approval. (Annexure 8, 8.1). We have received the final approval for Rs.48,001/- and rest of the amount was paid by patient and left hospital  (Annexure-9)”       

6.           In the rejoinder filed, the complainants reiterated all the averments contained in their complaint and controverted those contained in written reply filed by the Grewal Hospital and the insurance company.
7.           The District Forum after hearing the Counsel for the parties had passed the impugned order, relevant part whereeof has been reproduced in para no.1 of this order.
8.           We have heard counsel for the parties and carefully gone through the material available on the record. 
9.           After giving our thoughtful consideration to the rival contentions and pleadings of the parties; as well as findings available on the record, this Commission is of the considered view that some of the observations made by the District Forum in the order impugned, are without foundation or paradoxical.  In para no.10 of the impugned order, it has been stated that no option from Smt.Shabnam Khunger was taken at the time of advising Robolazr Cataract Surgery but this observation appears to have been passed by the District Forum on surmises. The Grewal Hospital in its letter dated 02.10.2017, reproduced above, has clearly advised Smt.Shabnam Khunger for Robolazr/Phaco Cataract Surgery and she was asked to discuss her surgeon which procedure will be best suited for her eyes
10.           It is a fundamental case of Smt.Shabnam Khunger that she faced some problem in her eyesight and on taking her to the Grewal Hospital, it opined that she was suffering from Cataract Ou left eye and was advised Robolazr Cataract Surgery with IOL implant Left Eye.  She sent a letter through email on 24.10.2017 to the insurance company, which reads as under :-

“I am insured with M/s Apollo Munich Health Insurance w.e.f. 26.12.2011 and thereafter the said policy was got renewed from time to time and the current policy is valid from 20.01.2017 to 19.01.2018.

That faced with the eye problem, I got myself checked from Grewal Eye Institute, Chandigarh on 02.10.2017 and after examination the Grewal Eye Institute had advised Robolazr Cataract Surgery with IOL implant Left Eye. A copy of the prescription slip dated 02.10.2017 is enclosed herewith for your ready reference.

The said Grewal Eye Institute has further informed that the approximate charges for the above said surgery shall be Rs.1,49,000/-

I may be informed as to whether there is cashless facility available with Grewal Eye Institute, Chandigarh or I shall have to pay and then claim the reimbursement.

An early reply shall be appreciated as I intend to get the surgery done on or about 27.10.2017.”

11.            In reply to letter dated 24.10.2017, the insurance company sent  reply vide email dated 25.10.2017 (Annexure C-4) relevant contents of which read as under:-

“Greetings from Apollo Munich Health Insurance.

Thank you for intimating us about your claim.

I have registered your request with claim intimation ID 130243.

Please submit the documents as given in the enclosed claim form and claim procedure for us to process your claim (as per policy terms and conditions).

Please be informed that the hospital is a network hospital hence you will be avail to take cashless benefit.

Cashless claim: Please carry, the patients valid íd proof and share his/her member id at the TPA desk in the network hospital.”

12.           Thus, it makes it very clear that on 02.10.2017, the Grewal Eye Hospital advised Robolazr Cataract Surgery with IOL implant left eye and the doctor concerned, specifically requested Smt.Shabnam Khunger to discuss the details with her surgeon to decide which procedure i.e. Phaco or Robolazr Surgery will be suited for her eyes and needs. However, she chose Robolazr Cataract Surgery and this is why the above letter dated 24.10.2017 (supra) was sent by her to the insurance company. Thus, the bare perusal of the documents transpire that option was given to Smt.Shabnam Khunger vide letter dated 02.10.2017 by Grewal Eye Hospital to discuss with her surgeon to decide which procedure will be best suited to her eyes and she chose Robolazr Cataract Surgery.
13.           In the grounds of appeal in para nos.12 to 14, the Grewal Hospital has given details and importance of Robolazr Cataract Surgery technology which is reproduced hereunder:-

“12. Robolazr is a technology which makes a near perfect incision and breaks the natural lens into equal number of pieces. As a result, the hazy natural lens can be removed in an easier manner by reducing the risks of any complications. Further as a result of the perfect incisions, the man-made lens fits better in the eye and remains stable given that the new lens has a near perfect opening to rest on. In a nutshell Robolazr technology ensures better results and  a safer surgical process.

13. The Robolazr technology substantially reduces the risks to which a patient is exposed to during the surgery. This is for the simple reason that when the surgery is performed, the patient is awake and is administered local anaesthesia. If the patient moves his head even slightly while the surgeon is manually making the incisions, the needle can may damage the eye and result in complications in the initial stage of surgery and can make incisions larger than necessary. The Robolazr technology ensures that the incisions are near perfect without exposing the patients to any untoward risks and complications.

14. There is ample evidence that Robolazr Cataract Surgery is definitely much safer as compared to incisions and breaking of the lens undertaken manually in the conventional method ..............”

14.           These averments have not been denied either by filing a rejoinder or during the course of arguments. In this view of the matter, we are of the view that Robolazr Cataract Surgery is one of the best technologies for the removal of cataract.
15.           In the circumstances enumerated above, the Insurance Company has no right to compel the patient or policy holder to go for a basic or Phaco surgery. The policy holder may chose the best of the medical treatment for e.g. if a policy holder is ready to deliver a baby, she can’t be compelled by the insurance company to go for a natural way to give birth and in case she chooses caesarean operation, she cannot be denied the charges thereof, solely on the ground that she chose caesarean operation instead of natural way of giving birth to a baby. 
16.           Now coming to the denial of making payment of remaining amount, in Annexure C-4 dated 25.10.2017, while replying letter dated 24.10.2017 of complainants, they nowhere stated that the liability will come only to Rs.48,000/-. In her letter dated 24.10.2017, which was sent alongwith email (Annexure C-3), Smt.Shabnam Khunger had categorically stated that the approximate charges of the surgery will come to Rs.1,49,000/- and she sought an opinion of the insurance company, as to whether there is cashless facility available with Grewal Eye Hospital or she had to pay and then claim reimbursement thereof. In its reply, it is simply stated by the insurance company that the said hospital is a network hospital and that she can avail cashless benefit.

A combined reading of letter dated 24.10.2017 as well as email dated 25.10.2017 (Annexure C-4) aforesaid, infer that the entire amount of Rs.1,49,000/- can be taken as cashless benefit, but, thereafter, the insurance company vide email dated 04.11.2017 (Annexure C-6), informed Smt.Shabnam Khunger that her request for cashless reimbursement has been approved to the extent of Rs.48,000/- only, with the condition to submit IOL sticker and copy of the invoice alongwith identity card of the patient at the time of claim submission.

17.           The District Forum has given observation that there was an agreement between the insurance company and the Grewal Hospital, which is based upon the cross examination of Dr S.P.S. Grewal, when he was called as a witness. On the queries put by the District Forum, following answers were given by Dr S.P.S. Grewal:-

“Q.     Were your hospital empanelled with OP No.1 & 2          Insurance    Company in cashless facility for the person     insured by OP       No.1 & 2 for month of November 2017?

A.      Yes sir.

Q.      What was your agreed rate of cataract surgery entered into    inter se your hospital and OP No.1 & 2?

A.      The agreed rate for basic cataract surgery was Rs.48,000/-.

Q.      Was Mrs.Shabnam Khunger, Complainant No.2, was hospitalized in your hospital       on 23.11.2017 and how           much amount was charged by you for cataract surgery?

A.      The total amount charged by us was Rs.1,49,000/- for Robo Lazer & Symfony Procedure Left Eye. The Robo Surgery was done, therefore, sum of was Rs.1,49,000/- was charged. It was under different package.

Q.      What was the term used in agreement with OP No.1 & 2, was it cataract surgery in which every method of cataract surgery is included?

A.      I do not recollect it.

Q.      Can you give the details of Rs.1,49,000/- charged by   you from the complainant?

A.      The details have been given in Annexure-8. We have charged for lens a sum of Rs.55,000/-.

Q.      What was the MRP price of the lens of which Rs.55,000/- was charged? Can you produce wrapper and any other proof disclosing the MRP of lens which was implanted on complainant No.2?

A.      The MRP was Rs.55,000/-. The wrapper is with the Insurance Company.

          (However, the party has produced one Tecnis Symfony, date of import 03/2017 & MRP as per Indian Currency Rs.59,000/-). After perusal, returned to the party.

A.      I cannot produce the wrapper of the lens implanted on complainant No.2 and description in Annexure-6, IOL details have not been given.

Q.      After subtracting Robo charges of Rs.50,000/- as per Annexure-6, how much you have charged from complainant No.2 over & above Rs.48,000/- agreed rate?

A.      We have charged Rs.99,000/- i.e. Rs.51,000/- over &   above agreed amount of Rs.48,000/-, but it was as per option of the patient.

Q.      How do you respond to the Annexure R-5 issued by Sai Deep Eye Clinic dated 22.11.2018?

A.      The report given by Dr.Nitin Balakrishnan is incorrect as he is not qualified for Robo Lazr Surgery, therefore, report is not correct, whereas I am qualified person for Robo Lazr Surgery.

X     X     X     X     X     X     X     X     X     X 

Opportunity given to counsel for OP No.3 for further examination on the answers given to the questions put by this Forum.

As and when patient is admitted for cataract surgery in our hospital, he selects his own package and final choice is done by patient after counseling. Complainant No.2 had herself written to the insurer for the package of Robo Lazr Surgery costing Rs.1,49,000/- as also admitted in the complaint by complainants. Therefore, we have performed the Robo Lazr Surgery for which additional charges over and above fixed Rs.48,000/- paid by complainants as the policy covered Rs.48,000/-.

Further examination/cross examination on behalf of OP No.1 & 2.

X     X     X     X     X     X     X     X     X     X 

Nil. Opportunity given.

X     X     X     X     X     X     X     X     X     X 

Further examination/cross examination on behalf of complainants.

I have perused the OPD prescription No.357554 dated 02.10.2017 which shows that our hospital has advised Robo Lazr Cataract Surgery with IOL Implant Left Eye to complainant No.2. In the present case/complaint, IOL could have been implanted in the left eye with the help of Robo Lazr procedure to achieve perfect result. If in the right eye, IOL is to be implanted, we will go for the same procedure”

18.           In a query put by the District Forum to Dr S.P.S. Grewal, as to what was the agreed rate of cataract surgery entered inter se his hospital and insurance company, he replied that the agreed rate for basic cataract surgery was Rs.48,000/-. It is nobody’s case that there was any agreement between the insurance company or the hospital for payment of only amount of Rs.48,000/- for the said surgery. Even no agreement has been produced either by the insurance company or by the hospital or by complainants in that regard.  Under Section 91 of the Indian Evidence Act 1872, it is provided as under:-
    • 91. Evidence of terms of contracts, grants and other dispositions of property reduced to form of documents.—When the terms of a contract, or of a grant, or of any other disposition of property, have been reduced to the form of a document, and in all cases in which any matter is required by law to be reduced to the form of a document, no evidence shall be given in proof of the terms of such contract, grant or other disposition of property, or of such matter, except the document itself, or secondary evidence of its contents in cases in which secondary evidence is admissible under the provisions hereinbefore contained."

19.           No doubt, as stated above, in his reply to above said query, Dr S.P.S. Grewal stated that the agreed rate of cataract surgery entered inter se his hospital and insurance company was Rs.48,000/- but in the present case, the patient had decided to go for the advised Robolazr Cataract Surgery, it cannot be inferred that the liability of the insurance company restricted to the extent of Rs.48,000/- only, because Dr.S.P.S. Grewal has stated that this amount was meant for basic cataract surgery. Thus, we are of the considered view that the insurance company is liable to make payment of the entire amount, which is reasonable in terms of the policy. In this view of the matter, the observations of the District Forum that the Grewal Hospital had conducted the Robolazr Cataract Surgery, which was neither necessary nor was advised nor was opted by the patient are against the facts and evidence, and thus, not sustainable in the eyes of law. 
20.           The insurance company has taken a specific plea that the detailed bill for cataract surgery is excessive one. We have considered this contention and minutely gone through the revised bill dated 23.11.2017 (at page no.131 of the appeal file) and found that the amount of Rs.1,49,000/- was received by the Grewal Hospital towards the said surgery under following heads:-

21.           In this case Robolazr Cataract Surgery charges of Rs.50,000/- has been imposed upon Smt.Shabnam Khunger, besides imposing surgery charges of Rs.28055.01ps.; OT Consumables charges to the tune of Rs.3444.99ps plus  OT Charges to the tune of Rs. 8000/-; Monitored Anaesthesia Care (MAC) charges to the tune of Rs.2500/-; IOL Charges to the tune of Rs.55000/-; and Bed Charges to the tune of Rs. 2000/-. During the course of arguments, it was submitted that the above charges also include the charges for purchasing the costly machine for performing Robolazr Cataract Surgery and its maintenance. We have considered the contention  but the same sans merit.
22.           We are not oblivious  of   the   fact   that   medical inventions are coming day by day both in equipments and medicines. Therefore, the   modern   technology  and paraphernalia   in   medical   science are   utmost   essential   for   betterment   of   the   patients. We are also aware of the fact that the medical equipments are too costly. Even then, the patients cannot be overburdened by charging from them the expenses incurred towards purchase and maintenance of medical equipments/machines. As such, a hospital or a medical doctor cannot impose cost of the machinery or its maintenance charges, upon the patients.
23.           Furthermore, if the machine is costly i.e. out of the reach of a particular hospital or a doctor, then they are not obliged to purchase and install it at the cost of the patients. If they have already installed it, then they cannot charge extra amount for installation of the said machine from the patients. To this extent, we are treating it as an unfair trade practice on the part of the Grewal Hospital. Thus, we are of the considered opinion that the insurance company is not liable to make payment of Rs.50,000/- and this amount shall be deducted from the bill and needs to be refunded to the complainants by the Grewal Hospital. Remaining amount of Rs.99,000/- has to be paid by the insurance company.
24.           Now coming to the opinion of the expert (Annexure R-5), it may be stated here that infact the same is not admissible into evidence. The said opinion has been submitted by Dr. Nitin Balakrishnan of one Sai Deep Eye Clinic, which is dated 22.11.2018. The said Doctor did not medically checkup the patient, rather, his opinion is basically based upon the documents. Relevant part of his report (Annexure R-5) is reproduced hereunder:-

“I have seen all the documents appended and observed that patient was advised to undergo Left Eye Cataract Surgery through Robolazor and a Symphony multifocal lens was implanted.

I have been asked to opine whether surgery through Robolazor was medically indicated or cataract could have been operated by conventional methods? I have also been asked to opine whether multifocal lens had to be installed or a unifocal lens would have been enough?

I opine that Robolazor was not medically mandated. The cataract could have been operated by conventional Phaco + IOL. Further, only if one eye already has a multifocal lens implanted, then the second eye has to be implanted with multifocal lens. Else (if other eye is not operated) unifocal lens suffices.”

Nothing is mentioned, which of the documents have been perused or considered by Dr. Nitin Balakrishnan. He did not furnish any affidavit; rather, affidavit has been furnished by Dr.C.H. Asrani, who is the Chief Executive of INCHES Healthcare Pvt. Limited, and on whose behalf expert medical opinion dated 22.11.2018 was given, on the request of insurance company. In these circumstances, opinion of Dr. Nitin Balakrishnan is not acceptable in the eyes of law. The observation of the District Forum to this extent is also not sustainable, as such, the same is hereby set aside.

25.           In view of above, this appeal is partly allowed with the modification as under:-
    1. Insurance company/respondents no.1 and 2 to pay an amount of Rs.51,000/- to the complainant- Smt.Shabnam Khunger (Rs.99,000/- minus (-) the amount of Rs.48,000/- already paid). alongwith interest @9% p.a. from 22.11.2017
    2. The Grewal Hospital/appellant shall refund the amount of Rs.50,000/-, referred to in para. no.23 of this order above,  alongwith interest @9% p.a. from 22.11.2017 to complainant- Smt.Shabnam Khunger.
    3. The appellant shall make the payment of compensation in the sum of Rs.50,000/- and respondents no.1 and 2, shall also make payment of Rs.50,000/- to complainant-Smt.Shabnam Khunger, as compensation for causing mental agony and physical harassment and also deficiency in providing service and adoption of unfair trade practice, as referred to above. 
    4. This order shall be complied with by the Grewal Hospital and insurance company within a period of 30 days from the date of receipt of a certified copy thereof, failing which, the amounts mentioned at sr.nos. (i) to (iii) above shall carry penal interest @12% p.a. from the date of default, till realization.

26.           Certified copies of this order be sent to the parties, free of charge.
27.           The file be consigned to Record Room, after completion.

Pronounced

11.02.2020

Sd/-

[JUSTICE RAJ SHEKHAR ATTRI]

PRESIDENT

Sd/-

 (PADMA PANDEY)

          MEMBER

Sd/-

(RAJESH K. ARYA)

MEMBER

 Rg.