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HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Surjit Singh, President, Chander Shekhar Sharma, Prem Chauhan, Members
Raavi Multi Specialty Hospital — Appellant
Vs.
Bakshi Chand Katoch — Respondent
First Appeal No. 161 of 2012
Decided on : 26-03-2013

Advocate Appeared:
For the Appellant :Mr. Vinod Kaystha and Mr. Manohar Lal Sharma, Advocates,
For the Respondent:Mr. Vinay Soni, Advocate

Headnote:

Consumer Protection Act - Medical Reimbursement - The court dismissed the appeal and upheld the order for the appellant to pay a sum of Rs. 57,229/- to the respondent within thirty days, failing which interest has been ordered to be paid on the aforesaid amount of money at the rate of 9% per annum, from the date of the complaint till actual payment, with a further direction for payment of Rs. 10,000/- as compensation and Rs. 5,000/- as costs.

Fact of the Case:

The respondent filed a complaint under the Consumer Protection Act, 1986, alleging that the appellant hospital falsely claimed to be recognized for reimbursement of medical expenses, resulting in the rejection of his claim for medical expenses incurred for his wife's treatment at the hospital.

Finding of the Court:

The court rejected the appellant's argument that the respondent was not a consumer and upheld the jurisdiction of the District Forum. It also found that the appellant had been served notice and that the evidence proved the false claim of recognition by the appellant hospital.

Issues: Misrepresentation of recognition for medical reimbursement, jurisdiction of the District Forum, and service of notice to the appellant.

Ratio Decidendi: The court held that the definition of a consumer includes a person who hires a service for consideration, even if they do not avail the service themselves. It also upheld the jurisdiction of the District Forum based on the rejection of the reimbursement claim at the respondent's place of employment.

Final Decision: The appeal was dismissed, and the order for the appellant to pay the sum of Rs. 57,229/- to the respondent, along with interest, compensation, and costs, was upheld.

ORDER :

(Retd.) Surjit Singh, President (Oral)

Appellant is aggrieved by the order dated 24.04.2012, of learned District Consumer Disputes Redressal Forum, Kangra at Dharamshala, whereby a complaint, under Section 12 of the Consumer Protection Act, 1986, filed against it by respondent, Bakshi Chand Katoch, has been allowed and it (the appellant) has been ordered to pay a sum of Rs. 57,229/- to the respondent within thirty days, failing which interest has been ordered to be paid on the aforesaid amount of money at the rate of 9% per annum, from the date of the complaint till actual payment, with a further direction for payment of Rs. 10,000/- as compensation and Rs. 5,000/- as costs.

2. Respondent, Bakshi Chand Katoch, filed a complaint, under Section 12 of the Consumer Protection Act, 1986, before the learned District Consumer Disputes Redressal Forum, Kangra at Dharamshala, alleging that he is a Government servant and is entitled to medical reimbursement of expenses incurred upon his own medical treatment as also the medical treatment of his dependent family members. He alleged that on 22.04.2011, when he alongwith his wife had gone to Pathankot, an accident took place, in which his wife sustained commented fracture of left proximal tibia with ipsilateral compound fracture grade II shaft of tibia, and she was taken to the appellant hospital, which was close to the site of the accident. It was stated that the respondent inquired from the workers of the hospital of the appellant, whether the hospital was recognized for reimbursement of medical expenses of government servants of Himachal Pradesh, who told that the appellant hospital was duly recognized. Also, it was displayed on a hoarding of the hospital that it was recognized by the State of Himachal Pradesh for reimbursement of medical expenses of Government servants and their dependents. Complainant further alleged that he got his wife admitted at the hospital of the appellant, believing that the medical expenses incurred would be reimbursed. It was further stated that the respondent paid a sum of Rs. 57,229/- on account of medical expenditure at the hospital of the appellant, but when he submitted the bills to his Head of Office for reimbursement, his claim was rejected on the ground that recognition of appellant hospital stood expired on 25.11.2010 and the treatment of the respondents wife was carried out in the month of April, 2011.

3. Appellant did not appear despite service of notice and was, therefore, proceeded against ex-parte. Learned District Forum, vide impugned order, has concluded that the appellant hospital was not recognized by the State of Himachal Pradesh for reimbursement of medical expenses of Government servants or their dependents at the time when the wife of the respondent took treatment at the appellant hospital. Learned District Forum has also held that it was mis-represented by the appellant that the hospital was recognized and this amounted to cheating. With these allegations, impugned order has been passed.

4. We have heard learned counsel for the parties and gone through the record.

5. It is submitted on behalf of the appellant that treatment was taken at the hospital of the appellant by the wife of the respondent and not the respondent himself and, therefore, he is not a consumer. Submission has been noticed only to be rejected. Reimbursement by the employer of the respondent was to be given to him not only in respect of his own treatment, but also the treatment of his dependents. Patient in this case being the spouse and dependent of the respondent, he was entitled to seek reimbursement of medical expenses. It was he, who incurred the expenditure, and made the payment at the hospital of the appellant. Definition of consumer as given in Section 2(1)(d)(ii) of the Consumer Protection Act, 1986, says that a person, who hires or avails of any service for consideration, is a consumer. That means, it is not only the availer of the service, who is included

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