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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. S.M. Kantikar, Presiding Member and Binoy Kumar, Member
Nandita Datta and Anr. —Petitioners
versus
Dum Dum Municipal Specialised Hospital and Ors. —Respondents
Revision Petition No.1886 of 2018 and Revision Petition No.1890 of 2018
Decided on 15.3.2022
For the Petitioners:Mr. Utpal Kumar Basu, Advocate
For the Respondent Nos.1 and 2:Ms. Sonali Bhattacharya and Ms. Sanghamitra Mukherjee, Advocates
For the Respondent Nos.3 and 4: Nemo
For the Respondent No.5: Nemo
For the Respondent Nos.6 and 7:Mr. Rabin Majumdar and Ms. Akansha Srivastava, Advocates
IMPORTANT POINT
Multiplicity of proceedings – The filing of two separate complaints, one by husband and the other by the wife for same cause of action is nothing but multiplicity of proceedings.
Headnote:
(A) Consumer Protection Act, 1986 – S.21 [Consumer Protection Act, 2019 – S.58] – Services – Insurance – Whether repudiation of Insurance co. for hospitalization claim on the ground of pre-existing disease (DM & HT) – whether two Complaints are maintainable for one Cause of action – the repudiation of Insurance co. for hospitalisation claim on the ground of pre-existing disease (DM & HT) is justified. The dispute arose for non-payment of the hospitalisation expenses and prima-facie, the case of the medical negligence was not made out. Thus, filing of two separate complaints, one by husband and the other by the wife for same cause of action is nothing but multiplicity of proceedings. Such complaints with inflated claims can cause disincentive to the doctors / hospitals. It should be borne in mind that, the Act, 1986 (now 2019) being a beneficial legislation casts equal to create responsibility to the complainants in alleged medical negligence case. [Para 13].
Held: Therefore, the Insurance Co. was justified to reject the hospital claim of Rs. 24,097/- on the ground of pre-existing disease, which was material concealment in the instant case.
(B) Consumer Protection Act, 1986 – S.21 [Consumer Protection Act, 2019 – S.58] – Services – Insurance – Medical Negligence – Whether Medical Negligence can be attributed to the OP’s – The patient was treated conservatively in Dum Dum Hospital, but the patient herself got discharged AMA from the hospital. Thereafter, the patient took OPD treatment at Apollo Gleneagles Hospital in Institute of Gastroscience, wherein same previous treatment was given. CT scan and USG done outside revealed no significant abnormality and nothing is on record to prove deterioration of her health. Therefore, the medical negligence is not attributable to either the Dum Dum Hospital or the treating doctors. Though both the Complainants have not raised any allegations against the Apollo Hospital and its Gastro Science Institute, they were unnecessarily impleaded in this litigation. [Para 12].
Result: Complaints dismissed.
ORDER
Dr. S.M. Kantikar, Presiding Member.—This order shall decide both the Revision Petitions filed under Section 21 of the Consumer Protection Act, 1986 (in short “the Act”) against the common order dated 11.06.2018 in R.P. 246/2017 of the State Commission.
2. The facts are drawn from R.P. No.1890/2018. Accordingly, Dr. Kaliprasad Dutta is the Complainant, Dum Dum Municipal Specialised Hospital is the OP-1 (for short, ‘Dum Dum Hospital’), Dr. Samit Kumar Chatterjee is the OP-2, the Star Health & Allied Ins. Co. Ltd. is the OP-3 (for short, ‘Insurance Co.’), the Apollo Gleneagles Hospital is the OP – 6 and its Institute of Gastro Science is the OP-7.
3. The Issue involved is whether two Complaints are maintainable for one Cause of action.
4. Both the Petitioners are original Complainants. Both have filed individual complaint before two different the District Forum. One Complaint CC/97/2017 was filed by Dr.Kaliprasad Datta at Kolkata-I. Another complaint CC/216/2017 was filed by the patient Mrs. Nadita Datta w/o Dr. Kaliprasad at Barasat, which was subsequently transferred to District Forum at Kolkata-I. The Opposite Parties filed an application before the District Forum to stop the proceedings in C.C.216/2017, but the District Forum dismissed the application.
5. Being aggrieved by the dismissal, the Dum Dum Hospital and Dr. Samir Kr. Chatterjee filed the Revision Petition No. 246/2017 before the State Commission, wherein following order was passed:
“Heard both the sides. Considered the respective submissions and perused the materials on record.
Materials on record reveal that the Complaint Case bearing No. C.C./95/2016 has been filed on 11.04.2016 by the husband of Smt. Nandita Dutta and Complaint Case No. RBT/C.C./216/16 has been filed on 13.05.2016 by Smt. Nandita Dutta herself for the identical cause of action being refusal by the Insurance Company concerned to reimburse the medical expenses. The materials on record also reveal that the parties of both the cases are common excepting the sequence of position of the parties. The said materials further reveal that the prayers in both the Complaint Cases are same excepting the difference in amount of the relief claimed.
The foregoing evidence on records indicate that the two Complaint cases as referred to above have been filed on the selfsame Cause of action, among the common parties and with same kind of prayer.
The foregoing facts, evidence on records and the decisions of the Hon’ble National Commission lead to the conclusion that second Complaint Case bearing no.RBT/ C.C./216/16 which has been filed on 13.5.2016 on the selfsame Cause or action after filing the first Complaint Case bearing No. C.C./95/2016 deserves dismissal.
Consequently, the instant Revision Case is allowed, the impugned order is set aside and the second Complaint Case being No.RBT/ C.C. /216/2016 stands dismissed.”
6. Being aggrieved, both the Complainants filed instant two separate Revision Petitions.
7. We have heard the learned Counsel for the parties. Perused both the Complaints and Orders of the District Forum & the State Commission.
8. The Complainants in both the complaints alleged that the medical reimbursement claim of Rs. 24,097/- under Mediclassic insurance policy was rejected by the Insurance Company. It was due to the alleged wrong diagnosis of Dr. Samir Kr. Chatterjee and because of vested interest of the hospital for unfair trade practices.
9. We further note that Dr. Kaliprasad Datta (husband of Nandita) obtained Medi-classic insurance policy covering hospitalization benefits for his wife and two daughters for total cover of Rs.1,50,000/-. The claim for Nandita’s treatment expenses about Rs. 24,079 was rejected by the insurance company on the ground of pre-existing disease. Therefore he filed Complaint - CC No. 97/2016 against the Insurance Co., hospitals and the doctors and
