ORDER

PER: - JUSTICE GAUTAM CHOURDIYA, PRESIDENT This order will govern disposal of Appeal Nos.FA/24/62& FA/24/68 as both these appeals, under Section 41 of the Consumer Protection Act, 2019 (hereinafter called “the Act” for short) filed by the complainant and the opposite party respectively of Complaint Case No.CC/2019/54, have arisen out of the same impugned order dated 21.12.2023 passed by District Consumer Disputes Redressal Commission, Dr. Anil Karnawat, CEO, VY Hospital Vs. Premsingh Chouhan Date of Pronouncement:

Page 2 of 7 Raipur (C.G.) (hereinafter called the “District Commission” for short) whereby the complaint was partly allowed and the opposite party was directed to pay Rs.50,000/- towards excess amount received by them and Rs.50,000/- towards benefit which was to be received from the Smart Card i.e. total Rs.1,00,000/- (One Lac) with interest @ 6% p.a. from the date of complaint 25.01.2019 till the date of realization. Compensation towards the acts of the opposite parties and mental agony Rs.25,000/- (Twenty Five Thousand) along with cost of litigation Rs.5,000/- (Five Thousand) were also directed to be paid. Hereinafter in this order, for the purpose of convenience, the parties will be referred as per their original nomenclature before the District Commission.

2. In nutshell the facts of the case are that the complainant with the problem of acute pain due to arthritis in both knees together with enlarged prostate consulted Dr. Purnendra Saxena, Department of Orthopaedics, V.Y. Hospital, Raipur owned & operated by the opposite party. Dr. Saxena after examination advised for operation on 22.11.2018 for which a package of Rs.1,30,000/- was informed for knee cap replacement. The complainant informed Dr. Saxena that he has Smart Card issued under Ayushman Bharat – National Health Protection Mission under Mukhyamantri Swasthya Bima Yojana (hereinafter called „MSBY‟ for short) which provides coverage of Rs.50,000/-. Dr. Saxena said that all facilities available under the MSBY will be provided and all necessary medicines and equipment required for knee cap replacement surgery have to be purchased by the complainant in addition to the package amount of Rs.1,30,000/-. Total amount of Rs.2,00,000/- along with MSBY card was deposited by the complainant on 21.11.2028 and 22.11.2018. Thereafter on 22.11.2018 knee cap replacement surgery of right Dr. Anil Karnawat, CEO, VY Hospital Vs. Premsingh Chouhan Date of Pronouncement:

Page 3 of 7 knee was done. On 26.11.2018 Dr. Saxena said that the complainant will be discharged today but Officials of the Hospital said that for getting benefit under Ayushman Scheme the patient has to remain admitted in the Hospital for 7 days and as the Smart Card was submitted on 22.11.2018 the complainant has to remain admitted till 28.11.2018 for which he was ready but on the directions of Dr. Saxena the complainant was discharged on 26.11.2018 at 18:50 hrs without giving benefit of MSBY despite depositing the Smart Card.

3. As per rules framed by the Government the approved expenditure of knee cap replacement was Rs.80,000/- under MSBY, whereas the complainant was eligible for adjustment of Rs.50,000/- and the excess amount, if any, was to be paid by the patient himself in addition and his stay for 7 days in Hospital is mandatory. The package of Rs.80,000/-

includes registration charges, nursing & boarding charges, medicines & drugs etc. Thus, alleging deficiency in service on the grounds that after adjustment of benefits under MSBY only Rs.30,000/- was payable by the complainant to the opposite party, but despite giving consent to stay till 28.11.2018 he was discharged forcibly on 26.11.2018 without giving any benefit under MSBY smart card. Even after admitting the complainant under Ayushman Scheme total amount of Rs.1,62,920/- on different heads were collected from the complainant whereas only Rs.30,000/- was payabl