MA No.71 of 2018

1

IN THE HIGH COURT OF JAMMU & KASHMIR AND LADAKH

AT JAMMU

CJ Court

Reserved on: 06.08.2021

Pronounced on: 09.09.2021

MA No. 71 of 2018

Om Parkash and others.

…Petitioner(s)/Appellants.

Through: Sh. Harshwardhan Gupta, Advocate.

Vs.

Bhupender Singh

….Respondent(s)

Through: Sh. Pranav Kohli, Sr. Advocate, with

Sh. Vikas Mahajan, Advocate.

CORAM:

HON’BLE THE CHIEF JUSTICE

HON’BLE MR. JUSTICE PUNEET GUPTA, JUDGE

J U D G M E N T

Pankaj Mithal, CJ

01.

In this Miscellaneous Appeal filed under Section 17 of the Jammu &

Kashmir Consumer Protection Act, 1987, the challenge is to the order dated

22.12.2017 passed by the Jammu & Kashmir State Consumer Disputes

Redressal Commission, Jammu, hereinafter referred to as 8Commission9, in

the complaint filed by the respondent-Bhupinder Singh claiming

reimbursement of medical charges in respect of his liver transplant surgery

at the Mendanta Hospital Gurgaon.

MA No.71 of 2018

2

02.

The

Commission

by

the

impugned

order

has

permitted

reimbursement of the medical claim to the tune of Rs.29,28,435.96/- as the

amount spent on treatment as aforesaid with 12% interest on the said

amount with effect from the date of filing of the complaint i.e. 10.11.2015

till its payment and a sum of Rs.01 lakh as compensation for the mental

agony and harassment suffered by the respondent. The aforesaid amount

was directed to be paid within a period of six weeks from the date of the

award failing which interest at the rate of 18% was also awarded on the

entire amount awarded.

03.

The brief facts which gave rise to the above complaint are that the

respondent was an employee of the Neptune Plastics, Phase-I S.I.C. Bari

Brahamina, Jammu. He was insured with the Employees State Insurance

Corporation and had made all required contributions for the relevant period.

He fell seriously ill on June 10, 2012 and was taken to the Emergency Ward

of Government Medical College (GMC), Jammu. On the advice of doctors,

he was shifted to Dayanand Medical College (DMC), Ludhiana, Punjab for

specialized treatment where he remained admitted from 11.06.2012 to

17.06.2012. He was advised liver transplant. It was alleged that the senior

specialists at D.M.C. Ludhiana, verbally advised the family members of the

respondent for emergency treatment and liver transplant which was not

possible in that hospital. Accordingly, they advised them to take the

respondent to Medanta City Hospital, Gurgaon, which is one of the best in

Asia in private sector for such treatment. On the advice of the doctors, the

MA No.71 of 2018

3

respondent was immediately shifted to the Medanta Hospital, Gurgaon, on

19.06.2012. The doctors there declared his condition to be very serious and

advised that he needs immediate liver transplant and surgery of kidney to

save his life. Both the surgeries i.e., in connection with the liver transplant

and kidney were simultaneously performed in the Medanta Hospital,

wherefrom he was finally discharged on 18.08.2012.

04.

The respondent in connection with his above treatment and operation

at Medanta Hospital, Gurgaon, incurred expenses of Rs.29,28,435.96.

Accordingly, he submitted an application for reimbursement of the above

amount on 23^rd January, 2013 with all necessary details and documents. The

respondent, however, did not claim any medical reimbursement in respect of

his treatment at G.M.C, Jammu, and D. M. C. Ludhiana. The entire papers

relating to the above claim were also submitted to the Medical Officer, ESI

Dispensary, Bari Brahamna, but no action whatsoever was taken to consider

his claim.

05.

The respondent was thus forced to make a complaint to the

Commission regarding the deficiency in service of the ESI in considering

his medical reimbursement claim (MRC) claiming the said amount with

14% intere