BOARD OF TRUSTEES, RAJASTHAN STATE PENSIONERS MEDICAL CONCESSION SCHEME & 2 ORS. THROUGH MEMBER SECRETARY & DIRECTOR, PENSION & PENSIONERS WELFARE DEPARTMENT KOTA RAJASTHAN Vs. SATISH CHANDRA GUPTA S/O CHAUTHMAL GUPTA, R/O HOUSE NO

JUDGEMENT

(1.) The impugned order dated 27.08.2013, passed by the Rajasthan State Consumer Disputes Redressal Commission, Circuit Bench Kota (hereinafter referred to as "the State Commission ") in Appeal No.161/2011, Satish Chandra Gupta Vs. Board of Trustees, State of Rajasthan Pensioners’ Medical Concession Scheme & Ors. , has been challenged by the petitioner, Board of Trustees in the present Revision Petition. The State Commission, vide said order, allowed the appeal and set aside the order dated 02.12.2011, passed by the District Consumer Disputes Redressal Forum, Kota, dismissing Consumer Complaint No. 311/2010, filed by the present respondent/complainant.

(2.) Briefly stated, the facts of the case are that the complainant/respondent Satish Chandra Gupta, who is a pensioner of the State Government, had to undergo by-pass surgery of heart at Wockhardt Hospital, Mumbai on 11.02.2008. He presented bills of the amount spent by him for the said surgery and the opposite party (OP), which is Board of Trustees, State of Rajasthan Pensioners’ Medical Concession Scheme, issued an order on 09.02.2010, sanctioning an amount of Rs. 52,400.00 to the complainant. The complainant was asked, vide letter dated 10.03.2010, to present an undertaking that the amount so approved, was in full and final settlement of the claim, after which the proceedings for payment of the said amount shall be carried out. The complainant did not give the said undertaking, but made the Consumer Complaint in question, seeking direction to the OPs to make him additional payment for expenses on medicines, diagnostic tests, investigations and for meeting charges on accommodation etc. He demanded a total sum of Rs. 73,386/- along with interest @ 12% p.a. and compensation of Rs. 1 lakh for mental harassment etc. The complaint was resisted by the OP, by filing a written statement before the District Forum in which they stated that the complainant presented a bill of Rs. 3,58,203.59.00 for reimbursement on 06.07.2009, but a sum of Rs. 52,400.00 had been approved for him vide letter dated 09.02.2010. The OP denied that they had asked the complainant to give an undertaking, vide letter dated 10.03.2010, for treating the amount so sanctioned as full and final payment. According to the OP, the complainant had got his treatment done outside the State and in such cases, he could be allowed 80% of the hospital expenditure, limited to Rs. 48,000.00.

(3.) The District Forum, after taking into account the contention of the rival parties, dismissed the Consumer Complaint and directed that the OP shall make payment of Rs. 52,400.00, as sanctioned by them, without receiving any undertaking. Being aggrieved against this order, the complainant challenged the same by way of an appeal before the State Commission, which having been allowed vide impugned order dated 27.08.2013, the OP Board of Trustees is before this Commission by way of the present Revision Petition.