CHIEF MEDICAL SUPERINTENDENT NORTHERN RAILWAY HOSPITAL, S.P.M. MARG, NEW DELHI Vs. POORAN CHAND AGARWAL A 3 OF 98, JANAKPURI NEW DELHI

JUDGEMENT

(1.) - This revision is directed against the order of the State Commission Delhi dated 18.05.2016 in First Appeal No. 604 of 2015, whereby the State Commission allowed the appeal preferred by the respondent complainant, set aside the order of District Forum and directed the petitioner Opposite Party to reimburse a sum of Rs.1,22,659.00 along with 6% interest thereon w.e.f. 01.01.2012 till the realisation of amount.

(2.) Briefly put, the facts relevant for the disposal of the revision petition are that respondent complainant was beneficiary of Health Scheme run by the opposite party being a retired employee of the petitioner opposite party. On 28.09.2011, the complainant had bout of giddiness and he passed blood through urine. The complainant alarmed by the situation went to Sir Ganga Ram Hospital and took treatment there. The complainant spent a sum of Rs.1,22,659.00 on treatment at Sir Ganga Ram Hospital. He submitted the bill for reimbursement but opposite party declined it on the ground that complainant had taken treatment in private hospital without taking prior permission and against the rules.

(3.) Being aggrieved of refusal of the petitioner opposite party to reimburse the medical expenses, respondent filed consumer complaint. The complaint was contested by the opposite party on the plea that complainant had taken treatment at private hospital against the rules in particular he did not take prior permission before going in for treatment at Sir Ganga Ram Hospital.