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2011 DIGILAW 617 (ORI)

Shri Sujit Kumar Chatterjee, IPS (Retd. ) former D. G. of Police, Orissa v. Chairman-cum-Managing Director, United India Insurance Co.

2011-12-28

A.K.SAMANTARAY, SMARITA MOHANTY, SUBASH MAHTAB

body2011
ORDER 1. JUSTICE A.K. SAMANTARAY, PRESIDENT - The complainant, who is a retired IPS officer and former Director General of Police, Orissa, has in this consumer complaint alleged serious deficiency in service on the part of the opposite parties. 2. The complainant's case is that he had purchased Indian Overseas Bank Healthcare Plus policy of United India Insurance Company Ltd. (for short 'UIIC') for an assured sum of Rs.5,00,000/- vide No.2007/484101384/1. The cashless claim for hospitalization of the complainant due to illness clearly falls within the purview of and in all fours of the UIIC Circular containing terms and conditions of the Indian Overseas Bank Healthcare Plus policy. The complainant had been under cover of Health Insurance policy of Oriental Insurance Company from 1998 to 2007 and thereafter taken over and renewed with UIIC through the Indian Overseas Bank from 2008 without any break in insurance. Being fully satisfied after perusal of all previous policy papers of another Indian Insurance Company, i.e., the Oriental Insurance Company, and on receipt of the prescribed premium amount through the Indian Overseas Bank, the UIIC issued in favour of the complainant the certificate for Indian Overseas Bank Healthcare policy. The complainant having been found eligible for the above cashless benefit for hospitalization in any TTK network hospital in eastern India, the Third Party Administrator of UIIC M/s TTK Healthcare TPA Pvt. Ltd. provided the complainant with UIIC Health Card No. CHE-UI-1801-01-17789 with TTK monogram valid up to 27.02.2009. The Complainant’s claim for cashless hospitalization, as promised and guaranteed by the UIIC Ltd. arose within the period of validity of the contractual policy binding upon the UIIC Ltd. and its service provider M/s TTK Health Care TPA Pvt. Ltd. In the morning of 20.11.2008, the complainant, a widower living alone in his residence, felt acute, unbearable and excruciating pain over his left hip joint radiating up to the leg. He was rushed immediately by some of his well wishers and neighbours to the emergency ward of the Ashwini Hospital, Cuttack, which is one of the TTK's network hospitals, for treatment. On production of TTK's valid healthcare card entitling the complainant to cashless hospitalization, the said hospital admitted the complainant as inpatient A 1275 and took immediate follow up by way of check up, X-Ray, MRI, blood tests, etc. On production of TTK's valid healthcare card entitling the complainant to cashless hospitalization, the said hospital admitted the complainant as inpatient A 1275 and took immediate follow up by way of check up, X-Ray, MRI, blood tests, etc. with due intimation to the TPA in conformity with the formalities, as is the practice in such cases in all network hospitals. The complainant was informed by Shri Bijay Kumar Sahoo, General Manager (Operation) of Ashwini Hospital that he was admitted on emergency after telephonic conservation with TTK's Bangalore office as the Chennai office of TTK could not be contacted by any means despite repeated efforts. Although the Ashwini Hospital dispatched the authorization application along with requisite investigation reports and complied with all queries of TTK made over phone from time to time, the hospital authorities failed to secure authorization and sanction, of advance from TTK, which frustrated the very purpose of TPA Health Card issued to the complainant promising and guaranteeing cashless hospitalization. It is categorically stated by the complainant that the copies of the letters/Fax/e-mails exchanged between the Ashwini Hospital and M/s TTK Healthcare TPA Pvt. Ltd., which are there in custody of the hospital authorities, are clear proof of TPA's stubborn attitude and lack of commitment and devotion to duty in total disregard to the safety and security of the customer-patient, that too of senior citizens. Till the date of discharge of the complainant from the hospital, i.e.; afternoon of 26.11.2008, the hospital authorities got no response, written or otherwise, from any of the offices of M/s. TTK Healthcare TPA Pvt. Ltd in the matter of approval and sanction of advance towards the cost of hospitalization and treatment of the complainant. Such a sad and painful circumstance created by the TPA compelled him to issue Indian Overseas Bank Cheque No.122514 for Rs.19,266/- in full settlement of the claim raised against him prior to discharge at 11.00 A.M. on 26.11.2008. It is also stated that on 22.11.2008, the Specialist of Ashwini Hospital, after control and management of pain of the patient, had ruled out surgery of any kind on the basis of the findings of the investigations reports and had advised the complainant to undergo physiotherapy immediately on discharge in any out side hospital due to non-availability of the said facility in Ashwini Hospital. Due to the callous and lackadaisical attitude of the TPA, the complainant was forced to stay in the Ashwini Hospital from 22nd to 26th November, 2008 with the fond hope of receipt of administrative approval and sanction of fund, although at that point of time, he urgently needed physiotherapy in the Hope Rehabilitation Centre under care of Dr. Sanjay Kumar Sazzan, SCB Medical College and Hospital, Cuttack. The complainant has further averred that in spite of having medi-claim policy running without any break since 1998 and valid healthcare entitling him to cashless hospitalization, he had to be unnecessarily and vexatiously kept confined except for routine check up for four days from 22nd November to the forenoon of 26th November, 2008, which delay, in absence and default of much needed physiotherapy had serious negative impact on his recovery and convalescence, thereby adversely affecting performance of his duty as External Monitor for Coal India Ltd. and its subsidiary companies across the country. The TTK's mischievous and inept handling of the complainant's entitlement to cashless hospitalization ran contrary to, and was violative of the TPA's own Health Insurance Guide Book, where it is mentioned- "Henceforth the insured will not have to pay the network hospital after undergoing treatment. He will have to sign the bills and we will pay the hospital for the treatment undertaken by the insured (subject to authorization being taken, bill be settled directly to the hospital up to the authorized amount." The complainant states in his complaint petition that the rejection letter of TTK Health Care TPA Pvt. Ltd. Addressed to the Ashwini Hospital, shown to have been issued on 25.11.2008 at 12.13 P.M. and received much later than the time of discharge of the complainant from the hospital contains the following grounds:- "As per UIIC records policy is fresh, insufficient data received. Possibility of long standing pathology cannot be ruled out. Hence cashless not possible." According to the complainant, such type of outright rejection of his claim not only indicate non-application of mind and deficiency in service but also are contrary to the facts and circumstances of his case inasmuch as his policy was an old and continuous policy and his disease was newly detected and was not an old one. Hence cashless not possible." According to the complainant, such type of outright rejection of his claim not only indicate non-application of mind and deficiency in service but also are contrary to the facts and circumstances of his case inasmuch as his policy was an old and continuous policy and his disease was newly detected and was not an old one. Since he had never undergone hospitalization and treatment for any kind of disease during the first four years or thereafter from the very inception of his medi-claim policy, he was given cumulative bonus by the for the former Insurance Company, i.e., the Oriental Insurance Company, which is a matter of record. The TPA unreasonably demanded for being furnished with all previous policy papers during the time of the complainant's confinement in the hospital, and notwithstanding the fact pointed out through the hospital that UIIC after due perusal of all previous policy papers earlier had issued the insurance certificate and the health card, the TTK refused to be convinced. The complainant-patient, after being provided with the hospital vehicle, had to go to his residence to fetch the copies of all previous papers. He supplied the same to the hospital authorities, who sent those papers immediately to M/s. TTK in compliance with the TTK's unjust insistence. This is nothing but an instance of deliberate harassment and humiliation to a widower senior citizen staying alone. It is the further case of the complainant that in spite of being furnished with all previous policy papers running from 1998 to 2007, the TPA rejected his claim for cashless hospitalization on quite frivolous and untenable grounds. The complainant has further stated that all these facts and circumstances were duly brought to the notice of the Chairman-cum-Managing Director of UIIC through a petition dated 01.12.2008 with copy thereof to the Chairman, Indian Overseas Bank followed by reminder dated 24.1 2.2008 to each of them, but to no result. Having thus failed to get the Chairman-cum-Managing Director, UIIC act on his petition, the complainant had no other means than to issue legal notice on 24.01.2009/27.01.2009 through speed post. On receipt of the legal notice, the Divisional Manager, UIIC replied that when they referred the matter to their TPA, i.e., M/s TTK Health Care TPA Pvt. Ltd. with regard to his claim, the TPA informed that they had already sent pre-authorisation approval for Rs.26,500/-. On receipt of the legal notice, the Divisional Manager, UIIC replied that when they referred the matter to their TPA, i.e., M/s TTK Health Care TPA Pvt. Ltd. with regard to his claim, the TPA informed that they had already sent pre-authorisation approval for Rs.26,500/-. The said approval letter is dated 30.01.2009 at 5.39 P.M. addressed to the Ashwini Hospital of M/s TTK Health Care TPA Pvt. Ltd., a unit of Cuttack Hospitals Pvt. Ltd., which clearly mentions authorization date/time as 26.11.2008 at 3.41 P.M. The complainant states that it is crystal clear that the defaulter TPA approved authorization and communicated the same to the Ashwini Hospital long after he left the hospital being harassed, disgusted and humiliated inasmuch as he was discharged only after due settlement of the hospital expenses from his own pocket. It is finally clarified by the complainant that the TPA clandestinely misled the Divisional Manager to believing that they had already sent the pre-authorisation approval for Rs.26,500/- to the Ashwini Hospital whereas the actual fact was that despite best of efforts from 22.11.2008 to 26.11 .2008 by his brother and the Ashwini Hospital authorities, no authorization, let alone pre-authorisation approval was sent and received, or else the complainant would not have been compelled to issue cheque in order to secure his discharge from the hospital at 11.00 A.M. on 26.11.2008. Thus, summing up his immense physical, mental and psychological torture and the agonizing circumstances the complainant, a widower and senior citizen, had to undergo for no fault of his, he has put forth his prayer for direction 'to the opposite parties to make payment of the hospital expenses of Rs.19,266/- and also make payment of compensation of Rs.40,00,000/- and any other direction as this Commission may deem just and proper to impart. 3. In response to the notice issued by the Commission after admission, all the opposite parties except opposite party No.3 entered appearance and filed separate written versions. Opposite party No.1, the Insurance Company has specifically averred that the complainant had not shown his previous policies before taking the present policy, i.e., the medi-claim policy. It is at the instance of the Indian Overseas Bank that the policy in question was issued. Opposite party No.1, the Insurance Company has specifically averred that the complainant had not shown his previous policies before taking the present policy, i.e., the medi-claim policy. It is at the instance of the Indian Overseas Bank that the policy in question was issued. According to the Insurance Company, the benefit guaranteed under the medi-claim policy is subject to certain terms and conditions, and if there is any breach thereof, the insured is not entitled to get any compensation. In paragraph 10 of the written version, it is stated that the Ashwini Hospital authorities reported the case of the complainant to M/s. TTK Health Care TPA Pvt. Ltd., but they did not intimate about the previous policies of the complainant, which he had obtained from the Oriental Insurance Company. There was requirement of, certain processing work for the claim for which the few days delay occurred. It has been repeatedly stated that as per the condition, if any cashless benefit is claimed by the insured, he has to intimate about the previous policies, but the insured, the complainant in the instant case, had, not intimated the same to M/s TTK Health Care TPA Pvt. Ltd., and the disease suffered by the complainant was a pre-existing disease for which the TTK Health Care TPA Pvt. Ltd. rejected the claim resorting to the exclusion clause, of the policy. But, subsequently the same was rectified and as such the TTK Health Care TPA Pvt. Ltd. is not at fault. It is also stated in the said written version that after getting information from the medical authorities, opposite party No.3 asked for the required documents, which were not supplied by the complainant, for which, at the initial stage, the claim was rejected. After supply of the same by the complainant, the claim was approved by the said opposite party on 26.11.2008, which was intimated by the Insurance Company to the complainant on 03.02.2009. It is further stated that opposite party No.3 directly deals with medi-claim policies and they have their panel of doctors and once a claim is registered, it is scrutinized by the said opposite party as to whether the claim should be approved or rejected. If the claim is approved, the agency deposits the claim amount with the hospital authorities deducting the same from the Insurance Company. If the claim is approved, the agency deposits the claim amount with the hospital authorities deducting the same from the Insurance Company. Towards the last part of the written version, it has been stated by the Insurance Company that the claim of R.s.40,00,000/- for mental agony, physical and psychological torture for an expenditure of R.s.19,266/- is absolutely vexatious. It is a frivolous claim and it does not attract the pecuniary jurisdiction of this Commission. Therefore, the Commission should have rejected the complaint. Opposite party No.2-the Indian Overseas Bank in its written version has stated that the Bank is providing insurance coverage to their clients having tie up with UIIC with regard to health policy. The complainant for the first time made medi-claim policy through the Bank where opposite party No.1-UIIC was the insurer and the policy was for the period covering from 28.02.2008 to 27.02.2009. M/s. TTK Health Care TPA Pvt. Ltd. is an organisation duly approved by the Insurance Regulatory and Development Authority. The said organisation has direct dealings with the medi-claim policies, hospital authorities and clients. They have their panel of doctors and hospitals Once the claim is registered, the same is scrutinized by them either to approve or reject the same. Opposite party No.3 has been authorized by the Insurance Company to extend third party administration services to the insured and they are to process all queries and claims relating to medi-claim policies, such as cashless access to network hospitals in case of hospitalisation and reimbursement of hospitalisation claims subject to the terms and conditions of the policy. In case the claim is approved, the aforesaid agency is to deposit the claim amount with the recognized hospital authority deducting the same from the Insurance Company. It is further stated that the complainant for the first time in his registered letter dated 02.12.2008 and letter dated 24.12.2008 brought to the notice of the chairman of the Bank at Chennai that the cashless facility has been denied by the TPA and the Insurance Company. Accordingly, the head office of the Bank enquired from the Insurance Company. The Insurance Company informed the Bank that the TPA has approved the cashless facility to the tune of Rs.26,500/- to the insured on 26.11.2008. This opposite party has pleaded that in the aforementioned circumstances it has committed no deficiency in service and as such it is in no way liable. The Insurance Company informed the Bank that the TPA has approved the cashless facility to the tune of Rs.26,500/- to the insured on 26.11.2008. This opposite party has pleaded that in the aforementioned circumstances it has committed no deficiency in service and as such it is in no way liable. Opposite party No.4, the General Manager of the network hospital, i.e., the Ashwini Hospital has in his written version admitted that the complainant was admitted to the hospital and remained as an indoor patient and all possible care and treatment had been rendered to him to his best satisfaction. It is also stated that the complainant was discharged from the hospital on 26.11.2008 and, in fact, he had paid Rs.19,266/-through cheque in full and final settlement of the bill raised against him by the hospital. The TTK Health Care TPA Pvt. Ltd. by letter dated 25.11.2008 had rejected the claim of the complainant and the said communication was received by the hospital much after discharge of the complainant from the hospital. It is specifically stated that the hospital-opposite party No.4 has nothing to do with the activities of the TPA and the hospital is in no way responsible for the action/inaction of the TPA. With such averments, it has been stated that impleadment of opposite party to the complaint is without any basis and its name should be struck off from the cause title of the complaint. 4. We have heared learned counsel for the parties. The admitted position, as we gather are as follows:- The complainant purchased Indian Overseas Bank Health Care Plus medi-claim policy of UIIC for an assured sum of Rs.5,00,000/-. The said policy was valid from 28.02.2008 to 27.02.2009. On 20.11.2008, the complainant felt intolerable and excruciating pain over his left hip joint radiating up to the leg. Immediately he was rushed to the emergency ward of the Ashwini Hospital, one of the TTK's network hospitals, for treatment and was admitted there as an indoor patient on production of TTK's health card. Till 26.11.2008, the hospital authorities got no response from the TTK Health Care in the matter of approval and sanction of advance towards the cost of hospitalisation and treatment of the complainant. Till 26.11.2008, the hospital authorities got no response from the TTK Health Care in the matter of approval and sanction of advance towards the cost of hospitalisation and treatment of the complainant. The complainant getting frustrated over the action/inaction of TTK Health Care issued a cheque for Rs.19,266/- in full and final settlement of the claim of the hospital and left the hospital at 11.00 A.M. on 26.11.2008. 5. Mr. Mohanty, learned counsel appearing for the Insurance Company submitted that the delay was caused as because Opposite parties 1 and 3 are having two different offices and at least 2 to 3 days are required for processing a claim. The claim of the complainant was finally approved on 26.11.2008, i.e., within 6 days, out of which 22nd and 23rd were holidays being Saturday and Sunday respectively. In this connection, Mr. Pattnaik, learned counsel for the complainant drew our attention to paragraph 4 of the Health Care Guide Book of TPA, wherein it has been stated thus: "4. EMERGENCY HOSPITALISATION. -The policyholder is advised to get admitted. In case of admission to a Network Hospital the Hospital will admit the patient as per the procedure of the hospital, The hospital will then contact TTK and send us a request for authorisation. At times the policyholder may be required to contact TTK' for authorisation. The policyholder must send the pre-authorisation request completely filled. TTK will revert within 6 hours of receipt of the request..." Mr. Pattnaik submitted that the Health Care Card was issued in favour of the complainant, each by the UIIC and the TTK. When the guidelines specifically state that within 6 hours from receipt of the request TTK would revert back, processing of file between the parties inter se should have been completed within 6 hours from the time of receipt of the request. It was argued by Mr. Pattnaik that the plea taken by the Insurance Company that Saturday and Sunday were holidays and for that these two days should be overlooked is not at all tenable in view of the over all scheme of the TTK, which comes under essential service of cashless treatment. It was argued by Mr. Pattnaik that the plea taken by the Insurance Company that Saturday and Sunday were holidays and for that these two days should be overlooked is not at all tenable in view of the over all scheme of the TTK, which comes under essential service of cashless treatment. Referring to the Health Insurance Guide Book, he submitted that when a request is made for authorisation and there is stipulation that TTK shall revert back within 6 hours, if there is no response for six days, the object of the scheme, i.e., cashless emergency hospitalisation, which is meant to treat the patient immediately when he is admitted to the hospital, gets totally frustrated. He further submitted that the condition incorporated in the Health Insurance Guide Books is to complete the formalities within the specified period of six hours, which is mandatory in nature and is meant to protect the insured from any harassment. Mr. Pattnaik submitted that it is not the case of TTK or UIIC that the hospital (Ashwini Hospital) dispatched the authorisation application at a belated stage and did not send the same after hospitalisation of the complainant, for which there was delay in disposal of the authorisation and approval. 6. The complainant has categorically stated in the complaint petition that TTK issued a letter to Ashwini Hospital on 25.11.2008 at 12.30 P.M. stating that as per United Insurance Company Ltd., the policy record is fresh, insufficient data received, possibility of long standing pathology cannot be ruled out, hence cashless is not possible. The UIIC has stated in its written version that as per the condition, if any cashless benefit is claimed, the insured has to intimate about the previous policies and whether the disease was pre-existing. For that, TTK is not at fault in rejecting the claim. Taking exception to this, Mr. Pattnaik argued that such a stand/ contention of the Insurance Company is contrary to the condition of the policy and the proposal form. Referring to the copy of the proposal form which is the basis of the contract/policy, he stated that in case of renewal of Insurance, photo copy of previous insurance policy/certificate is to be attached. Stamp size photographs are to be affixed for renewal. If photographs are not attached, original IP card from the TPA under the previous policy is to be attached. Stamp size photographs are to be affixed for renewal. If photographs are not attached, original IP card from the TPA under the previous policy is to be attached. Renewal from any Insurance Company is accepted and continuity benefit is available if renewal is made before expiry. Mr. Pattnaik, referring to the record took us through the previous policies of the complainant, which he had been taking from the Oriental Insurance Company, submitted that there is absolutely no doubt that there was continuity in obtaining the policies and it is nobody's case that the present policy with opposite party No.1-UIIC was taken after expiry of the previous policy. In such circumstance, as per the condition in the proposal form, the benefit of continuity is available to the complainant in respect of the present policy. We have ourselves examined the previous policies of the complainant taken from the Oriental Insurance Company right from the year 1998 up to 2007, whereafter he renewed the policy with UIIC through the Indian Overseas Bank from 2008. There is no break in the policies at any point of time. It is the categorical case of the complainant that being fully satisfied after perusal of all previous policy papers of another Indian Insurance Company, i.e., Oriental Insurance Company, and on receipt of the prescribed premium amount through the Indian Overseas Bank, the UIIC issued in his favour the certificate of the Indian Overseas Bank Health Card Policy. Besides, as we find, there is no condition whatsoever in the policy compelling the insured to provide the previous policy details after the issuance and receipt of the policy in case of a renewal policy at the time of admission to a network hospital. The insured is also under no obligation to intimate about the previous policies either to the TTK or to the Insurance Company at any point of time after issuance of renewal policy, more specifically for settlement of cashless benefit. It is the specific cases of the complainant and it was vehemently argued by Mr. Pattnaik, learned counsel appearing for him that in spite of repeated reminders to TTK as well as UIIC, the claim was not settled, for which lawyer's notice dated 24.01.2009/27.01.2009 was served on the Chairman-cum-Managing Director of UIIC and the claim was approved on 03.02.2009 by the Insurance Company-opposite party No.1, as intimated to the complainant. It was also submitted by Mr. It was also submitted by Mr. Patnaik that at no other point of time the Insurance Company had contacted the complainant regarding approval or otherwise of his claim. We have referred to the rejection letter of the TTK dated 25.11.2008 time 12.13 P.M. and approval letter said to be dated 26.11.2008 time 3.41 P.M. mentioning that the denial was reconsidered in view of continuous policy. The Insurance Company has put much stress on the latter letter to escape its liability. But, the said letter appears to have been issued on 30.01.2009 at 5.30 P.M. If any letter was issued on 26.11.2008 stating that after reconsideration approval was accorded of cashless benefit, why no intimation was received by the network hospital, i.e., Ashwini Hospital, makes the matter dubious and suspicious. We consider such a plea to be nothing but afterthought and conctee. 7. We have perused the documents filed and annexed. From the pleading of the complainant, we find that since repeated reminders to TTK as well as UIIC his claim was not settled, lawyer's notice dated 24.01.2009/27.01.2009 was served and thereafter the claim was approved on 03.02.2009 by the Insurance Company and this fact was intimated to the complainant. This itself goes to show that the plea taken by the Insurance Company as well as TTK that after reconsideration authorisation was approved on 26.11.2008 is based on blatant falsehood. We have perused the TTK's Health Insurance Guide Book where the TTK assures the highest quality of service, which commitment is backed by its 78 year-old TTK group. These assurances are only to lure customers, but when actual question of service arises, all tricks are applied to avoid such assured service, which ultimately frustrates the very purpose of the scheme. The instant matter is a glaring example of such calculated design to evade payment at the time of dire need of a customer. The complainant, who is a retired Director General of Police of this State and Tripura, is a widower and senior citizen staying alone. He is also acting as Independent External Monitor of Coal India Ltd. He is also a member or the Rotary Club and is also associated with many other organisations and commands respect in the society. His legal and genuine claim was turned down and the same was called to be vexatious and frivolous. He is also acting as Independent External Monitor of Coal India Ltd. He is also a member or the Rotary Club and is also associated with many other organisations and commands respect in the society. His legal and genuine claim was turned down and the same was called to be vexatious and frivolous. His non-acceptance of the so-called approved amount of Rs.26,500/-by not signing the discharge voucher, according to the Insurance Company, is due to his stubborn attitude. 8. The network hospital bill was for Rs.19,266/-, which was paid by the complainant through cheque to get himself discharged from the hospital. It is not understood how a sum of Rs.26,500/- was approved towards the claim of the complainant. Learned counsel for the Insurance Company could not explain the same to us. This approval appears to be the outcome of letters addressed to the Chairman-cum-Managing Director of the Insurance Company, Head Office at Chennai, with intent to cover up the blatant deficiency in service, which is apparent on record. The deficiency delayed the discharge of the complainant from the network hospital after the ailment was diagnosed. It also delayed the physiotherapy course, which was not available in the network hospital and the complainant had to spend some more days in the process for his complete recovery from agonizing and painful Lumber Spondylitis. Considering the situation to which the complainant was put, keeping in mind his status in the society and the humiliation and harassment he had undergone, which were due to the utter negligence and deficiency in service on the part of UIIC and TTK on the face of his being in possession of valid policy, health card, etc., entitling him to cashless benefit of treatment we have no hesitation to hold that opposite parties 1 and 3 are jointly and severally liable to reimburse the medical expenses incurred by the complainant and pay trim adequate compensation and cost. This, in our view, shall deter them from repeating exhibition of callous and negligent attitude while dealing with such delicate matters in future. We, however, find no material as against opposite parties 2 and 4 so as to fasten any liability to them as, in our considered view, they had no art and part in the matter. 9. This, in our view, shall deter them from repeating exhibition of callous and negligent attitude while dealing with such delicate matters in future. We, however, find no material as against opposite parties 2 and 4 so as to fasten any liability to them as, in our considered view, they had no art and part in the matter. 9. In the result, therefore, we allow the complaint and direct opposite parties 1 and 3 to jointly and severally reimburse to the complainant an amount of Rs.19,266/- (rupees nineteen thousand two hundred and sixty-six), which he has spent for his treatment in the Ashwini Hospital, They are also directed to pay compensation of Rs.5,00,000/- (rupees five lakhs) towards the mental agony suffered by him and Rs. 50,000/(rupees fifty thousand) towards cost of litigation. The aforesaid amounts shall be paid within 60 days from the date of receipt of our order. Complaint allowed.