Hyderabad: Consumer panel asks TSRTC to pay Rs 4,05,168 to former employee for Covid treatment

Hyderabad: District Consumer Disputes Redressal Commission-I, Hyderabad has directed Telangana State Road Transport Corporation (TSRTC) to reimburse the amount of Rs 3,60,168 incurred by a retired TSRTC employee towards the medical expenses, Rs 30,000 as reasonable compensation for causing mental anguish, and Rs 15,000 towards litigation cost.

Case Details

R Krishna Rao, regional manager of TSRTC and a native of Hyderabad, retired from his services in 1995. In August 2022, he was infected with Covid and incurred medical expenses of Rs.3,60,168 on his treatment. Rao was treated at AIG Hospitals and Apollo Hospitals. On September 9, 2022, Rao made representation to the TSRTC for reimbursement of medical expenses. As per the circular issued by APSRTC, Rao is eligible and entitled to reimbursement of medical expenses.

TSRTC denied allegations

Since the TSRTC has neither acknowledged the representation given by Rao nor reimbursed the medical expenses, he issued legal notice. Rao submitted that, as the TSRTC had failed to reimburse the medical expenses that have been incurred in the treatment of Covid-19, Rao knocked on the doors of the Consumer court alleging deficiency of service on the part of the TSRTC and prayed for relief as stated supra.

While denying the allegations made in the complaint, the TSRTC, in its written version, had contended that Rao had misguided and misrepresented the Commission with the sole intention of harassing and extracting money from them.

The TSRTC contended that Rao had not availed any service from the TSRTC for consideration, therefore, he is not a ‘Consumer’, and the complaint is not maintainable.

It is averred that, as per the instructions in vogue, Rao had to attend TSRTC hospital, Tarnaka to get treatment. It is further averred that, if no treatment is available in the said hospital, Rao will be directed to a referral hospital. Rao neither attended TSRTC hospital at Tarnaka nor Informed the authorities. As per the delegation of powers – 2014 reimbursement in ‘Medical Matters’ up to Rs 1 lakh is allowed to members of (the Retired Employees Medical Fund) REMF– 2003 for emergency treatment like heart ailment, accidents, and appendicitis.

TSRTC argues complainant does not come under definition of consumer

The TSRTC in its written version to the Court argued that Rao had not complied with the procedure that is mentioned in the delegation of powers –2014 and undergone treatment in AIG Hospitals, Gachibowli (August 04 to 8, 2022) and Apollo Hospitals, Jubilee Hills (August 19 to 22), has submitted the original bills belatedly i.e. on December 29, 2022. Thereafter, Rao took the original bills stating that he would return the same in a week, but had failed to submit the same. The original documents are necessary and crucial for processing the medical claim. It is further submitted that, as per the judgment by Apex Court in Civil Appeal No. 5476 of 2013, the complainant being an ex-employee (Government employee) does not come under the definition of ‘Consumer’.

Hence, denying the allegations of deficiency of service on their part, the TSRTC had prayed the Commission to dismiss the complaint with costs. The court noted that from the discharge summary of AIG Hospitals Rao was admitted on August 4 and discharged on August 8, 2022. As per the ‘emergency certificate’ of AIG Hospitals, Rao was admitted to the hospital on August 4 in emergency condition and was diagnosed with ‘moderate COVID-19 pneumonia’. It is further evident from the discharge summary of Apollo Hospitals that Rao was admitted to the hospital on August 19 and discharged on August 22. As per the ‘emergency admission certificate’ of Apollo Hospitals, Rao presented with complaints of cough with excitation from two weeks of shortness of breath for five days.

TSRTC failed to produce any evidence to disprove the case

The court took the evidence from the genuine certificate issued by AIG Hospitals and the essentiality certificate issued by Apollo Hospitals that Rao paid the total amount of medical bills. Rao submitted documentary evidence i.e. emergency certificates from both hospitals substantiating his plea that he was admitted to AIG Hospitals, Gachibowli from August 4 to 8 as he needed urgent treatment after getting infected with Covid-19 and due to relapse of the infection, he was again admitted in Apollo Hospitals, Jubilee Hills as in-patient from August 19 to 22. The TSRTC failed to produce any evidence to disprove the case of Rao. Therefore, the court noted that the case fell under the category of emergency and non-reimbursement of medical expenses on the ground that the complainant did not comply with the procedure was nothing but a deficiency of service on the part of the TSRTC.

After going through the documentary evidence, the court said that the non-settlement of medical expenses of Rao is against the principles of natural justice and fair play. Therefore, it directed the TSRTC to pay the reimbursement of Rs 3,60,168, reasonable compensation of Rs 30,000, and Rs 15,000 towards litigation costs to him.