Things fall apart; the Centre cannot
hold;
Mere anarchy is loosed upon the world,
…. W. B. Yeats.
The era of virtue and innocence is drowned in the cobweb of
commercialization, meekly uttered Bijay Kumar Bhattacharjee. Quivering voice of
a 77-year old retired employee, Bijay Kumar Bhattacharjee aptly described
elderly persons’ helplessness in today’s modern society. Duped by an agent and a medi-claim insurance
company, he moved to court only to be disappointed further.
Bhattacharjee, originally hailing from Agartala and now
settled in Kolkata, had endured severe mental and physical agony due to
merciless commercial practices and apathetic society. Narrating his harrowing experiences,
Bhattacharjee informed he was persuaded by an agent of the Star Health and
Allied Insurance Co. Ltd of Chennai to purchase a medi-claim policy. With
pace-maker implanted in his chest, Bhattacharjee could not believe that an
Insurance company would really offer him a medi-claim policy. However, the
agent politely mentioned, the aforesaid company has rolled out ‘Senior Citizens
Red Carpet Insurance Policy’ for elderly people. However, no medi-claim will be
granted if he suffers from heart disease. He purchased the Policy for an amount
of Rs 1 Lac from the said Company on February 2012. As per the terms and
conditions, Shri Bhattacharjee submitted all the relevant documents pertaining
to diseases he was suffering from including fitment of pace-maker before
signing on the dotted lines.
Unfortunately, Bhattacharjee fell seriously sick due to
sudden attack of PNEUMONITIS and had to be hospitalized later in 2012, couple
of months after obtaining the policy. However, the Insurance Company bluntly
denied paying the costs of treatment. The Company argued Bhattacharjee did not
disclose information relating to his pre-existing illness, even though
pneumonia cannot be termed as pre-existing disease. Notably, the Company did
not stop accepting premiums from Bhattacharjee. The policy was renewed duly
thereafter for 2013 and 2014.
Shocked and aggravated, Bhattacharjee filed a case in
District level Consumer Forum, Alipore (DCF) against the Insurance Company (C.
C. no. 291 of 2013). Frail and sick, yet he fought the case by himself without
appointing advocates. During 14 rigorous trials, he fought the case fiercely
and justified his claim. The DCF ordered the Company to pay the medical
expenses with 15% interest. The Court levied heavy penalties amounting to Rs
5,72, 434 on the Insurance Company for adopting ‘unfair’ trade practices (Rs
one lakh for mental agony and harassment, Rs one lakh as compensation and three
lakh for unfair trade practice totaling to Rs 5,72,434, out of which Rs 2 lakh
to be deposited to the Consumer Welfare Fund). However, the accused Company moved
to the State Consumer Commission (SCC) vide No. FA/166/2014. Astonishingly, Judges of SCC delivered verdict
after a single trial, which Bhattacharjee again fought out by himself. The
Verdict, in sharp contrast of DCF verdict, shocked and shattered Bhattacharjee.
He informed, the Judges of the SCC, comprising Jagannath Bag,
Member and Debasis Bhattacharya, Member, too found the Company guilty for
non-payment of Bhattacharjee’s medical bills and accordingly, ordered the Company
to pay Rs 61,646 for his treatment plus Rs 5000 as litigation cost. However Judges
waived all other levies imposed by DCF including penalty for causing mental
agony, compensation etc. “It is unfortunate that the SCC though identified the
Company as offender, ignored my mental agony and physical stress that I had to
endure during the trials and allow the erring Company The c waived the penalty slapped by the DCF
for causing mental agony and stress by denying my bona fide medi-claim”, he
said. Most strikingly, he added, the SCC Judge passed a one liner verdict
without mentioning any clarification or justification. Shaking his head with
disgust about present-day societal systems, Shri Bhattacharjee lamented, I won
the battle but lost the faith.
Bhattacharjee’s predicament is nothing new and unheard. Small
wonder that ageing people, no matter whether educated, wealthy or penniless,
are emerging as one of the most vulnerable sections of the country. Analysing
the prevailing situation of elderly people in India, Central Statistics Office
under the Ministry of Statistics and Program implementation observed, the size of the elderly
population, i.e. persons above the age of 60 years is fast growing in the
country although it constituted only 7.4% of total population at the turn of
the new millennium. For a developing country like India, this may pose mounting
pressures on various socio economic fronts including pension outlays, health
care expenditures, fiscal discipline, savings levels etc. Again this segment of
population faces multiple medical and psychological problems. There is an
emerging need to pay greater attention to ageing-related issues and to promote
holistic policies and programmes for dealing with the ageing society with
delicacy devoid of ugly commercial interests. Though
policy makers are concerned about the problems and vulnerability of the ageing
society in India, the service delivery particularly health services and
insurance products delivery are grey areas where greater focus is needed. Echoing W B Yeats he added, “…. the best lack
all conviction, while the worst are full of passionate intensity”.
Jaydip Chakrabarti.
