INSURANCE COMPANIES IN DEFENCE WITH DOCTORS 

There was a lot of hue and cry among the medical practionars after the judgment of Supreme court in 1995 Indian Medical Association vs. V Shantha which brought the Doctors under the preview of Consumer forums for their medical negligence But by now all the dust and storm has been settled and the issue is no more a controvercial one In due course of time Doctors also opted for professional insurance which brought insurance companies in the picture as a party in defense with Doctors It created a panic among the consumers finding themselves too small to stand  against two powerful giants Its high time to tell consumers to rest assure that  their interests are well taken care by consumer protection agencies National Commission in its recent judgment has categorically defined the role of insurance companies and Doctors which will surely burry the  worry of consumers

Before dealing with the latest law laid down on the subject recently by the National Commission and then confirmed by the Supreme Court, it will be relevant to through light on the background of the situation which had created   concern for the legal lobbies of the country It was a  death case of a young and talented boy of sixteen year old ,who died in 1996 due to medical negligence of doctors which came before the National commission for judication The boy was given spinal anesthesia  for performing operation whereas such anesthesia is not allowed to the person of this age as per the medical literature availed on the subject This wrong application resulted into death of the boy But no negligence could be proved in this case in 1996 because  Insurance companies jumped in to picture for defense of doctors with battery of eminent lawyers and raised number of preliminary objection and father of the boy was forced to compromise ultimately This was a very unfortunate situation where Insurance companies  being party in defense defended the genuine case of the complainant with full force without considering the pains of a father who lost his young son

There was a case again where the similar situation was before consumer redressal agencies and vital question was whether Insurance companies be allowed or not to be party in defense with the doctors

The case Gurudatta Puri Hospital lithantripsy center vs Nusrat [2002] travelled from District Forum in Maddhya Pradesh  wherein Doctors remained absent for defending their case and it was only insurance companies present before the forum to defend the negligence of Doctors as defending parties .The case was decided against Doctors. An appeal was filed by Doctors as well as by insurance companies. before State commission One of the issues before the commission was whether the Insurance Companies should be made party in defense in Doctors medical negligence cases State Commission held ;

*The case can be dealt and decided without the help of insurance companies with the records available with the idea that if insurance companies are brought in the picture the consequences will be adverse for the consumers causing more delay and harassment by two big giants Doctors too may also take the things easy if their responsibility is shared by insurance companies *

National Commission dealt with the  similar case while disposing off two revision petitions from Punjab State commission on different footing though the motive was to safe guard the interest of the consumers only In those two Revision petitions New India Assurance Company Ltd. V/S Hardeep Singh and others  Revision petitions No 2640 AND 2648 OF 2002arising out of two separate judgments from Punjab state consumer dispute redressal commission ,the view taken by National Commission was that if insurance companies are barred from making party, they will have a good case to go in appeal on this very ground Even if they do not go for appeal, there may be another case by Doctors against insurance company for their claim wherein consumer is a sufferer if dragged in their litigation or  not paid in spite of winning the case. Against the Doctors. National Commission with the intention to help the consumers allowed insurance companies to be imp leaded as party in defense but at the same time defined the role of both ,Doctors as well  as Insurance companies and held that doctors are to defend their cases on merit on their own .Insurance companies will be an agency who will tell about the validity of insurance made and its other relevant espects.i.e admissibility, period of the policy made etc.Any other objections if company has in respect of the policy can also be decided here itself.

This view of National commission was further confirmed by Honorable Supreme Court and now, may it be known to consumers that insurance companies if made party to the case with defendants, it is no more a matter to worry for them as both have to play their own roles and interest of consumer shall be taken care by the consumer protection agencies i.e. Forums and Commission for getting them justice.

 Case law:

Gurudatta Puri Hospital lithantripsy center vs Nusrat 2002 CTJ 53 CP

State commission Madhya Pradesh held;

 “The proper and final adjudication of the dispute can be made without impleading the insurance company as a party .Moreover, the act or rules do not provide for impleading the insurance company as a party …the plea that in case the insurance company denies to indemnify to the insured doctor under the contract of indemnity, the consumer is further dragged to litigation is not acceptable”

 New India Assurance Company Ltd. V/S Hardeep Singh and others Revision petitions No 2640 AND 2648 OF 2002arising out of two separate judgments from Punjab state consumer dispute redressal commission   , National commission Held:

‘It is an abuse of the process of the whole system and simply because Insurance company has means to challenge each and every order without regard to the circumstances of the case and its obligation to pay the amount under the policy .It was neither necessary nor proper for the insurance company to take up the cause of the doctors to save its own liability.’

Further,

‘It is the duty of the insurance company to see that frivolous cases are not filed so as to clog the wheels of justice “

 

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