WBHS and Consumer Protection Act

[adil85]

WBHS has been introduced in our State for the treatment of those employees of the Government and their dependant family members who are enrolled under this scheme.In such scheme a government servant opts voluntarily and pays the medical allowances every month as a premium for the membership to get the benefit of the scheme, which as policy matter is deducted automatically from his salary each month.Consumer Protection Act 1985 says that if you get a service against the payment of the money, you become a consumer. Under the provision of the consumer law thus a government employee enrolled under the scheme becomes a consumer and if there is any deficiency in service or denial or curtailment of the reimbursement of his medical bill which would amount to unfair trade practice or deficiency in service, he gets the legal right to sue the Government because the Government is also one of the the service providers or medical insurer in such cases. I as a legal consultant feel that the rights of the government servants in the matter of treatment and subsequent reimbursement of the treatment cost are well protected under the consumer law and there is no space for denial of his right as a consumer. In cases of deficiency or refusal or rejection of the calim can not an employee take up his case with the consumer redressal forum for the redressal of his grievance? What the other Hon'ble mambers say? This is a tricky situation of law and requires extensive discussions amongst the senior members of this forum and others also. Members should also discuss the issue raised by me with their bosses as an academic discussion and post their views on this forum so that an awareness may be created in the employees.

[som]

Dear Adil85, as you said the Govt. Employees after subscribing to this scheme, become consumer. But one thing is not clear to me. When the rate of subscription is uniform for all, why the facilities are not same for all class of employees? I would like to draw your kind attention to the fact that the Scheme provides "General ward" for lower income group, "Semi private ward" for middle income group and "Private ward" for higher income group. Is it not violating the Consumer protection Act?

[adil85]

Consumer Protection Act is meant for deficiency in service or unfair trade practice. Here in the case of WBHS the employee is agreeing to the terms and conditions of the Government at the time of enrollment in the scheme which is voluntary. So the C.P Act is not applicable here. However since the medical benefits drawn by every one is almost same but categorized in the standard of accomodation etc. and the monthly premium is also same but the benefits are different according to category then the terms and conditions of the facilities of the scheme are based on arbitrariness which is violative of Article 14 of the Constitution of India. If some one approaches the Court of Law then either the benefits will become the same for every one or the rules of WBHS 2008 will be quashed.

[jmmisir]

Thanks for your compliment, Preetam Basak, Raiganj, Uttar Dinajpur.

[donyi_polo]

Dear som,
What, in your opinion, may be the basis of such discrepancy in WBHS - parity in contribution but disparity in facilitty! Is it seen only in case of WB employees? Can you compare with other states!

[som]

Is it seen only in case of WB employees? Can you compare with other states!

Sorry, I dont know about other states and the Scheme of Central Govt. Please share if you know.

[donyi_polo]

Dear som,
No, no... I wanted to know what, in your opinion, may be the basis of such discrepancy in WBHS - parity in contribution but disparity in facilitty!

[donyi_polo]

Sorry, I dont know about other states and the Scheme of Central Govt. Please share if you know.

@som
As you desired, following are the information furnished to you in relation to the Central Govt. Health Scheme:

MONTHLY CONTRIBUTIONS FOR CENTRAL GOVT. HEALTH SCHEME (CGHS)

Sl.No.	Grade Pay	Monthly contribution
1 2 3 4 5	Up to Rs 1650 Rs. 1800, Rs 1900, Rs. 2000, Rs 2400, Rs. 2800 Rs.4200 Rs. 4600, Rs. 4800, Rs. 5400, Rs. 6600 Rs. 7600 and above	Rs 50 Rs. 125 Rs. 225 Rs. 325 Rs. 500

ENTITLEMENTS OF WARDS IN PRIVATE HOSPITALS EMPANELLED UNDER CGHS

Sl. No.	Pay in Pay Band (excluding G.P.)	Ward entitlement
1 2 3	Up to Rs 13950 From Rs. 13960 to Rs 19530 Rs. 19540 and above	General ward Semi-private Private

As of now, hope this would suffice.

[adil85]

In WBHS 2008 scheme it is seen that the entire rule is based upon discrimination and violation of Article 14 of the Constitution. If some one (participant or beneficiary) moves to the Court of law the scheme will be quashed ab-initio.Had government paid the money it could have differentiated according to the ranks. But as the same amount is being deducted from the salary of the employee the Government have no right to mete different treatment to different class of employees on the basis of pay scale.In fact such rules are framed by the fresher law graduates who join WB legal Service or by the ill educated big wigs of the Government who give it to frame to their section officers instead of doing their selves. In WB patch work is done by cutting and pasting different paragraphs from different Governments rules of similar nature and hence the illegality is bound to be there.

[bithi_dutta]

@som,
Why can't you raise your voice and make protest against such draconian policy of the State Govt. which has arranged for different wards in Pvt. Hospitals on the basis of pay of employees though their monthly contributions being the same under WBHS! It's clear that such discrimination is not there in the Central Govt. Health Scheme, which seem to be more logical!

What about the teachers of aided schools! For them there is no Child Care Leave, no definite Health Scheme! Are they always be treated as 2nd class citizen in WB!