The Supreme Court bench has ruled that the insurance company covering the doctors must pay back the complainant’s damages for any carelessness to the extent that their culpability is covered by the insurance policy, as relevant to the specific doctor in question.
The National Consumer Disputes Redressal Commission’s (NCDRC) ruling directing compensation to a complainant in a case of medical malpractice was challenged in an appeal, and the bench of the Supreme Court comprised of Justices A.S. Bopanna and Dipankar Datta issued the aforementioned directive in their consideration of the appeal. The bench dismissed the hospital’s appeal and ruled that insurers must pay the complainant compensation up to the amount of their policy’s liability.
The issue relates to the NCDRC order from February 6, 2013, in which the highest consumer court held the Appellant Hospital and its physicians accountable for medical malpractice that led to the patient’s death. The NCDRC bench found them guilty and ordered them to compensate the plaintiff in the first case.
Taking note of this, the Supreme Court bench observed,
“We see no other contrary material available on record to arrive at a different conclusion. Insofar as the conclusion reached by the NCDRC with regard to the negligence, it is un-exceptionable and as such does not call for interference.”
After coming to this judgement, the bench stated that the liability of the insurer, New India Assurance Co. Ltd., was one aspect of the case that needed clarity.
The court noted that the concerned doctors had been deemed negligent by the NCDRC bench and that the Insurance Company had issued the insurance in favour of them through the appellant institution.
“In such circumstance, it is the Insurance Company which would have to reimburse the compensation to the extent of the liability under the Policy as against the said respondents,” the Supreme Court bench observed at this outset.
The attorney for the Insurance Company argued that when the Policy is issued in the name of the Doctors and the benefit is claimed by the Hospital, it is not payable by the Insurance Company, citing the Supreme Court’s ruling in the case of Sheth M.L. Vaduwala Eye Hospital v. Oriental Insurance Co. Ltd. The bench made a distinction between the facts of the relevant judgement and the current case, nonetheless. It was mentioned that the doctors had also been made parties as respondents before the NCDRC panel in this matter, in addition to the Appellant Hospital.
“Having perused the same, we note in the said case the Hospital itself was seeking to take advantage of the policy. In the instant facts, as noted, in addition to the appellant-Hospital, the Doctors in whose name the Policy had been issued were also arrayed as respondents in the NCDRC and the NCDRC having adverted to all the contentions had arrived at its conclusion that the said Doctors were negligent and such conclusion has attained finality in view of our above conclusion,” noted the Supreme Court.
Holding the Insurance Company liable to reimburse compensation, the bench ordered,
It is in that circumstance, in the instant case the Insurance Company is liable to reimburse to the extent they had agreed under the Policy. Hence to that extent, we modify the order holding the Insurance Company(Respondent No.6) to be liable to the said extent and in all other respects, the appellant shall reimburse the compensation jointly and severally.”