Central Administrative Tribunal - Mumbai
Raju Kanti Dabhi vs Central Railway on 9 October, 2025
1
OA No.1026/2024
CENTRAL ADMINISTRATIVE TRIBUNAL
MUMBAI BENCH, MUMBAI.
ORIGINAL APPLICATION No.1026/2024
Dated this Thursday the 09th day of October, 2025
Coram: Hon'ble Shri Sangam Narain Srivastava, Member (A)
Raju Kanti Dabhi, Age: 35 yrs, Pointsman,
Under Sr.DOM, Mumbai, Central Railway, CSMT,
Maharashtra-400001. AND R/at: Central Railway Colony,
RB/I/A/2, Vidya Vihar (E) Near Rajawadi Hospital.
Mumbai-400 077. Mob: 8368177526. ... Applicant
(By Advocate Shri Samir Singh)
VERSUS
1. Union of India (Through),
The General Manager, Central Railway,
Headquarters Office, CSMT, Mumbai- 400 001.
2. Principal Chief Medical Director,
PCMD's Office, Mumbai CSMT, CSMT, Mumbai-400 001.
3. Sr. DMO (REIMB)
DRH Mumbai Division, Kalyan.
Thane, Maharashtra - 421 301. ... Respondents
(By Advocate Shri Rishi i/b Shri B.K. Ashok)
Order Reserved on : 23rd September, 2025.
Pronounced on: 09th October, 2025.
Digitally signed by Deepti Ganesh Munarshi
DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone=
270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra,
Deepti Ganesh Munarshi
SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh
Munarshi
Reason: I am the author of this document
Location:
Date: 2025.10.14 10:54:52+05'30'
Foxit PDF Reader Version: 2024.3.0
2
OA No.1026/2024
ORDER
The Original Application has been filed along with an application for condonation of delay. Since there is a delay of 253 days/08 months and 10 days, the applicant has sought condonation thereof.
2. The applicant submits that his claim for medical reimbursement incurred towards the treatment of his wife under emergent circumstances was rejected vide order dated 01st November, 2022. He further submits that his wife, despite having undergone two operations, had to be taken for regular checkups, dressing, and continuous medical observation. It is further stated that during this period he also lost his brother, which caused severe mental and emotional distress. The applicant submits that the delay of 253 days/ 08 months and 10 days, occurred due to the prolonged medical treatment of his wife and the unforeseen personal circumstances. Consequently, he could not prefer the OA on or before 01st November, 2023. He submits that Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 3 OA No.1026/2024 the delay was neither deliberate nor intentional, but was due to the aforesaid reasons, and therefore, in the interest of justice, the delay may be condoned.
3. The respondents have filed reply opposing the prayer for condonation of delay and have sought dismissal of both the MA and the OA.
4. I have considered the submissions made by both sides and perused the material on record.
5. The admitted position is that the impugned order rejecting the applicant's claim for medical reimbursement is dated 01st November, 2022. The Original Application has been filed along with the present application after a delay of 253 days, i.e., 08 months and 10 days.
6. The explanation furnished by the applicant is that during the relevant period his wife was undergoing prolonged treatment, having been operated upon twice, and was required to be taken for continuous follow-up, dressing and medical supervision. It is also his case that during this Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 4 OA No.1026/2024 time he lost his brother, which caused severe mental and emotional strain, and consequently he was unable to prefer the Original Application within the prescribed period of limitation.
7. While the respondents have opposed the prayer for condonation, it is well settled that in matters relating to condonation of delay, a liberal approach is to be adopted where sufficient cause is shown. The reasons cited by the applicant appear to be bona fide and not lacking in diligence.
I find that the delay cannot be attributed to any deliberate inaction or negligence but is on account of circumstances beyond the control of the applicant.
8. In the facts and circumstances of the case, and in the interest of justice, I am satisfied that sufficient cause has been made out for condonation of delay. Accordingly, the delay of 253 days/08 months and 10 days in filing the Original Application is condoned. Miscellaneous Application stands allowed.
Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 5 OA No.1026/2024 On merits
9. The facts of the case are that the applicant is serving as a Pointsman at Lokmanya Tilak Terminus Railway Station under Mumbai Division, Central Railway. The present OA has been filed seeking the following reliefs:
"8.i) This Hon'ble Tribunal after going into the legality, propriety and validity of the impugned order dated 01.11.2022, quash and set aside the same.
8.2) This Hon'ble Tribunal be further pleased to direct the Respondents to consider the medical reimbursement claim of the Applicant with interest.
8.3) To pass any other just and equitable order(s) as deemed fit and proper by this Hon'ble Tribunal under the given facts and circumstances of the case.
8.4) The cost of this original application be ordered in favor of the Applicant.
9.1. The Applicant is a Pointsman at Lokmanya Tilak Terminus Railway Station under Mumbai Division, Central Railway. It is contended that the Applicant is eligible and entitled to medical treatment for himself and his family from Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 6 OA No.1026/2024 Dr. B. R. Ambedkar Memorial Hospital, Byculla, in terms of the provisions contained in Chapter VI of the Indian Railway Medical Manual (IRMM), Vol-I, and the Railway Board's instructions on medical attendance and treatment issued from time to time.
9.2. It is submitted that the Applicant had been continuously attending the Railway Hospital and availing treatment for his wife, Smt. Kanchan Raju Dhabi, who was suffering from piles. He states that her condition deteriorated due to profuse bleeding. The Applicant rushed his wife to the Railway Hospital where, after preliminary check-up, she was discharged with one tube of ointment.
However, he was informed that she required surgery in view of the seriousness of her case. Owing to the ongoing COVID- 19 pandemic, the operation could not be performed at the Railway Hospital at that stage, and she was asked to wait. 9.3. It is further stated that the Applicant, being unable to initially afford the cost of an operation in a private Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 7 OA No.1026/2024 hospital, decided to wait for the pandemic situation to ease, intending to have the surgery carried out in the Railway Hospital. However, despite his expectation of improvement, the pandemic situation remained critical, and his wife's condition progressively worsened, with continuous bleeding and increasing pain leading to life-threatening complications. Faced with the emergent and deteriorating circumstances, and the inability of the Railway Hospital to perform the surgery, the Applicant had no option but to get his wife operated on in a private hospital. He asserts that this decision was made out of absolute necessity to preserve his wife's life and well-being.
9.4. The Applicant submitted that he admitted his wife on 02nd October, 2021, in the nearest private facility owing to the prevailing partial lockdown. The operation was performed on the same day, and she was discharged on 03rd October, 2021, to minimize costs. However, a second surgery became necessary, which was performed on 14th November, Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 8 OA No.1026/2024 2021, and she was discharged on 15th November, 2021. The Applicant thereafter submitted a claim for medical reimbursement of expenses incurred for both operations conducted in the private hospital under the emergent circumstances. The said claim was rejected by Respondent No.3 vide order dated 22nd July, 2022 (Annexure A-5). 9.5. Aggrieved by the rejection, the Applicant preferred an appeal dated 16th August, 2022, before Respondent No.2. The said appeal was rejected by Respondent No.2 vide impugned order dated 01st November, 2022 (Annexure A-1), on the ground that the case did not qualify as an "emergency" within the meaning of Railway Board's Letter No.2005/H/6-4/Policy-II dated 31st January, 2007.
9.6. The Applicant further states that as per the aforesaid Railway Board letter an emergency situation is defined as:
"Emergency" shall mean any condition or symptom resulting from any cause, arising Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 9 OA No.1026/2024 suddenly and if not treated at the early convenience, be detrimental to the health of the patient or will jeopardize the life of the patient."
9.7. The Applicant states that his claim squarely falls within the ambit of "Emergency" as defined under the relevant directives. In particular, during the prevailing COVID-19 pandemic and lockdown circumstances, his wife was suffering from profuse bleeding, a condition severely detrimental to her health and posing a grave threat to her life and well-being. The urgent nature of her medical condition necessitated immediate surgical intervention, which could not be deferred without risking further life-threatening complications. The Applicant, being aggrieved by the illegal and arbitrary impugned order of the Respondents, has been unjustly deprived of his rightful entitlement to medical reimbursement. Hence, the present Original Application.
10. Learned counsel for the applicant has placed reliance on the judgment of the Hon'ble Supreme Court in the case of Shiva Kant Jha Vs. Union of India, (2018) 16 SCC 187 Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 10 OA No.1026/2024 dated 13th April, 2018 to support his claim.
11. The respondents have filed their reply contending that the applicant's wife, Smt. Kanchan Dabhi, attended Zonal Railway Hospital, Byculla, from 20th April, 2021 to 18th June, 2021 on various occasions for treatment of sentinel piles, where she was under conservative management under the care of a surgeon. Thereafter, she got admitted in Ruby Hospital, Bhandup (West), with complaints of bleeding per rectum, painful defecation and burning sensation persisting for the last 6-8 months. As per the discharge summaries for the periods 02.10.2021- 03.10.2021 and 14.11.2021-15.11.2021, the patient's general condition was fair and her vitals were stable at the time of admission. There is no mention of profuse bleeding or any deteriorating condition. She was diagnosed as fissure in ano with internal hemorrhoids with fistula in ano, and underwent laser fistulectomy with hemorrhoidectomy and fissurectomy under spinal anesthesia.
Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 11 OA No.1026/2024 11.2 It is submitted that the ailment was chronic in nature. The operation theatre of Zonal Railway Hospital, Byculla, was functional during October and November, 2021, and the facility for surgery was available. Had the patient reported to Railway Hospital, a decision regarding surgical intervention, if required, could have been taken and treatment provided accordingly.
11.3 It is further submitted that the surgery performed was not life-saving but elective, and therefore does not qualify as an "emergency" under the extant rules. As per Railway Board's letter No. 2005/H/6-4/Policy-II dated 31st January, 2007, a Railway beneficiary must report to the Railway Medical Officer for treatment of self or dependents.
The Authorized Medical Officer will then make necessary arrangements through Railway/Government/Recognised Private Hospitals. Direct approach to a private hospital is permissible only in case of a real emergency, i.e. a sudden condition which, if not treated promptly, would be Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 12 OA No.1026/2024 detrimental to the health of the patient or jeopardize life, such as road accidents, acute heart attack, etc. In such situations, claims may be considered for reimbursement, subject to ex- post facto confirmation of the emergency by the authorised Railway Medical Officer.
11.4 It is submitted that in the present case, as the discharge summaries clearly show that the patient's condition was stable and the surgery undertaken was elective, the treatment at Ruby Hospital does not satisfy the emergency criteria. Accordingly, the applicant's claim was rejected, and the Original Application deserves to be dismissed.
12. Learned counsel for the respondents has placed reliance on the order/judgment of the coordinate bench of this Tribunal in OA No.118/2023 in the case of Sunil Kumar Vs. Union of India & Ors. decided on 06th March, 2024 wherein it was held that even in emergent situation the reimbursement is to be limited to CGHS rates. Digitally signed by Deepti Ganesh Munarshi
DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 13 OA No.1026/2024
13. I have heard the learned counsel for the applicant and the respondents and have perused the pleadings and documents on record.
14. The applicant's spouse had to undergo two surgeries for which the total claim amount is Rs.92,126/-.
The applicant's spouse suffered from piles and there was bleeding, for which reasons the applicant had to take his spouse to a Private Hospital. The Rule says reimbursement can be made in case of emergent treatment. The Railway Board letter No.2005/4/6-4/Policy-II dated 31st January, 2007 governs the reimbursement of medical expenses. As per this, emergency has been defined and parameters to be examined to establish emergency conditions have been prescribed. One such parameter is active bleeding. The applicant's spouse was suffering from such a situation and, therefore, treatment has to be considered as taken under emergent conditions. The second surgery was a follow-up of the first surgery and has to be looked at in continuation Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 14 OA No.1026/2024 and not as a separate incident.
15. In view of the condition of the spouse of the applicant, it is held that the treatment in Private Hospital was necessitated and taken under emergency condition.
16. Having held so, the amount of reimbursement to be sanctioned to the applicant for treatment in private hospital will have to be decided. This is dealt with in the same letter of 31st January, 2007 in para II. The applicant's case would be covered under clause 'II(c)' of letter dated 31 st January, 2007, which is reproduced herein below:
"c) Treatment taken in a Recognized Private Hospital but for an ailment for which it is not recognized or treatment taken in a non- recognized Private Hospital: -
Reimbursement should be made at the CGHS rates of that city or nearest city. CGHS (Central Govt. Health Scheme) approved rates are to be recommended/processed as an upper limit for sanction."
17. The applicant is, therefore, entitled to reimbursement at the CGHS rates of the concerned city or the nearest city, as applicable, subject to the total claim amount Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0 15 OA No.1026/2024 and the prescribed limits.
18. The respondents are, therefore, directed to calculate the amount of reimbursement to the applicant accordingly and disburse it within a period of four weeks from the date of receipt of a copy of this order.
19. The applicant has relied on the decision in Shiva Kant Jha Vs. Union of India (supra). However, the Hon'ble Supreme Court in para 19 of the said judgment has clearly observed that the directions therein were confined to the facts of that particular case and cannot be cited in other cases.
Therefore, reliance on the said judgment does not advance the case of the applicant and the reimbursement will have to be limited to the amounts permissible as per extant Rules.
20. The Original Application is partly allowed. Pending MAs, if any, stand closed. No costs.
(Sangam Narain Srivastava) Member (A) dm.
Digitally signed by Deepti Ganesh Munarshi DN: C=IN, O=Personal, OID.2.5.4.65=dd2229ccb2a64933849d0e889f7908d1, Phone= 270b8c883fb6c7df159699dde8a3a29e49a591f4547843867fc06f0095732d99, PostalCode=400083, S=Maharashtra, Deepti Ganesh Munarshi SERIALNUMBER=60e5a202fd00f69f0731b41e2e3bdfa180f471e3c55c542947568cc8f7d6a4f4, CN=Deepti Ganesh Munarshi Reason: I am the author of this document Location:
Date: 2025.10.14 10:54:52+05'30' Foxit PDF Reader Version: 2024.3.0