Karnataka High Court
The Regional P F Commissioner-1 vs C K Nagendra Prasad on 13 June, 2013
Bench: D.V.Shylendra Kumar, B.S.Indrakala
1
IN THE HIGH COURT OF KARNATAKA AT BANGALORE
DATED THIS THE 13TH DAY OF JUNE, 2013
PRESENT
THE HON'BLE MR. JUSTICE D. V. SHYLENDRA KUMAR
AND
THE HON'BLE MRS. JUSTICE B.S. INDRAKALA
WRIT PETITION NO. 8995/2013 (S-CAT)
BETWEEN:
1. The Regional P.F. Commissioner-1,
# 13, R.M. Roy Road,
"Bhavishyanidhi Bhavan",
Bangalore-560 025.
2. The Additional Central P.F. Commissioner,
(Karnataka & Goa)
# 13, R.M. Roy Road,
"Bhavishyanidhi Bhavan",
Bangalore-560 025.
3. The Central P.F. Commissioner,
No.14, Bhikaji Cama Place,
"Bhavishyanidhi Bhavan",
Bangalore-560 025.
4. Union of India,
through Secretary,
Ministry of Labour,
Shram Shakti Bhavan,
New Delhi-110 001. ...Petitioners
(By Sri Hari Prasad for Sri G. Mallikarjunappa, Adv.)
2
AND:
C.K. Nagendra Prasad,
Age 61 years,
S/o Late C.V. Krishnamurthy,
Retired S.S.
# 5340, 1st Floor, 17th Cross,
35th Main, J.P. Nagar, 6th Phase,
Bangalore-560 078. ...Respondent
(By Sri C.K. Nagendra Prasad, Party-in-person)
...
This Writ Petition is filed Under Articles 226 and 227
of the Constitution of India praying to issue a writ of
certiorari quashing the order passed by the CAT in O.A.
65/12, dated 20.12.2012, at Annexure-A and
Consequently dismiss the O.A.65/2012 and allow the writ
petition with costs.
This Writ Petition coming on for Preliminary Hearing
this day, D.V. Shylendra Kumar. J., made the following:
ORDER
This writ petition is by the Regional Provident Fund Commissioner, Central Provident Fund Authorities and Union of India against the order dated 20.12.2012 passed by the Central Administrative Tribunal, Bangalore Bench, Bangalore in Original Application No. 65/2012. 3
2. The Tribunal had in terms of the impugned order allowed the application filed by the respondent herein questioning the response of the respondent therein/Provident Fund Authorities in the application, not paying the entire medical expenses amount of Rs.1,53,929/- which had been claimed by the applicant as the expenses incurred for treatment and surgery of his wife at a hospital recognized for the purposes of the scheme under which the applicant was entitled for claiming such medical benefits and known as Civil Services (Medical Attendance) Rules, 1944 (for short 'CS(MA) Rules').
3. The applicant was aggrieved as the Department did not pay the amount as claimed by him but restricted that amount to Rs.31,725/- and declined the payment for the balance contending that this was the maximum amount permissible under the Central Government Health Service Rules (for short 'CGHS Rules') as the amount permitted under the rule was this amount though the applicant claimed that he had paid much more. It was aggrieved by this restricted payment, the applicant was before the Tribunal.
4
4. The applicant was serving as Section Supervisor in the Provident Fund Organisation, Bangalore and had taken voluntary retirement and retired from service with effect from 1.4.2001. The claim for reimbursement of the medical expenses incurred for treatment of his wife was in terms of Rule 6 of CS(MA) Rules. The Tribunal looked into the rule under which the applicant was entitled to claim such benefit and also examined the provisions of CGHS Rules and opined that though under the CGHS Rules there may be a ceiling fixed for the manner of reimbursement of the medical expenses regulated, the rule applicable to the applicant for the employee of a Provident Fund Organisation was not CGHS Rules but was only CS(MA) Rules.
5. The Tribunal also looked into Rule 6 of this CS(MA)Rules under which such benefit of reimbursement of medical expenses incurred by the employee or dependant members of the family employee was claimed and found in the rule there is no ceiling limit or restriction to the reimbursement of expenses actually incurred as 5 medical expenses either for the retired employee or permitted members of the family of the employee and restriction was to be found only where in the claim of reimbursement under CGHS Rules were applicable. In this view of the matter, allowed the application in light of Rule 6 of the CS(MA) Rules and held that the applicant was entitled to claim reimbursement of the actual amount of expenses incurred while undergoing treatment at Sagar Hospital which is a recognized hospital under the CS(MA) Rules and further held that the petitioner was not only entitled for reimbursement of the full amount but also entitled for interest on the amount which was not distributed. The direction was for full amount without any restriction or reduction and further amount which had been paid with interest of 12% had to be paid.
6. It is aggrieved by this order of the Tribunal, the writ petition by the Central Government calling for interference. The learned Counsel for the petitioners submits that the Tribunal has wrongly interpreted CS(MA) Rules, 1944; that the Tribunal has failed to take into note the full effect of Rule 6; that there is a ceiling limit to the 6 reimbursement of medical expenditure and that was the amount as fixed by the Government under the CGHS Rules, which is either the actual expenditure incurred or the amount as per the rates fixed under the CGHS Rules which ever is less. He also submits that the Tribunal has erroneously understood the rule in the case of STATE OF PUNJAB & OTHERS -vs- RAM LUBHAYA BAGGA, ETC. (D.D. 26.2.1988).
7. Appearing on behalf of the petitioner, Sri Hari Prasad, learned Standing Counsel has failed to convince us that as per the rule, a Government Servant cannot claim reimbursement of full expenses incurred towards the medical treatment even at a private hospital even it a recognised one; that it has to be only up to the ceiling as mentioned in the CGHS Rules and has placed reliance on Office Memorandum bearing No. S.14025/7/2000 MS dated 28th March, 2000 which is as hereunder:
"(6) Government employees/members of their families may take treatment from any hospital recognized under CGHS/State Government.--The issue for 7 grant of permission for treatment of Central Government employees and the members of their family in any of the hospitals recognized by the State Government/CGHS Rules/CS (MA) Rules, 1944, had been under consideration of the Government for some time past. It has now been decided that the Central Government employees and the members of their families may be permitted to avail of medical facilities in any of the Central Government, State Government Hospitals and the hospitals recognized by the State Government/CGHS Rules/CS(MA) Rules, 1944, as well as the hospitals fully funded by either Central Government or the State Government subject to the condition that they will be reimbursed the medical expenditure at the rates fixed by the Government under the CGHS Rules/CS(MA) Rules, 1944 or the actual expenditure incurred, whichever is less.
In other words, the permission can be granted by the Head of the Ministry/Department/Office to the Central Government employees/members of their families to obtain medical services from any of the private hospitals 8 recognized under CGHS in the 18 CGHS covered cities also.
2. If the treatment for a particular disease/procedure is available in the same city where the Government servant is employed, he may be permitted to avail of the medical services in any other city of his choice but in such cases, he will not be eligible for sanction of T.A./D.A. In case the treatment for a particular disease/procedure is not available at the same station, the beneficiary will be eligible for sanction of TA of his entitled class for taking treatment in a different city
3. xxxxxxx
4. xxxxxxx."
It is therefore submitted that the Tribunal committed an error in directing reimbursement of the full amount ignoring office memorandum which supplements the rule and therefore operates in support of his claims for reimbursement of medical expenses.
9
8. Notice had been issued and the respondent is served and has appeared in person. Respondent points out that the provisions of CGHS Rules are not applicable to the employees of the Provident Fund Organisation and are governed by the CS(MA) Rules. He submitted that the rule does not impose such restrictions. It is also submitted that the hospital where the treatment was received by his wife is a recognized hospital.
9. Rule 6 of CS(MA) Rules, 1944 reads as under:
"6. (1) A Government servant shall be entitled, free of charge, to treatment -
(a) in such Government hospital at or near the place where he falls ill as can in the opinion of the authorized medical attendant provide the necessary and suitable treatment; or
(b) If there is no such hospital as is referred to in sub-clause (a) in such hospital other than a Government hospital at or near the place as can in the opinion of the authorized 10 medical attendant, provide the necessary and suitable treatment.
(2) Where a Government servant is entitled under sub-rule (1), free of charge, to treatment in hospital, any amount paid by him on account of such treatment shall, on production of a certificate in writing by the authorized medical attendant in this behalf, be reimbursed to him by the Central Government;
Provided that the Controlling Officer shall reject any claim if he is not satisfied with its genuineness on facts and circumstances of each case, after giving an opportunity to the claimant of being heard in the matter. While doing so, the Controlling Officer shall communicate to the claimant the reasons, in brief, for rejecting the claim and the claimant may submit an appeal to the Central Government within a period of forty- five days of the date of receipt of the order rejecting the claim."
10. The respondent has also placed reliance on the Single Judge decision of the Madras High Court in the case 11 of E.V. KUMAR -vs- THE UNION OF INDIA (2003(4) CTC
29) wherein the very rule had come in for interpretation and it has been held that the execution or administrative instructions contrary to the rules cannot be enforced and the rule which is statutory prevails. The Madras High Court followed the view expressed by the Supreme Court in the case of S.JAGANNATH -vs- UNION OF INDIA AND OTHER {1997(2) SCC 87].
11. A perusal of Rule 6 indicates there is no fetter imposed unless rule itself is fixing any ceiling for the cost of the treatment and it contemplates reimbursement of the expenses incurred or paid by the employee in the opinion of the authorized medical attendant unless such treatment was necessary, etc. The restriction imposed which Mr. Hari Prasad has relied upon is as per the Office Memorandum of the year 2000.
12. The office memorandum cannot regulate the rules or restrict the operation of the rule. Rule 6 being a beneficial provision, we think it should be interpreted to 12 give its full effect and not to restrict or to deprive of the benefits to the employee.
13. We find the Tribunal has not committed any error in taking the view warranting interference. Therefore, writ petition is dismissed.
Sd/-
Judge Sd/-
Judge Nsu/-