Central Administrative Tribunal - Delhi
Bhagwan Singh vs M/O Railways on 11 October, 2018
CENTRAL ADMINISTRATIVE TRIBUNAL
PRINCIPAL BENCH: NEW DELHI
O.A. No.603 of 2016
This the 11th day of October, 2018
Hon'ble Ms. Nita Chowdhury, Member (A)
Bhagwan Singh, aged - 63 years,
s/o Late Sh. Jaswant Singh,
retired from the post of SME (Coaching),
Northern Railway, Baroda House,
New Delhi.
r/o Flat No.C-82, Rohit Coop, Group Housing Society,
Plot No.30, Sector-10, Dwarka, New Delhi-75.
....Applicant
(By Advocate : Shri Yogesh Sharma)
VERSUS
1. Union of India through,
The Chairman Railway Board,
Ministry of Railways, Rail Bhawan, New Delhi-110001.
2. The Director General (Railway Health Services)
Railway Board, Ministry of Railways,
Room No.348, Rail Bhawan, New Delhi-110001.
3. The Secretary,
Railway Board, Ministry of Railways,
Rail Bhawan, New Delhi-110001.
4. The General Manager,
Northern Railway Headquarters Office,
Baroda House, New Delhi-110001.
5. The Chief Medical Director,
Northern Railway Headquarters Office,
Annexe-II, Baroda House, New Delhi-110001.
6. The Medical Director,
Central Hospital,
Northern Railway, Basant Lane,
New Delhi.
7. The Senior Divisional Medical Officer (Dental),
Northern Railway Central Hospital,
Basant Lane, New Delhi.
.....Respondents
(By Adv. : Sh. Prabodh Kumar Singh for Sh. Kripa Shanker Prasad)
ORDER (Oral)
By filing this OA, the applicant is seeking the following reliefs:-
2
"(i) That the Hon‟ble Tribunal may graciously be pleased to pass an order of quashing the impugned order dated 01.04.2004, order dated 31.05.2004, order dated 06.08.2004, order dated 01.06.2005, order dated 25.05.2012 and order dated 17.04.2013 declaring to the effect that the same are illegal, arbitrary and against the law of the land and consequently, pass an order directing the respondents to sanction reimbursement of Rs.38,340/- (Rupees Thirty Thousand Three Hundred & Forty only.).
(ii) The respondents may graciously be ordered to grant interest at the rate of 18% on this amount of Rs.38,340/- from the date of application dated 16.06.2003 was received on 29.09.2003 in the office of Medical Director, Northern Railway Central Hospital, Basant Lane, New Delhi till the date this reimbursement is actually paid to the applicant.
(iii) The respondents may graciously be ordered to pay cost of litigation.
(iv) Any other relief which the Hon‟ble Tribunal deem fit and proper may also be granted to the applicant along with the costs of litigation."
2. Brief facts of the case as stated in the OA are that the applicant who was retired from the post of SME (Coaching) from the Railways and having a Medical Identity Card No.4352 for free medical treatment in Railway health unit/hospital for self, wife, son and unmarried daughter.
2.1 The applicant‟s son was selected on the basis of written examination conducted by the Union Public Service Commission, New Delhi in September 2002 for 110 course of National Defence Academy and finally selected on the basis of Services Selection Board (SSB) at Allahabad from 5.2.2003 to 11.3.2003 for interview. His son was, however, declared temporarily unfit in Dental check- up by Selection Medical Board (Army) at Allahabad during 11.3.2003 to 15.3.2003 and was required to reappear at Base Hospital, Delhi Cantt on appeal against the findings of Selection Medical Board (Army) Allahabad within 42 days from 15.3.2003. 2.2 The applicant contacted Medical Director (MD), Northern Railway Central Hospital on 17.3.2003 for son‟s dental treatment on his return from Allahabad. The applicant was advised verbally that no further treatment is available in Dental OPD except extraction of his teeth as the condition is very bad. The applicant was also advised by MD, Northern Railway Central Hospital, New Delhi that the dental treatment cases cannot be referred to any Govt./Private Hospital.
32.3 The applicant had therefore, no other alternative except to go to a private clinic of repute where his son can be treated within the stipulated allowed time of 42 days to reappear on appeal before Medical Board at Base Hospital, Delhi Cantt., as it was the question of his son‟s whole life career. As such the applicant took the treatment of his son at Dental Clinic of Dr. S. Khosla at B- 4/76, Safderjung Enclave, New Delhi a reputed private clinic where x-ray of his son‟s teeth was done and thereafter diagnosed multiple caries damaged twelve (12) tooth. He was given treatment for dental caries and full mouth restoration/rehabilitation. Seven (07) ceramic crowns cemented and two (02) ceramic bridges prepared to replace two (02) missing teeth. Root Canal Treatment (RCT) of all the seven teeth was also given. Crowning and Bridging of teeth is a specialized treatment which was not available in Northern Railway Central Hospital, Base Lane to dental patients. An amount of Rs.38,340/- was incurred towards dental treatment at the said Clinic by the applicant.
2.4 The applicant‟s son reappeared before Medical Board at Base Hospital, Delhi Cantt., for dental fitness in last week of April, 2003 and was finally selected for 110 course of National Defence Academy.
2.5 The applicant submitted a claim of Rs.38340/- on 29.9.2003 to Medical Director (MD), Northern Railway, Central Hospital, Basant Lane, New Delhi for reimbursement but the same has been turned down by all the functionaries on the plea that it was not referred by Railway Authorized medical officer (AMO). 4 2.6 On 29.9.2003, the applicant applied on prescribed forms together with prescription duly countersigned by treating doctor, essentiality certificate and verified bills for reimbursement of medical expenses of Rs.38,340/- to Medical Director (MD), Northern Railway, Central Hospital, Basant Lane, New Delhi vide application dated 16.6.2003.
2.7 The Chief Health Director, Northern Railway, Baroda House, New Delhi rejected the reimbursement claim of applicant vide letter No.139 dated 1.4.2004 on the ground that the case was not referred by Railway Authorized Medical Officer to Private Clinic/Hospital.
2.8 The applicant preferred his appeal before the Chief Medical Director, Northern Railway, HQrs Office, Baroda House, New Delhi vide his application dated 30.4.2004. However, the said authority rejected the appeal of the applicant vide letter dated 31.5.2004. 2.9 Applicant again preferred appeal to Chief Medical Director, Northern Railway, HQrs Office, Baroda House, New Delhi on 23.6.2004 to review his case. However, the same was also rejected by the competent authority vide letter dated 6.8.2004. 2.10 On 8.1.2005, the applicant appeal for review to Addl. G.M. (AGM), Northern Railway, Headquarters Office, Baroda House, New Delhi for reimbursement of the said medical expenses and the said appeal was also recommended by SDGM, Northern Railway, Baroda House on 17.1.2005. But the same was also rejected by AGM, N.R., HQs, Baroda House, New Delhi vide letter dated 1.6.2005. Thereafter the applicant preferred an appeal to G.M., 5 Northern Railway, Baroda House, vide his letter dated 14.7.2005 and again appealed on 13.10.2006 and 26.3.2007 to Director General, Railway Health Services, Railway Board, New Delhi for reimbursement of the said claim but the same was also not replied. 2.11 On 6.1.2012, the applicant submitted a mercy petition to G.M., Northern Railway, HQs Office, Baroda House, New Delhi and the said appeal was forwarded to Railway Board vide letter dated 17.2.2012 for considering as a special case for sanction. However, on 25.5.2012, the said was also rejected on the very same plea that it was not referred by Railway Authorized Medical Officer to private hospital/clinic.
2.12 On 31.8.2012, the applicant retired on superannuation from the said post and deposited one month‟s salary and joined RELHS Scheme for self, wife and unmarried daughter as railway and requisite Identity card had been issued to the applicant. 2.13 The applicant again submitted an appeal on 4.3.2013 to the Secretary, Railway Board, Member Staff & Chairman Railway Board to review the case vide letters dated 1.3.2013, 2.3.2013 and 4.3.2013. On 17.3.2013, the said appeal of the applicant was again rejected vide Executive Director/H(G) Railway Board on the same very plea.
2.14 Feeling aggrieved by the aforesaid orders of the respondents, the applicant has filed this OA seeking the relief as quoted above.
3. Pursuant to notice issued to the respondents, they have filed their reply in which they have stated that the applicant approached to Dental OPD on 6.4.2002 and 8.4.2002 of the 6 Central Hospital, N. Rly., NDLS and according to the Notes on the OPD paper, six teeth of the son of applicant were found diseased with caries and one teeth caries cleaned and temporary filled done. As per the notes, it is evident that after 8.4.2002, the applicant with the patient never reported back to continue the rest of treatment like RCT etc. The respondents denied that he was never advised for RCT. Further the advise for crowning and bridging of teeth depends on the successfulness of RC treatment. 3.1 They further stated that the applicant went to private clinic for the treatment of his son one year after consulting the Railway Hospital and went to Dr. Khosla‟s Dental Clinic on 9.4.2003. However, he has not presented himself on 17.3.2003 before the Sr. DMO/Dental/NRCH in relation of the treatment of his son. As such the applicant went to private clinic on his own without referral of Railway authorized medical attendant for the treatment of his son. They further stated that RCT and Extractions facilities are very much available at NRCH.
3.2 By placing reliance of letter of the Railway Board dated 31.1.2007, they stated that the treatment taken by the applicant for his son at private clinic does not confirm the "emergency" and hence disqualifies his claim for reimbursement. 3.3 They further stated that the respondents have rightly rejected the claim of the applicant as per the policy guidelines and no violation of Articles 14, 16 & 21 of the Constitution of India.
4. In the rejoinder, the applicant reiterated the averments of the OA and denied the contents of the counter affidavit filed by the 7 respondents and further stated that the said treatment of his son was taken in emergent circumstances by the applicant and therefore, he has claimed reimbursement of the said amount as incurred by him towards his son‟s treatment.
5. During the course of hearing, learned counsel for the applicant emphatically submitted that when the applicant‟s son was attended by Dental OPD at Northern Railway Central Hospital from 6.4.2002 to 8.4.2002, they had also conducted x-ray and diagnosed six (06) teeth caries exposed and another one teeth doubtful. One (01) tooth carries cleaned and temporary filling done. But the proper treatment had not been given to the applicant‟s son. However, urgency of having the treatment of teeth of applicant‟s son came when his son although selected for 110 course of National Defence Academy but declared temporarily unfit in Dental check-up by Selection Medical Board (Army) at Allahabad during 11.3.2003 to 15.3.2003 and was required to reappear at Base Hospital, Delhi Cantt. within 42 days from 15.3.2003 as per the decision taken by them on his appeal.
5.1 Learned counsel further submitted that applicant contacted Medical Director, Northern Railway Central Hospital on 17.3.2003 upon return of his son from Allahabad but he was verbally advised that no further treatment is available in Dental OPD, except extraction of his teeth as the condition is very bad and applicant was further advised that dental treatment cases cannot be referred to any Govt./Private Hospital. Therefore, due the urgency and emergent circumstances as stated above, the applicant had no 8 option except to approach a private clinic of reputation, if the said required treatment of teeth of his son had not been done properly, his candidature would have been rejected for 110 course of National Defence Academy. Therefore, in compelling circumstances, the applicant took treatment for his son at Dental Clinic of Dr. S. Khosla at B-4/76, Safdarjung Enclave, New Delhi and the fact that due to the proper treatment given by the said clinic, the applicant‟s son was declared fit finally for selection for 110 course of National Defence Academy.
5.2 learned counsel also submitted that applicant knocked at the doors of each and every Authorities for redressal of his grievance but none of them have considered the same and all of them rejected his claim on the same ground that it was not referred by Railway Authorized medical officer (AMO). However, all of them, failed to consider the fact that applicant in emergent circumstance has taken treatment of his son from private clinic. As such the respondents are duty bound to consider the case of the applicant for medical reimbursement sympathetically.
6. Learned counsel for the respondents vehemently argued that this case is highly barred by limitation as the applicant is seeking the relief of reimbursement of medical expenses which he had incurred towards the treatment of his son from private clinic that too in the year 2003 and the instant OA has been filed in the year 2016.
6.1 learned counsel further submitted that each and every representation of the applicant with regard to medical 9 reimbursement of aforesaid amount had been considered but the same were rejected on the ground that there was no emergency at all and the said treatment had been taken without referral from the competent authority or even no referral has been sought from the competent authority.
7. Heard the learned counsel for the parties and perused the material placed on record. So far as limitation point raised by the respondents in this case is concerned, the same cannot be said to be a reasonable ground to dismiss this case, in the peculiar facts and circumstances of this case, as the applicant had vigorously pursuing his claim from bottom to the top most authorities of the respondents‟ department and none of them considered the same and have merely rejected his claim of medical reimbursement of treatment of his son on the ground of non-referral case and no emergency.
8. Although it is a trite law that in emergency, there was no need for any referral, the expenditure incurred towards such treatment taken even in non-empanelled hospital is required to be considered as per the Rules on the subject and the same cannot be rejected on any technical ground(s).
9. The urgency in this case is that the applicant‟s son who had been selected for 110 course of National Defence Academy was required to appear before the Base Hospital, New Delhi within 42 days from 15.3.2013 as he had been temporarily declared as „unfit‟ in Dental check-up by Selection Medical Board (Army) at Allahabad during 11.3.2003 to 15.3.2003. However, on his appeal he was 10 required to reappear at Base Hospital, Delhi Cantt. and it is an admitted fact that in the year 2002, applicant‟s son attended by Dental OPD at Northern Railway Central Hospital from 6.4.2002 to 8.4.2002, they had also conducted x-ray and diagnosed six (06) teeth caries exposed and another one teeth doubtful. One (01) tooth carries cleaned and temporary filling done. But the proper treatment had not been given to the applicant‟s son. However, when the said urgency arrived as per the averment of the applicant that he had contacted Medical Director, Northern Railway Central Hospital on 17.3.2003 upon return of his son from Allahabad but he was verbally advised that no further treatment is available in Dental OPD, except extraction of his teeth as the condition is very bad and applicant was further advised that dental treatment cases cannot be referred to any Govt./Private Hospital. It is admitted fact that advice for crowning and bridging of teeth depends on the successfulness of RC treatment. If the RC treatment, which they are capable to provide, is not successful, then in that eventuality the case of the applicant could not have been advised for crowning and bridging of teeth. As such due to this emergent situation, the applicant had no option except to approach a private clinic of reputation, if the said required treatment of teeth of his son had not been done properly, his candidature would have been rejected for 110 course of National Defence Academy. Therefore, this Court is of the opinion that in the said compelling circumstances, the applicant took treatment for his son at a private Dental Clinic and the fact that due to the proper treatment given by the said clinic, 11 the applicant‟s son was declared fit finally for selection for 110 course of National Defence Academy.
10. Now coming to the fact that the applicant had taken treatment of his son from a private clinic, which neither is empanelled one nor of any CGHS recognized one, the reimbursement in full cannot be granted to him in such circumstances. However, his case in such peculiar facts and circumstances is required to be considered for reimbursement of the said medical reimbursement claim at CGHS rates applicable for taking treatment of such nature.
11. In the peculiar facts and circumstances of this case and for the foregoing reasons, the respondents are directed to allow the claim of medical reimbursement of the applicant, which was taken towards the treatment of his son, at CGHS rates applicable for such treatment and pass a reasoned and speaking order about the amount to be paid to the applicant and then pay the same to the applicant within a period of 60 days from the date of receipt of this Order.
12. In the result, the present OA is allowed in above terms. There shall be no order as to costs.
(Nita Chowdhury) Member (A) /ravi/