Central Administrative Tribunal - Jaipur
Sneh Kumar Jain vs M/O Environment And Forests on 28 October, 2021
1
0.A. No, 825/2013
CENTRAL ADMINISTRATION TRIBUNAL
JAIPUR BENCH, JAIPUR
Original Application No. 825/2013
Order reserved on: 21/10/2021
Date of Order: 9%/\»/202]
Coram:
Hon'ble Mr. Dinesh Sharma, Administrative Member
Hon'ble Mrs. Hina P. Shah, Judicial Member
Sneh Kumar Jain, Son of Shri Moti Ram Jain, aged about
51 years, resident of Flat No. 101, Pearl Pleasure
Apartment, B-134, Rajendra Marg, Bapu Nagar, Jaipur
and presently holding the post Chief Conservator of
Forest, Eco Tourism, Van Bhawan, Jaipur.
.. Applicant
Shri C.B. Sharma, counsel for applicant.
VERSUS
14. Union of India, through its Secretary, Department of
environment and Forest, Ministry of Environment and
Forest, New Delhi- 110001.
2. Union of India, through its Secretary, Department of
Gealth, Ministry of Health and Family Welfare,
Government of India, Nirman Bhawan, New Delhi-
110001.
3, state of Rajasthan, through its Chief Secretary,
Government of Rajasthan, Secretariat, Jaipur- 302005.
4. state of Rajasthan, through its Principal Secretary
Department of Personnel, Government of Rajasthan,
Secretariat, Jaipur- 302005. an,
5, State of Rajasthan through its Principal Secreta
Department of Financ®, Government of Rajasth n
Secretariat, Jaipur- 302005, an,
i
'
i
{
4
dygh yee Tee ecm, pig
2
O.A. No. 825/2013
6. State of Rajasthan through its Principal Secretary,
Government of Rajasthan, Department of Forest,
Secretariat, Jaipur- 302005.
7. Principal Chief Conservator of Forest, Rajasthan, Van
Bhawan, Jaipur- 302005.
....Respondents
Shri Rajendra Vaish for respondents No. 1 & 2.
Shri V.D. Sharma for respondents No. 3 to 7.
ORDER
Per: Hina P. Shah Judicial Member Per: Hihar. nae The present Original Application has been filed by the applicant under Section 19 of the Administrative Tribunals Act, 1985 for the following reliefs: -
(i) That the respondents be directed to entertain full medical claim of Rs. 10,89,898/- of the applicant and to release payment of remaining amount Rs.
7,74,7431- towards medical reimbursement along with interest @ 12% p.a. from January, 2012 till payment by modifying order dated 15/12/2011 (annexure-A/4) by quashing letter dated 52/04/2013 (Annexure-A/1) = with all consequential benefits.
(ii) That respondents No. 3 to 7 be directed to made applicable all India Services (Medical Attendance) aules 4954 and settle the claim without any ceiling of amount.
(iii)
(iv) 3 0.A. No. 825/2013 Any other order, direction or relief may be passed in favour of the applicant which may be deemed fit, just and proper under the facts and circumstances of the case.
That the costs of this application may be awarded.
The facts as stated by the Applicant is that he belongs to All India Services and is presently serving in Indian Forest Services in state of Rajasthan. His daughter, Kumari Yashna Jain was facing problem of hearing and speaking and she was admitted in Indraprastha Apollo Hospital, New Delhi on 30/04/2011. As per medical advice, she got operated and Cochlear Implant was carried out. She was discharged on 02/05/2011. The medical authorities charged Rs. 10,89,898/-
as per the chart given as follows:-
SNe) Description Amount (Rs.) | =" 1 Aidiometry Testings 2,600 pi. Scan 4,190 | 2 ee 9,410 | 3. Bed Charges, Consultations, Medical 10,73,728 4 Records, OT-Consumables including | (From which Rs cochlear implant nucleus C 1512 9,94,000/- towards cost PCT The applicant submitted the said Medical bill amounting to Rs. 10/89,898/- vide request letter machine, others services, pharmacy | of cochlear implant) atc. (Item wise details mentioned in the bill) |__| Medicines 270 [5 _____;----~_ Tetal 10,89,898 --
eel Tne 4 O.A. No. 825/2013 dated 04/05/2011. The Government of Rajasthan allowed claim of Rs. 3,15,155/- including cost of cochlear implant of rupees three lacs vide order dated 45/12/2011. He was not allowed the expenditure towards medicine, consultation charges, "etc. but was only allowed charges of CT scan, MRI and Bed charges which are also less paid in the grab of AIIMS rates. Applicant made several requests vide _ letters dated 06/01/2012, 21/02/2012 and 28/02/2012, but no action was taken by the State Government. Rule 14 of All India Services (Medical attendance) Rules, 1954 do not provide any limitation and State Government without any base e only allowed a sum of Rs. 3,15,155/-. It is clear that applicant is entitled for ; bursement of full amount towards the medical claim and rest of the amount of Rs. 7,74,743/- be gigbursed immediately. Since the amount was not id, the applicant filed O.A. No. 54/2013 and the e was disposed of vide order dated 29/01/2013 erty to represent afresh and respondents with 4 lib consider the same within a period of three to ths Applicant thereafter made representation months.
95/02/2015 along with all ruling position and on d documents, but the respondents vide 5 O0.A. No. 825/2013 request for full reimbursement cannot be acceded to (Annexure-A1), Therefore, being aggrieved by the action of respondents, applicant has filed the present O.A. seeking a direction for release of full medical claim of Rs. 10,89,898/- and that the respondents be directed to release the remaining amount of Rs. 7,74,743/- towards reimbursement along with interest.
3.(a) Respondent No. 3 to 7 have filed the reply stating
(b) that the representation filed by the applicant in compliance of the order dated 29/01/2013 has been examined by the Department and Finance Department in light of All India Services (Medical Attendance) Rules, 1954 and Rajasthan Civyj Services (Medical Attendance) Rules, 2008, It is found that the treatment undertaken in a Private hospital outside the State without competent medical reimbursement under Rule 4 and Rule 7 of All India Services (Medical Attendance) Rules, 1954 admissible and accordingly, the presentation of the applicant was disposed of. re Respondents submit that the case of the applicant e arding medical reimbursement of Cochlear reg plant of his daughter has been sympathetically Im mined and it is found that the treatment has exa undertaken in @ private hospital} Outside the been 6 O.A. No. 825/2013 State without competent medical reference, hence full reimbursement of Cochlear Implant upto maximum financial ceiling has not been allowed to the State Government employees and keeping in view the State Government policy _ partial reimbursement was allowed to the applicant. Since the applicant has not challenged the validity of the rules of All India Services (Medical Attendance) Rules, 1954 and Rajasthan Civil Services (Medical Attendance) Rules, 2008, in absence thereof no relief can be claimed because the reimbursement allowed to the applicant is as per the rates prescribed by the State Government and no employee can claim as a matter of right for granting relaxation in the matter of medical reimbursement. The respondents have also stated that the applicant has failed to establish the fact and did not mention about the compelling reasons for seeking treatment in private hospital when the said facility was provided in the SMS Hospital and other recognized nt Hospitals. Thus, the claim of the Governme icant is not legally sustainable and the present appl! j deserved to be dismissed.
O.A. t filed any rejoinder denyin th icant has no gane The applic respondents, submiss! 7 O.A, No. 825/2013 Heard the parties at length and perused the material available on record and the judgments cited by the parties.
The applicant besides retreating his submissions stated that in order to save life of his daughter he had no option but to take treatment as indoor patient in Indraprastha Apollo Hospital, New Delhi. He had incurred money in emergent condition, and therefore, the action of respondents in not releasing full amount is unjustified. The applicant states that the State Government is managing und from Chief Minister Relief Fund for treatment of children and therefore the daughter of the applicant also deserves to be paid under the said fund. The daughter of the applicant is having more than 70 percent permanent disability and as he is facing financial hardship and has incurred the medical expense, he deserves reimbursement of full claim. The respondent No. 4 has rejected the representation without taking into note the earlier der sheets as well as provisions of All India or services (Medical Attendance) Rules, 1954. Thus e ' ne action of the respondent No. 4 deserves to be t ashed and set aside. The applicant has also qu ed on the judgment of the Hon'ble Supreme reli 8 0.A. No. 825/2013 Court (Writ petition (civil) No. 694 of 2015) in case of Shiva Kant Jha versus Union of India, wherein it has been held that in an emergent condition, law does not require prior permission to be taken in a situation where survival of the person is prime consideration. And in such circumstances, treatment of patient in non- empanelled hospital was considered as genuine and the respondents-State was required to pay the balance amount to the writ petitioner.
The respondents besides retreating the submissions have further stated that the order dated 22/04/2013 has been issued strictly in accordance with the provisions contained in All India Services (Medical Attendance) Rules, 1954 and Rajasthan Civil Services (Medical Attendance) Rules, 2008. Respondents further state that nowhere in the application made by the applicant 'tis shown that there was an emergent situation i here the daughter of the applicant was required w to be admitted and treatment was required to be 0 ken urgently: It is further stated that implant ta "cochlear Implant" is not stated to be done in ergency and therefore the payment made to em ne applicant pertaining to the said medica} t 9 O.A. No. 825/2013 expense is as per rules. Pertaining to the submissions that he is entitled to the full imbursement of the medical expense, it is stated that the Hon'ble Chief Minister is the competent authority under the Chief Minister Relief Fund for sanctioning the amount. It is further clarified that the medical reimbursement in case of the applicant does not show any case of emergency.
The respondents further stated that the case of Shiva Kant Jha (Supra) cannot be applied to the present case as it is clear that in the present case there was no question of any emergency, no question of saving life of a person was there. It was @ treatment required to be done and therefore the said case does not cover the present case. It is further stated that as mentioned in the jna case, the Supreme Court has observed at Para 15 that the said decision confined to the said case only. In that case also is there was an emergent situation where in an emergency the person was required to be admitted to the hospital and was not able to take prior permission of the authorities. Such was not the condition 17 the present case. Therefore, as per rule 'the payment of the medical Pere emer er te Aca :
. . 1 10 O.A. No. 825/2013 reimbursement for Cochlear Implant of his daughter has been already made and therefore the present O.A. deserves to be dismissed as the applicant is not entitled for any relief. The factual matter of the case is that the daughter of the applicant was facing problem of hearing and speaking and after advice, was admitted in Indraprastha Apollo Hospital, New Delhi on 30/04/2011. And operation was conducted to implant "Cochlear Implant" and thereafter she was discharged on 02/05/2011. The applicant has submitted all medical bills amounting to Rs. 10,89,898/- with a request letter dated 04/05/2011 to the Government of Rajasthan. The Government of Rajasthan vide order dated 45/12/2011 allowed a claim of Rs. 3,15,155/-. since the applicant did not get his ful] claim of eimbursement he made representation to the r State Government but same was not admitted by the respondents as no action was taken by them. hereafter applicant approached _ this Hon'ble Tribunal in O.A. No. 54/2013 and this Hon'ble Tribunal vide order dated 29/01/2013 gave liberty to the applicant to file a fresh representation anq the respondents to consider the same Within a ef ----
11 0.A. No. 825/2013 period of three months. Accordingly, applicant made a representation on 25/02/2013 along with several documents and ruling position. But instead of paying the balance reimbursement claim, the State Government rejected his said request. It was clarified by the State Government that the representation of the applicant was duly examined by the Department as well as by the Finance Department in light of All India Services (Medical Attendance) Rules, 1954 and Rajasthan Civil Services (Medical Attendance) Rules, 2008. It was | pointed out that the treatment in case of the also ghter of the applicant has been undertaken in dau private hospital outside the State without i ference; hence he was not nt medical re ' compete wed for medical reimbursement under Rule 4 allo q Rule 7 of All India Services (Medical an attendance) Rules, 1954. It is further pointed out that the State Government has been allowing ;mbursement of Cochlear Implant upto re aximum financial ceiling in all cases uniformly m 9 case reimbursement beyond this limit been allowed to State Government employees: The respondents, therefore, stateg a eters Steg --j
10.
mgmt = 12 O.A. No. 825/2013 that in view of the rule position, the request for allowing full reimbursement cannot be acceded to.
We have observed that the present case cannot be said to be an emergent case where the applicant without taking prior permission was required to take treatment in 4 private hospital outside State. Cochlear Implant does not fall under the category of emergency: the applicant did 'not take prior approval of the authorities in order to take treatment outside Rajasthan. Such type of available in the SMS pital and several other government hospitals. As far as question of payment of amount of full medical ursement |S proval of the authorities and had the concerned, had the applicant taken prior aP ion of the dau in such a case the State Government hter of the appli ina i condi g pplicant being in aia nave considered for the medical co
-eimbursement' coming © the grounds raised by the applicant we t find any of the grounds as convincing as the did n° plicant should have challenged the virus of Ali ap services (Medical Attendance) Rules, 1954 go coming to the judgment of Shiva Kant jh a A ) relied by the applicant, it is clear that th e (supra .. not applicable to th same '° € facts a nd 13 O.A. No, 825/2013 circumstances of the present case as treatment of Cochlear Implant cannot be said to be an operation done under emergent condition.
observations made above, it is clear
11. In view of the that the action of the Respondents does not deserve any interference and therefore the order dated 11 (Annexure-A4) as well as an order 15/12/20 dated 92/04/2013 (An g devoid of merits deserves to be nexure-A1) is just and proper.
The O.A. bein O.A. is dismissed. No costs.
eS . dismissed. Accordingly, A Lin aa P. Shah) | (Dinesh Sharma) judicial Member Administrative Member AP