Central Administrative Tribunal - Chandigarh
Parmeshwar Sarup Dixit vs M/O Health And Family Welfare on 12 September, 2023
1- O.A. No. 060/01009/2021
CENTRAL ADMINISTRATIVE TRIBUNAL
CHANDIGARH BENCH
Original Application No.060/01009/2021
Pronounced on: 12.09.2023
Reserved on: 05.09.2023
CORAM: HON'BLE MR. SURESH KUMAR BATRA, MEMBER (J)
Parmeshwar Sarup Dixit age 70 years son of Sh. M.M. Dixit, retired Lab.
Technician Central Research Institute for Ayurvada (CRIA) Patiala.
R/o 18-D, 4th floor Ambay apartment, Near Sai Market, now residing H.
No. 752 A, Street 5, Anand Nagar-A (Exten) Patiala, District Patiala,
Punjab- 147001
....Applicant
(By Advocate: Mr. Ashwani Kumar Sharma)
Versus
1. Union of India through Secretary, Ministry of Health & Family
Welfare, Nirman Bhawan, New Delhi -110108.
2. Union of India through Secretary, Ayush Bhawan, B-Block, GPO
Complex, INA New Delhi - 110001.
3. Central Council for Research, Ayurvadic Sciences through Director
General, No. 61-65, Industrial Area, New Delhi -110014.
... .Respondents
(By Advocate: Mr. B.B. Sharma)
ORDER
Per: SURESH KUMAR BATRA MEMBER (J):-
1. The applicant has filed present Original Application under Section 19 of the Administrative Tribunals Act, 1985 seeking the following relief:-
(i) The impugned order dated 01.01.2021 (A-1) may kindly be set aside in the interest of justice and the Original Application may kindly be allowed.
2- O.A. No. 060/01009/2021
2. The facts of the case, in brief, are that the applicant retired from the Central Council for Research in Ayurvadic Sciences on 31.07.2011.
Before retirement, he was availing medical facilities as per Central Services (Medical Attendance) Rules 1944. The applicant underwent pace-maker implant on 28.10.2019 from PGI, Chandigarh and incurred an amount of Rs.1,37,000/- on the treatment. He submitted medical bills for reimbursement to Respondent No. 3. The claim of the applicant was rejected on the ground that the CS (MA) Rules, 1944 are not applicable to retired employees. He filed O.A. No. 060/512/2020 before this Tribunal for redressal of his grievance. This Tribunal vide order dated 07.08.2020 quashed and set aside the order passed by the respondents rejecting the claim of the applicant and remitted back the matter to the respondents for re-consideration in view of the law laid down in the judgments noticed in the order. The respondent no. 3 again rejected the medical claim of the applicant relying upon letter dated 13.01.2015 stating that the retired employees are entitled to OPD facilities and medicines from CGHS dispensaries in Delhi/NCR only and that the CS (MA) Rules are not applicable to retired government employees.
3. Learned counsel for the applicant contended that the action of the respondents is not in consonance with law on the issue as laid down by the Hon'ble Supreme Court in the case of Shiva Kant Jha Vs. Union of India (W.P. (Civil) No. 695/2015 decided on 13.04.2018 and by the Hon'ble Punjab and Haryana High Court in the case of Union of India Vs. Mohan Lal Gupta and Another, 2018 (1) SCT 687. Reference has also been made to identical case before the Hon'ble High Court of 3- O.A. No. 060/01009/2021 Judicature for Rajasthan at Jodhpur in WP No. 4366/2014 decided on 03.12.2014.
4. The respondents have filed written statement contesting the claim of the applicant based on OM dated 13.01.2015 whereby applicability of CGHS facilities has been extended to the retired employees of CCRAS based in Delhi/NCR only. It has been stated that since the applicant has been retired from Patiala, therefore, the relief claimed by the applicant is not maintainable. The applicability of CS (MA) Rules to the retirees has been denied by the respondents.
5. I have considered the rival contentions of learned counsel for both sides and gone through the pleadings as well as the relied upon judicial pronouncements.
6. This is the second round of litigation by the applicant. The plea of the respondents that the retired employees are not covered under CS (MA) Rules, 1944 has already been quashed and set aside by this Tribunal in view of the law laid down by the Hon'ble Supreme Court in the case of Shiva Kant Jha (supra) and by the Hon'ble High Court in the case of Mohan Lal Gupta (supra). The respondents were directed by this Tribunal vide decision dated 07.08.2020 in the earlier O.A. No. 512/2020 (filed by the applicant) to re-visit the matter in view of the law laid down on the issue. The respondents, however, without considering the law, again rejected the claim taking the same plea that the CS (MA) rules are not applicable to the retired employees. The action of the respondents, thus, is held to be in total defiance of the mandate given by the Court of law. The Hon'ble Supreme Court has discussed the issue in detail in the case of Shiva Kant Jha (supra) and held as under:-
4- O.A. No. 060/01009/2021 "17) It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court.
18) This is hardly a satisfactory state of affairs. The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement. The Central Government Health Scheme (CGHS) was propounded with a purpose of providing health facility scheme to the central government employees so that they are not left without medical care after retirement. It was in furtherance of the object of a welfare State, which must provide for such medical care that the scheme was brought in force. In the facts of the present case, it cannot be denied that the writ petitioner was admitted in the above said hospitals in emergency conditions. Moreover, the law does not require that prior permission has to be taken in such situation where the survival of the person is the prime consideration. The doctors did his operation and had implanted CRT-D device and have done so as one essential and timely. Though it is the claim of the respondent-State that the rates were exorbitant whereas the rates charged for such facility shall be only at the CGHS rates and that too after following a proper procedure given in the Circulars issued on time to time by the concerned Ministry, it also cannot be denied that the petitioner was taken to hospital under emergency 5- O.A. No. 060/01009/2021 conditions for survival of his life which requirement was above the sanctions and treatment in empanelled hospitals.
19) In the present view of the matter, we are of the considered opinion that the CGHS is responsible for taking care of healthcare needs and well being of the central government employees and pensioners. In the facts and circumstances of the case, we are of opinion that the treatment of the petitioner in non-empanelled hospital was genuine because there was no option left with him at the relevant time. We, therefore, direct the respondent-State to pay the balance amount of Rs. 4,99,555/- to the writ petitioner. We also make it clear that the said decision is confined to this case only.
20) Further, with regard to the slow and tardy pace of disposal of MRC by the CGHS in case of pensioner beneficiaries and the unnecessary harassment meted out to pensioners who are senior citizens, affecting them mentally, physically and financially, we are of the opinion that all such claims shall be attended by a Secretary level High Powered Committee in the concerned Ministry which shall meet every month for quick disposal of such cases. We, hereby, direct the concerned Ministry to device a Committee for grievance redressal of the retired pensioners consisting of Special Directorate General, Directorate General, 2 (two) Additional Directors and 1 (one) Specialist in the field which shall ensure timely and hassle free disposal of the claims within a period of 7 (seven) days. We further direct the concerned Ministry to take steps to form the Committee as expeditiously as possible. Further, the above exercise would be futile if the delay occasioned at the very initial stage, i.e., after submitting the relevant claim papers to the CMO-I/C, therefore, we are of the opinion that there shall be a timeframe for finalization and disbursement of the claim amounts of pensioners. In this view, we are of the opinion that after submitting the relevant papers for claim by a pensioner, the same shall be reimbursed within a period of 1 (one) month.
21) In view of the foregoing discussion, we dispose of the petition filed by the writ petitioner with the above terms."
6. The another plea of the respondents is that since the applicability of CGHS facilities have been extended to the retired employees serving in the Delhi/NCR and the applicant having been retired from Patiala is not eligible for the medical claim. The discrimination against the retirees for medical facilities on the basis of their duty station has been held to 6- O.A. No. 060/01009/2021 be illegal by the Hon'ble High Court of Judicature for Rajasthan at Jodhpur in WP No. 4366/2014 decided on 03.12.2014, while affirming the order of the Tribunal and held as under:-
"Learned Tribunal after considering all relevant facts and the law applicable, arrived at the conclusion that no discrimination could have been made in extension of medical attendance on basis of place of residence of the pensioner, may that be in CGHS or non- CGHS area. Learned Tribunal declared the original applicant entitled for reimbursement of the expenditure in availing the treatment concerned. At the threshold, learned counsel for the petitioners states that a petition for writ of similar nature i.e. D.B. civil Writ Petition No. 3301/2005 (Union of India and Ors Vs. Smt. Roop Kanwar Mehta) covers the issue involved in the instant matter. Besides the above, certain other matters of similar nature were considered by Hon'ble Gujarat High Court wherein too, it was held that no discrimination is permissible in awarding medical attendance on basis of the place of residence of a pensioner. The judgment passed by Hon'ble Gurajat High Court has already been confirmed by Hon'ble the Apex Court on rejection of Special Leave Petition No. 10659/2005 vide order dated 03.04.2012. Looking to the factual aspect noticed above, we do not find any just reason to interfere with the order impugned. Accordingly, this petition for writ is dismissed. The directions given by learned Tribunal are affirmed."
Thus, the decision of the respondents to restrict the benefit of CGHS facilities to the retirees based in Delhi/NCR only vide O.M. dated 13.01.2015 is held to be illegal. The applicant cannot be deprived of the 7- O.A. No. 060/01009/2021 benefits on the basis of his place of residence, as are available to his counter-parts based in Delhi/NCR. Similar plea of the respondents has been thrashed by the Hyderabad Bench of the Tribunal in O.A. No. 21/692/2017 filed by the CRIUM Pensioners Welfare Association & others Vs. Union of India and others decided on 14.08.2019 wherein the respondents were, iner-alia, directed to process the medical bills of the applicants therein as per CS (MA) Rules.
"The Hon'ble High Court of Rajasthan has held that there cannot be any discrimination on grounds of residence of the pensioner. (III) Thus, as can be seen from the facts stated, the respondents organization is extending medical facilities to those employees, who retired from the respondents organization from Delhi while as to those who retired from other stations, the same facilities have not been extended. It needs no reiteration that such an approach has to be obviously termed as discriminatory.
Respondents organization is a model employer being an instrumentality of the State. A model employer is expected not to discriminate its employees wherever they may be. The Hon'ble Delhi High Court, taking note of the OM dated 10.04.2014, has disposed of the Writ Petition, referred to hereinbefore, and thereby the employees of the respondents organization, who retired from Delhi, are availing the medical facilities. Hon'ble High Court of Rajasthan, has categorically opined that the pensioners should not be discriminated for granting medical facilities based on the place of their residence. By telescoping the legal principle established by the High Court of Rajasthan, the respondents are duty bound to provide medical facilities to the 8- O.A. No. 060/01009/2021 applicants, who have retired from the Hyderabad Office of the respondents organization. Also Item 40 of the Bye-laws of the respondents organization has given full powers to sanction the reimbursement of medical expenses incurred by an employee for himself and his family members. In addition, Bye-law 34 provides that the rules governing retirement of the employees of the Government of India, as amended from time to time, shall mutatis mutandis apply to the employees of the respondents organization.
(IV) Thus, as can be seen from the Bye-laws, the respondents organization is expected to extend the medical rules governing Central Government pensioners. It is not understood as to why the respondents organisation has not invoked these clauses provided in the Bye-laws of the respondents organization, to extend medical facilities to the retired employees located at different stations other than Delhi.
(V) Nevertheless, as the law has been well settled with the observations of the Hon'ble High Court of Rajasthan wherein clearly laid down that there should not be any discrimination in extending the medical facilities to retired employees, based on the place they have settled. The relief sought by the applicants is genuine and fair. The law supports their cause. Even Bye-laws of the respondents organization provide the feasibility to grant the relief sought.
(VI) Consequently, in view of the aforesaid the action of the respondents in not extending the medical facilities to the applicants residing at Hyderabad is arbitrary, discriminatory and 9- O.A. No. 060/01009/2021 illegal. Hence, the respondents are directed to process the medical bills."
7. Further, the respondents have placed on record the letters dated 18.08.2023 and 25.08.2023 wherein the Respondent No 2 has repeatedly requested the respondent no. 3 to send a detailed proposal with regard to adoption of Ministry of Health and Family Welfare OM No. S11011/15/2013-CGHS/EHSS dated 18.09.2018 for amending the MoA Rules and Regulations of CCRAS which shows the positive intent of Respondent No. 2 to consider the grant of benefit.
8. In view of the facts and legal position on the issue, the impugned order dated 01.01.2021 (Annexure A-1) is hereby quashed and set aside. The respondent No. 3 is directed to take up the matter with the Ministry of Health and Family Welfare by sending a detailed proposal as requested by respondent no. 2 and till a decision in the matter is taken by respondent No. 1, the respondent No. 3 shall process the medical claim of the applicant as per CS (MA) Rules 1944, within a period of two months from the date of receipt of a certified copy of this order. The Original Application is disposed of with the above directions. No costs.
(SURESH KUMAR BATRA) MEMBER (J) 'mw'