Central Administrative Tribunal - Mumbai
Vinay Kumar Sinha vs Hindustan Copper Limited on 6 September, 2022
ed OA No. Fi 7/206
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"4 weed ay tS 4 $4 qt 7 $2a a ra anf us be a 'a vb oi rf . fo eed ¢ & my oO oo rc ne poe ef wD al ot Oo. £5 gr cs e A © te @ ~ os 8 oe "4 = wl . Oe fs a a3 4 j wo 44 Led : rf 5 4 su & 2, oo fc) ry re we cA 2 5 c p ord Qy 3 ca ry ns Ch, - . ; t we mt & ee nay ; 3 oh, I es 44 is) fe4 Le S ps wD 's) ey os qi OA NG. 7iR20R1 we See ey e et pee 4 Sy laren FE arguments, relied on the judgement of the De ourt im the case cof Narendra Pal Singh vs Union of India & Oxs., ILR 1899 Delhi 325. Relevant portion is wa A gt an. My ey y my rs = % nop. reproduced as below:
The lew is, therefore, well settled that right to health is an integral part to life and the Government has constitutional obligation fo pray ee the fealth faciiities to its employees or retired ¢ foyees and in case an employee requires @ specialized treatment in an approved hospital it is the duty of the Government to bec ov reimburse the expenses. The petitianer in this case had to be operated in an emergency as he suffered a heart problen 'and in case he Aad watied for a prior sanction ha might mor Aave survived. Therefore, in this siteation Wis the duty of the Crovernment £© grant ex-post facto sanction and not deny the claim of the petitioner on technical and Alinsy grounds. Fiestly the Government does nol give amy proper reasoning to deny ihe claim of the petitioner ay ity communication dated 4°" December, 997 and secondly the affidavit of Dr PR. Baliar Siagh merely states that since the petitioner had taken the treatment in nan-CGH iS covered area and as per Central Government Health Scheme Orders and instructions ay issued by the Government, a pensioner is not entiled to the faeilities of reimbursement, These reasons cannot be appreciated in Wew of the settled position ihat the petitioner ix sufitled to fake recourse fo an emergency freatment in any area if the circumstance 3s and the mature of disease so warrant."
faa) "5 mY Ste pt . es ~ td 3-- '~ LZ. She has also relied upen one JRragemenk if $ 3 Y th he case of Shiva Kant Jha vs Union of India, Writ Petition (Civil) No.694 of 2015 decided on 13° ap x hee caret " OCHICE < pd LO 2S abe Feproaucea as 2 OA No. 7227/2027 "C8 3} ft is a settled legal position that the Government employee during his life time or after his retirement is entitied to get the benefit of the medical facilities and no fetters ean be placed an his rights. It is acceptable to common sense, that ultimate deeision as to how a patient should be treaied vests only with the Doctor, who is well versed and expert both en academic qualification and experience gained. Very Hale scope is leff fo the patient or his relative to decide as fo the manner in which the a@ilwent should be treated. Spe etadity Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed &y patients only to ensure propen required and safe treatment, Can if be sated reat 'aking 0 ireatment int Speciality Hospital by itself would deprive a person to chain: reimbursement solely an the ground that the said Hospital is not ded in the Government Order The right to medical claim cannot be denied merely because fhe negite a ine Aospital is nat included in the ex The real test must be the fac nen oft veal merit J Bef re any medical claim is hosoured the authorities are bound to ensure ay to whether the claimant had veto Wy ta ken treatment and the fochan af eeatment ix supported by records duly certified by Doctors' Hospitals 'concerned Onee, if is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very in fuoman approach, the officials ef the CGHS heave denied the grant of medical reimbursement br full to the petitioner forcing hin to approach this Court.
(fa) This is hardly « satisfactory state of affairs. The relevant aquihorities are required fo be more responsive @nd cannot in @ mechanical manner deprive an employee of his ooifimate rebmdursement. The Central Ger verpmment Health & cheme (OC HS) was propounded with a prrpose of oviding health facility scheme fo the central overrment €F vile ovees So ttat they are not. deft & oe ;
without meaicel care afler retirement if was i furtier ance a the object of a we fare State &, "whieh i z fo ee ou Ka & a ors oad a ¢ foe ~~ tA ae pes o% ieee ot wef pay & £-, ae keer [5 ts oy Me By ra, pa ve ac Ry Re or ae, oe in bP:
coor on £ s* Les x Was > Brought ia force. dn tite faces ¢ of the presen He CUE, p : if petitioner was ais OA No. Fi7/2n2 cabnitted in the above seid hospitals iM emergency conditions. Moreover, fhe law does nat require that prior pernission has to be taken in such sifuation where the survival of the persan is fhe prime consideration. The doctors did his operation and had implanted CRE-D device and have Gone S@ 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 shail be only at the CGHS rates ad that too after following a proper procedure given in ihe Circulars issued on time fo time by the concerne ed Ministry, if aiso cannot he denied that the petitioner was taken to hospital jer emergency conditions for survival of fis life Alo requirement Was above the sanctions and t, freaimanl pt GHipal Hed ROSE tals, (15) de the present view of the matien we are of the considered opinion that the CGHS is re esponsinie far taking care of healthcare needs and well hetig of the central government employees and pensioners. in the feels and clreumstances of ie case, we are of opinion Hut the treatment af the pelitioner i non-
empanelled hosplial was genuine because there Wes no aption left with him at the relevant time. We, therefore, direct the respondent-State fo pay ihe halance amount of Re 4,99, S854 to fhe wri petitioner. We also make elear that the suid decision is confined to this case only", of State of Rajasthan vs. Mahesh Kumar Shaxma, "8 Jn this connection iw we be profitable to rejer to whe fies colnet of a Beneh of three Judges of 'this Court be State of Punjab and Others Fy. Ram Lubheaye Bagea ami Others reported in (1 898) € SCC uty where the Bench has laid down that the Government would be justified in limiting the medical facilities to .
14 GA No 7E7Ff2022 the extent if is permitted by its financial resources. In the Instant case, the Government has formulated necessary rules permitting the reimbursement of medical expenses in certain sltuations and uplo a certain limit. The Government has been reimbursing the necessary expenditure as permitted by the rules uniformly Jf will, therefore, nat be proper for a Government emtplayee or for hig relatives tp claim reimbursement of medical expenses otherwise than what was provided in the Rules".
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14. In cebutteal to the judgement relied upon by BRE " fe Ant oe tA oy yoemcnneant anrmi jee ~ ak the Cs PLCanc, Che respendeants Snoemarctea ocnal ene 4udgement in the case of Narendra Pal Singh vs Union = 4 , : * " sso ns : wD ayn of India §& Ors. {Supre}) is not a case of amergency 4s ' : : . -- :
a +. = cs * - ait ~ S nd Foe = it wes the case where UNS PELALLOMNEY Naa SuULrLraered a oe a Ye fe ¢ sudden and emerdent medical KGAart ALTACE. ik LG &@ SBuceenm anh EMeErgeni MeaLcas one wit 7 Jar ee a ao Tay ye a ' ~ ~~ az _ condition, whereas, in this case, the mother of fhe to > + = Br a ay ey . hag -, a" : eat VALS ay 4 + applicant was suffering From cancer since 2006 which oo) =a --. 24 somos - + ok ake a ~ a ", L a Misease which she had been surtering ror a f GaSe ra tone ei Lerpimet = 3 Va pet Aa ef the present facts and circumstances. He alse referred bo the cules "National Mineral Derelopment Corporation Emplovees (Medical Attendance & Treatment} Rules {As adopted by Hindustan Copper Yee geet ew oe peep ote ee . a 7 et oes "pe tore ee en Bed.j, which are governing the medical reimburgement he NAS * Lth + les Re YAS Meebeee & EP SS r meld moe tte ERAT MA RANT @ whith €& vespondent company and arguec that parents st aay' fam 5 Res ex widowed or iy ae 3 ¢ deed & HIPRGES 2 N idre Bok chide pare.
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(Harvinder Kaur Oberoi) Member (7) Sk.
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