Central Administrative Tribunal - Delhi
Dr R K Chauhan vs University Grant Commission on 18 March, 2026
1
Item No.15 (C-V)
O.A. No.2536/2024
Central Administrative Tribunal
Principal Bench, New Delhi
O.A. No.2536/2024
Order reserved on : 22.12.2025
Order pronounced on: 18.03.2026
Hon'ble Mr. Rajveer Singh Verma, Member (J)
Dr. R.K. Chauhan
Age 74 years,
S/o Shri J.L. Chauhan
Retired Secretary,
University Grants Commission,
New Delhi- 110002
Resident of: -
258, Hauz Khas Apartments,
New Delhi-110016.
... Applicant
(In person)
VERSUS
1. University Grants Commission (UGC)
Through its Secretary,
Bahadur Shah Zafar Marg,
New Delhi - 110002.
2. Union of India
Through its Secretary,
Ministry of Health & Family Welfare
Nirman Bhawan,
New Delhi - 110011
3. Central Government Health Scheme
Through its Director,
Ministry of Health & Family Welfare
CGHS Bhawan, Sector - 13,
R. K. Puram,
New Delhi - 110066
...Respondents
(By Advocate : Shri Manoj R. Sinha for R-1
Shri Jalaj Agarwal for R-2&3)
Digitally signed by
RACHNA KAPOOR
RACHNA KAPOOR
Date: 2026.03.20
15:49:15+05'30'
2
Item No.15 (C-V)
O.A. No.2536/2024
ORDER
The applicant, who appears in person, has filed this OA challenging inaction of the respondents in not reimbursing medical bill balance amount of Rs.1,10,643/-.
2. The brief factual matrix of the case is that the applicant, who was superannuated as Secretary, University Grants Commission (UGC) in the year 2010, had undergone left eye cataract surgery on 17.05.2023 and right eye cataract surgery on 07.06.2023 at Dr. Rajendra Prasad Centre for Ophthalmic Science, All India Institute of Medical Science, New Delhi. Pursuant to that, the applicant submitted his medical reimbursement bill to respondent - UGC on 12.06.2023, claiming an amount of Rs.1,51,259/-, duly verified from the authorised doctor of the hospital. However, the respondent- UGC reimbursed only Rs.40,616/- out of the total claimed amount of Rs.1,51,259/- on the ground that „Laser Surgery is not admissible under CGHS rules and Cataract Surgery by AIIMS is restricted according to CGHS Rules'. Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 3 Item No.15 (C-V) O.A. No.2536/2024
3. The applicant sent an email to the respondent UGC on 03.10.2023, making a request to provide the details of processing of his medical bills. In response, the respondent No.1 issued the impugned communication dated 31.10.2023, providing detailed breakup of the medical reimbursement and denying the reimbursement of Rs.1,10,643/- to the applicant. Thereafter, the applicant submitted a detailed representation dated 29.11.2023 before the respondent No.1 against the denial of the full medical reimbursement for his treatment, making reference to various judgments of Hon‟ble High Court and Hon‟ble Supreme Court. However, the respondent No.1 i.e. UGC rejected the claim of the applicant vide impugned order dated 15.01.2024 reiterating its earlier decision. Aggrieved, the applicant has filed the present OA seeking the following relief(s) :-
"(a) Summon the original records of the case.
(b) Quash and set aside the impugned Letter F.No. 11-2/2004 (Admn.I/A&B) dated 31.10.2023 and impugned letter F.No. 11-2/2004 (Admn.I/A&B) dated 15.01.2024, in the facts and circumstances of the present case and in the interest of justice and consequently;
(c) Direct the respondents to reimburse the balance amount of Rs. 1,10,643/- (Rupees one lakh and ten thousand six hundred and forty-three only) to the humble applicant alogwith interest at the rate of Digitally signed by RACHNA KAPOOR 12% p.a. from the date of expenses till the date of RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' realization with consequential benefits, in the 4 Item No.15 (C-V) O.A. No.2536/2024 interest of justice and in the facts and circumstances of the present case and /or
(d) Direct the respondents to pay the cost of the litigation charges @ Rs. 25,000/- and mental agony to the tune of Rs. 1,00,000/- which should be borne by the officers who are responsible for the impugned decision in the interest of justice and in the facts and circumstances of the present case and /or
(e) Pass such other further order(s) as this non‟ble Tribunal may deem fit and proper in the facts and circumstances of the present case."
4. The contention of the applicant is that the denial of balance amount of medical reimbursement in favour of the applicant is illegal, arbitrary and unconstitutional and the respondents failed to appreciate that the applicant is a senior citizen aging more than 74 years and he is entitled for reimbursement of whole amount of Rs.1,51,259/- as per the Central Government Health Scheme. It is further submitted that the CGHS provides reimbursement of expenses for the treatment availed in private/government under emergency. It also provides reimbursement of expenses incurred for purchasing artificial limbs, hearing aids, appliances etc. The rates are determined as per the standard of rates prevalent in the AIIMS and as such the denial is illegal, as the AIIMS is premier medical institution Digitally signed by fully owned by the Central Government and RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 5 Item No.15 (C-V) O.A. No.2536/2024 expenditure incurred by pensioners at AIIMS is fully reimbursable and that the concept of approved rates of CGHS was originally based on AIIMS rates.
5. In support of his contentions, the applicant relied upon the following judgments :-
(i) Judgment of Hon‟ble Supreme Court in State of Punjab Vs. Mohinder Singh Chawla 1997 (2) SCC 83.
(ii) Judgment of Hon‟ble Supreme Court in State of Punjab & Ors. Vs. Mohan Lal Jindal (2001) 9 SCC 217.
(iii) Judgment of Hon‟ble Supreme Court in Shiva Kant Jha Vs. Union of India (2018) 16 SCC 187.
(iv) Decision of Hon‟ble High Court in WP(C) No.5317 of 1999 titled M.G. Mahindru Vs. Union of India & Anr. 2001(59) DRJ 564 dated 18.12.2000.
(v) Decision of the Delhi High Court in Prithvi Nath Chopra Vs. Union of India & Anr. 2004 III AD (DELHI) 569.
6. Pursuant to notice, the respondent No.1 filed its reply opposing the OA. However, learned counsel for the respondents No.2&3 submitted that he does not wish to file reply. Learned counsel for the respondents, relying upon the counter affidavit, Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 submitted that in continuation to the Ministry of 15:49:15+05'30' 6 Item No.15 (C-V) O.A. No.2536/2024 Health and Family Welfare OM dated 10.06.2014, the CGHS facility was granted to the employees of UGC vide letter dated 27.04.2015, however, subject to certain conditions enumerated hereinbelow :-
"(a)CGHS facilities shall be extended to the retired employees of UGC only in Delhi / NCR. They will be entitled to OPD facilities and medicines from CGHS dispensaries in Delhi/ NCR only on the same lines as being done in case of serving employees of UGC.
(b)They may avail treatment from CGHS empanelled hospitals at CGHS approved rates. The medical expenses for IPD/ hospitalization treatment will be borne by UGC and they will not be eligible for cashless medical facilities.
(c) The pensioner‟s card will be issued to these pensioners who have recommended by UGC and on payment of service charges on cost-to-cost basis in advance on yearly basis at the rates determined by Department of Health and Family Welfare in consultation with O/o The Chief Advisor (cost), Department of Expenditure, Ministry of Finance. The CGHS membership card will have to be renewed annually by UGC in advance for both serving as well as retired employees (wherever applicable). Failure to renew the CGHS membership within the specified time period will lead to de-activation of the CGHS Card.
(d) There is no provision for issue of lifetime CGHS Cards to the pensioner beneficiaries of UGC."
7. Learned counsel for respondents submitted that applicant was reimbursed an amount of Rs.40,616/- as per the CGHS norms/rules with the approval of competent authority. He further submitted that as per the office OM, the LASIK Surgery and INTACS Digitally signed by Rings are not recommended for the reimbursement. RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 7 Item No.15 (C-V) O.A. No.2536/2024 By order dated 31.10.2023, applicant was provided detailed break up of medical reimbursement, which clearly mentioned that Laser Surgery is not admissible under CGHS rules and cataract surgery by AIIMS is restricted according to CGHS rules. Learned counsel for the respondents submitted that on 03.08.2023, the applicant was reimbursed with an amount of Rs.40,616/- and Rs.8,214/- (Total Rs.48,830), as per the norms of CGHS towards medical treatment.
8. In rejoinder, the applicant submitted that the view taken by the respondents is perverse as it is not in the hands of the patient to undergo treatment in a particular manner or methodology. The treatment is decided by treating doctor/surgeons of the hospitals in the best interest of the patient. Moreover, how can a person think of a cataract surgery without Lasik surgery in today‟s world.
9. Heard the applicant who appeared in person as well as the learned counsel appeared for the respondents. The material placed on record in support of contentions of each of the parties has also been gone through.
Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 8 Item No.15 (C-V) O.A. No.2536/2024
10. The applicant was superannuated from service in the year 2010 and had undergone left and right eye cataract surgery on 17.05.2023 and 07.06.2023 respectively at Dr. Rajendra Prasad Centre AIIMS and submitted medical reimbursement bill amounting to Rs.1,51,259/- to the respondents. However, the respondent - UGC reimbursed only Rs.40,616/- and denied the reimbursement of rest of the amount i.e. Rs.1,10,643/- on the ground that LASIK surgery is not admissible under CGHS Rules. According to the respondents, the applicant was reimbursed with an amount of Rs.40,616/- and Rs.8,214/- (Total Rs.48,830/-), as per the extent norms of CGHS towards medical treatment. It is the case of applicant that the treatment is decided by treating doctor/surgeon of the hospitals in the best interest of the patient and such decision is not in the hands of the applicant.
11. Ministry of Health and Family Welfare has issued its OM No.S.11011/34/2014-CGHS(P) dated 27.04.2015 on the subject extension of CGHS facilities to the retired employees of UGC. Sub paras (a), (b) Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 9 Item No.15 (C-V) O.A. No.2536/2024 and (c) of para 2 of the said OM are reproduced below :-
"a) CGHS facilities shall be extended to the retired employees of UGC only in Delhi/NCR. They will be entitled to OPD facilities and medicines from CGHS dispensaries in Delhi/NCR only on the same lines as is being done in case of serving employees of UGC.
b) They may avail treatment from CGHS empanelled hospitals at CGHS approved rates. The medical expenses for IPD/hospitalization treatment will be borne by UGC and they will not be eligible for cashless medical facilities.
c) The pensioner's card will be issued to those pensioners who have been recommended by UGC and on payment of service charges on cost-to-cost basis in advance on yearly basis at the rates determined by Department of Health and Family Welfare in consultation with O/o the Chief Advisor (Cost), Department of Expenditure, Ministry of Finance."
12. The Hon‟ble Supreme Court in Shivakant Jha Vs. Union of India (2013) 16 SCC 187 has held that "The real test must be the factum of treatment. Before any 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 Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' technical grounds. (Para 13).
10Item No.15 (C-V) O.A. No.2536/2024
13. In the case of State of Punjab Vs. Mohinder Singh Chawla AIR 1997 SC 1225, the Hon‟ble Supreme Court held that "it is now settled law that right to health is an integral to right to life. Government has constitutional obligation to provide the health facilities. If the Government Servant has suffered an ailment which requires treatment at a specialised approved hospital and on reference whereat the Government Servant had undergone such treatment therein, it is but the duty of the State of bear the expenditure incurred by the Government servant."
14. In the instant case, there is no doubt regarding the genuineness of factum of medical bills submitted by the applicant for reimbursement to the medical treatment undergone at AIIMS. The controversy is only with regard to the fact that the respondents have made reimbursement at CGHS approved rates and denied the reimbursement towards LASIK Surgery as per their CGHS norms.
15. As per the settled legal position, as discussed in paras 12 & 13 above, the stand taken by the respondents is having no merit and balance of Digitally signed by convenience lies in the favour of the applicant. RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30' 11 Item No.15 (C-V) O.A. No.2536/2024 Therefore, the OA deserves to be allowed. As a result thereof, the OA is allowed with the following directions:-
(a) Letters dated 31.10.2023 and 15.01.2024 are set aside.
(b) The respondents are directed to reimburse the balance amount of Rs.1,10,643/- to the applicant within eight weeks (08 weeks) from the date of receipt/production of the certified copy of this order.
(c) No interest is payable to the applicant on such payment.
16. Pending MAs, if any, shall stand disposed of.
There shall be no order as to costs.
(Rajveer Singh Verma) Member (J) 'rk' Digitally signed by RACHNA KAPOOR RACHNA KAPOOR Date: 2026.03.20 15:49:15+05'30'