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Showing contexts for: csma rules in Champa Gulati vs Uoi & Ors. on 21 May, 2012Matching Fragments
1. Vide instant petition, the petitioner impugned the order dated 28.11.2008 (A-1) passed by respondent No.2.
2. The facts of the case in brief are that the petitioner is 65 years old widow lady and her late husband was working as Stenographer, who died in harness on 04.05.1989. Petitioner is a family pensioner beneficiary and is entitled for medical facilities from the respondents under CSMA Rules.
3. On 26.05.2008, petitioner was residing in Adarsh Nagar, Delhi, became seriously ill, thereafter admitted in emergency in the nearest hospital i.e. Max Health Care, Netaji Subhash Place, Wazirpur District Centre, Pitampura, Delhi. She was diagnosis for diabetes, mellitus, septicaemia, shock, cholelithiasis and thereafter, discharged on 09.06.2008. The concerned hospital issued the emergency certificate as well as minimum facilities provided certificate. The total expenditure was `1,63,986/- and the said amount was paid by the petitioner at the time of her discharge as per hospital procedure. She submitted the bills with representation dated 07.07.2008 for medical claim.
4. The grievance of the petitioner is that the respondent No.2 without considering the procedure, norms and law on the subject returned the claim of the petitioner in original vide order dated 28.11.2008 on the ground that ex post facto permission can be granted only if treatment has been taken in recognized hospital under CSMA Rules, only in emergency/accident cases.
5. Learned counsel for petitioner submitted that the impugned order is totally illegal and against the rules and policy of the Government.
11. Vide impugned order, it is stated that since the ex post facto permission could be granted, only if the treatment has been taken from any recognized hospital under CSMA Rules, only in emergency and accidental cases. The case of the petitioner though comes under emergency category, therefore, all of sudden, though she was aware about the disease suffering from; however, due to emergency, she was admitted in hospital mentioned above.
12. The law has been settled in catena of cases by this Court that in such eventuality, the employee is not entitled to the full amount, if has been charged by the hospital over and above the prescribed rate of Government Policy. But, certainly, he is entitled to the charges as prescribed in the policy. The case is hand falls in emergency category. Emergency certificate has also been issued by the hospital.