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2005 Supreme(Del) 938

HIGH COURT OF DELHI
S. Ravindra Bhat, J.
V.K. Jagdhari – Petitioner
Versus
Union of India & Ors .- Respondents
W.P.(C) 7493/2002
Decided on : 07.10.2005

Advocates appeared:
Mr. Arun Monga, Advocate for the Petitioner.
Mr. Rajiv Shakdhar, Advocate for the Respondents.

Headnote:Constitution of India Article 226 - Writ petition seeking reimbursement of medical expenses - Petitioner after superannuating from Indian Revenue Service opting for one time payment towards CGHS contribution and admitted to its membership - The petitioner undergone bypass surgery, which was verified by Central Board of Direct Taxes Held that petitioner is entitled to reimbursement.

       [Paras 16 & 17]

       

S. Ravindra Bhat, J.

1. The petitioner is seeking issuance of a writ to the respondents to reimburse the medical expenditure incurred by him. The respondents have denied their liability.

2. The petitioner, a former member of the Indian Revenue Service (IRS) superannuated from the service of the first respondent on 31.10.1995. At the time of his retirement, the Government of India had introduced, w.e.f. 1.4.1984 the Central Government Health Scheme (CGHS) for medical treatment of its employees and former employees who opted under the scheme. In terms of Rule 9 of that scheme pensioners could opt for making for one time payment towards CGHS contribution equal to 10 times the annual contribution which entitled them to issuance of a permanent CGHS card.

3. The petitioner had settled down at Neemuch in Madhya Pradesh. It is averred that no CGHS facility was available at that time nor is available even today, in that place. It is averred that the petitioner had applied for a CGHS card mentioning his Neemuch address but was asked to give a Delhi address. He furnished his daughter's New Delhi address. The application for the card was made on 26.4.1999 and he paid Rs. 18,000/- for the purpose.

4. In the meanwhile, during November 1998, the petitioner suffered high fever and developed medical complications while at Neemuch. He was. under the care and treatment of the medical practitioners in the local Government Hospital; he underwent treatment from 25.11.1998 to 2.12.1998. He was advised Echo-cardio Graphy (ECG) and immediate medical attention. The petitioner went to Mumbai, where his son was residing. After investigation, he was advised open heart by-pass surgery, which he underwent at the Bombay Hospital and Medical Research Centre. The petitioner was in that Hospital for more than two weeks between 17.12.1998 and 3.1.1999. The surgery resulted in grafting of three coronary arteries and replacement of one valve. The petitioner had to incur an expenditure of Rs. 313452/-.

5. The petitioner applied to the third respondent for reimbursement, of the expenses incurred, on 10-5-1999, attaching all the medical bills and vouchers. This application was routed through the Chairman, Central Board of Direct Taxes. The petitioner apparently followed up the matter and eventually the respondent rejected the request for reimbursement on the ground that the claim was not permissible since the life card was issued to the petitioner on 26.4.1999 and that the surgery was carried out before the card was issued. This rejection dated 12.5.2000 has been impugned in these proceedings as arbitrary. It is alleged that with the issuance of the card in April, 1999, the coverage of the petitioner related back to, and operated from the date of his retirement and that the entitlement flows not from the card itself but from his status as a pensioner and former Central Government Employee.,

6. The respondents have resisted the claim in these proceedings. It is denied that the Central Civil Services (Medical Attendance Rules) are application to the pensioners. It is averred that as per existing instructions governing the scheme, the pensioners have to obtain CGHS card within a grace period of three months from the date of retirement failing which the card would be valid from the date of issue. In this case, the petitioner opted for CGHS card, in April 1999 after he had undergone the surgery and incurred the expenditure; thus he was clearly disentitled to the claim for reimbursement.

7. It is further averred that the rules applicable to Central Government Employees residing in non-CGHS 'areas or for serving employees for treatment in non-CGHS areas and are inapplicable to the petitioner. 8. Mr. Monga, learned counsel for the petitioner submitted that the dispute in this case is no-longer res integra. It is covered by several judgments of this Court. He has placed reliance upon the judgment reported as P.N. Chopra v. Union of India, 111(2004) DLT 190 and the judgment in W.P.(

















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