JUDGMENT

Hima Kohli, J.(Oral)--The petitioner has filed the present writ petition praying inter alia for directions to the respondent/DTC to pay the balance sum of Rs. 1,02,251/- incurred by the petitioner for her medical treatment.

2. In a nutshell, the facts of the case are that the petitioner, who is working as a Store Attendant at the dispensary of the Wazirpur Depot of the respondent/DTC, suffered from cardiac arrest on 21.4.2004 and immediately thereupon, she was rushed by her neighbours to the nearest hospital i.e. Amar Leela Hospital, from where she was taken by her family members to Batra Hospital on the same day. At Batra Hospital, the petitioner underwent treatment of angiography, angioplasty and other procedures, and was discharged by the said hospital on 24.4.2004. The total bill raised by the hospital upon the petitioner was for a sum of Rs.2,42,170/- which amount was duly paid by the petitioner.

3. The petitioner claimed reimbursement of the medical expenses incurred by her at the Batra Hospital from the Respondent No.1. As against a claim of Rs.2,41,970/- the respondent/DTC sanctioned the medical reimbursement to the tune of Rs. 1,39,919/- and released the said amount to the petitioner on 24.9.2004. But the balance amount was not released to her. Aggrieved by the refusal to pay her balance bills for a sum of Rs.1,02,251/- towards medical reimbursement, the petitioner made a representation to the chairman of the respondent/DTC on 01.11.2004. The said representation was rejected by the respondent/DTC, vide letter dated 2.3.2005, on the ground that her case for reimbursement of the entire amount of specialized medical bill of Rs.2,41,970/- was not payable as it did not come within the purview of the judgment referred to by the petitioner in the case of Milap Singh v. Union of India & Anr. reported as 113 (2004) DLT 91.

4. The respondent/DTC in its courter affidavit has taken a stand that the DTC has adopted and enforced the circulars with regard to medical facility issued by the Govt. of NCT of Delhi, respondent No.2 herein, which has in turn adopted the rate list revised and formulated by the Govt. of India to its employees. Under the said new policy, the employees are given free choice to get treatment in any private hospital in Delhi (listed with the Corporation) but the amount of reimbursement is regulated by fixing the rate list.

5. Counsel for the respondent/DTC refers to circulars dated 12.11.2003 and 19.8.2003. In the circular dated 12.11.2003, the respondent noted that the CGHS rates have been enforced in DTC for reimbursement against specialized treatment cases under Office Order of the Govt. of NCT of Delhi dated 19.8.2003, where the CGHS rates have been revised with the approval of the Govt. of India. It was further noted that the said rates were duly approved by the Chairman-cum-Managing Director of the respondent/DTC for implementation, vide his decision dated 15.9.2003. The second circular dated 19.8.2003, regarding revision of rates under DGHS, Delhi for specialized and general purpose treatment and diagnostic procedures and fixation of package ceiling rates in respect of Govt./private hospitals/diagnostic centers, etc., was issued in partial modification of the earlier circular dated 25.10.2002 revising the rates circulated for various treatments vide earlier O.M. Dated 7.9.20001. Clause (c) of Item 2 of the said circular specifies that the claims of the members shall be restricted in accordance with the rates approved under the scheme and Clause (c) of Item 5 of the said circular stipulates that the DGHS beneficiaries/members taking treatment in the recognized hospitals of the DGHS will be entitled for reimbursement as per the package rates given in Annexure-A to the said circular.

6. Learned Counsel for the respondent/DTC submits that in view of the aforesaid circulars, the respondent/DTC was justified paying the rates as per the package rates for the hospital. It is further state