SupremeToday Landscape Ad
Back
Next
Judicial Analysis Court Copy Headnote Facts Arguments Court observation
Listen Audio Icon Pause Audio Icon
judgment-img

2018 Supreme(Ker) 18

IN THE HIGH COURT OF KERALA
P.R. RAMACHANDRA MENON, V. SHIRCY, JJ.
The Central Provident Fund Commissioner, Employees Provident Fund Organisation, New Delhi & Others - Petitioners
Versus
N. Satheesan & Another - Respondents
OP (CAT) No. 167 of 2017
Decided On : 19-01-2018

Advocates:
Advocate Appeared:
For the Petitioners: N.N. Sugunapalan, T.N. Girija
For the Respondents: A.R. Gangadas, N. Nagaresh, Dr. K.P. Satheesan, P. Mohandas (Ernakulam), S. Vibheeshanan, K. Sudhinkumar, Muhammed Ibrahim Abdul Samad

Headnote:Central Services (Medical Attendants) Rules 1944, Rr. 2(h) & 6 - There is no restriction for availing reimbursement as part payments under the rules even they received treatment from empanelled hospitals

JUDGMENT :

Shircy V., J.

1. Ext.P4 verdict dated 11th April 2017 rendered by the Central Administrative Tribunal, Ernakulam Bench in O.A 740/2015 is under challenge at the instance of the respondents in the Original Application.

2. The brief facts involved in this Application are as follows: The applicant joined service in the year 1972 in the Employees Provident Fund Office ('EPFO' for short) and retired as Assistant Provident Fund Commissioner on 31.10.2011. As per an order dated 6.11.2006, the benefit under Civil Service (Medical Attendants) Rules, 1944, ('CS (MA) Rules' for short) was extended to the retired employees of the Provident Fund Office with effect from 24.10.2006. As such the employees and their family members are eligible for medical reimbursement. The wife of the applicant had undergone treatment on various spells incurring considerable amount but the full amount spent by him was not reimbursed. The details of the actual amount incurred for treatment and the amount reimbursed are furnished in the Tabular form as follows:

Sl. No.

Date of claim

Amount claimed

Amount paid

1

12/10/12

Rs.28,157/-

Rs.12,300/-

2

19/12/13

Rs.1,50,420/-

Rs.1,22,000/-

3

28/04/15

Rs.48,349/-

Rs.12,300/-

4

08/06/15

Rs.24,214/-

Rs.7,213/-

3. As the entire amount claimed was not sanctioned by the authority, he submitted a representation as Annexure- A2 with Annexure A1, as a similar claim was allowed by the Central Administrative Tribunal, Bangalore but, it was rejected stating that the claim raised by him was deviating from CS (MA) Rules. He never raised any claim deviating from the Rules. Hence, the O.A. was filed with the following reliefs:

“i. to set aside Annexure-A3 letter No.KR/Adm,1(7)/Medical/2015 dated 29.07.2015 issued by the 4th respondent as it is illegal and void.

ii. to issue an order or direction to the 3rd respondent to reimburse the balance amount on the medical bills out of the total claim to the applicant with interest from the respective due dates till the date of payments,

iii. to declare that the applicant is entitled for full reimbursement of the medical bills as provided under rule 6 of CS(MA) Rules, 1944.

iv. To issue such other order or direction as this Hon'ble Tribunal may be deem fit and proper in the facts and circumstances of the case''

4. The respondents /petitioners admitted that all the Central Government employees and their family members are entitled to avail medical facilities in any of the Central Government/State Government Hospitals and in the Hospitals recognized by the State Government, subject to the condition that the actual expenditure incurred or the medical expenditure at the rate fixed by the Government whichever is less. It was contended that, though all facilities are available at the Medical College Hospital, Trivandrum, she had undergone cataract operation in a private hospital of applicant's choice, against the Rules. For implantation of pace maker(the second claim), he claimed an amount of Rs.1,50,420/-, though the hospital where the treatment was undertaken was not a recognized hospital. But considering the emergency situation and the ceiling prescribed under CS (MA) Rules, a sum of Rs.1,22,000/- was granted. The third claim was also for cataract operation of right eye of his wife and for the same, a sum of Rs.12,300/- has been granted and for the last claim of Rs.24,214/- for treatment in NIMS Hospital, Neyyattinkara, a sum of Rs.7213/- was granted as the hospital has now empanelled to undertake treatment with the facility of reimbursement.

5. Thereafter a counter affidavit was filed by the applicant and produced Ext.R1(a), true copy of the order of the CAT, Bangalore Bench in O.A. No. 334/2014 and Ext.R1(b) the order of the High Court of Karnataka confirming Ext.R1(a) order. Ext.R1(c) is a copy of the order of the Supreme Court dismissing the Special



















Click Here to Read the rest of this document

1
2
3
4
5
6
7
8
9
10
11
SupremeToday Portrait Ad
supreme today icon
logo-black

An indispensable Tool for Legal Professionals, Endorsed by Various High Court and Judicial Officers

Please visit our Training & Support
Center or Contact Us for assistance

qr

Scan Me!

India’s Legal research and Law Firm App, Download now!

For Daily Legal Updates, Join us on :

whatsapp-icon Back to top