(Reserved on 09.02.2026)

CENTRAL ADMINISTRATIVE TRIBUNAL JABALPUR BENCH JABALPUR Jabalpur, this the 20th day of February, 2026 HON’BLE MR. JUSTICE AKHIL KUMAR SRIVASTAVA, JUDICIAL MEMBER Original Application No. 1267 of 2024 Ramesh Chandra Verma, S/o Shri Jagdish Prasad Verma, Aged about 72 years, Occupation – pensioner, R/o Duplex No. 9, Old Tyre Godown, Jai Prakash Nagar, Adhartal, Jabalpur (MP) - 482004.

…….Applicant V E R S U S Union of India through Secretary, Department of Health &

Family Welfare, 156-A, Nirman Bhawan, New Delhi - 110011.

Director, CGHS (HQ), 5th Floor, Nirman Bhawan, New Delhi -

110011.

Additional Director, Central Government Health Scheme, 1544/A, Napier Town, Jabalpur (MP) - 482001.

……Respondents Advocate for the applicant: Shri J.B. Singh Advocate for the respondents: Shri Surendra Pratap Singh O R D E R Present original application has been directed against the RAJUL NAMDEO order dated 04.11.2022 (Annexure A-8) and order dated 13.08.2024 DDMAPeae4RLDF 1ca2 o o nh iN e a a g 82 8b c x do a t d:i e 6 a i 5 e4 t hn s t h aC : d t d c1o ue P i y l o2 = 3c 5 cn w= y a D f n0 2 6 I 8 : d N a s :2F P 1 e 6 I 5 , i , 6 3 6 0 g r a 2 R JaO . 0 0 c n m 6 0 ad e 1f 9 e= 4 2 b e e a f , dP t 4 . a 7, s h d2 E d e l aS b h e e p 4 =c r 1 y , E r u s ca b 1 e Sr R o V R hu 3 6 0 Tn M i e I t 0 A : a y A h 3 aR r aa a 1 J s o L 1 lE f , p U d 2 i r 6 N :o P 4 a Eh b L 2 o n U 7 r y b oT 0 fi : N a + 3 Mc s= f t 2 1 h c @ 0 tA "P a B 0 c 9 i 5 3 M s l 2 r E5 gc C ' 8a 34 d e 1m D R 5o d 0. o 9 8 0 E 3 d = e a ' c 5 d , . e s i O 0 ul 0 3 S . h = cm 2 9 h4 o I 0 6 e nu8 m 4 6 d n b2 8 2, i t h0 a 6 1C a0 0 3 4s4 N d 4 8h, = 7 c 2 LN 7R 7 0 = 6 9 a A 0 J 5 5 g4 J a d 9 a" U b e , 1 r a L c T 2 Al 8 p c = N a 4 u 0 9 A d a r 1 1h, Me 8 3aS c 8 6 D r= 2 2 t, E a c 2

(Annexure A-9) whereby the claim of applicant for medical

reimbursement has been restricted.

2. Learned counsel for the applicant submitted that the applicant’s wife undergone surgery at AIIMS, New Delhi where she was admitted from 12.08.2019 to 23.08.2019 and after discharge from there, the applicant submitted claim for reimbursement of Rs. 5,24,132/- (Annexure A-7) but same was restricted and only Rs. 86,046/- was paid to him. The representation of the applicant in this regard has also been rejected vide letter dated 13.08.2024 on the ground amount has been reimbursed as per the prescribed rates of the CGHS. Referring to Annexures A-2, A-3, A-4 and A-5 of the OA, the learned counsel for the applicant submitted that the patient was referred by the CGHS for further treatment at AIIMS, New Delhi which is a Government hospital, therefore, the applicant is entitled for reimbursement of total amount incurred by him as per rules. In support of his contentions, learned counsel for the applicant has also cited the judgment dated 13.04.2018 passed by Hon’ble Supreme Court in Writ Petition (Civil) No. 694/2015 – Shiva Kant Jha Vs. UOI & Ors and submitted that non-payment of full amount of treatment taken in a Government hospital despite the fact RAJUL NAMDEO that the patient was duly referred by the CGHS to take treatment at DDMAPeae4RLDF 1ca2 o o nh iN e a a g 82 8b c x do a t d:i e 6 a i 5 e4 t hn s t h aC : d t d c1o ue P i y l o2 = 3c 5 cn w= y a D f n0 2 6 I 8 : d N a s :2F P 1 e 6 I 5 , i , 6 3 6 0 g r a 2 R JaO . 0 0 c n m 6 0 ad e 1f 9 e= 4 2 b e e a f , dP t 4 . a 7, s h d2 E d e l aS b h e e p 4 =c r 1 y , E r u s ca b 1 e Sr R o V R hu 3 6 0 Tn M i e I t 0 A : a y A h 3 aR r aa a 1 J s o L 1 lE f , p U d 2 i r 6 N :o P 4 a Eh b L 2 o n U 7 r y b oT 0 fi : N a + 3 Mc s= f t 2 1 h c @ 0 tA "P a B 0 c 9 i 5 3 M s l 2 r E5 gc C ' 8a 34 d e 1m D R 5o d 0. o 9 8 0 E 3 d = e a ' c 5 d , . e s i O 0 ul 0 3 S . h = cm 2 9 h4 o I 0 6 e nu8 m 4 6 d n b2 8 2, i t h0 a 6 1C a0 0 3 4s4 N d 4 8h, = 7 c 2 LN 7R 7 0 = 6 9 a A 0 J 5 5 g4 J a d 9 a" U b e , 1 r a L c T 2 Al 8 p c = N a 4 u 0 9 A d a r 1 1h, Me 8 3aS c 8 6 D r= 2 2 t, E a c 2

AIIMS, New Delhi and the bills have been co