Government employees, including pensioners, are entitled to medical reimbursement for specialized treatments, such as cancer care, even in the absence of a specific departmental circular, as such reimbursement flows from the fundamental right to health and is supported by binding judicial precedents.

O R D E R

Hon’ble UrmitaDatta (Sen), Judicial Member

This O.A. has been filed by the applicant under Section 19 of the Administrative Tribunals Act, 1985 seeking the following reliefs:-

“A. (i) An order be passed setting aside the Impugned Communication dated 29.10.2025 the respondent No.6 contended that on the basis of the judgment relied by the petitioner there is no circular and each case has to be decided on the basis of its merit and return back the original medical claim of the applicant but the case of the applicant was not decided on merit and all consequential order/orders;

(ii) An order be passed directing the respondent No.5 to immediately reimburse the applicant an amount of Rs.7,11,988/- (Rupees Seven Lakhs Eleven Thousand Nine Hundred Eighty Eight Only) towards the expenditure incurred by him on his treatment at Apollo Cancer Hospital, Chennai with 12% interest in terms of his claim application dated 06/08/2025 submitted before the respondent No.6;

B. An order be passed directing the respondent authorities to transmit the original records of the case before this Hon’ble Court, so that after perusing the same conscionable justice may be rendered to the applicant;

C. Any other relief or reliefs, order or orders, direction or directions as your Honour deem fit and proper.”

The facts of the case tersely put by Learned Counsel for the applicant are as follows:-

(a) The applicant has retired from service on superannuation w.e.f. 01.08.2003 while working as Junior Accounts Officer under the Respondent No.6. At the time of retirement, the applicant opted for Fixed Medical Allowance. Thereafter, as per circular dated 27.06.2024 (Annexure A/5) issued by the Government of India, the applicant has opted for CGHS facility and requested the authorities to discontinue his medical allowance. Accordingly his medical allowance was discontinued w.e.f. March, 2024 (Certificate issued by the Banker is annexed as Annexure A/6 to the O.A.).

(b) The applicant visited G.B. Pant Hospital, Sri Vijaya Puram on 28.02.2025 as he was feeling pain on the left side of his chest with abnormal growth. A surgeon who treated the applicant, advised him for biopsy of the said abnormal growth in his chest, which was later on detected as Cancer. Thereafter the applicant had to go to Chennai for specialized treatment of cancer. In Chennai, he visited the office of the CGHS and was informed that for availing the benefit of CGHS for treatment of his disease, he need to be a permanent resident of CGHS covered area and since Andaman and Nicobar Islands are not covered under the CGHS, he is not covered under the benefit of CGHS Card.

(c ) Accordingly the applicant had undergone surgery of his left chest on 24.03.2025 and on the same day he was discharged with necessary medicines and advice. Radio therapy of the applicant was done by Dr. Ratna Devi, Senior Consultant Radiation Oncologist at Apollo Speciality Hospital and he came back to Sri Vijaya Puram after completion of treatment on 08.05.2025.

(d) The applicant again went to Apollo Cancer Centre, Chennai for medical review and after examining him thoroughly the doctor advised him to visit again after 06 months for review. Thereafter he came back to Sri Vijaya Puram on 05.07.2025. The applicant incurred an amount of Rs.7,11,988/- for the purpose of his treatment and he submitted his claim for reimbursement of medical expenses to the Respondent No.6 on 04.08.2025 along with the requisite bills issued by the medical authorities. He has also submitted copies of some judgments to impress upon the respondents on the point that some similarly situated government employees (pensioners) got such benefit of medical reimbursement on the basis of some circulars issued by the Government pursuant to the orders passed by courts but the Respondent No.6 vide communication dated 29.10.2025 (Annexure R/4) returned the medical claim of the applicant on the ground that no circular has been issued by the Government exte