FMA for routine expenses does not bar reimbursement of specialized medical treatments for pensioners.

ORDER 

Hon’ble UrmitaDatta (Sen), Judicial Member

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

“A.(i) An order be passed setting aside the impugned Speaking Order No.2636 dated 07.08.2024 passed by the respondent No.5 whereby rejected the medical reimbursement claim of the applicant on the score that the applicant is getting fixed Medical Allowances in his monthly pension and that the applicant has not opted for Central Government Health Scheme and that the applicant has not availed the benefit of notification dated 25.11.2020 under Pradhan Mantri Jan Arogya Yojana which provide pensionary cashless treatment worth Rs.500,000/-(Five Lakhs Only) per patient per illness from empanelled hospitals at mainland and all consequential order/orders;

(ii) An order be passed directing the respondent No.5 to immediately reimburse the applicant an amount of Rs.4,24,573/- incurred by him on his treatment of Heat Disease at Madras Medical Mission Hospitl and an amount of Rs.46,170/- for his eye treatment at Dr. Anup’s Insight Eye Hospital totaling an amount of Rs.4,70,743/- (Rupees Four Lakhs Seventy Thousand Seven Hundred and Forty Three Only), with 12% interest in terms of his claim application dated 30/01/2024 and dated 26/08/2024 respectively submitted before the respondent No.5;

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.”

2. Brief facts of the case as submitted by Learned Counsel for the applicant are that :-

a) The applicant was initially appointed to the post of Lower Division Clerk under amalgamated clerical cadre in the office of the respondents. Thereafter he was promoted to various posts as per promotional hierarchy in the department and finally retired from service on 31.03.2009 while working as Assistant Director.

b) After the pandemic of COVID-19, while the applicant was 70 years old, his health condition was deteriorated as he was suffering from shortness of breath on exertion. As he was at Chennai. At that time, he was admitted in Madras Medical Mission Hospital on 26.12.2020 and had undergone Angiography on 28.12.2020 followed by some other medical treatments. He was discharged from the said hospital on 01.01.2021 (Annexure A/6).

c) For the purpose of treatment w.e.f. 26.12.2020 to 01.01.2024 the applicant incurred an amount of Rs.4,24,573/-. Bills are attached as Annexure A/7 to the O.A. After availing the treatment when he came back to Port Blair, he submitted his claim for reimbursement of medical expenses on 30.01.2024 to the Respondent No.5 along with copies of the judgment whereby Government employees got the benefit of medical reimbursement after order of the courts (Annexure A/8) followed by reminders dated 04.03.2024 and 02.05.2024 (Annexure A/9 collectively). The Respondent No.5 vide reply dated 15.05.2024(Annexure A/10) informed the applicant that his claim for reimbursement of medical expenses was sent to Andaman and Nicobar Administration for concurrence.

d) As nothing yielded thereafter, the applicant sent a further representation dated 08.08.2024 for medical reimbursement before the Respondent No.3 and 5 (Annexure A/11). However, one day before that a Speaking Order dated 07.08.2024 (Annexure A/12) was issued by the Respondent No.5 rejecting the claim of the applicant on the ground that the applicant was getting a