O R D E R

Hon’ble Mrs. Harvinder Kaur Oberoi, Member(J)

With consent of both parties, this OA was taken up for final arguments at the admission stage itself.

The instant OA has been filed by the applicant seeking the following relief:-

“i) Quash and set aside the impugned order bearing No. CAMO/CNZ/MCD/2024-25 dated 12.03.2025;

ii.) Direct the respondents to process and reimburse the medical expenses incurred by the applicant amounting to ₹3,35,967/- along with applicable interest;

iii) Such other orders or orders as this Hon’ble Tribunal may deem fit and proper in the facts and circumstances of the case may also be passed in favor of the Applicant.”

The applicant is a retired employee of the Municipal Corporation of Delhi, having superannuated on 30.11.2007 from the post of Head Mistress, and is a pensioner aged about 76 years. She was admitted to Holy Family Hospital, New Delhi on 26.01.2024 and remained hospitalized till 09.02.2024.

Applicant submitted application for issuance of a medical card under the MCD Medical Scheme for Pensioners. The same was submitted on 18.03.2024, along with requisite formalities and payment of contribution.

Thereafter, the applicant submitted a claim for reimbursement of medical expenses amounting to ₹3,35,967/- along with supporting documents.

The claim came to be rejected vide impugned order dated 12.03.2025 on the ground that the treatment had been availed prior to issuance of the medical card/admission as member in the scheme. Hence, this OA.

Learned counsel for the applicant submitted that the applicant had undergone treatment in a certified emergency condition and it is a settled position that in such cases, reimbursement cannot be denied on mere technical or procedural grounds such as non-possession of a medical card at the relevant time.

He further submitted that the action of the respondents violates the applicant’s right to life and health under Article 21 of the Constitution of India. It was contended that the medical scheme being a beneficial scheme for pensioners is required to be interpreted liberally, particularly when the applicant has subsequently complied with all formalities and deposited the requisite contribution.

To strengthen his arguments, learned counsel for the applicant relied on the decision of the Hon’ble High Court in Narendra Pal Singh Vs. Union of India in CWP No. 509/1998 dated 28.04.1999, more specifically on Para 5 of the same, which is reproduced herein below:-

“5. The law is, therefore, well settled that right to health is an integral part to life and the Government has constitutional obligation to provide the health facilities to its employees or retired employees and in case an employee requires a specialised treatment in an approved hospital it is the duty of the Government to bear or reimburse the expenses. The petitioner in this case had to be operated in an emergency as he suffered a heart problem and in case he had waited for a prior sanction he might not have survived. Therefore, in this situation it is the duty of the Government to grant ex-post facto sanction and not deny the claim of the petitioner on technical and flimsy grounds Firstly the Government does not give any proper reasoning to deny the claim of the petitioner in its communication dated 4th December, 1997 and secondly the affidavit of Dr. P.K. Baliar Singh merely states that since the petitioner had taken the treatment in non-C.G.H.S. covered area and as per Central Government Health Scheme Orders and instructions as issued by the Government, a pensioner is not entitled to the facilities of reimbursement. These reasons cannot be appreciated in view of the settled position that the petitioner is entitled to take recourse to an emergency treatment in any area if the circumstances and the nature of disease so warrant.”

He submitted that the right to health forms part of Article 21 and the respondents are under an obligation to reimburse medical expenses, especially in cases of emer

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