Central Administrative Tribunal

Principal Bench, New Delhi.

OA No.362/2017

Reserved on: 30.11.2018

Pronounced on: 19.12.2018

Hon’ble Mr. A.K. Bishnoi, Member (A)

Smt. Jasjeet Kaur. UDC (Retd.) Age-61 years

W/o Late Shri Ravindra Singh,

R/o A-450, Defence Colony,

New Delhi-110 024

-Applicant

(By Advocate: Ms. Priyanka Bhardwaj for Shri M.K. Bhardwaj)

Versus

1. Union of India,

Through its Secretary,

Ministry of Urban Development,

Nirman Bhawan, New Delhi.

2. The Director General (Works),

Ministry of Urban Development,

Nirman Bhawan, New Delhi.

3. The Chief Engineer (NDZ-II)

CPWD, Vidyut Bhawan, New Delhi

4. The Superintending Engineer (Elect),

DCEC-2, Room No. C-311,

I.P. Bhawan, New Delhi.

-Respondents

(By Advocate: Shri Satish Kumar)

O R D E R

The applicant has filed the present OA seeking the following

relief:-

“(i)

To quash and set aside the impugned order dated

20.10.2016

and

11.08.2015

and

direct

the

respondents to reimburse the medical claim as

raised by the applicant.

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OA No.362/2017

(ii)

To declare the action of the respondents in not

clearing the medical claim amounting to Rs.

5,40,115/- of applicant as illegal, arbitrary and

unjustified

and

direct

the

respondents

to

reimburse the medical claim to the tune of

Rs.5,40,115/-

to

applicant

along

with

18% interest.

(iii)

To direct the respondents to release the medical

claim as submitted by the applicant and not by

reducing the same by applying CGHS rates.

(iv)

To pass such other and further orders which their

lordships of this Hon’ble Tribunal deem fit and

proper in the existing facts and circumstances of

the case.

(v)

To allow the OA with exemplary cost”.

2. The brief facts of the case are that the applicant was working

as UDC in CPWD and remained a CGHS beneficiary. The

applicant’s husband suffered seizure and as an emergency case, he

was admitted in National Hearth Institute on 28.07.2013. As the

applicant’s husband did not show any improvement, he was again

shifted to Max Healthcare Super Speciality Hospital on 03.08.2013

in an emergency. After undergoing treatment for about 11 days, he

expired on 13.08.2013. After his expiry, discharge summary and

bill for the treatment were raised by the hospital, which the

applicant submitted to the respondents with all necessary

documents for reimbursement. The applicant had submitted that

though she and her spouse did not have separate CGHS Card since

she was depositing the CGHS contribution, the benefit would

accrue to both the applicant and her husband.

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OA No.362/2017

2.1 However, the claim of the applicant was not settled and

payment was not made. She sent representations to the

respondents from time to time. In reply to the same, she received

several communications seeking clarifications. The required

information was duly submitted by the applicant. Despite this, the

medical reimbursement was not made. The applicant was retiring

in July, 2015 and she continued making her claim for medical

reimbursement. The claim of the applicant was finally rejected by

the respondents vide letter dated 11.08.2015. The ground given for

rejection of the claim was that the applicant did not have a CGHS

card and in the absence of it she could not avail of the facility of

CGHS for medical reimbursement

2.2 Aggrieved by the said action of the respondents, the applicant

sent legal notice dated 22.06.2016 to the respondents and when the

same was not even considered by them, she filed OA No.2848/2016

before this Tribunal. The said OA was disposed of with the

following directions to the respondents:-

“....to reconsider the matter and pass detailed and speaking

order, after giving an opportunity to the applicant to be

heard, as to why the claim for reimbursement has been

rejected, especially making it clear under what circumstances

the husband’s name was not included in the list of family

members.”

2.3 The applicant was calle