Distinctions between serving and retired government employees regarding medical reimbursements violate constitutional principles of equality and fairness, yet current regulations do not permit treatments abroad for pensioners.

1. The present petition under Article 226 of the Constitution of India seeks the following prayers:-

“a) Issue an appropriate Writ or an order/direction to the Department of Health and Family Welfare to reimburse the Petitioner's claim of Rs. 10,03,636 (Rupees ten lakh three thousand six hundred and thirty six only) at the Dollar rate prevalent in 2011 only; and

b) pass any such other order/s as this Hon’ble Court may deem fit in the facts and circumstances of the case.”

2. The present petition has been filed by the petitioner, a retired Indian Police Service Officer, raising grievance that he has been denied reimbursement of medical expenses in USA under emergency condition. He challenges the stand of the respondent, who has denied his claim on the ground that retired government officials/personnel are not eligible to get treatment abroad either under Central Government Health Scheme (CGHS)1 or under Central Services (Medical Attendance) Rules, 19442.

3. The case of the petitioner is as under: -

3.1. The Petitioner, an IPS Officer, superannuated on 31.01.1994 as Director General, BSF. He is also recipient of Padma Shri Award in year 1991 for his contribution to Civil Service. He has also been awarded Police Medal for Meritorious Service and Police Medal for Distinguished Services by the Government of India.

3.2. The Petitioner was visiting his son in Chicago, USA during 15th June, 2011 to 5th July, 2011. On 4th July, 2011, he had to be admitted in emergency at Rush University Medical Centre, Chicago, USA with complaint of “slurred speech, altered mental status and fever”. He remained admitted in the said hospital from 5th July, 2011 to 8th July, 2011. He was diagnosed with “herpes simplex encephalitis”. During that period, he had to incur USD 20,449.00 (INR 10,03,636 ($ 49.08)) on hospital bills and other medical expenses. (Emergency Medical Treatment Certificate @ Pg. 25 to 27)

3.3. After returning to India, he submitted his claim alongwith all the bills to the Director General, Medical & Health Services, Union of India, seeking reimbursement, but his claim was denied on the ground that “facility of treatment abroad is available under Rule 11 of CCS (MA) Rules for serving Central Government employees. However, pensioners are not eligible to get treatment abroad neither under CGHS nor under CS (MA) Rules”.

3.4. Therefore, even though it was admitted by the Respondents that the Government Servants are entitled to “treatment abroad”, but the Petitioner was denied the said entitlement on the ground that he is “retired”. Such a distinction, on the face of it, is violative of Articles 14 & 21 of the Constitution. As such, the rules do not draw any such distinction between “serving” and “retired” government servants.

3.5. There are various judgments in which it has been held that no distinction can be made between the “serving” and “retired” government servants, while considering their entitlement for medical treatment. In fact, in another set of judgments it has been held that no fetters of any kind be imposed in providing medical facility to the retired government servants.

3.6. In the Counter Affidavit filed on 02.07.2019, the Respondents have taken the same stand. They have also filed Additional Affidavit on 11.10.2019, placing on record the Guidelines and the Office Memorandum, pertaining to the entitlement of a pensioner CGHS but none of these Guidelines or Office Memorandum address the issue of medical treatment availed abroad, especially in an emergency situation.

3.7 The government servants (serving or retired) are entitled to receive medical treatment or the reimbursement under the provisions of CS (MA) Rules. Rule 11 of the CS (MA) Rules provides for the medical treatment abroad to the Government Servant, obviously, with prior permission, but Rule 11(7) of the Rules, also provides for the post facto approval, which would be app