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2025 Supreme(Online)(Ker) 47942
IN THE HIGH COURT OF KERALA AT ERNAKULAM
AMIT RAWAL, K. V. Jayakumar, JJ
Union of India – Appellant
Versus
Balakrishnan V – Respondent
OP (CAT) NO. 26 OF 2023
For the Appellants/Petitioners: Smt. Sindhumol T.P.
For the Respondents: Kala T. Gopi, Nishitha Balachandran
Retired employees have a fundamental right to medical reimbursement regardless of hospital eligibility as outlined by constitutional provisions governing rights to health.
Headnote:(A) Constitution of India - Article 21 - Medical Reimbursement - The right to medical claim of a retired employee cannot be denied solely because treatment was in a non-empanelled hospital; survival and active need for treatment supersedes technical compliance with hospital lists. (Paras 13-16)
(B) Right to Life - The right to health is integral to the fundamental right to life as guaranteed by the Constitution, which mandates the provision of medical assistance to employees post-retirement. (Paras 19-20)
Facts of the case:
The respondent, a retired Sub Postmaster, was denied medical reimbursement for treatment at an emergency hospital due to not being listed under the Central Services (Medical Attendants) Rules, despite being in a non-CGHS area.
Findings of Court:
The Tribunal ruled against the denial of reimbursement, emphasizing the equal treatment of serving and retired employees in medical claims.
Issues: Whether the distinction made by the Government regarding reimbursements to serving employees versus pensioners infringes upon constitutional rights to equity and life.
Ratio Decidendi: The court confirmed that the right to health post-retirement is fundamental and cannot be hindered by arbitrary rules denying reimbursement based on hospital listings.
Result: O.P.(CAT) dismissed.
| Table of Content |
|---|
| 1. legal challenges to reimbursement for medical expenses due to retirement status. (Para 1 , 2) |
| 2. arguments regarding eligibility for medical reimbursement based on hospital affiliation. (Para 3 , 4) |
| 3. court's consideration of equitable rights and past judicial decisions. (Para 5 , 6) |
| 4. constitutional principles regarding health and dignity in relation to government policies. (Para 7 , 8) |
JUDGMENT
K. V. JAYAKUMAR, J.
1.Impugning the order of the Central Administrative Tribunal in O.A.No.959/2019 dated 05.08.2022, Union of India and its officers preferred this OP(CAT). The issue under consideration before the Tribunal was whether the distinction drawn between the serving Government employees and pensioners in respect of medical reimbursement is violative of rights relating to equity and right to life guaranteed by the Constitution of India .
2. The facts in narrow compass are as follows:
The respondent/applicant, a retired Sub Postmaster of Kozhikode division of Department of Posts had superannuated from service on 31.05.2005. Since the respondent/applicant staying in an area in Kozhikode, which is not directly covered by the Central Government Health Services (CGHS), opted for drawing Fixed Medical Allowance (FMA) in lieu of CGHS. On 24.12.2014 due to a medical emergency of severe chest pain, respondent/applicant was taken to MIMS in a critical condition. Later, the applicant submitted medical reimbursement claim for an amount of Rs.1,10,930/- to the Superintendent of Post Offices, Calicut Division. The claim of the respondent/applicant was not considered and through Annexure-A1, letter it was intimated that, retired Central Government employees do not come under the purview of Central Services (Medical Attendants) Rules, 1944 [CS(MA) Rules] and hence not eligible for medical reimbursement. The respondent/applicant approached the Central Administrative Tribunal. The Tribunal by order dated 05.08.2022 allowed the original application and directed the petitioners to consider the claim of the applicant sympathetically and pass necessary orders within three months. Aggrieved by the same, petitioners approached this Court.
3. The contention of the respondent/applicant before the Tribunal and before us is that, in terms of the policy guidelines and the decisions rendered by various Tribunals/Apex Courts, the petitioner is fully entitled to reimbursement of the medical claim for treatment undergone in the hospitals empanelled for such treatment. It was submited that, MIMS is a Co-operative Hospital and also an empanelled hospital of Government of Kerala and it comes under the definition of Government hospital for the purpose of treatment of Government servants in terms of Rule 2B(d) of the CS(MA) Rules. He also submits that since MIMS was the nearest hospital, he was immediately rushed to the same and it was an emergency condition.
4. The petitioners opposed the claim of the applicant and submitted that, after superannuation of the respondent/applicant, he was paid the (FMA) Family Medical Allowance along with monthly pension. It is further submitted that, retired Central Government employees do not come under the purview of CS(MA) Rules and hence, not eligible for medical reimbursement and also MIMS hospital is not an empanelled hospital in the approved list of Government of Kerala.
5. We have heard the rival contentions of the counsel for the parties and appraised the paper book.
6. The Tribunal, noticing the rival contentions of the counsel for the parties, allowed the claim, placing reliance on the decision reported in Shiva Kant Jha Vs. Union of India ( 2018 KHC 6285 ) and allowed full reimbursement to the claimant. Impugning the said order, the Union of India and its officers preferred this O.P(CAT). The relevant paragraphs of the order of the Tribunal are extracted hereunder:
“7. I have heard learned counsel from both sides and have gone through the judgments and documents provided. It is submitted by the applicant t
