THE HONOURABLE SMT. JUSTICE P.SREE SUDHA WRIT PETITION No.16187 of 2004

ORDER:

This writ petition is filed by the petitioner seeking to declare the proceedings issued by the respondent vide proceedings No.HWPM/Admin.(EM)/2004/1659, dated 31.03.2004 as illegal and arbitrary and consequently to direct the respondent to reimburse the medical bill of Rs.81,733.89/-. 2. Learned Counsel for the petitioner stated that petitioner was working as Head Constable in the respondent’s Organization i.e., Heavy Water Plant (Manuguru), Khammam District. As his mother fell sick, he applied for availing medical facility. Thereafter, respondent’s Organization has issued a letter dated 25.02.2003, stating that the competent authority has accorded approval for availing medical facility to his mother at native place i.e., Trivandrum and it was also stated that medical bills will be regulated under CS (MA) Rules, 1944, as such he admitted his mother in a hospital at his native place. Accordingly, she underwent operation and admitted in the hospital from 03.02.2003 to 08.02.2003. The said hospital authorities have raised a bill for Rs.81,733.89/- and thus the petitioner applied for medical reimbursement. However, the respondent Organization gave a reply on 15.07.2003 stating that the committee has opined that “the claim is not admissible as per CS (MA) Rules,” against which the petitioner gave a representation on 03.09.2003 and also got issued a legal notice dated 10.03.2003, for reimbursement.

3. Learned Counsel for the respondent stated that petitioner’s mother has taken treatment as in-patient in a private hospital and it is not permissible under CS (MA) Rules and it is allowed only depending upon the merits of the each case. Petitioner did not reveal that his mother was already undergoing treatment in a private hospital, as such she is not entitled for reimbursement. Initially, petitioner gave an application and it was approved on 15.07.2003, but later when his reimbursement was rejected, he preferred an appeal before the Chief General Manager on 03.09.2003.

4. In the counter filed by the respondent, it is stated that they placed medical bills before the scrutiny committee and they also called for additional information from the petitioner and the petitioner had submitted the same on 09.04.2003. On examination, the committee observed that the claims were not in order and hence not admissible.

5. As per the rules of the respondent’s Organization, the medical claim is applicable only to the persons who are wholly dependent on the employee and their monthly income should not exceed Rs.4,000/- per month. In this case, the petitioner claimed medical bills of his mother, who is dependent on him and she is a home maker. It is not the case of the respondent that the mother of the petitioner is an employee with a salary of more than Rs.4,000/- per month. The main contention of the respondent is that the petitioner’s mother was treated in a private hospital. In fact, initially when she was not feeling well, she was admitted in the hospital and as it was an emergency, she underwent heart surgery in the same hospital. As per the respondent’s rules, treatment can be availed in a private hospital in the case of emergency. Even in this case, as there was emergency, surgery was done by the private hospital, as such the claim is as per the rules of the respondent’s Organization and cannot be denied.

6. It is also stated by the respondent that petitioner had never informed at the time of approval that his mother was already admitted in the hospital. The parents of the petitioner were residing at their native place and the petitioner was working at Khammam. When he got information regarding the admission of his mother in the hospital, he sought for permission for approval and the approval was accorded. Accordingly, treatment was done in the private hospital and as there was emergency, surgery was conducted in the same hospital. Accordingly, petitioner submitted medical