In exercise of the powers under the proviso to Article 309 of the Constitution, the Governor is pleased to make the following rules:--

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S.2 Extent of application.--

(i) These rules shall come into force with immediate effect, in supersession of all other rules on the subject, provided that all claims which might have accrued under any rules in force before the coming into force of these rules, will be dealt with and disposed of under the appropriate rules.

(ii) In respect of Gazetted Officers belonging to the erstwhile Travancore-Cochin State, these rules shall apply with retrospective effect from 15/08/1956.

S.4 Persons entitled to free medical attendance.--

(1) All Government servants are entitled to free of all charges except as expressly specified in these rules, to medical attendance by their Authorised Medical Attendant.

(2) Government servants are entitled to free medical attendance irrespective of whether they are on duty or on leave anywhere within the State.

(3) Families of a Government servant are entitled to medical attendance free of charge to the same extent as the Government servant himself except that they shall not be entitled to free medical attendance at their residence unless the Authorised Medical Attendant is of the opinion that the patient cannot be removed without grave risk to his/her health. (see Note 1 below)

S.6 Consultation with Specialists.--

Persons entitled to free medical attendance under these rules are entitled to free medical attendance only of the Authorised Medical Attendant and for facilities available in Government Medical Institutions and such other Institutions within the State or as may be specified under Rule 8(2). Where the Authorised Medical Attendant considers it necessary to consult a Specialist, he can requisition the services of the nearest Specialist in Government service including Honorary Medical Officers and such person shall comply with the requisition. (see Note 1 below)

Note 1:-- Government does not undertake to provide Government servants with services of Specialists except to the extent mentioned above.

Note 2:-- Free medical attendance under these rules is available either under Allopathic Systems or under other Systems of medicine like Homoeopathy, Ayurveda etc. But no person will be entitled to free medical attendance under more than one system simultaneously. C

S.7 Reimbursement of expenditure incurred outside the State.--

The expenditure incurred by a patient entitled to free medical attendance under these rules, on medical treatment when stationed or travelling on duty outside the State will be reimbursed subject to the following conditions:--

(a) The Director of Health Services should certify that the illness which necessitated the medical attendance was so sudden that immediate treatment was necessary and the treatment could not have awaited the return of the patient to the State.

(b) The charges claimed are considered reasonable having regard to the circumstances of the case.

S.8 Reimbursement of expenditure incurred for "Special Treatment" outside the State.--

The expenditure incurred by a patient entitled to free medical attendance under these rules for any special treatment obtained by him/her outside the State but within India will be reimbursed subject to the condition that the Director of Health Services Certifies.--

(i) that there were no facilities in the State for such special treatment,

(ii) that the nature of the disease warranted the special treatment outside the State but within India by the Specialist concerned, and

(iii) the charges claimed are reasonable.

Note 1:-- Such treatment outside the State but within India shall be taken only with the prior sanction of the Director of Health Services on the recommendation of the Authorised Medical Attendant. The Director of Health Services while sanctioning such treatment shall specify the Institution in which the treatment is to be undergone.

[G.O.(P)263/61/HLD. dated 6th March, 1961]

Note 2:-- Claims in respect of the under

S.9 A Government servant or a member of his family or an attendant shall be entitled to T.A. at the following rates to and from the headquarters of the Authorised Medical Attendant.--

(i) Journey by Rail.-- (a) For the Government servants.-- Fare of the entitled class or of the lower class by which they actually travel, plus incidentals as for the journey on tour under the rules in force (but without halting allowance.)

(b) For the members of their families.-- Fare of the class by which the Government servant is entitled to travel on tour under the rules in force or the lower class by which they actually travel.

Note:-- The facility of travel by Air Conditioned Accommodation at Government expense is not admissible for journeys performed for receiving medical attendance and treatment.

(ii) Journey by Road.-- (a) For the Government servants.-- For the road portion of the journey or for journeys between stations connected by road only actual fare paid for the journey by bus or other public conveyance, or road mileage as on tour admissible under the rules in force, whichever is less;

(b) For the members of th

S.10 Special concessions in regard to medical treatment.--

(1) Government shall not be responsible for any expenditure incurred by a Government servant on medical treatment by admitting himself into a non-Government Institution or by consulting a Private Doctor, except as specifically provided in these rules. (see Note 1 below)

(2) The Director of Health Services may specify the Private Medical Institutions within the State to which a Government servant may resort for purposes of medical relief, provided that no Private Medical Institution shall be so notified where a Government Medical Institution capable of giving similar treatment exists within a radius of 5 miles.

(3) Government servants who have no Government Medical Institutions within a radius of 5 miles of their station, may resort to such Private Institutions and the charges incurred by them would be reimbursed by Government to the extent they would have received such treatment free in a Government Institution or at the hands of an Authorised Medical Attendant. (see

S.11 Reimbursement of cost of medicine purchased.--

(1) Government servants who are allowed free medical attendance at their own residences or in the consulting rooms of the Authorised Medical Attendant are entitled to free supplies' of medicines prescribed from Government Medical Institutions. But they should make their own arrangements to collect the medicines.

(2) If drugs essential for the effective treatment of a patient entitled to free medical attendance are not available in the Government Medical Institution, they may be purchased from the open market and the ^*[cost of medicine including sales tax] incurred thereon reimbursed to the Government servant. No Government servant shall claim under this provision reimbursement of ^*[cost of medicine including sales tax] on account of purchase of items which are not "medicines" as defined in clause (f) of Rule 3. (see Note 1 below)

^*[Notification No. 70258/D3/67/HLD. dated 6th June, 1968.]

#Note:-- In the case of antigens o

S.12 Identification of Government servants.--

(1) Where an Authorised Medical Attendant is not sure of the identification of a person claiming to be a Government servant, he may insist that the Government servant concerned should produce an Identify Certificate from the Head of his Office.

[G.O.(P)267/62. dated 21st March, 1962]

(2) Where a person claiming to be a Government servant is so ill that immediate treatment is necessary and the treatment cannot be postponed till the production of an Identity Certificate, the Authorised Medical Attendant can give necessary treatment to the person concerned and require him to produce a certificate within ^*[one month] of his being able to do so. If he fails to do so, the cost of the treatment shall be recovered from the patient.

* [Notification No.23602/G2/69/HLD. dated 4th September, 1969]

S.13 Treatment of Government servants in out-patient Departments.--

In order to facilitate prompt treatment of Government servants in the outpatient department of a Hospital or Dispensary, the Doctor in charge of the Institution shall specify a time not exceeding one hour daily during which time Government servants resorting to the Institution for treatment will be given preference arid treated first. Among the Government servants inter-seeking treatment at the out-patients' department, no preference shall be shown and the treatment will be on the basis of first-come first-served, except that Police Constables will be entitled to special priority.

S.14 Preference for admission.--

Government servants will be entitled to special preference for admission to the General or Special Wards of all Government Medical Institutions up to ^*[15 per cent] of the beds in the Institutions. They will not be liable to pay any charge in the General Wards. In Pay Wards, they shall pay 50 per cent of charges fixed for rent, light, fans, etc., and full diet charges.

[Memo No. 12051/F2/63/HLD. dated 27th February, 1963]

^*[Notification No.15905/G2/77/HD. dated 20th April, 1977]

S.15

One Pay Ward Room shall be kept separate for the Nursing Staff of the. Hospital, where sufficient number of Pay Ward Rooms are available. In hospitals where sufficient number of Pay Ward Rooms are not provided a small room, shall be set apart for the Nursing Staff.

If these rooms are at any time unoccupied either partially or in full, they should be made available for accommodation of other patients.

[G.O.(P) 809/63/HLD. dated 12th November, 1963]

S.16 Issue of Medical Certificates.--

On a written requisition from a patient, the Medical Officer who treated the patient will issue a Certificate noting the dates of admission for treatment and discharge arid diagnosis, free of charge.

(2) The appropriate Medical Authority will issue a Medical Certificate to a Government servant free of charge on request.--

(a) at the time of first appointment;

(b) for the purpose of confirmation in Government Service;

(c) for application for leave on Medical Certificate, stating whether the person concerned requires leave and if so, for what period;

(d) for rejoining duty on expiry of leave on Medical Certificate; and

(e) on any other occasion where the Government requires the Government servant to produce a Certificate of Physical Fitness.

S.1 Short title.--

These rules may be known as "The Kerala Government Servants' Medical Attendance Rules, 1960".

S.3 Definitions.--

For the purpose of these rules.-- (a) "Government servant" (see Note 1 below) means a whole time Government servant employed under Government and under its rule making control and includes employees under the Central and other State Governments with whom reciprocal arrangements in respect of medical attendance have been entered into by Government, but does not include non-pensionable employees paid from Contingencies, Part-time Employees and Honorary Workers.

Note:-- Government servants shall also include Government servants under suspension and Honorary Nursing Sisters of Health Services Department.

[G.O.(P)123/62 dated 29th January, 1962 and added as per Government Notification No. 41977/D3/67/HLD. dated 8th November, 1967 and G.O.(Ms.) 310/68/HD. dated 26th August, 1968]

(b) "Government" means the State Government of Kerala.

(c) "Authorised Medical Attendant" means the District Medical Officer of Health or Principals of Medical Colleges o

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Kerala Government Servants Medical Attendance Rules, 1960 – Section 3 Commentary

Introduction

Section 3 of the Kerala Government Servants Medical Attendance Rules, 1960 deals with the entitlement of Government servants to free medical attendance, the scope of such entitlement, and the conditions subject to which medical benefits are available.

What does Section Says

Section 3 provides that all Gazetted Government servants are entitled to free medical attendance at their residences by an Authorized Medical Attendant. It further extends coverage to family members and specifies conditions regarding reimbursement when treatment is obtained from private hospitals or at places outside the State.

Essential Ingredients

• Entitlement of Gazetted Government servants to free medical attendance at their residences.
• Role of the Authorized Medical Attendant in providing such attendance.
• Coverage extended to dependent family members of the Government servant.
• Conditions for reimbursement when medical treatment is obtained outside the State or from private hospitals.
• Requirement that Government rate alone will be reimbursed in certain cases.

Scope of Section

The scope of Section 3 is to ensure that Government servants and their families have access to medical facilities either through authorized medical attendance at their residences or through reimbursement mechanisms when treated in private hospitals or outside the State. The Section applies to all Gazetted officers and their dependents.

Punishment for Section

No specific punishment is prescribed in Section 3 of the Kerala Government Servants Medical Attendance Rules, 1960. However, misuse of the rules or false claims may attract disciplinary action under the Kerala Government Servants Conduct Rules.

Legal Comments

• "Entitlement of Government Servants" - All Gazetted Government servants are entitled to free medical attendance at their residences by the Authorized Medical Attendant, subject to the provisions of sub-rule (3).
• "Coverage of Family Members" - The rules extend medical attendance benefits to the families of Government servants, ensuring dependent family members are also covered.
• "Reimbursement for Private Treatment" - Government servants treated at private hospitals are entitled to reimbursement only at the Government rate, subject to the conditions laid down in the rules.
• "Treatment Outside the State" - Government servants and their families can receive medical attendance outside the State, subject to reimbursement conditions as specified in the rules.
• "Role of Authorized Medical Attendant" - The Authorized Medical Attendant plays a key role in providing free medical attendance to Government servants at their residences.
• "Proforma for Medical Attendance" - A standard proforma is prescribed to be filled up by the Authorized Medical Attendant when a patient is referred for medical attendance.
• "Applicability to All Government Servants" - The rules apply to all regular employees and their dependent family members, ensuring broad coverage. [Chapter XIV(8)]
• "No Ceiling on Consultation" - There is no ceiling limit on the number of consultations fixed for medical attendance, ensuring unrestricted access to medical care. [The All India Services (Medical Attendance) Rules, 1954]
• "Reimbursement at Government Rate" - The intention of the rules is that Government servants when treated at their residence should be reimbursed only to the extent of the Government rate. [Handbook on medical reimbursement]
• "Empanelment of Private Hospitals" - Private hospitals can be empaneled for medical reimbursement under the rules, subject to the condition that only the Government rate will be reimbursed. [KERALA GOVERNMENT SERVANTS' MEDICAL]
• "List of Diseases and Hospitals" - The Government Order appended a list of diseases and hospitals inside and outside the State where treatment can be availed. [kerala govt. servants medical attendance rule, 1960]
• "Disciplinary Action for Misuse" - While no specific punishment is prescribed in Section 3, misuse of medical attendance rules may lead to disciplinary action under the Conduct Rules. [Kerala government servants conduct rules, 1960]
• "Free Medical Facilities" - The objective of the rules is to provide free medical facilities to regular employees and their dependent family members. [Chapter XIV(8)]
• "Treatment at Corporation Hospital" - Employees and their families shall receive medical attendance and treatment at Corporation Hospital/Dispensary as stipulated in the rules. [medical attendance rules]
• "Provisions of Welfare Legislation" - Provisions of welfare legislation should be liberally construed in favour of the weak and infirm, ensuring that benefits are not defeated by subtle devices. [Animal Welfare Board of India VS A. Nagaraja - 2014 4 Supreme 451]
• "Legal Interpretation of Scope" - Subordinate legislation cannot enlarge the scope of the provisions of the statute; the rules must be interpreted within their statutory limits. [Messrs. Pals Theatres VS B. Abdul Gaffoor Saheb - 1972 0 Supreme(Mad) 496]
• "Government Servants Statutory Tenant" - Government servants availing medical benefits are akin to statutory beneficiaries, and the State must ensure continuity of such benefits. [R. Parimala VS The Accommodation Controller - 1990 0 Supreme(Mad) 364]
• "Powers of Government" - The Government has the jurisdiction to allow any person no longer in Government service to continue in occupation of medical benefits, subject to rules. [Manghraj Thekurdas VS The Accommodation Controller of Madras - 1965 0 Supreme(Mad) 181]
• "Validity of Notices" - Notices issued for summary dispossession or cancellation of medical benefits must be valid and in accordance with the rules. [P. Balakrishna Reddy VS The Accommodation Controller, Madras - 1974 0 Supreme(Mad) 464]
• "Allotment and Transfer of Benefits" - Benefits under the medical attendance rules continue even after transfer or allotment of premises, ensuring uninterrupted medical coverage. [A. Narasinga Rao VS The State of Madras represented by the Secretary to Government, Home Department, Fort St. George, Madras-9 - 1967 0 Supreme(Mad) 252]

S.5 Medical attendance at residence.--

(1) Subject to the provision of sub-rule (3) all Gazetted Government servants are entitled to free medical attendance at their residences by the Authorised Medical Attendant.

[G.O.(P)6/64/HLD. dated 4th January, 1964]

(2) If the Authorised Medical Attendant certified that the condition of a patient entitled to free medical attendance under the rules is so serious that his removal to the Government Medical Institution is likely to cause serious deterioration in his condition, the patient will be entitled to medical attendance at his residence, notwithstanding the provisions in clause (1) above. This rule will also apply where there is no proper accommodation suitable to the status of the Government servant at the nearest appropriate Government Medical Institution.

(3) Cases of medical attendance requiring hospitalisation will normally be referred to a Government medical institution by the Authorised Medical Attendant for admission.

If hospitalisation is no

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Kerala Government Servants Medical Attendance Rules, 1960 – Section 5

Introduction

Section 5 of the Kerala Government Servants' Medical Attendance Rules, 1960, is a pivotal provision that delineates the scope, eligibility, and conditions under which government servants and their dependents are entitled to free or reimbursed medical attendance and treatment. It functions as the foundational provision governing the medical welfare framework for Kerala state government employees.

What Does Section Say

Section 5 primarily addresses the entitlement of government servants to free medical attendance by an Authorized Medical Attendant. It specifies the conditions under which medical charges are reimbursable, the categories of persons covered (including family members), and the circumstances under which treatment outside the usual channels may be availed. It also deals with the rules regarding medical reimbursement for treatments received outside the state, the documentation required, and the limitations on such reimbursements.

Essential Ingredients

The essential elements of Section 5 include:- Entitlement to Free Attendance: A government servant is entitled to free medical attendance by an Authorized Medical Attendant.- Coverage for Dependents: The rules extend to members of the government servant's family.- Reimbursement for External Treatment: Medical charges incurred for treatment outside the government hospital system are reimbursable subject to specific conditions and limits.- Documentation and Procedure: The rules mandate the use of specific proformas (like the one in Appendix II) to be filled by the Authorized Medical Attendant when referring patients to other hospitals, detailing the patient's condition, treatment, and expected charges.- Government Rate Reimbursement: Reimbursement for treatments outside the government system is made at government rates, not private hospital rates.

Scope of Section

The scope of Section 5 is comprehensive, covering:- All Kerala Government Servants, including those covered by the Kerala Shops and Commercial Establishments Act, 1960, as per relevant notifications.- Members of the government servant's family, including spouse and dependent children.- Medical treatment both within government institutions and through authorized private hospitals under the reimbursement scheme.- Procedures for referral to hospitals outside the state for specialized treatment.- The exclusion of certain categories, such as hospitals specifically notified as being excluded from the purview of the rules for a defined period (e.g., hospitals excluded from the Kerala Shops and Commercial Establishments Act for 2 years from the date of retirement).

Punishment for Section

The Kerala Government Servants Medical Attendance Rules, 1960, being a set of administrative rules framed under the Kerala Government Servants Conduct Rules, 1960, do not contain a specific punishment clause within Section 5 itself. However, violations of the rules can lead to disciplinary action under the broader Conduct Rules, and misuse of the medical attendance facilities (e.g., fraudulent claims) can result in penalties including dismissal, removal, or compulsory retirement from service, as provided under the Kerala Civil Services Rules, 1960.

Legal Comments

• "Legal Comment" - Section 5 provides the foundational entitlement for government servants to free medical attendance, which is a statutory benefit that cannot be unreasonably withheld by the employer. -
• "Legal Comment" - The rules extend the benefit of free medical attendance to family members of the government servant, establishing a comprehensive welfare scheme for the employee's household. -
• "Legal Comment" - Reimbursement for medical treatment obtained outside the government hospital system is a conditional benefit, subject to the rules regarding authorization, documentation, and reimbursement at government rates only. -
• "Legal Comment" - The procedure for claiming reimbursement requires the completion of a specific proforma by the Authorized Medical Attendant, which serves as a crucial documentary evidence for the claim. -
• "Legal Comment" - The notification dated 30/9/1976 and subsequent SROs (like S.R.O. 978/2005) have been issued to clarify and amend the scope of Section 5, including specific exclusions for certain categories of hospitals. - [Lourdes Hospital, represented by its Director VS Abraham Mathew - 2013 0 Supreme(Ker) 575]
• "Legal Comment" - Hospitals that were excluded from the purview of the Kerala Shops and Commercial Establishments Act, 1960, for a period of 2 years from the date of retirement of an employee were also excluded from the gratuity and medical benefits, showing the interplay between different statutes. - [Lourdes Hospital, represented by its Director VS Abraham Mathew - 2013 0 Supreme(Ker) 575]
• "Legal Comment" - The Kerala Government Servants' Medical Attendance Rules are part of a larger handbook that also includes the Kerala Government Medical Institutions Admission and Levy of Fees Rules, indicating a comprehensive regulatory framework. -
• "Legal Comment" - The rules apply to all government servants, and the scope is not limited to the direct employee but extends to their dependent family members, reflecting a welfare-oriented legislation. -
• "Legal Comment" - The Kerala Government Servants Conduct Rules, 1960, provide the overarching disciplinary framework, under which violations of the Medical Attendance Rules can be treated as misconduct. -
• "Legal Comment" - The Kerala Civil Services Rules, 1960, specifically Rule (5) regarding penalties, can be invoked in cases of misuse or fraudulent claims under the Medical Attendance Rules, potentially leading to dismissal or removal. -
• "Legal Comment" - The principle of "Government Rate" reimbursement ensures that the state does not bear the cost of private healthcare beyond a certain limit, promoting the use of public health infrastructure. -
• "Legal Comment" - The Authorized Medical Attendant acts as the gatekeeper for the medical attendance system, and their certification is essential for the commencement of treatment and subsequent reimbursement. -
• "Legal Comment" - The Kerala Government Servants Medical Attendance Rules, 1960, are a self-contained code that must be interpreted in harmony with the broader Kerala Government Servants Conduct Rules, 1960. -
• "Legal Comment" - The handbook containing these rules serves as the authoritative guide for both government servants and medical practitioners, ensuring uniformity in the application of the medical attendance scheme. -
• "Legal Comment" - The rules provide for the empanelment of private hospitals for the purpose of medical reimbursement, expanding the choice of treatment for the government servant beyond government hospitals. -
• "Legal Comment" - The list of diseases and hospitals appended to the government order is a crucial component of Section 5, guiding the government servant on where and for what ailments they can seek treatment outside the usual channels. -
• "Legal Comment" - The interpretation of Section 5 must consider the welfare state policy of the Kerala government, which aims to provide comprehensive healthcare to its servants as a matter of right. -
• "Legal Comment" - Any dispute regarding the denial of medical attendance or reimbursement can be addressed through the appropriate administrative and judicial remedies available under the Kerala Government Servants Conduct Rules. -