CHARANJEET SINGH Vs. SOUTH EASTERN COAL FIELDS LIMITED

JUDGEMENT

(1.) This Writ Petition has been filed for reimbursement of the medical bill of Rs.1,92,000.00 on account of treatment of mother of the petitioner namely, Smt. Chandrakanta, who was treated for knee replacement and was referred vide Annexure-P/5 to Sancheti Hospital, Pune, which was disallowed by the respondent authorities vide order dtd. 20/12/2014.

(2.) Facts of the case are that the petitioner has earlier filed a Writ Petition viz. WPS No.4245/2014 claiming medical reimbursement of his mother who had undergone knee replacement, as the same was refused by the respondents on 13/6/2012 on the ground that the petitioner was not entitled for medical reimbursement in accordance with the policy of SECL In the said writ petition, the petitioner has submitted that he is entitled for medical reimbursement as has been granted to similarly situated employee of the SECL namely, Shri Arbind Kumar Sharma and because of refusal of medical reimbursement, he has been discriminated. The aforesaid writ petition was disposed of vide order dtd. 23/9/2014 by observing that if any fresh representation is made by the petitioner, it is expected from respondent No.1/SECL to decide the representation strictly in accordance with law, considering the aforesaid aspect. Thereafter the respondents have passed the impugned order rejecting the representation stating reasons that mother of Shri Arbind Kumar Sharma underwent right total hip joint replacement at Sancheti Hospital due to intracapsular neck of femur fracture and she was admitted in emergency whereas the case of the petitioner is that his mother was suffering from Oseoarthritis, a degenerative disorder of knee and the said disease is due to aging process. Hence reimbursement was not allowed as per the SECL norms.

(3.) Learned counsel for the petitioner submits that this Court, after rejection of the representation vide order dtd. 20/22/12/2014, directed the respondent authorities to produce any norms/guidelines/circular issued by the employer to demonstrate as to for which category of persons, reimbursement of medical expenditure shall be admissible. In compliance of the same, an affidavit has been filed by the respondents in which it has been mentioned that the forms of treatment like eye treatment, dental and/or gum treatment, diabetic treatment are defined, however, knee replacement is not defined anywhere. Considering the expenses involved in such surgeries, reimbursement is only allowed to the employee/spouse for such nature of treatment. However, by a subsequent letter issued by the CMO, SECL, Bilaspur, on 2/11/2017 (Annexure-R/1), it was informed that joint replacement therapy of the dependent parents of an employee, as a part of treatment procedure, after approval of the competent authority, has now become admissible, and the employees are governed under the Coal India Limited Medical Attendance Rules, 1981 (for short 'the Rules, 1981').