JAI PAL AGGARWAL Vs. UNION OF INDIA

JUDGEMENT

(1.) THE petitioner, on superannuation from this Court, was issued a CGHS card valid till November, 2014. In November, 2010, the petitioner visited Sri Balaji Action Medical Institute, Paschim Vihar for treatment of some urinal problem developed by him and was advised prostatic biopsy suspecting that he may be suffering from prostatic cancer. The biopsy report revealed that the petitioner was having adenocarcinoma, prostate gleason score ­ 8(3+5). He was advised MRI of the pelvis region which was carried on 24.6.2011. On 21.7.2011, the petitioner went to Gurgaon to attend a family function. During the said function, he developed a serious urinary problem and in emergency, he was taken to Medanta Hospital for treatment. There is no Government/CGHS approved hospital in the vicinity of the place where the petitioner was attending the function. He was immediately admitted for robotic radical prostectomy and his family was made to deposit a sum of Rs.2, 18,000/- which they deposited on the same date. The surgery was carried out on 22.7.2011 and the petitioner was discharged from the hospital on 25.7.2011. A total sum of Rs.2,24,120.55 was charged from him by the hospital. He was charged a sum of Rs.1926.67 for removing catheter on 1.8.2011.

(2.) THE petitioner thereafter submitted a bill of Rs.2,26,047/- to the Chief Medical Officer, CGHS Dispensary, Vikaspuri, New Delhi seeking payment of the aforesaid amount. CGHS, however, made payment of only Rs.25,731/- to him. The petitioner represented to the Technical Committee in the office of Additional Director, seeking reimbursement of the balance amount. He also intimated CGHS that though Medanta Hospital was not on the panel of CGHS at the time when he was admitted in the said hospital, it had since been brought on the panel with effect from 16.11.2011. The claim of the petitioner, however, was rejected by the respondent. Being aggrieved from rejection of his claim, he is before this Court, seeking the following reliefs:

(3.) CLAUSE 10 of MH and FW, OM No.S.11011/23/2009-CGHS D.H/Hospital, Cell (Part-I), dt. 17.8.2010 reads as under: