N.C.JAIN Vs. AIR INDIA LTD

JUDGEMENT

(1.) THE petitioner before this Court is a retired employee of the respondent -Air India Limited and is entitled to avail the Medical Benefit Scheme of Air India Limited, which covers not only the serving but also the retired employees of the said organization. The petitioner who is now aged about 68 years was examined in Tata Memorial Hospital and found to be suffering from Carcinoma Prostate. He underwent surgery on 23.3.2007, followed by post operative External Radiation Therapy from 20.10.2008 to 4.12.2008. He was, however, advised to consult a Urologist for further management of urinary incontinence. The petitioner was then examined by Dr. T.B. Yuvaraja, Consultant Urologist at Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute at Mumbai. It was found by the aforesaid doctor that he had moderate incontinence of urine. He was, therefore, advised to undergo Male sling operation for the aforesaid problem. The approximate cost of the surgery was estimated at Rs.3.00 lakh which included Rs.1.7 lakh towards cost of the implant. The petitioner then went to a doctor in the Medical Services Department of Air India where the concerned doctor recommended issue of a letter to Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute for admission for four (4) days under Dr. Yuvaraja of the said hospital. The petitioner accordingly underwent the surgery for implantation of male sling and a bill of Rs.2,66,322.00 was raised by the aforesaid hospital on NACIL ­ Air India & Indian Airlines. However, the respondent vide letter dated 24.1.2011 informed the petitioner as under:

(2.) I have perused the Medical Benefits Scheme of Air India Limited. Nowhere does the said Scheme exclude penile transplant Surgery. Clause 12 (b) of the aforesaid Scheme which applies to referrals outside the panel of Air India reads as under:

(3.) FOR the reasons stated hereinabove, the respondent -Air India is directed to refund the amount of Rs.2.00 lakh which the petitioner was compelled to deposit with it within a week from today. The respondent shall also examine the claim of the petitioner for reimbursement of Rs.41,109.00 and to the extent found admissible under the Scheme the aforesaid claim shall also be reimbursed to the petitioner within two (2) weeks from today. The petitioner shall be entitled to avail all the facilities of medical scheme which are available under the Medical Benefits Schemes of Air India. The writ petition stands disposed of. No orders as to costs.