R K SINGH Vs. UNION OF INDIA

JUDGEMENT

(1.) THE petitioner was working as a Director in the Ministry of Rural development. He retired on 31st January, 1992. His wife is suffering from cancer. It is the petitioner's case that he is entitled for reimbursement of all medical expenses incurred by him on the treatment of his wife in terms of the Central Government Health Scheme ('cghs') for treatment in approved hospitals which, according to him, has been turned down on flimsy grounds. The petitioner opted for the benefit of CGHS on 27th June, 1996 through the CGHS Dispensary No. 79, Vivek Vihar, Delhi. An Identity Card, bearing Token No. P050093, was duly issued to him. This card is valid both for himself and his wife. It is stated that on 24th April, 2006, the petitioner's wife was diagnosed with Breast Cancer. Consequent upon this, she was admitted to the All India Institute of Medical Sciences ('aiims') on 28th April, 2006 where she underwent surgical intervention. She was also advised to undergo chemotherapy, to be followed up by radiotherapy. Petitioner states that he was also advised that any delay in chemotherapy or in the radiotherapy procedure, as advised, could be dangerous for his wife. He states that during that period, intermittent strikes were going on in the aiims and therefore, since the same was urgently required, he thought it fit to take his wife to the Rajiv Gandhi Cancer Institute and Research Centre for chemotherapy. The petitioner's wife underwent treatment consisting of seven cycles of chemotherapy at the Rajiv Gandhi Cancer Institute and research Centre from 20th May, 2006 to 18th December, 2006. On completion of the same, the petitioner applied to the Competent Authority for reimbursement of medical expenses incurred in terms of the Central government Health Scheme. He had raised a claim for a total sum of Rs. 1,20,894. 17 in this behalf.

(2.) ON 14th February 2007, the petitioner's claim for reimbursement of the aforesaid expenses was returned by respondent No. 2 with the request that the requisite information/ documents mentioned in the said letter be furnished for further processing of the case. According to the petitioner, after he furnished this requisite information, the respondents have issued another letter dated 30th July 2007 containing a fresh set of objections. He states that the only common objection forthcoming in the aforesaid letters dated 14th February, 2007 and 30th July, 2007 issued by the respondents is with regard to the time within which the claim has been made. Whilst in the letter dated 14th February, 2007, it is stated that, ?claim is to be preferred within 3 months of discharge from the hospital?; in the other letter dated 30th July, 2007, it is stated that, ?the time bar of 90 days to be followed for submission and resubmission?. The claim was returned with the request to furnish the particulars sought to enable the respondents to proceed further in the matter. Counsel for the petitioner states that apart from the items listed at sub-para (f) and sub-para (2) and (3) in the letter dated 30th july, 2007, all the other particulars had already been furnished to the respondents. He states that as regards the emergency certificate required in terms of sub- para (f) also, a certificate dated 3rd February, 2007 issued by the Senior Consultant, Medical Oncology, at the Rajiv Gandhi Cancer institute and Research Centre certifying that the petitioner's wife underwent treatment at that institute and that, ?in view of poor prognostic features, chemotherapy was required on urgent basis? has already been submitted by him. He states that this certificate satisfies the requirements. As regards the objection in sub-para (2), learned counsel for the petitioner points out that in the Rajiv Gandhi Cancer Institute arid Research centre, where his client's wife underwent the necessary chemotherapy, is on the list of the hospitals approved by the CGHS and therefore, keeping in mind the difficulties faced by the petitioner in going from Rohini, where the petitioner's wife was being given the treatment, all the way to Vivek Vihar dispensary where the petitioner was registered, simply to obtain the requisite medication, made no sense. As regards the objection in sub-para (3), counsel for the petitioner states that his claim was preferred within the time prescribed. He states that the chemotherapy, which the petitioner's wife had undergone, had seven cycles and treatment was only completed after she underwent all the cycles. He states that the treatment started on 20th May, 2006 and it ended on 18th December, 2006, when the last cycle of chemotherapy was undergone. He states that he has preferred his claim on 2nd February, 2008 and, therefore, computed from the date of the last cycle, the claim is well within the time and for these reasons, the rejection of his claim is unjustified.

(3.) ON 30th November, 2007, counsel for the petitioner had sought time to file an affidavit giving particulars of various documents filed by him before the respondents. The said affidavit has been filed.