SATHEESH KUMAR R. Vs. UNION OF INDIA

JUDGEMENT

(1.) The original petition has been filed by the petitioner challenging an order dated 25.02.2020 in O.A.No.119/2019. The petitioner challenged the action taken on behalf of the respondents in rejecting his claim for full medical reimbursement. The Tribunal observed that, the petitioner is entitled to get all medical expenses as per CGHS rate. The petitioner filed review, which also came to be dismissed. The contention urged by the learned counsel appearing for the petitioner is that as per O.M. dated 22.05.2018 and 06.06.2018 (Exts.P7 and P8) of the Govenment of India, Ministry of Health and Family Welfare, Department of Health & Family Welfare, new guidelines had been formulated, by which, certain category of persons who had obtained treatment in private unrecognised hospitals under emergency and was admitted for prolonged period for treatment of Head Injury, Coma, Septicemia, Multi-organ failure, etc., are entitled for full reimbursement.

(2.) For easy reference we may refer to the said O.M. dated 06.06.2018 especially clause 2(a) which reads as under :

(3.) According to the learned counsel, the case of the petitioner comes under clause 2 (a) (i) and (ii), in which event, the petitioner's claim is required to be considered by an expert committee under the Chairperson of Addl.DGHS. According to the petitioner, there was no necessity for the matter to be referred to the High Power Committee as his claim does not come under clause 2(b) of the said O.M.