RAM PAL Vs. UNION OF INDIA AND ORS.

JUDGEMENT

(1.) THIS OA has been filed under Section 19 of the Administrative Tribunals Act, 1985, seeking the release of medical reimbursement claim of Rs. 5,78,825/ - with interest in respect of Cochlear implantation surgery undertaken by the daughter of the applicant.

(2.) THE background of the matter is that Ms. Harjit Kaur, daughter of the applicant who is posted as Station Master Chhajali, is suffering from hearing and speaking impairment since infancy. The applicant contacted ADMO Dhuri on 18.7.2011 for the treatment of his daughter and she was thereafter referred to DMO(Physician), Ambala for further treatment vide OPD Slip No. 3869 dated 18.7.2011 having Reference No. 113 dated 19.7.2011 (Annexure A -3). The applicant was referred to PGI by Dr. Atit and reference slip was countersigned by Dr. I.P. Sharma, Chief Medical Superintendent, Northern Railways, Ambala Cantt. (Annexure A -5). The applicant alongwith his daughter visited PGI on 26.7.2011 and continued to visit the Institute thereafter with gaps of fifteen days to one month for testing vide Central Registration No. 3276644 of PGI. On 27.9.2011, the Head of Department of ENT, PGIMER, recommended Ms. Harjit Kaur for Cochlear implantation surgery. Ms. Harjit Kaur was admitted in PGI on 6.1.2012 and underwent surgery for Cochlear implantation. She was discharged on 17.1.2012 and directed to come for follow up treatment at PGI on the dates advised (Annexure A -7). The applicant's daughter is continuing to visit PGI for follow up treatment. The expenditure incurred on the treatment was Rs. 5,78,825/ - and the applicant arranged for this huge amount by pledging his house for Rs. 6,00,000/ -. When the bill for reimbursement of medical expenses was submitted to the Chief medical Superintendent, Ambala Cantt on 24.2.2012, objections had been raised on the same and till date no payment had been released on this account. Hence, this OA.

(3.) IT has further been stated that the patient was referred to PGI only once on 19.7.2011 for evaluation (not for surgery), but attended PGI 7 days later on 26.7.2011 in violation of instructions that require that the patient must attend the referred hospital within three days in non -emergency cases. The patient was not admitted in PGI on 26.7.2011 and was asked to go for PTA test. She did not report back to the Railway hospital alongwith the estimated cost of treatment in PGI for further recommendation by the Railway hospital as required by the mandatory instruction No. 2 in Annexure R -1. After a gap of nearly six months of being referred to PGI on 19.7.2011, the patient got admitted in PGI on 6.1.2012, underwent Cochlear Implant Surgery on 11.1.2012 without being re -referred by the concerned Railway doctor in terms of instruction No. 2, 5 dated 03.02.2014 (Annexure R -1) and the Railway Board Circular dated 31.12.2009 (Annexure R -2). The patient was discharged from PGI on 17.1.2012 and asked to come back for follow up treatment. She failed to report to the Railway doctor as required by instruction No. 5 which reads as under: - -