NAUNIHAL SINGH Vs. UNION OF INDIA AND OTHERS

JUDGEMENT

(1.) This is Letters Patent Appeal under Clause 10 of the Letters Patent for setting aside the judgment dated 19.1.2010 passed by the learned Single Judge whereby the claim of the petitioner for reimbursement of the medical bills incurred for an operation for the implant of automatic inera- cardiac defibrillator (AICD), from the Fortis Hospital, Mohali has been disallowed.

(2.) The petitioner is a member of Central Government Health Scheme and is entitled to reimbursement of the expenses incurred by him for medical treatment. The reimbursement is admissible for taking treatment from the Central Government / the State Government hospitals and the hospitals, which are fully funded by the Central Government or State Government. Treatment from the private hospitals recognised by the Central / State Government under the Central Government Health Scheme/ the Central Civil Services (Medical Attendance) Rules, 1944 (hereinafter referred to as "the Rules, 1944"), medical treatment from unrecognized private hospitals is eligible for reimbursement in the case of emergency only.

(3.) The petitioner was operated upon for implant of Automatic Intra Cerdiac Defibrilator (hereinafter referred to as AICD) on 2.4.2009. He submitted an application on 15.4.2009 to the Additional Director, Central Government Health Scheme, (Ministry of Health and Family Welfare), Government of India, Sector 34, Chandigarh, for reimbursement of the expenses incurred by him i.e. Rs. 4,50,379.00 as operation charges and Rs. 34,357/- for the follow-up treatment, the total amount being Rs. 4,84,736/-.