RAM PAL Vs. CENTRAL ADMINISTRATIVE TRIBUNAL AND OTHERS

JUDGEMENT

(1.) This writ petition has been filed impugning the order dated 24.3.2015 of the Central Administrative Tribunal, Chandigarh Bench, whereby the Original Application filed by the petitioner seeking release of medical reimbursement claim of Rs.5,78,825/- with interest in respect of Cochlear Implantation Surgery undergone by his daughter has been dismissed.

(2.) The petitioner is working as Station Master, Chhajli Station of the Ambala Division of Northern Railway. His daughter Ms. Harjit Kaur was deaf and dumb by birth. He contacted ADMO Dhuri on 18.7.2011 for treatment of his daughter. She was referred to D.M.O.(Physician), Ambala for further treatment vide OPD Slip No.3869 dated 18.7.2011. On 19.7.2011, the Chief Medical Superintendent, Northern Railway, Ambala Cantt. referred the daughter of the petitioner to PGIMER, Chandigarh (for short "PGI") for further evaluation and management. The petitioner along with his daughter visited PGI on 26.7.2011 and continued to visit the Institute as advised after a gap of 15 days/ one month. On 27.9.2011, Dr. Naresh Panda, the Head of Department of ENT, PGI recommended the daughter of the petitioner for Cochlear Implantation Surgery. She was admitted in the PGI on 6.1.2012 and successfully underwent the surgery. She was discharged on 17.1.2012 and thereafter, visited PGI for follow up as advised. An expenditure of Rs.5,78,825/- was incurred by the petitioner on the treatment, which he arranged by pledging his house for Rs.6 lacs. He submitted the bill for reimbursement to Chief Medical Superintendent, Amabala Cantt. on 24.2.2012. Certain objections were raised. The petitioner removed those objections and re-submitted the bill on 27.12.2012. As required by the respondents the petitioner even got his daughter admitted in the Railway Hospital, Northern Railway, Ambala Cantt on 13.05.2013 to assess the result of the treatment given at the PGI. She appeared before the Board and was discharged on 15.05.2013 with a more than satisfactory report. The medical reimbursement claim having not been cleared, he sent legal notices. Finally vide order dated 01.07.2013 his claim was rejected. Hence the Original Application.

(3.) The case of the respondents was that reimbursement of medical expenses to its employees and their family members is governed by Guidelines dated 31.12.2009 contained in the Indian Railways Medical Manual (IRMM). Para 667 of this IRMM, 2000 is relevant in this regard. The petitioner had not conformed to these guidelines. As per these guidelines before an employee is permitted for go in for Cochlear Implantation Surgery for which reimbursement is to be claimed, a proposal for surgery duly recommended by the Chief Medical Director and concurred by Associate Finance, should be sent to the Railway Board for their sanction. This was not done.