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Judgment
ORDER
Per Hon’ble Mr. Pankaj Kumar, Member-Administrative
In this case relating to medical reimbursement, the applicant has sought following reliefs:-
A. To quash the impugned order dated 14.03.2024 contained as Annexure No. A-1 to this OA, with all consequential benefits.
B. To release the amount incurred by the applicant in treatment of his wife in terms of the claim submitted by him alongwith interest @12% pa from the date of due till the actual date of payment.
C. Any other relief, which this Hon'ble Tribunal may deem fit, just and proper under the circumstances of the case, may also be passed.
D. Cost of the present case.
The facts of the case are that the applicant, who was working on the post of Hockey Coach under the respondents, retired from service on 31.08.2016. His wife, who was suffering from kidney ailment, passed away on 14.10.2020. When no action was taken by the respondents to settle his claim for medical reimbursement for treatment of his wife, the applicant approached this Tribunal in OA No. 337 of 2022 whereupon this Tribunal, vide order dated 31.01.2024, directed the respondents to consider and decide the applicant’s representation dated 14.12.2020. The respondents rejected the applicant’s claim vide order dated 14.03.2024. Aggrieved, the applicant has preferred this OA.
The applicant’s contention is that his case is covered by the judgment and order dated 19.09.2018 rendered by the Principal Bench of this Tribunal in OA No. 1422 of 2017 K N Sharma vs Union of India in case of a similarly situated employee of SAI.
The respondents state that in October 2020 the applicant submitted a claim for reimbursement of Rs. 5,45,797 for medical expenses incurred in treatment of his wife. However, they contend that the Sports Authority of India (SAI) is an autonomous body under the Ministry of Youth Resources & Sports and it is not covered under the Central Government Health Scheme (CGHS) meant for Central Government employees. They further contend that while the working employees of SAI are being reimbursed medical expenses for treatment taken from Central or State Govt. hospitals or from CGHS empaneled hospitals on CGHS prescribed rates, there is no provision under the rules of SAI for medical reimbursement after retirement and that all retired employees of SAI are paid fixed monthly allowance of Rs. 1,000 in accordance with office memorandum (OM) dated 19.07.2017 issued by the Department of Personnel & Training (DoPT). They state that the judgment and order in K N Sharma (supra) has been challenged before Hon’ble High Court of Delhi.
Heard both the parties.
It is noted that the controversy in K N Sharma (supra) also pertained to medical reimbursement claim of a retired SAI employee and it was settled in the following terms by the Principal Bench of this Tribunal:
“11.The matter has been heard at length. It is seen that the service conditions of SAI are silent in respect of the medical facilities for the retired employees except to the extent of granting a fixed medical allowance which admittedly had already been paid to the applicant. However, the same rules also contain para 44 wherein a provision is kept to follow the instructions as are applicable to Central Govt. Servants, if bye laws are silent (Para 4 supra). Since the bye laws are silent on specific provision for reimbursement to retired employees, para 44 comes into effect. The judgment quoted by the applicant of the Hon’ble Delhi High Court in WP(C) No. 1844/2011 is relevant considering that our country profess to be a Welfare State and medical benefits are need of the hour. The plea of the respondents that reimbursement can be considered for serving employees but not for retired employees, is beyond any logic as it is in old age that adverse medical conditions are likely to arise, and therefore this plea cannot be accepted.
12.In the event, OA is allowed. Respondents are directed to consider the reimbursement claim of Rs. 2,40,418/- as valid and process the same for reimbursement to the extent permissible as per the rates applicable in respect of serving employees of SAI. This exercise shall be completed within a time period of eight weeks from the date of receipt of this order.”
(emphasis supplied)
It is observed that the essential elements of present controversy are squarely covered by K N Sharma (supra) which holds sway as there is no material placed on record to show that it has been stayed or reversed. As similar controversy stands adjudicated by the Coordinate Bench of this Tribunal, there is no reason to take a different view in the present dispute.
In view of the foregoing, this OA is allowed and the respondents are directed to reimburse the claim of Rs. 5,45,797/- for medical expenses incurred in treatment of the applicant’s wife to him to the extent permissible as per the rates applicable in respect of serving employees of SAI within three months of receipt of certified copy of this order.
Associated MAs also stand disposed of.
Parties shall bear their own costs.