Satish Chandra Jha vs Union Of India & Ors.

This Original Application has been filed by the applicant challenging the order dated 01/06.11.2017, passed by the respondents, whereby the claim of the applicant to provide him facility of Semi Private Ward has been rejected.

From the pleadings, the facts regarding the case of the applicant are that the applicant was initially appointed on 07.04.1961 as Filer Wiseman (Fitter) and during his service tenure, he was promoted and stood retired on 28.02.2002 as Chargeman-I. At the time of superannuation, the applicant was receiving his pay in the pay Scale of Rs. 5500-9900/-, and the last basic pay drawn by the applicant was Rs. 7250. It has been submitted by the applicant that he is covered under the Central Government Health Scheme for the purpose of Medical Treatment and as per the Direction of the CGHS, the applicant has deposited Rs. 8400/- towards the Life Time Membership of CGHS Scheme. The applicant further submits that the Ministry of Health and Family Welfare has issued an instruction dated 27.05.1998 (Annexure A/3), regarding rate of contribution which is to be paid by the employee has been prescribed and as per the instruction, the applicant was required to pay Rs. 70/- per month and the amount of contribution is calculated 70 x 12 x 10, which will come Rs. 8400/-.

It has been further submitted by the applicant that the Ministry of Health and Family Welfare further issued an instruction dated 09.07.2002 (Annexure A/4), whereby the slab of pay has been enhanced to avail the benefit of General, Semi Private and private Ward. As the instruction dated 09.07.2002, if the pay of the employee is up to 7500/- he will be entitled to get facility of General Ward at the time of Hospitalization, whereas, if the pay of the employee is Rs. 7501/- to 10,500/- or Rs. 10,501/-and above, he will be entitled to get facility of Semi Private Ward and Private Ward respectively.

It has been further submitted by the applicant that facility of CGHS Scheme is based upon the contribution of employees and as per the direction of CGHS Authorities, the applicant had deposited contribution @ Rs. 70/-, per month, therefore, he should have been given the facility of Semi Private Ward like other beneficiaries. The applicant has also enclosed the copies of CGHS cards of Shri Durga Prasad Pandey (Annexure A/5) and Shri R. D. Mishra (Annexure A/6), retired from Gun Carriage Factory, Jabalpur, who are receiving the facility of Semi Private Ward and having deposited their contribution @70/- per month to avail facility of CGHS and Shri Muthu Krishna Naidu, who retired from Gun Carriage Factory has contributed Rs. 40/- per month and availing facility of CGHS and therefore he is given the facility of General Ward. The applicant further submits that he also preferred representations dated 30.10.2017 & 16.11.2017 (Annexure A/7), which had been rejected by the respondents vide order dated 01/06.11.2017 (Annexure A/1).

The main grounds urged as submitted by the applicant are that the applicant deposited his contribution @ Rs. 70/- per month which was applicable for semi private ward at the time of his retirement from service on 28.02.2002, therefore his contribution and facility of CGHS will be governed on the basis of slab of pay and contribution fixed by instruction dated 27.05.1998 (Annexure A/3) and not on the basis of subsequent instruction dated 09.07.2002 (Annexure A/4). The applicant also submitted that the similarly situated employees who have deposited contribution @ Rs. 70/- per month are availing facility of Semi Private Ward.

The respondents have filed the reply, wherein it has been submitted by the respondents that the applicant was awarded General Ward for indoor facility in CGHS Card no. 26714 with life time membership and the applicant had misunderstood that ward entitlement is based on CGHS subscription whereas it is based on the basic pension/pay which he has opted for CGHS subscription and the applicant has been informed vide office letter dated 06.11.2017 (Annexure R/1) and 21.12.2017 (Annexure R/2) that his ward entitlement is as per basic pension and is in order. The respondents in their reply further submits that Ministry of Health and family welfare revised the CGHS subscription slab S-11011/31/2001CGHS-II/CGHS (P) dated 09.07.2002 is enclosed herewith as Annexure R/4 and as per Annexure R/4, those who are getting pay/pension up to Rs. 7500/- will get General Ward entitlement. It has been further submitted by the replying respondents that the applicant has also been informed accordingly vide letter dated 06.11.2017 (Annexure R/1) and 21.12.2017 (Annexure R/2).

This Tribunal has considered the rival contentions for both the parties and also gone through the documents annexed herewith.

The applicant in support of his submission has relied upon the OM dated 27.05.1998 (Annexure A-3), which is in respect of rates of subscription towards CGHS, enhanced w.e.f. 01.05.1998. The said OM is in regard to contribution to be made as per the pay range. It is an admitted fact that the pay range of the applicant was Rs. 6001-10000 and the last basic pay of the applicant was fixed as Rs.7250/-, and as such, an amount of Rs. 70/- was being deducted towards the CGHS contribution. In their reply, the respondents have categorically stated that the entitlement of ward depends on the last basic pay/pension. Since in the instant case, the last basic pay of the applicant was Rs. 7250, he is not entitled for Semi-private ward as per the instructions issued on 09.07.2002 by the CGHS.

It is pertinent to mention that the rates of subscription towards CGHS vis-à-vis entitlement of ward for indoor treatment are altogether different. So far as the documents filed by the applicant at annexure A/5 and Annexure A/6 are concerned, it is clear from the perusal of Annexure A/5 & A/6 that Shri Durga Prasad Pandey’s last basic pay was Rs. 8850/- and last basic pay of Shri R D Mishra was Rs. 9700/- and so far as contention regarding Shri M Krishna Naidu’s contribution is concerned, the applicant has not filed any document in this regard.

Thus, it cannot be said that the applicant is entitled for indoor treatment in semi-private ward as admittedly, the last basic pay drawn by the applicant was less than Rs. 7500/-. Therefore, the applicant is entitled only for general ward as per his last drawn basic pay. Entitlement of ward as indoor patient has only criteria of last drawn basic pay, not contribution paid. So far as the contribution on the basis of notification of G.I., Ministry of Health and F.W. O.M. No. S-11011/6/98-CGHS (P) dated 27.05.1998, those persons who are getting basic pay in pay range of Rs. 6000/- to 10,000/- have to contribute Rs. 70/- per month. Therefore, contribution paid by the applicant and entitlement of ward awarded by the respondents are correct and warrant no interference. Thus, it cannot be said that the applicant is entitled for indoor treatment in semi-private ward as admittedly the last pay drawn by the applicant was less than Rs. 7500/-. Thus, the applicant is entitled for General Ward as per his basic pay and option given by him, which is the sole criterion for ward entitlement.

In the result, I do not find any merit in this Original Application and the same is accordingly dismissed without there being any order as to costs.