AI Structured Summary
Not yet generated for this judgment
Judgment
K.V. Eapen, Member A
This Original Application has been filed by the applicant seeking the following reliefs:
“(i) to call for the records leading to Annexure A1 and Annexure A4 and set aside the same.
(ii) declare that the applicant herein is entitled for reimbursement of medical claim, for the treatment undergone in M. V. R. Cancer Centre and Research Institute, Calicut.
(iii) to direct the 2nd respondent to disburse the medical reimbursement claim to the applicant that is Rs. 1,62,071/- (Rupees One Lakh Sixtytwo thousand and seventyone only) within a time frame.
(iv) award cost to the applicant;
(v) To issue such other appropriate order or direction as this Hon'ble Tribunal deems just and fit in the circumstance of the case.”
The brief facts of the case are as follows:
It is submitted by the applicant that she had undergone treatment for Cancer from MVR Cancer Centre, Calicut and an amount of Rs. 1,62,071 was incurred for treatment. She submits that she is entitled for reimbursement as per the scheme for medical reimbursement. Claim for reimbursement was rejected by Annexure A1.
She submits that she filed Annexure A2 appeal before the appellate authority and the same was also rejected by Annexure A4. Aggrieved by the non-reimbursement of the medical expenses incurred, the applicant has approached this Tribunal.
When the matter came up for consideration before this Tribunal today, it is noted that that the respondents have passed two orders at Annexure A1 and A4 which are non-speaking orders relating to the matter and there are no details as to why the Competent Authority has rejected the claim for medical reimbursement.
In view of the above circumstances, the competent authority (appellate authority) is directed once again to consider Annexure A2 appeal filed by the applicant and pass a speaking order in the light of relevant rules, regulations and guidelines and after considering all aspects, within a period of 45 days from the date of issue of this order.
The Original Application is disposed of as above at the admission stage itself. No costs.