Region: Asia
Year: 2004
Court: Central Administrative Tribunal - Gwalior
Health Topics: Chronic and noncommunicable diseases, Health care and health services, Health systems and financing, Hospitals
Human Rights: Right to health, Right to life
Tags: Access to treatment, Emergency care, Heart disease, Private hospitals, Public hospitals, Reimbursement, Secondary care, Tertiary care
Laxmi Chand, the Petitioner, was a retired Accounts Officer in the office of the Accountant General, Gwalior. After suffering a heart attack, he was referred to Indraprashta Apollo Hospital, New Delhi. On submitting his bills for medical reimbursement, his claims were rejected.
The Petitioner approached the Central Administrative Tribunal, requesting it to direct the Respondent to grant his reimbursement. The Respondent contended that since the Petitioner was now a retired government employee, he was “not covered under CS (MA) Rules, 1944, [and] was not entitled to the medical reimbursement.” Respondent also contended that Petitioner was living in a non-Central Government Health Scheme (CGHS) area and if he had obtained a CGHS pension card, he would have been granted reimbursement for his bills.
As to whether a retired Government employee is entitled to medical reimbursement, the Court held that retired employees must not be deprived of access to medical facilities. It further held that the CS(MA) Rules, 1944 should be extended to pensioners and not remain limited to current Government employees. The Court held that the purpose of these rules was to cover people not already covered by the CGHS.
Regarding the nature of the obligation of the State towards its employees, the Court held that the government could not make a distinction between its employees based on the status of their service. It further held that the government was under an obligation to provide its citizens with the best of health. The Court further held that even if the Petitioner was not a member of CGHS he was not precluded from receiving reimbursements for medical expenses incurred.
“Govt. is under an obligation to provide its every citizen all necessary facilities to enjoy the best of health. When the Govt. is not in position to provide necessary hospital facilities, for securing the best medical treatment available it is under obligation to reimburse the treatment taken in other hospitals. For this purpose, no discrimination can be made between serving Govt. official and a retired Govt. official, both are citizen of India and both are entitled to same treatment.” Para. 7.