Supreme Court to Centre: Form panel to disburse medical claim under CGHS

Representational pictureIn a bid to protect retired public servants from unnecessary harassment in claiming reimbursements under the Central Government Health Scheme CGHS the Supreme Court has asked the Centre to expeditiously set up a highpowered committee to disburse claims in a month A bench of justices R K Agrawal and Ashok Bhushan also directed the Ministry of Health and Family Welfare to form the panel within seven days It would comprise special directorate general directorate general two additional directors and one specialist in the field and shall ensure timely and hassle free disposal of the claims to the pensioners it directedWith regard to the slow and tardy pace of disposal of Medical Reimbursement Claims MRC by the CGHS in case of pensioner beneficiaries and the unnecessary harassment meted out to pensioners who are senior citizens affecting them mentally physically and financially we are of the opinion that all such claims shall be attended by a secretarylevel high powered committee in the ministry concerned which shall meet every month for quick disposal of such cases the bench said The directions came on a plea of a retired government servant who was denied medical claim under the CGHS in 2014 for his treatment at Fortis Escorts Hospital in Delhi and Jaslok hospital in Mumbai due to the nonempanelment of the hospitals under the scheme The bench which directed the ministry to give the petitioner Rs 499555 spent by him on his treatment also observed that the CGHS officials responsible for clearing medical claims took a very inhuman approach by denying him the full cost of his treatment Can it be said that taking treatment in speciality hospital by itself would deprive a person to claim reimbursement solely on the ground that the said hospital is not included in the government orderThe right to medical claim cannot be denied merely because the name of the hospital is not included in the government order The real test must be the factum of treatment it said It observed that authorities must be responsive and ensure medical care to senior citizens after retirement The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement The CGHS was propounded with a purpose of providing health facility scheme to the central government employees so that they are not left without medical care after retirement it said The apex court while directing the ministry to form the panel expeditiously said there shall be a timeframe for finalisation and disbursement of the claim amounts of pensionersIn this view we are of the opinion that after submitting the relevant papers for claim by a pensioner the same shall be reimbursed within a period of one month it said The court was hearing the petition filed by Shiva Kant Jha seeking reimbursement on account of his treatment done in November 2013 for Rs 986343 for his cardiac ailment involving the implant of CRTD device and two sets of bill amounting to Rs 398097 for his treatment at Mumbai for cerebral stroke and paralytic attack He had claimed that he was denied the amount of Rs 499 lakh out of the entire amount on the ground that he did not seek approval of authorities for the device implantThe court taking note of the facts said the law does not require that prior permission has to be taken in such situation where the survival of the person is the prime consideration The bench said that the CGHS is responsible for taking care of healthcare needs and wellbeing of the central government employees and pensioners In the facts and circumstances of the case we are of opinion that the treatment of the petitioner in nonempanelled hospital was genuine because there was no option left with him at the relevant time We therefore direct the state to pay the balance amount of Rs 499555 to the petitioner We also make it clear that the said decision is confined to this case only it said PTI AG SJK ABA MNLCatch up on all the latest Crime National International and Hatke news here Also download the new midday Android and iOS apps to get latest updatesThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever