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Addl Director Cghs And Ors v. Shri Dharam Vir (lrs)

Addl Director Cghs And Ors v. Shri Dharam Vir (lrs)

(National Consumer Disputes Redressal Commission, New Delhi)

Revision Petition No. 511/2007 | 14-09-2011

Complainant/respondent was a retired Indian Administrative Officer of the Rajasthan cadre. On retirement, he being a beneficiary of CGHS scheme, was issued Card No.61377. Respondent visited his daughter in U.S.A. in April 2000. Allegedly, he developed urine problem and had to undergo emergency operation for which he had -2- made expenditure equivalent to Rs.27,305.85ps. After coming back from U.S.A. he submitted claim for reimbursement but the Addl. Director CGHS, petitioner herein, informed him vide letter dated 07.02.2001 that Ministry of Health had not agreed to the reimbursement as a CGHS beneficiary is not covered by the CS (MA) Rules for taking treatment abroad. Respondent being aggrieved filed the complaint before the District Forum. District Forum allowed the complaint and directed the petitioner to pay an amount of Rs.27,305.85ps. along with interest at the rate of 12% per annum from the date of producing the bill up to the date of recovery. Rs.1,000/- were awarded as costs. Petitioner being aggrieved filed the appeal before the State Commission which has been dismissed by the impugned order. The stand taken by the petitioner throughout was that the CGHS beneficiary is not covered by CS (MA) Rules for treatment abroad. Without dealing with this point, the fora below have directed the petitioner to reimburse the expense incurred by the respondent towards medical expenses in foreign country only on the ground that he had to undergo the emergency surgery while abroad. CGHS -3- beneficiary can be reimbursed for an expense incurred by him within India from specified and named hospital. The expense incurred in a foreign country, unless provided for under the Rules, cannot be reimbursed. The fora below have clearly erred in directing the petitioner to reimburse the expense incurred by the respondent towards medical treatment in a foreign country. For the reasons stated above, the Revision Petition is allowed, orders passed by the fora below are set aside and the complaint is ordered to be dismissed with no order as to costs. ......................J ASHOK BHAN PRESIDENT ...................... VINEETA RAI MEMBER

Advocate List
Bench
  • MR. ASHOK BHAN, PRESIDENT
  • MRS. VINEETA RAI, MEMBER
Eq Citations
  • LQ/NCDRC/2011/2412
Head Note

CONSUMER PROTECTION — Services — Medical and Health Services — Medical expenses — Reimbursement of — Reimbursement of medical expenses incurred abroad — Inapplicability of, held, unless provided for under the Rules — Central Civil Services (Medical Attendance) Rules, 1954 — Rule 105 — Consumer Protection Act, 1986, S. 2(1)(o)