Hemant Gupta, J. - (1.) THE challenge in the present writ petition is to an order passed by Central Administrative Tribunal, Chandigarh Bench, Chandigarh on 21st May, 2013 whereby, an original application filed by the respondent No. 2 was allowed holding that he is entitled to reimbursement of the expenditure -incurred in connection with the treatment of his wife. Learned Tribunal has returned the findings, which are as under: - "It is held, accordingly, that the fact of the treatment having been obtained from a Hospital which was not on the par notwithstanding, the applicant is entitled to the reimbursement claimed by him. Non -issuance of the emergency certificate, too, cannot said to constitute a valid premise for rejection of the claim for medical reimbursement, particularly when the wife of the applicant is proved, on point of fact, to have undergone heart surgery for Coronary Angioplasty (PTCA). It cannot be disputed that the Escorts Hospital, New Delhi is the one of the Institutes of repute in cardiac matters." A perusal of the record shows that wife of the respondent underwent Coronary Heart Angioplasty on 13th January, 2005 from Escorts Heart Institute and Research Centre, New Delhi and an expenditure of Rs. 2,99,823/ - incurred on her treatment. The said amount was not reimbursed for the reason that the hospital in which the surgery has been undertaken is not a approved hospital and that the applicant has not produced a certificate to the effect that there was an emergency requiring approval from the Chief General Manager, Telecom before undergoing surgery. The Learned Tribunal allowed the claim finding no merit in the objections raised by the present petitioners.
(2.) WE have heard learned counsel for the parties and find no merit in the present petition. The BSNL Employee Medical Reimbursement Scheme is on the record. All serving and retired employees of BSNL are eligible for the benefit of such scheme but an employee who opts for this scheme is not entitled for the facility provided under the Central Government Health Scheme. The relevant conditions in respect of treatment in a recognized hospitals and in non -recognised hospitals for the employees of the BSNL are as under: - "2.2.0 Treatment in recognized hospitals/nursing homes etc.: - An employee (including retired employee and his/her dependants shall be entitled to the reimbursement of expenses at the approved rates at all hospitals recognised from time to time by the management. Till such time as approved rates in recognised hospitals are not notified by BSNL management, the reimbursement will be as per actual expenses basis. Entitlement under this clause will be separate and distinct from the ceiling amount prescribed in para 2.1.0 and 2.1.1 under domiciliary/outdoor treatment. All expenditure incurred in connection with the treatment will be reimbursed subject to a limit on the room rent which will be as per Annexure -1. "2.2.2 Treatment in non -recognised hospitals: - In emergency cases, the reimbursement will be allowed for treatment in non -recognised hospitals with the approval of CGM for field office employees and concerned Director of BSNL Board for C.O. employees. The amount will be restricted to rates applicable for a particular recognised hospital to be notified by CGM/BSNL C.O." Clause 2.2.0 as reproduced above entitles an employee to the reimbursement of expenses at the approved rates at all hospitals recognised from time to time by the management but till such time rates in recognised hospital are not notified, the reimbursement shall be as per actual expenses basis. Admittedly, the Escorts hospital is not a recognised hospital, therefore, the Clause 2.2.0 would not be applicable in respect of the respondent. It is Clause 2.2.2 which deals with treatment in non -recognised hospitals. The clause contemplates treatment in non -recognised hospital in an emergency cases with approval of Chief General Manager, Telecom for field office employees such as respondent and the amount is restricted to the rates applicable for particular hospital recognised by the Chief General Manager, Telecom.
(3.) THOUGH , the wife of the respondent was undergoing treatment for sometime but the requirement of angioplasty surgery could not wait approval of the Chief General Manager, Telecom. The petitioner has not pointed out the rates applicable for any recognised hospital. The petitioner has not produced any list of recognised hospitals nor the rates fixed for such recognized hospitals. The treatment has been taken from an unrecognized hospital but without prior approval. The claim of the applicant could not be declined for the reason that the approval from Chief General Manager was not obtained. The heart surgery requires immediate attention. The rates at which the reimbursement is to be allowed even in respect of the recognised hospitals has not been produced. Thus, the applicant has been rightly given the reimbursement as per actual expenses in the absence of any rates even in respect of recognised hospitals. In view of the same, we do not find any error in the order passed by the Tribunal, which may warrant any interference. Consequently, the present petition stand dismissed.;