R.D. DEHARIA Vs. UNION OF INDIA

JUDGEMENT

(1.) THE applicant is a retired Senior Personnel Officer (L&W) of Railways and is a member of Retired Employees Liberalized Health Scheme -1997 (RELHS -97). The applicant has filed this Original Application challenging the order passed on his appeal dated 22.8.2008 on the ground of arbitrariness and total non -application of mind. The facts of the case as made by the applicant are that the applicant being the retired Railway employee of Retired Employees Liberalized Health Scheme Card Holder is entitled for treatment of himself and his family even in a non -Railway Private Hospital in emergency. The wife of the applicant, Mrs. Saroj Deharia developed serious unbearable pain in her back and numbness in her various organs required medical attention. On 9.1.2008, the applicant took his wife to the hospital at Kalyan where he was told that the said hospital did not have the required facility to deal with such emergency. The applicant was told to take his wife to Railway Hospital, Byculla. So, as per advice of the officials at Kalyan Hospital, the applicant was taking his wife to Railway Hospital, Byculla. On their way to said Railway Hospital, Byculla, shooting and unbearable pain developed, the applicant became afraid that the same may be life threatening. The wife, of the applicant was rushed to the nearest suitable clinic being the Private Hospital namely Dr. Sonagra Medical and Surgical Centre at Ghatkopar (W), Mumbai. One Dr. Shailendra S. Verlekar of the said center advised immediate operation to save her from permanent incapacitation. She was immediately admitted on 9.1.2008 and after the investigations were done on 9.1.2008 and 10.1.2008, the wife of the applicant was operated on 11.1.2008 successfully. The applicant withdrew all his money from his fixed deposit and made the payment to the said private hospital. The wife of the applicant was discharged from the said private hospital on 16.1.2008 and immediately on the same date i.e. 16.1.2008 the applicant informed the Medical Director, Central Railway Hospital, Byculla being the respondent No. 3. The applicant, thereafter, submitted his claim for reimbursement of the Medical expenses for Rs. 63,030/ - along with all requisite original documents on 20.5.2008. The said claim application along with all requisite documents are annexures to this Original Application. The respondent No. 3 rejected his claim vide order dated 5/9.8.2008. Respondent No. 3 held that the case seemed to have no emergency and hence regretted. The applicant being aggrieved by the said decision of the respondent No. 3 submitted his appeal vide letter dated 22.8.2008 to the respondent No. 2 being the Chief Medical Director, Central Railway, CST, Mumbai. The said Appellate Authority also rejected his claim merely repeating the decision of the respondent No. 3 and conveyed the decision dated 9.9.2008 to the applicant. Being aggrieved by the said order dated 9.9.2008, the applicant filed Original Application No. 588/2008 before this Tribunal. This Tribunal set aside the order of the Appellate Authority and remanded the matter back to the Chief Medical Director, CST to decide the appeal afresh duly taking into consideration the points raised by the applicant in his appeal as well as in the present O.A. The authorities were further directed to redress the grievances of the applicant. The operative part of the said order is set out hereinbelow - -

(2.) PURSUANT to the order of the Tribunal passed in O.A. No. 588/2008, the respondent No. 2 passed the impugned order rejecting the claim of the applicant once again. Hence, the applicant has challenged the said order of the Appellate Authority being the Chief Medical Director dated 12.12.2011 in this Original Application. The said order is set out herein below -

(3.) WE have heard Mr. C.M. Jha, learned Counsel for the applicant and Mr. S.C. Dhawan, learned Counsel for the respondents and perused the documents.