HIGH COURT OF JUDICATURE AT ALLAHABAD LUCKNOW WRIT - A No. - 13701 of 2025 Court No. - 18 HON'BLE SHREE PRAKASH SINGH, J. Heard learned counsel for the petitioner and Ms. Deepti Tripathi, learned counsel for the respondents. By means of the present petition, the petitioner is challenging the letter dated 18.12.2019 by virtue of which the medical claim of the petitioner has been rejected and observation has been made that the bills are fake. Contention put forth by the learned counsel for the petitioner is that the petitioner after being relieved from the hospital concerned, claimed for the medical expenditure, which has been rejected by the impugned order. He submitted that the medial claim has been rejected on the ground that the same was found by the authorities as fake. He next submitted that in fact, the policy for medical claim under clause 7.11 says that if the claim lodged by a member is found to be false, such member would be terminated and expelled from the scheme and debarred from availing benefit under the scheme without prejudice to the right of the Corporation to initiate appropriate legal action as deemed necessary in the facts and circumstances of the case for lodging and/or facilitating the false claim. Clause 7.11 reads as under:- "If the claim lodged by a member is found to be false, such member would be terminated and expelled from the scheme and debarred from availing benefit under the scheme without prejudice to the right of the Corporation to initiate appropriate Versus Counsel for Petitioner(s) : Ram Kumar Verma Counsel for Respondent(s) : Dr. Deepti Tripathi Keshav Kishore Awasthi .....Petitioner(s) Food Corporation Of India 16-20 Barakhamba Lane New Delhi And 2 Others .....Respondent(s) legal action as deemed necessary in the facts and circumstances of the case for lodging and/or facilitating the false claim." Referring the aforesaid, he submits that since dire consequences are provided for a false claim of medical expenditure and, therefore, prior passing any order, opportunity of hearing should have been given to the petitioner as the severe prejudice is caused to the petitioner. He further raised his argument that the bills are said to be fake whereas the fact remains that no response was given by the Sai Hospital, Lucknow and that does not mean that the bills are fake. He added that there may be certain technical issues regarding 'investigation' but the patient has no concern with the same and he cannot be made liable for the same as this is in the hands of the doctors not to the patients. He also submitted that the medical claim has been rejected on non est ground and, therefore, the same is unsustainable in the eyes of law. On the other hand, learned counsel for appearing for the Corporation has opposed the contentions aforesaid and submitted that a detailed scrutiny of the medical bills has been done as per the rules and circulars of the Department. She has placed a copy of the order of the scrutiny committee and submitted that the conclusion of the committee is that the bills as submitted by the retired employees including the present petitioner are fake as there is no details regarding any investigation of the patient. Therefore, submission is that the impugned order has rightly been passed. Upon considering the submissions of the learned counsel for the parties, it transpires from clause 7.11 that there are serious consequences in case claim lodged by the members is found false. It is an admitted position that the petitioner has not been associated before scrutiny committee, whereas there are serious consequences of the decision of scrutiny committee, where the committee reaches to the conclusion that the medical claim made by such member is false one. This Court has noticed that the shortcomings, which were found by the scrutiny committee that no investigation was got done by the hospital concerned, it is upto the wisdom of the doctor, who is treating the patient, to take decision for investigation, therefore, this is not incumbent upon the patient to dictate the doctor for investigation. Further there can be a ground WRIA No. 13701 of 2025 2 that the hospital is not empaneled as is required in law but there is no such finding while passing the order impugned dated 18.12.2019 and the claim of the petitioner has been rejected only on the ground that the bills are fake. Consequently, the order dated 18.12.2019 is unsustainable and resultantly, the same is hereby quashed. The scrutiny committee is directed to take a fresh decision considering the relevant laws with respect to the medical claim of the petitioner within four weeks while affording opportunity of hearing to the petitioner and the petitioner is directed to co-operate before the scrutiny committee so as to take decision. Since the record is already available with the Department, therefore, the petitioner need not apply afresh. With the aforesaid observations, present petition is disposed of. December 4, 2025 Ram Murti WRIA No. 13701 of 2025 3 (Shree Prakash Singh,J.) Digitally signed by :- RAM MURTI YADAV High Court of Judicature at Allahabad, Lucknow Bench