2025:KER:24588 IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT THE HONOURABLE MR. JUSTICE AMIT RAWAL & THE HONOURABLE MR.JUSTICE K. V. JAYAKUMAR THURSDAY, THE 20TH DAY OF MARCH 2025 / 29TH PHALGUNA, 1946 OP (CAT) NO. 134 OF 2019 AGAINST THE ORDER DATED 20.02.2019 IN OA NO.415 OF 2018 OF CENTRAL ADMINISTRATIVE TRIBUNAL, ERNAKULAM BENCH PETITIONERS/RESPONDENTS: 1 THE CHIEF GENERAL MANAGER, TELECOM, BHARAT SANCHAR NIGAM LIMITED, KERALA CIRCLE, THIRUVANANTHAPURAM- 695033. 2 THE GENERAL MANAGER TELECOM, BHARAT SANCHAR NIGAM LIMITED, ALAPPUZHA- 688011. 3 THE ASSISTANT GENERAL MANGER (ADMN), BHARAT SANCHAR NIGAM LIMITED, ALAPPUZHA- 688011. 4 THE ACCOUNTS OFFICER (PC), BHARAT SANCHAR NIGAM LIMITED, ALAPPUZHA- 688011. BY ADV RAJIT RESPONDENT/APPLICANT CHANDRASEKHARAN PILLAI R., AGED 59 YEARS, S/O.RAGHAVAPANIKER, TELECOM TECHNICIAN, TELEPHONE EXCHANGE, BSNL NOORANAD P.O., ALAPPUZHA, RESIDING AT VILAYIL VEEDU, R.C.VILLA, THATHAMUNNA, NOORANAD P.O., ALAPPUZHA DISTRICT- 690504. BY ADVS. SRI.T.C.GOVINDA SWAMY SMT.KALA T.GOPI SRI.R.S.SARAT THIS OP (CAT) HAVING BEEN FINALLY HEARD ON 20.03.2025, ALONG WITH OP (CAT).150/2020, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: OP(CAT) Nos.134/2019 and 150/2020 2 2025:KER:24588 IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT THE HONOURABLE MR. JUSTICE AMIT RAWAL & THE HONOURABLE MR.JUSTICE K. V. JAYAKUMAR THURSDAY, THE 20TH DAY OF MARCH 2025 / 29TH PHALGUNA, 1946 OP (CAT) NO. 150 OF 2020 AGAINST THE ORDER DATED IN OA NO.961 OF 2018 OF CENTRAL ADMINISTRATIVE TRIBUNAL, ERNAKULAM BENCH PETITIONERS (RESPONDENTS 2 TO 5): 1 BHARAT SANCHAR NIGAM LIMITED REPRESENTED BY ITS CHAIRMAN -CUM - MANAGING DIRECTOR, CORPORATE OFFICE, BHARAT SANCHAR BHAVAN, HARISH CHANDRA MATHUR LANE, JANPATH, NEW DELHI - 110 001. 2 THE CHIEF GENERAL MANAGER BHARAT SANCHAR NIGAM LIMITED, KERALA CIRCLE, THIRUVANANTHAPURAM, KERALA. 3 THE GENRAL MANAGER B.S.N.L., SANCHAR BHAVAN, PALAKKAD - 678 014. 4 THE DEPUTY GENERAL MANAGER B.S.N.L., SANCHAR BHAVAN, PALAKKAD - 678 014. BY ADV T.C.KRISHNA RESPONDENT/APPLICANT: AMBIKA K.K., W/O. LATE RAJAGOPALAN O., RESIDING AT ODUPARA HOUSE, KUTTAMASSERY P. O., THIRUVAZHITYODE VIA, PALAKKAD, KERALA - 679 514. BY ADVS. SMT.REKHA VASUDEVAN SMT.M.N.UMARANI THIS OP (CAT) HAVING BEEN FINALLY HEARD ON 20.03.2025, ALONG WITH OP (CAT).134/2019, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: OP(CAT) Nos.134/2019 and 150/2020 3 2025:KER:24588 COMMON JUDGMENT K. V. JAYAKUMAR, J This judgment shall dispose of two OP(CAT)s. OP(CAT) No.134/2019 is preferred by the Bharath Sanchar Nigam Limited (BSNL) impugning the order of the Central Administrative Tribunal in O.A.No.415/2018 dated 20.02.2019 and OP(CAT) No.150/2020 is preferred impugning the order in O.A.No.961/2018 dated 03.01.2020, whereby the claim of the respondents/applicants for medical reimbursement was allowed. 2. The facts in narrow compass are as follows: The respondent in OP(CAT) No.134/2019 retired from the BSNL as a Telecom Technician. The respondent/applicant was treated at Amrita Institute of Medical Sciences and Research Hospital, Ernakulam and when he made a claim for medical reimbursement, that was rejected by the petitioners holding that, though Amrita Institute is an empanelled hospital of the petitioners’ organization, there is no provision under BSNL Medical Reimbursement Scheme for full reimbursement. OP(CAT) Nos.134/2019 and 150/2020 4 2025:KER:24588 3. The respondent in OP(CAT) No.150/2020 is aggrieved by the denial of medical reimbursement for the treatment undergone by her husband, late O.Rajagopalan, an employee of the Bharat Sanchar Nigam Limited. 4. The stand of the petitioner, BSNL, is that the employees of BSNL are entitled to reimbursement of medical benefits at the rate prescribed under the Central Government Health Scheme (CGHS). 5. The Tribunal noticing the rival contentions of the counsel for the parties, placing reliance on the decisions reported in Shiva Kant Jha Vs. Union of India (2018 KHC 6285), Kirloskar Bros. Ltd. Vs. ESI Corpn. [(1996) 2 SCC 682], Surjit Singh Vs. State of Punjab (AIR 2006 SC 1388) and in Paschim Banga Khet Mazdoor Samity Vs. State of W.B. [(1996) 4 SCC 37] allowed full reimbursement to the claimant. Impugning the said order, the petitioners preferred this O.P.(CAT). 6. The short question involved in this case is whether the reimbursement of a retired/serving Government employee or his family members can be rejected on the ground that he was treated in a hospital OP(CAT) Nos.134/2019 and 150/2020 5 2025:KER:24588 not approved by the State Government or on the ground that the claim is above the limit prescribed under CGHS? In Shiva Kant Jha Vs. Union of India (2018 KHC 6285) the Honourable Apex Court held that, the right to medical claim cannot be denied merely because name of the hospital is not included in the Government Order. It was observed that the real test must be the factum of treatment supported by records duly certified by Doctors/hospitals concerned. It was made clear that survival of the person is the prime consideration, and the law does not require that prior permission has to be taken in such situation. Paragraph Nos.13, 14 and 15 of the Shiva Kant Jha’s case (supra) are extracted hereunder: “13) It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe 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 Order. The 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. Before any medical claim is OP(CAT) Nos.134/2019 and 150/2020 6 2025:KER:24588 honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court. 14) This is hardly a satisfactory state of affairs. The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement. The Central Government Health Scheme (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 was in furtherance of the object of a welfare State, which must provide for such medical care that the scheme was brought in force. In the facts of the present case, it cannot be denied that the writ petitioner was admitted in the above said hospitals in emergency conditions. Moreover, 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 doctors did his operation and had implanted CRT-D device and have done so as one essential and timely. Though it is the claim of the respondent-State that the rates were exorbitant whereas the rates charged for such facility shall be only at the CGHS rates and that too after following a proper procedure given in the Circulars issued on time to time by the concerned Ministry, it also cannot be denied that the petitioner was taken to hospital under emergency conditions for survival of his life which requirement was above the sanctions and treatment in empanelled hospitals. 15) In the present view of the matter, we are of the considered opinion that the CGHS is responsible for taking care of healthcare needs and well being of the central government employees and pensioners. In the facts and circumstances of the case, we are of opinion that the OP(CAT) Nos.134/2019 and 150/2020 7 2025:KER:24588 treatment of the petitioner in non-empanelled hospital was genuine because there was no option left with him at the relevant time. We, therefore, direct the respondent-State to pay the balance amount of Rs. 4,99,555/- to the writ petitioner. We also make it clear that the said decision is confined to this case only.” 7. In Central Provident Fund Commissioner, New Delhi and Others Vs. N.Satheesan and Another (2018(1) KHC 921), the Division Bench of this Court opined that, when the genuineness of the bill submitted cannot be doubted, the denial of a portion of amount claimed, asserting that there was deviation from the relevant Rules, is quite unjustifiable and illegal. 8. The learned counsel for the respondents/applicants supported the order of the Tribunal. 9. Per contra, the learned Deputy Solicitor General of India (in-charge), Sri.T.C.Krishna, submitted that the impugned orders of the Tribunal are illegal. According to the DSGI (in-charge), the employees of the Central Government and their family members are permitted to avail medical facilities in any of the hospitals, recognized by the State Government and only at the rates prescribed by the CGHS. 10. We have heard the rival contentions of the counsel for OP(CAT) Nos.134/2019 and 150/2020 8 2025:KER:24588 the parties and appraised the paper books. The issue involved in these cases are no longer res integra in view of the dictums laid down by the Honourable Apex Court in various judicial pronouncements. We are of the considered view that, O.P.(CAT).Nos.134/2019 and 150/2020 are devoid of any merit and are liable to be dismissed. Thus, the O.P.(CAT)s are dismissed. 10. We have heard the rival contentions of the counsel for OP(CAT) Nos.134/2019 and 150/2020 8 2025:KER:24588 the parties and appraised the paper books. The issue involved in these cases are no longer res integra in view of the dictums laid down by the Honourable Apex Court in various judicial pronouncements. We are of the considered view that, O.P.(CAT).Nos.134/2019 and 150/2020 are devoid of any merit and are liable to be dismissed. Thus, the O.P.(CAT)s are dismissed. Sd/- AMIT RAWAL JUDGE Sd/- K. V. JAYAKUMAR JUDGE Sbna/ OP(CAT) Nos.134/2019 and 150/2020 9 2025:KER:24588 APPENDIX OF OP (CAT) 150/2020 PETITIONER ANNEXURES ANNEXURE-A6 TRUE COPY OF THE LETTER NO.DGM( P&A) GMY/PGT/CPGRAMS/20-16-17/213 DATED 3.12.2016 ISSUED BY THE 5TH RESPONDENT ANNEXURE-A9 TRUE COPY OF LETTER NO 4641/IP MEDL/AO(PC)/PGT/2 DATED 21.8.2017 ISSUED FROM THE OFFICE OF THE 4TH RESPONDENT ANNEXURE-A1 TRUE COPY OF BSNL, EMPLOYEES MEDICAL REIMBURSEMENT SCHEME (BSMRS) ANNEXURE-A2 TRUE COPY OF ADDITIONAL GUIDELINES FOR THE IMPLEMENTATION OF BSNL, MEDICAL REIMBURSEMENT SCHEME ANNEXURE-A3 TRUE COPY OF REIMBURSEMENT OF MEDICAL CLAIM FOR RETI3ED EMPLOYEES OF BSNL, ANNEXURE-A4 TRUE COPY OF ENROLLMENT CARD OF THE APPLICANT'S HUSBAND IN THE MEDICAL REIMBURSEMENT SCHEME OF BSNL ANNEXURE-A5 TRUE COPY OF DEATH CERTIFICATE ISSUED BY THE REGISTRAR OF BIRTH AND DEATH, NETTOOR MUNICIPALITY ,KERALA STATE ANNEXURE-A7 TRUE COPY OF LETTER DATED 6/.7/2017 ISSUED BY DR.WESLEY M JOSE THE CLINICAL ASSOCIATED PROFESSOR, DEPARTMENT OF MEDICAL ONCOLOGY, AIMS, KOCHI ANNEXURE-A8 TRUE COPY OF REPRESENTATION DATED 4.8.2017 SUBMITTED BY THE APPLICANT TOT HE 4TH RESPONDENT ANNEXURE-A10 TRUE COPY OF REPRESENTATION DATED 17.1.2018 SUBMITTED BY THE APPLICANT TO THE 4TH RESPONDENT ANNEXURE-A11 TRUE COPY OF THE JUDGMENT DATED 19.1.2018 RENDERED BY THE HONOURABLE HIGH COURT OF KERALA IN OP(CAT) NO.167/2017 AS REPORTED IN 2018 ICO 29 ANNEXURE-12 TRUE COPY OF ORDER DATED 19.9.2018 OF THE CENTRAL ADMINISTRATIVE TRIBUNAL IN OA 180/530/2017 ANNEXURE-A13 TRUE COPY OF IDENTITY CARD ISSUED TO THE DECEASED HUSBAND OF THE APPLICANT BY THE AGM(A) IN THE OFFICE OF THE 4TH RESPONDENT ANNEXURE-RA1 TRUE COPY OF ORDER DATED 3/1/2020 IN OA NO.961/2018 EXHIBIT P1 TRUE COPY OF ORIGINAL APPLICATION FILED BEFORE THE CENTRAL ADMINISTRATIVE TRIBUNAL, ERNAKULAM OP(CAT) Nos.134/2019 and 150/2020 10 2025:KER:24588 BENCH AS OA NO.961/2018 WITH ANNEXURES. EXHIBIT P2 TRUE COPY OF REPLY STATEMENT FILED BY THE PETITIONER IN OA NO.961/2018 DATE NIL EXHIBIT P3 TRUE COPY OF REJOINDER FILED BY THE RESPONDENT IN OA NO.961/2018 WITH ANNEXURES DATE 12.8.2019 EXHIBIT P4 TRUE COPY OF ADDITIONAL REPLY STATEMENT FILED BY PETITIONERS IN OS NO.961/2018 DATE NIL EXHIBIT P5 TRUE COPY OF ORDER DATED 3/1/2010 IN OA NO.961/2018 EXHIBIT P6 TRUE COPY OF REVIEW APPLICATION DATED 6.2.2020 FILED BY THE PETITIONER IN OA 961/2018 EXHIBIT P7 TRUE COPY OF ORDER DATED 14.2.2020 PASSED BY THE CENTRAL ADMINISTRATE TRIBUNAL IN RA 3/2020 IN OA NO.961/2018 EXHIBIT P8 TRUE COPY OF LETTER NO-BSNL/ADMN.1/15-10/07 DATED 16.4.2010 EXHIBIT P9 TRUE COPY OF MEMORANDUM OF UNDERSTANDING DATED 18/9/2014 ARRIVED AT WITH LAKESHORE HOSPITAL EXHIBIT P10 TRUE COPY OF COMPILED STATEMENT OF CLAIM AND PAID EXPENDITURE FOR AMRITHA HOSPITAL BILLS. EXHIBIT P11 TRUE COPY OF ORDER OF THE CENTRAL ADMINISTRATIVE TRIBUNAL DATED 20.2.2019 IN OA NO 415/2018 EXHIBIT P12 TRUE COPY OF ORDER OF THE HON'BLE HIGH COURT OF KERALA DATED 30.5.2019 IN OP CAT 134/2019 EXHIBIT P13 TRUE COPY OF COMPILED STATEMENT OF CLAIM AND PAID AMOUNT FOR BILLS PERTAINING TO INDOOR TREATMENT AT LAKESHORE HOSPITAL. RESPONDENT EXHIBITS EXHIBIT R1(A) TRUE COPY OF THE LETTER NO GENL/197-11/2002 DATED 3.7.2003 ISSUED BY THE DEPUTY GENERAL MANAGER(PG) FOR THE 2ND PETITIONER EXHIBIT R1(B) TRUE COPY OF THE LETTER NO AOPC/IP MEDICAL BILL/RAJAGOPALAN O/2020-2021/8 DATED 28.9.2020 ISSUED BY THE CHIEF ACCOUNTS OFFICER IN THE OFFICE OF THE 4TH PETITIONER OP(CAT) Nos.134/2019 and 150/2020 11 2025:KER:24588 APPENDIX OF OP (CAT) 134/2019 PETITIONER EXHIBITS EXHIBIT P1 TRUE COPY OF THE ORIGINAL APPLICATION FILED BY THE RESPONDENT. Exhibit P1-A1 A TRUE COPY OF REPRESENTATION DATED 29.12.2017 ADDRESSED TO THE 3RD RESPONDENT Exhibit P1-A1(a) TRUE TRANSLATION OF A1 Exhibit P1-A2 A TRUE COPY OF COMMUNICATION DATED 03 JAN 2018, ISSUED BY THE DEPARTMENT OF UROLOGY, AMRITA INSTITUTE OF MEDICAL SCIENCES & RESEARCH CENTRE. Exhibit P1-A3 A TRUE COPY OF ESTIMATE DATED 08.01.2018 ISSUED BY THE AMRITA INSTITUTE OF MEDICAL SCIENCE & RESEARCH CENTRE. Exhibit P1-A4 A TRUE COPY OF REPRESENTATION DATED 09.01.2018, ADDRESSED TO THE 4TH RESPONDENT. Exhibit P1-A4(a) TRUE TRANSLATION OF A4 Exhibit P1-A5 A TRUE COPY OF APPLICATION FORM FOR MEDICAL ADVANCE IN THE PRESCRIBED FORMAT SUBMITTED TO THE 4TH RESPONDENT. Exhibit P1-A6 A TRUE COPY OF DISCHARGE SUMMARY ISSUED BY THE AMRITA INSTITUTE OF MEDICAL SCIENCES & RESEARCH CENTRE Exhibit P1-A7 A TRUE OF MEDICAL REIMBURSEMENT CLAIM FOR INDOOR TREATMENT IN THE PRESCRIBED FORMAT AFFIXING ALL THE REQUIRED DOCUMENTS Exhibit P1-A8 A TRUE COPY OF REPRESENTATION DATED 12.03.2018 SUBMITTED TO THE 3RD RESPONDENT Exhibit P1-A8(a) TRUE TRANSLATION OF A8 Exhibit P1-A9 A TRUE COPY OF COMMUNICATION DATED 06TH APRIL 2018 ISSUED BY THE DEPARTMENT OF URO-ONCOLOGY, AMRITA INSTITUTE OF MEDICAL SCIENCE & RESEARCH CENTRE. Exhibit P1-A10 A TRUE COPY OF LETTER BEARING NO. G97/BSNL MRS/2016-2017/VOL. II/92 DATED 12.03.2018 ISSUED BY THE 3RD RESPONDENT. Exhibit P1-A11 A TRUE COPY OF REPORT DATED 15.03.2018 SUBMITTED BY THE DIVISIONAL ENGINEER/ BSNL/ TELEPHONE EXCHANGE/ KALOOR Exhibit P1-A12 A TRUE COPY OF LETTER BEARING F. NO. G91/BSNL MRS/2016-17/VOL. II/198 DATED 20.03.2018, ISSUED BY THE 3RD RESPONDENT. Exhibit P2 TRUE COPY OF THE REPLY STATEMENT FILED BY THE OP(CAT) Nos.134/2019 and 150/2020 12 2025:KER:24588 PETITIONER HEREIN IN THE O.A. Exhibit P3 TRUE COPY OF THE ORDER PASSED IN O.A.NO.180/00145/2018 DATED 20.02.2019. Exhibit P4 TRUE COPY OF THE OFFICE MEMORANDUM BSNL/ADMN.I/15-10/07 DATED 16TH APRIL 2010.