APHC010124582025 IN THE HIGH COURT OF ANDHRA PRADESH AT AMARAVATI (Special Original Jurisdiction) [3565] FRIDAY, THE SIXTH DAY OF MARCH TWO THOUSAND AND TWENTY SIX PRESENT THE HONOURABLE SRI JUSTICE BATTU DEVANAND THE HONOURABLE SRI JUSTICE SUBHENDU SAMANTA WRIT PETITION NO: 8583/2025 Between: 1. THE UNION OF INDIA, REP. BY ITS SECRETARY, DEPARTMENT OF ATOMIC ENERGY, ANUSHAKTI BHAVAN CSM MARG, MUMBAI. 2. BHABHA ATOMIC RESEARCH CENTRE (BARC), 6TH FLOOR, CENTRAL COMPLEX, TROMBAY, MUMBAI-400085, REPRESENTED BY ITS DIRECTOR. 3. PROJECT DIRECTOR, BHABHA ATOMIC FTESEARCH CENTRE (BARC VIZAG) ANUVIHAR, MEKARASI HILL, MADUTURU SUB P.O. VISAKHAPATNAM - 531011 ...PETITIONER(S) AND 1. V J RAMALINGESWARA RAO, S/O SURYANARAYANA, AGED 65 YEARS, OCC.RETD.SO/G OF BARC/IGCAR, R/O. 49-40-3/2, FLAT NO.301, GOUTHAMA NILAYAM, N.G.Os COLONY, AKKAYYAPALEM, VISAKHAPATNAM-530016. ...RESPONDENT Petition under Article 226 of the Constitution of India praying that in the circumstances stated in the affidavit filed therewith, the High Court may be pleased to issue an appropriate writ, order or a direction particularly one in the nature of certiorari, by calling for the records pertain to order dated 05.04.2024 in O.A. No. 436 of 2023 on the file of the Hon’ble Central 2 Administrative Tribunal, Hyderabad Bench and quash the illegal, arbitrary, contrary to law and unconstitutional and pass IA NO: 1 OF 2025 Petition under Section 151 CPC praying that in the circumstances stated in the affidavit filed in support of the petition, the High Court may be pleased to dispense with from filing of certified copy of order dated 05.04.2024 passed by the Hon'ble C.A.T., Hyderabad bench in O.A. No. 436 of 2023 in the above writ petition and pass IA NO: 2 OF 2025 Petition under Section 151 CPC praying that in the circumstances stated in the affidavit filed in support of the petition, the High Court may be pleased to suspend the Order dated 05.04.2024 in O.A. No. 436 of 2023 on the file of the Hon’ble Central Administrative Tribunal, Hyderabad Bench and to pass Counsel for the Petitioner(S): 1. Pasala Ponna Rao, Deputy Solicitor General of India Counsel for the Respondent: 1. ANITA SWAIN 3 The Court made the following Order: (Per Hon’ble Sri Justice Subhendu Samanta) Instant Writ Petition is preferred against the order dated 05.04.2024 in O.A.No.436 of 2023 on the file of the Hon’ble Central Administrative Tribunal, Hyderabad Bench (for short referred as ‘Hon’ble Tribunal’ hereinafter) 2. Brief fact of the matter is that the respondent is a retired employee of Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, Tamilnadu in Fast Bredder Test Reactor. He is in regular medication with cardiac care initially in Apollo Chennai and then in Care Hospital, Ramnagar, Visakhapatnam. On 05.04.2023 he got chest pain and his family members admitted him in Apollo Hospitals, Health City, Visakhapatnam for treatment. He got discharged therefrom on 10.04.2023. He placed his medical bill for reimbursement before the petitioner authority amounting to Rs.2,65,424.40 ps. His bill claim was rejected by the petitioner authority on the ground that ‘for non-submission of emergency certificate’. He again submitted the bill with requisite certificate and also submitted reasons for getting treatment in non- empanelled hospital. The petitioner authority second time also rejected the claim on the ground that as per the request of the applicant for In-Patient referral letter for Coronary Angiogram (CAG) from the Care Hospital, Visakhapatnam Dr.G.S.R.Murthy, prescribed for CAG and Percutaneous Transluminal Coronary Angioplasty (PTCA) in the same Care Hospital but the applicant not followed doctor advise but after CAG procedure, he got discharged and again admitted in Apollo on 05.04.2023; another ground for 4 rejection in the Care Hospital (empanelled) is nearer to the house of the applicant than Apollo Hospitals. 3. Aggrieved by the decision of the petitioner authority, the applicant/respondent approached the Hon’ble Tribunal in O.A.No.21 of 2023 seeking relief as follows: “To declare the action of the respondent No.3 in rejecting the genuine medical claim of applicant vide No.BARC(V)/CHSS- 1044/2017/210, dated 19.04.2023 and vide order No.BARC(V)CHSS-1044/2017/329, dated 02.06.2023 to grant the medical expenses of Rs.2,65,424.40/- (Rupees Two Lakhs Sixty Five Thousand Four Hundred Twenty Four and Forty Paise Only) incurred by him for the surgery operated for heart on the ground that since the applicant has not intimated the same to the respondents within four days of admission in non-panel hospital as illegal, arbitrary and violation of Constitution as well as a statutory obligation and Articles 14,21 and 47 of the Constitution of India, and the Rules issued under the proviso to Article 309, and quash the rejection order of respondent No.3 No.BARC(V)/CHSS-1044/2017/210, dated 19.04.2023 and vide order No.BARC(V)CHSS-1044/2017/329, dated 02.06.2023 and consequently direct the respondents to pay full medical expenditure incurred by him i.e., Rs.2,65,424.40/- with 18% interest within a reasonable time fixed by this Tribunal and pass such other order and further orders as this Tribunal may deem fit, just and proper in the interest of justice.” 4. The Hon’ble Administrative Tribunal, after hearing the parties, allowed the O.A by quashing the rejection order issued by the petitioner authority and directed them to reimburse the full claim of the applicant amounting to 5 Rs.2,65,424.40/-. Challenging the said order, the instant writ petition has been preferred by the Central Government Authority. 5. Heard the learned counsel for the parties at length. Perused the observation of the Hon’ble Tribunal. 6. It is admitted fact that the respondent is a retired scientific officer Kalpakkam, of Appellant authority, who was a registered Contributory Health Services Scheme (CHSS) beneficiary for life time initially at Kalpakkam and later transferred his membership of Contributory Health Services Scheme (CHSS) facility to Bhabha Atomic Research Centre, Visakhapatnam with effect from 05.01.2018. Since then he is availing medical facilities through various multi and super-speciality hospitals in Visakhapatnam. According to the said scheme, the medical facilities are provided to all the beneficiaries either in service or retired, on credit basis as per Central Government Health Services (CGHS)-2014 rates. It is also admitted fact that while the applicant was in Chennai, during his service, he underwent few cardiac procedures in Apollo, Chennai. 7. It is also admitted fact that Apollo Hospital, Visakhapatnam is a non- empanelled hospital whereas the Care Hospital, Visakhapatnam is an empanelled hospital under CGHS. It further appears from the record that there was 100% block in Ostial LCX (Left Circumflex Artery) of the applicant/respondent. 6 8. Learned counsel for the appellant submits that concerned medical officer of Care Hospital, Visakhapatnam has prescribed the applicant for CAG and PTCA procedure. The applicant was admitted on 24.03.2023 and underwent procedure for CAG only at Care Hospital but he did not undergo PTCA from Care Hospital, Visakhapatnam, inspite of the fact that CAG report revealed there was 100% block in Ostial LCX of the applicant. He submits that the petitioner authority is justifiably rejected the medical reimbursement claim of the applicant as he treated in non-empanelled hospital and also not informed or reported the emergency treatment within four days of his admission in non-empanelled hospital. 9. I have perused the impugned order passed by the Hon’ble Tribunal, the Hon’ble Tribunal has particularly gone through respective pleadings and arguments of the parties, Hon’ble Tribunal also referred the OM issued on 15.07.2014 gives relaxation of procedure to be followed in considering requests for medical reimbursement claims wherein there are medical relaxation regarding treatment in non-empanelled hospitals in emergency. Hon’ble Tribunal has also no doubt that the OM issued on 27.05.2015 by the Ministry of Health and Family Welfare was also extended the period of submission of claim bills from three months to six months. Hon’ble Tribunal is of the opinion that report to the emergency treatment by an employee within four days is non-practical. 7 10. Similar issue has arisen before the Hon’ble Apex Court in Shiva Kant Jha vs. Union of India reported in (2018) 16 Supreme Court Cases 187 wherein, the Hon’ble Apex Court has held at paragraph 16 and 17 as follows: 16. With a view to provide the medical facility to the retired/serving CGHS beneficiaries, the government has empanelled a large number of hospitals on CGHS panel, however, the rates charged for such facility shall be only at the CGHS rates and, hence, the same are paid as per the procedure. Though the respondent- State has pleaded that the CGHS has to deal with large number of such retired beneficiaries and if the petitioner is compensated beyond the policy, it would have large scale ramification as none would follow the procedure to approach the empanelled hospitals and would rather choose private hospital as per their own free will. It cannot be ignored that such private hospitals raise exorbitant bills subjecting the patient to various tests, procedures and treatment which may not be necessary at all times. 17. 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 8 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 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. 11. Again the Hon’ble Apex Court has dealt with the similar issue in Surjit Singh vs. State of Punjab reported in (1996) 2 Supreme Court Cases 336 wherein it is held that “Self-preservation of one’s life is the necessary concomitant of the right to life enshrined in Article 21 of the Constitution of India, fundamental in nature, sacred, precious and inviolable. The importance and validity of the duty and right to self-preservation has a species in the right of self-defence in criminal law. Centuries ago thinkers of India conceived of such right and recognized it.” 12. Following the observation of the Hon’ble Apex Court, it appears that claim of medical reimbursement by the petitioner under particular scheme of Central Government Health Scheme by a retired employee is one of fundamental right of security of his life which can well defined under Article 21 of the Constitution of India. The State being a model employer cannot deprive the fundamental right of his employee who served for him during his entire service period and also adopted the policy of Central Government Health 9 Scheme (CGHS); denying medical reimbursement to the applicant/respondent itself violating to the principle of Article 21 of the Constitution of India. Moreover, it further appears that the claim of the applicant is not at all exorbitant one and there are no finding or material with the petitioner authority to disentitle the respondent’s medical reimbursement claim. 13. In our view, reasons, as categorically pointed out by the Hon’ble Tribunal for allowing the O.A., appear to be justified. This Court has categorically perused the relevant rules of CHSS scheme along with OM issued by the concerned Ministry of Health and Family Welfare, dated 15.07.2014 and 27.05.2015. We are of the clear view that Hon’ble Tribunal has decided the issue placed him logically, reasonably and in judicious manner. 14. High Court exercise judicial review over the Tribunals under Articles 226 and 227 of the Constitution of India and generally interfered by issuing prerogative writ only if, the order passed by the Hon’ble Tribunal is without jurisdiction or based on an erroneous interpretation of law appears on the face of the record, or violates the principles of natural justice. In this particular case, after thorough scrutiny of the impugned order, on the attending facts and circumstances of the case, we find there are no error apparent in the face of the order itself; the impugned order is very much speaking order and the Hon’ble Tribunal has assigned reasons for passing the order. We are of a clear view that the order suffers no perversity thereby requires no interference. 10 15. Under above circumstances, instant Writ Petition appears to be devoid of merit and consequently, the same is hereby dismissed. There shall be no order as to costs. As a sequel, pending miscellaneous applications, if any, shall stand closed. ________________________ JUSTICE BATTU DEVANAND ____________________________ JUSTICE SUBHENDU SAMANTA Date: 06.03.2026 SPP 11 HON’BLE SRI JUSTICE BATTU DEVANAND AND HON’BLE SRI JUSTICE SUBHENDU SAMANTA W.P.No.8583 of 2025 (per Hon’ble Sri Justice Subhendu Samanta) Dated 06.03.2026 SPP