{"id":52364,"date":"2018-04-16T10:39:06","date_gmt":"2018-04-16T05:09:06","guid":{"rendered":"https:\/\/www.legalindia.com\/news\/?p=52364"},"modified":"2018-04-16T10:39:06","modified_gmt":"2018-04-16T05:09:06","slug":"supreme-court-centre-form-panel-disburse-medical-claim-cghs","status":"publish","type":"post","link":"https:\/\/www.legalindia.com\/news\/supreme-court-centre-form-panel-disburse-medical-claim-cghs","title":{"rendered":"Supreme Court to Centre: Form panel to disburse medical claim under CGHS"},"content":{"rendered":"

\"\"<\/a>In a bid to protect retired public servants from “unnecessary harassment” in claiming reimbursements under the Central Government Health Scheme (CGHS), the Supreme Court has asked the Centre to “expeditiously” set up a high-powered committee to disburse claims in a month.<\/p>\n

A bench of justices R K Agrawal and Ashok Bhushan also directed the Ministry of Health and Family Welfare to form the panel within seven days.<\/p>\n

It would comprise special directorate general, directorate general, two additional directors and one specialist in the field and shall ensure timely and hassle- free disposal of the claims to the pensioners, it directed.<\/p>\n

“With regard to the slow and tardy pace of disposal of Medical Reimbursement Claims (MRC) by the CGHS in case of pensioner beneficiaries and the unnecessary harassment meted out to pensioners who are senior citizens, affecting them mentally, physically and financially, we are of the opinion that all such claims shall be attended by a secretary-level high powered committee in the ministry concerned which shall meet every month for quick disposal of such cases,” the bench said.<\/p>\n

The directions came on a plea of a retired government servant who was denied medical claim under the CGHS in 2014 for his treatment at Fortis Escorts Hospital in Delhi and Jaslok hospital in Mumbai due to the non-empanelment of the hospitals under the scheme.<\/p>\n

The bench, which directed the ministry to give the petitioner Rs 4,99,555 spent by him on his treatment, also observed that the CGHS officials responsible for clearing medical claims took a “very inhuman approach” by denying him the full cost of his treatment.<\/p>\n

“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.<\/p>\n

“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…,” it said.<\/p>\n

It observed that authorities must be responsive and ensure medical care to senior citizens after retirement.<\/p>\n

“The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement. The 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 said.<\/p>\n

The apex court, while directing the ministry to form the panel expeditiously, said there shall be a time-frame for finalisation and disbursement of the claim amounts of pensioners.<\/p>\n

“In this view, we are of the opinion that after submitting the relevant papers for claim by a pensioner, the same shall be reimbursed within a period of one month,” it said.<\/p>\n

The court was hearing the petition filed by Shiva Kant Jha, seeking reimbursement on account of his treatment done in November, 2013 for Rs 9,86,343 for his cardiac ailment involving the implant of CRT-D device and two sets of bill amounting to Rs 3,98,097 for his treatment at Mumbai for cerebral stroke and paralytic attack.<\/p>\n

He had claimed that he was denied the amount of Rs 4.99 lakh out of the entire amount on the ground that he did not seek approval of authorities for the device implant.<\/p>\n

The court, taking note of the facts, said “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.”<\/p>\n

The bench said that the CGHS is responsible for taking care of healthcare needs and well-being of the central government employees and pensioners.<\/p>\n

“In the facts and circumstances of the case, we are of opinion that the 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 state to pay the balance amount of Rs 4,99,555 to the petitioner. We also make it clear that the said decision is confined to this case only,” it said.<\/p>\n","protected":false},"excerpt":{"rendered":"

In a bid to protect retired public servants from “unnecessary harassment” in claiming reimbursements under the Central Government Health Scheme (CGHS), the Supreme Court has asked the Centre to “expeditiously” set up a high-powered committee to disburse claims in a month. A bench of justices R K Agrawal and Ashok Bhushan also directed the Ministry […]<\/p>\n","protected":false},"author":1,"featured_media":52362,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[42330,10385,42328,31987,42331,42332,42329,47726],"class_list":["post-52364","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-top-law-news","tag-ashok-bhushan","tag-cghs","tag-crt-d","tag-featured","tag-medical-reimbursement-claims","tag-mrc","tag-r-k-agrawal","tag-supreme-court"],"yoast_head":"\nSupreme Court to Centre: Form panel to disburse medical claim under CGHS - Legal News India - Supreme Court & High Court Updates<\/title>\n<meta name=\"description\" content=\"In a bid to protect retired public servants from "unnecessary harassment" in claiming reimbursements under the Central Government Health Scheme (CGHS), - Get the latest legal news from the Supreme Court, High Courts, and government. 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The submission was made by the Civil Aviation Ministry before Justice\u2026","rel":"","context":"In "Top Law News"","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2020\/04\/medical-evacuation-flights.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":21731,"url":"https:\/\/www.legalindia.com\/news\/govt-to-pay-employee-for-wifes-death-in-cghs-hospital","url_meta":{"origin":52364,"position":1},"title":"Govt to pay employee for wife’s death in CGHS hospital","author":"Legal India Admin","date":"July 13, 2012","format":false,"excerpt":"The Union government has been ordered by the country\u2019s apex consumer panel to pay Rs 5 lakh as compensation to one of his employees, whose wife had died of excess bleeding in a CGHS hospital soon after giving birth to a child through cesarean section over 13 years ago. \u00a0The\u2026","rel":"","context":"In "Top Law News"","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":40677,"url":"https:\/\/www.legalindia.com\/news\/himachal-pradesh-hc-centrefoot-medical-bills-of-retired-employees","url_meta":{"origin":52364,"position":2},"title":"Himachal Pradesh HC-Centre:Foot medical bills of retired employees","author":"Legal India News","date":"December 31, 2015","format":false,"excerpt":"The Himachal Pradesh High Court has asked the Centre to take care of medical needs of its retired employees, observing that their \"genuine\" medical requirements cannot be permitted to be buried in the labyrinth of red tape. Dismissing an appeal filed by the central government, challenging an order of the\u2026","rel":"","context":"In "Top Law News"","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"Himachal Pradesh HC-Centre:Foot medical bills of retired employees","src":"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2015\/12\/Himachal-hc.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":33933,"url":"https:\/\/www.legalindia.com\/news\/invite-bids-cghs-medicines-brand-hc","url_meta":{"origin":52364,"position":3},"title":"Why invite bids for CGHS medicines by brand: HC","author":"Legal India Admin","date":"June 30, 2014","format":false,"excerpt":"The Delhi High Court has asked the Centre reasons for inviting bids for supply of CGHS medicines from drug manufacturers on the basis of brand names instead of their chemical composition and sought an explanation from the government. \"Why not go by composition,\" a vacation bench of justices Pratibha Rani\u2026","rel":"","context":"In "Top Law News"","block_context":{"text":"Top Law News","link":"https:\/\/www.legalindia.com\/news\/category\/top-law-news"},"img":{"alt_text":"medicines","src":"https:\/\/i0.wp.com\/www.legalindia.in\/news\/wp-content\/uploads\/2014\/06\/medicines.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":57941,"url":"https:\/\/www.legalindia.com\/news\/centre-has-freedom-to-amend-its-cghs-scheme-delhi-high-court","url_meta":{"origin":52364,"position":4},"title":"Centre has freedom to amend its CGHS scheme : Delhi High Court","author":"Legal India Admin","date":"November 6, 2019","format":false,"excerpt":"The Delhi High Court on Tuesday declined to interfere with the modified Central Government Health Services (CGHS) scheme, saying it is for the Centre to decide how to give health benefits and supply medicines to its serving and retired employees. A bench of Chief Justice D N Patel and Justice\u2026","rel":"","context":"In "High Profile Cases"","block_context":{"text":"High Profile Cases","link":"https:\/\/www.legalindia.com\/news\/category\/high-profile-cases"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.legalindia.com\/news\/wp-content\/uploads\/sites\/2\/2019\/11\/CGHS.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":52470,"url":"https:\/\/www.legalindia.com\/news\/pil-high-court-new-tender-empanel-chemists-cghs","url_meta":{"origin":52364,"position":5},"title":"PIL in High Court against new tender to empanel chemists under CGHS","author":"Legal India Admin","date":"April 23, 2018","format":false,"excerpt":"The Delhi High Court has sought the response of the Centre on a PIL challenging an e-tender issued for empanelment of authorised local chemists under the Central Government Health Scheme (CGHS) for the national capital area. 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