YASHVANTSINH N JADEJA vs All India Radio on 14 October 2026

ORDER

Per: Hon’ble Shri Sanjiv Kumar, Member (A)

1. Applicants have filed the present OA, under Section 19 of the Administrative Tribunals Act, 1985, seeking the following reliefs: “A. The Hon’ble Tribunal may be pleased to admit and allow the present application. B. The Hon’ble Tribunal may be pleased to quash and set- aside the decision vide No. D-12019/28/2014-WL/73 dated February 24, 2014 (24.02.2014). Mp/ D-1209/28/2014-WL/517 dated October 16, 2014 (16.10.2014) and No. D-12019 D- 12019/28/2014-WL/76 dated February 19, 2016 (19.02.2016) rejecting the claim of re-imbursement of medical claim (annexed as Annexure A/1, A/2 and A/3 respectively), further directing the Respondent(s) to sanction the payment of medical Bills submitted on the grounds as mentioned therein and be directed to pay the amount of Medical Bill of Rs. 3,22,088/- (Three Lakhs Twenty-Two Thousand Eighty-Eight Rupees Only) with interest at the rate of 12% from the date Bills are submitted till the amount is paid. C. The Hon’ble Tribunal may be pleased to declare and direct that the clarification of the rule in terms of Office Memo No.S11015/10/2011-CGHS (P) dated 19-07-2011 at Annexure- A/8 does not govern the case of the Applicant. D. The Hon’ble Tribunal may be pleased to hold and declare that clarification of rule in terms of Office Memo No. S 11015/10/2011-CGHS (P) dated July 19,2011 (19.07.2011) be declared as ultavires and be quashed. E. Any other reliefs or relief which may be deemed to be fit in the interest of justice; be awarded to the Applicant.

2. Brief facts of the case as stated by the applicants are as under: - 2.1 The applicants are the sons of Late Smt. Hansaben N. Jadeja. Applicant No.1 was serving under All India Radio, Rajkot. Late Smt. Hansaben N. Jadeja was the mother of Applicant No.1 and was claimed to be dependent upon him for the purpose of medical facilities. 2.2 Late Smt. Hansaben N. Jadeja was a pensioner and was drawing family pension of Rs.3,500/- per month plus Dearness Relief pursuant P ANUKUMA

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to the revised PPO dated 15.12.2012. The father of the applicants, Shri Nirubha Jadeja, had died on 13.07.1992. 2.3 During the year 2013, Late Smt. Hansaben N. Jadeja underwent medical treatment. She was treated at Ratanam Hospital, Rajkot from 19.07.2013 to 04.08.2013 in an emergency situation and thereafter at Laprosurge Hospital, Rajkot from 13.09.2013 to 23.09.2013. She died on 23.09.2013 during the course of treatment. 2.4 The applicants submitted medical reimbursement bills to the respondent authorities. The total claim was stated to be Rs.3,22,088/-. The claim was initially rejected by the respondents on the ground that the income of the deceased pensioner exceeded the prescribed dependency limit. 2.5 The first rejection was made in light of the directions contained in Office Memorandum dated 19.07.2011 issued by the Ministry of Health & Family Welfare, according to which the income limit for dependency was said to be less than Rs.3,500/- per month, i.e. up to Rs.3,499/- per month, plus Dearness Relief. Since Late Smt. Hansaben N. Jadeja was drawing family pension of Rs.3,500/- plus Dearness Relief, the respondents considered her to be outside the definition of a dependent family member. 2.6 Aggrieved by the rejection, the applicants approached this Tribunal by filing OA No.346 of 2015. The said OA was disposed of by this Tribunal on 24.11.2015 and considered the interpretation placed by the respondents upon the expression “dependency” and the income limit of Rs.3,500/-. 2.7 The relevant observation of the Tribunal, as reproduced in the present OA, was that the words “dependency” and “limit of income” had been understood wrongly by treating Rs.3,500/- as Rs.3,499/-. The Tribunal observed that the provision was a beneficial clause and that the emphasis ought to be on welfare rather than technicalities. It was accordingly held that where the pension being drawn by the person was Rs.3,500/-, the person would remain within the prescribed limit. The matter was thereafter remanded to the authorities to decide the P ANUKUMA

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claim with regard to the other parameters for grant of medical reimbursement. 2.8 The order dated 24.11.2015 also granted liberty to the applicants to approach the Tribunal again if they had any grievance against the subsequent action of the respondents, without being burdened by the principle of res judicata. 2.9 Pursuant to the aforesaid order, the respondents passed a speaking order dated 19.02.2016. 2.10 The respondents recorded that the deceased was a pensioner drawing a monthly pension of Rs.3,500/-. They further noticed that Rajkot was not covered by CGHS and that a Fixed Medical Allowance of Rs.300/- was being paid to pensioners residing in such areas. The speaking order thereafter proceeded to rely upon the fact that the deceased was receiving Fixed Medical Allowance and observed that, on that basis, she could not be treated as dependent upon Applicant No.1. 2.11 The respondents further relied upon the Office Memorandum dated 19.07.2011 relating to the income limit for dependency and reiterated that the income of the deceased, being Rs.3,500/- per month plus Dearness Relief, did not satisfy the requirement as understood by the department. 2.12 The applicants thereafter initiated contempt proceedings alleging non- compliance with the order dated 24.11.2015 passed in OA No.346 of 2015. The contempt petition, being C.P. No.14 of 2016 in OA No.346 of 2015, was ultimately disposed of on 22.02.2021. Hence, the applicants have filed the present OA challenging the speaking order dated 19.02.2016 and seeking reimbursement of the medical expenses.

3. Submissions of Learned Counsel for the Applicants: 3.1 Learned counsel for the applicants submits that the issue relating to the interpretation of the income limit of Rs.3,500/- had already been considered and decided by this Tribunal vide order dated 24.11.2015 wherein it has been specifically held that a pensioner drawing P ANUKUMA

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Rs.3,500/- would fall within the prescribed limit and the interpretation treating the limit as Rs.3,499/- was incorrect. 3.2 Learned counsel submits that despite the said categorical finding, the respondents again relied upon the same Office Memorandum and the same interpretation while passing the speaking order dated 19.02.2016. 3.3 Learned counsel further submits that the receipt of Fixed Medical Allowance of Rs.300/- cannot extinguish the entitlement to reimbursement of hospitalization expenses. In support of the contention, learned counsel placed reliance upon the decision of the Jodhpur Bench of this Tribunal in OA No.207/2013, Vinod Kumar Bohra vs Union of India, decided on 11.02.2014, in OA No. 280/2013, Smt. Geeta Devi Vs Union of India and in OA No. 290/00421/2016, Gyan Chand Vs Union of India. 3.4 It is submitted that in the said decision, the Tribunal had distinguished the Fixed Medical Allowance from hospitalization expenses and had held that the allowance was meant for day-to-day medical expenses which did not require hospitalization. The applicants have relied upon the said decision to contend that receipt of Fixed Medical Allowance cannot be treated as an absolute bar against reimbursement of hospitalization expenses. 3.5 Learned counsel further submits that the deceased was a pensioner residing in a non-CGHS area and the medical treatment was undertaken in emergency circumstances. Therefore, the claim ought not to have been rejected merely on the technical ground of the interpretation of the income limit. 3.6 It is also contended that the clarification dated 19.07.2011 cannot override the substantive scheme and cannot be interpreted in a manner which defeats the beneficial object of extending medical facilities to eligible dependent family members. Learned counsel therefore prays that the impugned orders be quashed and set aside and that the respondents be directed to reimburse the medical expenses of P ANUKUMA

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Rs.3,22,088/- with interest @ 12% per annum from the date of submission of the bills till actual payment.

4. Submissions of Learned Counsel for the Respondents 4.1 Per contra, the respondents have filed their reply and denied the claim of the applicants. 4.2 It is submitted that Late Smt. Hansaben N. Jadeja was drawing family pension of Rs.3,500/- per month plus Dearness Relief. The respondents further submit that she was also receiving Fixed Medical Allowance. The fact of receipt of Fixed Medical Allowance was not properly disclosed by the applicants and is evident from the relevant pension/payment records. Therefore, the question of treating the deceased as a dependent for the purpose of the applicants’ medical claim does not arise. 4.3 Learned counsel further submits that the earlier order dated 24.11.2015 did not direct automatic reimbursement of the medical bills. According to the respondents, the Tribunal had only remanded the matter to the competent authority to examine the claim with reference to the other parameters governing medical reimbursement. In compliance with the said order, the Directorate General, All India Radio considered the matter and passed a speaking order dated 19.02.2016. Therefore, there was no disobedience of the order of the Tribunal. The respondents further submit that the applicants’ contempt proceedings were also dropped by order dated 22.02.2021, and therefore no cause of action survives against the respondents.

5. The applicants have filed a rejoinder and reiterated the submissions made in the OA.

6. Heard learned counsel for the parties and perused the material available on record.

7. The principal issue that arises for consideration in the present OA is whether the respondents were justified in rejecting the medical reimbursement claim of the applicants amounting to Rs.3,22,088/- incurred towards the treatment of Late Smt. Hansaben N. Jadeja, mother of the applicants, on the grounds that she was drawing a P ANUKUMA

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family pension of Rs.3,500/- per month plus Dearness Relief and was receiving Fixed Medical Allowance of Rs.300/- per month.

8. It is an admitted position that this Tribunal, vide order dated 24.11.2015 passed in OA No.346 of 2015, had already considered the interpretation adopted by the respondents regarding the prescribed income limit for dependency. The Tribunal observed that the income ceiling of Rs.3,500/- could not be interpreted as Rs.3,499/- and that the provision, being beneficial in nature, required an interpretation consistent with its welfare objective. The matter was accordingly remitted to the competent authority for consideration of the claim in the light of the other applicable parameters.

9. In view of the aforesaid order, the respondents were required to reconsider the claim in its proper perspective and in accordance with the observations made by this Tribunal. However, while passing the impugned speaking order dated 19.02.2016, the respondents again relied upon the pension income of the deceased and her receipt of Fixed Medical Allowance to deny the claim. In our considered view, the respondents could not have rejected the claim merely by reiterating the interpretation of the income limit which had already been disapproved by this Tribunal. Such an approach defeats the very purpose of the earlier order and reflects a failure to give due effect to the findings recorded therein. The respondents’ plea that, on the closure of the contempt proceedings, no cause of action survives also cannot be accepted. Contempt proceedings are concerned only with wilful disobedience; their closure is not an adjudication on the legality of the speaking order dated 19.02.2016, and the order dated 24.11.2015 expressly reserved liberty to the applicants to challenge any fresh order.

10. As regards the receipt of Fixed Medical Allowance, we find merit in the contention of the learned counsel for the applicants that the said allowance, by itself, cannot be treated as an absolute bar against reimbursement of hospitalization expenses. Fixed Medical Allowance is intended to meet routine medical expenses of eligible pensioners P ANUKUMA

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residing in areas not covered by CGHS. The admissibility of hospitalization expenses, however, has to be examined in accordance with the applicable rules and the circumstances of treatment.

11. We also take note of the fact that Late Smt. Hansaben N. Jadeja underwent treatment at Ratanam Hospital, Rajkot, from 19.07.2013 to 04.08.2013 and thereafter at Laprosurge Hospital, Rajkot, from 13.09.2013 to 23.09.2013, where she died during treatment. The applicants have asserted that the treatment was undertaken in emergency circumstances. The medical reimbursement claim was required to be examined with due regard to the nature of the treatment, the circumstances necessitating hospitalization and the applicable rules governing reimbursement of medical expenses. A rejection founded primarily upon the pension amount and the receipt of Fixed Medical Allowance, without proper consideration of the relevant aspects of the claim, cannot be sustained.

12. The applicants have also placed reliance upon the decisions of this Tribunal in Vinod Kumar Bohra v. Union of India, OA No.207/2013, decided on 11.02.2014, Smt. Geeta Devi v. Union of India, OA No.280/2013, and Gyan Chand v. Union of India, OA No.290/00421/2016, in support of their contention that receipt of Fixed Medical Allowance should not automatically disentitle a pensioner or an eligible dependent from reimbursement of admissible hospitalization expenses. The respondents were required to consider the claim in the light of the applicable rules and the principles emerging from the relevant judicial decisions. 12.1 At this stage, it is important to refer to the judgment passed by Jodhpur Bench of this Tribunal in the case of Vinod Kumar Bohra(Supra). The relevant portion reads as under: -

“Para 15

It is also clear from the OM No.45/57/97-P&PW (C) dated 19th December, 1997 that the fixed Medical Monthly Allowance is given for meeting expenditure on day-to-day medical expenses that do not require hospitalization. In this case, the applicant is claiming expenditure on account of treatment at MDM Hospital regarding heart ailment, therefore, it cannot be said that no other claim P ANUKUMA

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besides the Fixed Medical Allowance of Rs.300/- per month is admissible to the applicant and this case hospitalization also. Para 16. Therefore, in my considered view in the light of OM dated 05.06.1998, which has been sent by the respondent themselves to the applicant as at Annexure-A/3 and by which the CS (MA) Rules have been directed to be extended to retired Government officials and the same has been upheld to hold the field as per judgment of the Hon ble High Court of Gujarat at Ahmedabad in Special Civil Application No.7895/2004 and also in the light of the judgment of the Hon ble High Court of Karntaka at Bangalore in Writ Petition No.39031/2003 wherein rule regarding non-applicability of CS (MA) Rules, 1944 to retired Government servants has been declared unconstitutional, and in the spirit of judgment of the Hon ble Delhi High Court in Civil Writ Petition No.4873/2000 that discrimination cannot be made on the basis of the pensioners residing in CGHS area or non-CGHS area, the applicant is entitled to reimbursement of his medical claims for expenditure in a hospitalization case. Accordingly, the respondents are directed to consider the claim of the applicant for reimbursement of medical expenditure for treatment in the Government Hospital (as at Annexure-A/4) and decide the same within a period of four months from the date of receipt of a copy of this order.”

13. We are, therefore, of the considered view that the impugned rejection of the medical reimbursement claim is not sustainable in law. The respondents have failed to show that the claim was examined in the light of the earlier order of this Tribunal and the applicable provisions governing medical reimbursement. In view of this, it is not necessary to examine the challenge to the OM dated 19.07.2011 (reliefs C and D), since the question of the income limit already stands decided between the parties by the order dated 24.11.2015.

14. In the facts and circumstances of the case, we find merit in the OA. The applicants have established sufficient grounds. However, the precise amount admissible towards medical reimbursement is required to be determined by the competent authority after verification of the medical bills and relevant records. The claim for interest shall also be considered in accordance with the applicable rules and law.

15. In view of the facts on record applicable rules/regulations cited above:

(i) The impugned orders dated 24.02.2014 (Annexure A/1), 16.10.2014 (Annexure A/2) and 19.02.2016(Annexure A/3), rejecting the medical reimbursement claim of the applicants are hereby quashed and set aside. P ANUKUMA

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(ii) The respondents are directed to examine and determine the medical reimbursement claim of the applicants amounting to Rs.3,22,088/- incurred towards the treatment of Late Smt. Hansaben N. Jadeja, in accordance with the applicable rules and release the admissible amount to the applicants within a period of three months from the date of receipt of copy of this order failing which interest will be payable at the rate of GPF for the year 2026-27.

16. There shall be no order as to costs.

17. MA pending, if any, also stands disposed of.

(Sanjiv Kumar)

(Jayesh V Bhairavia)

Member (A)

Member (J)

//Anu// P ANUKUMA