WP/34080/2023 of THE DIRECTOR Vs THE REGISTRAR on 9 October 2026

O R D E R

(Order of the Court was made by M.Dhandapani J.) The present writ petition has been filed challenging the order dated 19.09.2023 passed by the Central Administrative Tribunal, Chennai Bench, in O.A.No.757 of 2022, whereby the Tribunal allowed the Original Application filed by the second respondent and directed reimbursement of the balance medical expenses.

2. The learned counsel appearing for the petitioners would submit that the second respondent joined service on 26.11.1982 and, after rendering 37 years of service, retired on attaining the age of superannuation on 31.03.2018. The second respondent was a beneficiary under the Central Government Health Scheme.

3. It is submitted that the second respondent was diagnosed with Right Frontal Intracranial Space-Occupying Lesion (ICSOL), for which craniotomy and excision of the tumour under general anaesthesia were prescribed by Velammal Medical College Hospital, Madurai. The second respondent was referred to the said hospital by the petitioners’ Medical Officer vide referral letter dated 27.11.2021 for treatment as a pensioner.

4. The total medical expenditure incurred by the second respondent amounted to Rs.1,74,990/-, out of which a sum of Rs.64,689/- was reimbursed. As the balance amount of Rs.1,10,301/- remained unpaid, the second respondent submitted a representation seeking reimbursement of the same. However, the claim was rejected by the proceedings dated 21.07.2022. Aggrieved by the said rejection, the second respondent filed O.A.No.757 of 2022 before the Central Administrative Tribunal. The Tribunal, by order dated 19.09.2023, allowed the Original Application. Challenging the said order, the present writ petition has been filed.

5. The learned counsel appearing for the petitioners would contend that the claim for medical reimbursement is governed by the rates prescribed under the Government Memorandum dated 23.02.2017, in consonance with the Central Government Health Scheme. It is further contended that, though the second respondent had undergone treatment for 21 days in a non-empanelled hospital, reimbursement was permissible only for the prescribed period of seven days and that the claim beyond the said period was not admissible under the applicable norms.

6. It is also contended that the Tribunal erred in applying the principles laid down by the Hon’ble Supreme Court in Shiva Kant Jha v. Union of India, reported in (2018) 16 SCC 187, to the facts of the present case, as the said decision was rendered in the context of the particular circumstances obtaining therein. According to the learned counsel, each claim for medical reimbursement has to be considered on its own facts and in accordance with the applicable rules and guidelines.

7. During the pendency of the writ petition, the second respondent died, and the third respondent was impleaded as his legal representative to represent his estate.

8. This Court has considered the submissions made by the learned counsel appearing for the petitioners and perused the materials available on record.

9. The materials placed before the Tribunal disclose that the second respondent, a retired pensioner, was referred by the petitioners’ Medical Officer to Velammal Medical College Hospital, Madurai, for treatment of a serious medical condition requiring neurosurgical intervention. The treatment was undertaken pursuant to the said referral, and the medical expenses incurred were supported by the relevant medical records and bills.

10. The principal contention of the petitioners is that reimbursement is restricted by the prescribed CGHS rates and that the claim beyond the permissible period is inadmissible. However, such a contention cannot be considered in isolation, without taking into account the circumstances necessitating the treatment and the principles laid down by the Hon’ble Supreme Court in Shiva Kant Jha v. Union of India, reported in (2018) 16 SCC 187.

11. The Hon’ble Supreme Court has emphasised that a genuine claim for medical reimbursement cannot be rejected on technical grounds once the factum of treatment is established. The claim has to be considered in the light of the circumstances of the case, particularly where the treatment was undertaken pursuant to a referral by the competent medical authority and the expenditure is supported by the relevant medical records.

12. In the present case, the Tribunal considered the circumstances under which the second respondent underwent treatment and applied the principles laid down by the Hon’ble Supreme Court. Having regard to the nature of the ailment, the neurosurgical procedure undertaken and the referral issued by the petitioners’ Medical Officer, this Court finds no sufficient ground to interfere with the order passed by the Tribunal. Accordingly, the order dated 19.09.2023

passed by the Central Administrative Tribunal, Chennai Bench, in O.A. No.757 of 2022 is confirmed, and the writ petition is dismissed. No costs. Consequently, connected miscellaneous petition, if any, stands closed. (M.D.I.,J.) (A.D.M.C.,J.) 09-10-2026 Index: Yes/No Speaking/Non-speaking order Neutral Citation: Yes/No sts To: The Registrar Central Administrative Tribunal, Chennai

M.DHANDAPANI J. AND DR.A.D.MARIA CLETE J. sts Order made in W.P.No.34080 of 2023 Dated: 09-10-2026