V Prasada Rao vs BHARAT SANCHAR NIGAM LIMITED on 16 October 2026

ORAL ORDER

(As per Hon’ble Mr. Manish Garg, Judicial Member)

By this O.A., the applicant is seeking the following relief: “....to declare the inaction of the respondents in settling the Medical Reimbursement Claim of the applicant for Indoor Treatment for Rs.5,65,586/- (Rupees Five Lakhs Sixty Five Thousand Five Eighty Six only) as illegal, arbitrary and violative of Article 14 and 16 of the Constitution of India and law of the land and consequently direct the respondents to release the Medical Reimbursement Claim of the applicant forthwith with an interest @ of 12% PA, and be pleased to pass such other order or orders as this Hon'ble Tribunal may deem fit and proper in the circumstances of the case.”

2. Highlighting the facts of the case, counsel for the applicant submits that the applicant joined the Department of Telecommunications as Telephone Operator on 30.07.1974, was promoted as Repeated Station Assistant, Junior Engineer, Sub- Divisional Engineer and Assistant General Manager in 1980, 1982, 1998 & 2009, respectively. He retired as Assistant General Manager on 31.05.2015 at Hyderabad. In December, 2021, the applicant was diagnosed with Covid-19 and was admitted, on an emergency basis, as an indoor patient at Dr. Rela Institute and Medical Care Centre, Chennai, from 12.12.2021 to 27.12.2021. The applicant submitted the relevant bills, reports, etc., vide letter, dt. 14.02.2022. The Respondents sought some more documents, which were submitted by the applicant, vide letter, dt.05.07.2022. However, the Respondents, vide letter, dt.27.10.2022, expressed their inability to process the applicant’s claim due to non-submission of original certificates/ vouchers for the claim of ₹5,65,586/-. Despite the applicant’s representation(s), dt.17.05.2024 & 15.07.2024, the claim of the applicant was not reimbursed. Hence, the O.A.

3. Respondents have filed a reply contending therein that the non-empanelled medical bills submitted by the applicant, vide letter(s), dt. 18.02.2022 & 05.07.2022, were unsubstantiated, i.e., the original cash receipts/ vouchers for the amount of ₹5,65,586/- were not enclosed. Another contention has been raised by the counsel for the Respondents that the applicant was admitted under the medical insurance of

MINHAJUL HAQUE

MEDIASSIT INSURANCE TPA PVT LTD & the medical claims were addressed to VIDAL HEALTH, TPA, Chennai, rather than the concerned employee.

4. In rejoinder to the arguments put forth by the counsel for the Respondents, counsel for the applicant has drawn attention to the applicant’s representation, dt. 15.07.2024, which reads as under: Kindly refer to the letters cited above, wherein I requested the reimbursement of my indoor medical bill dated 14-02-2022. The amount still needs to be reimbursed. I am 72, with many health problems like Hypertension, diabetes and issues related to my heart. I am also suffering financially as the amount still needs to be reimbursed. I am unable to meet day-to-day medical expenditures. Hence I once again request you Sir to kindly arrange the payment of the same at an early date, as l am very much dependent on the amount at this age of 72 years with many ailments of myself and my wife and day-to-day requirements.

5. Having heard learned counsels for the parties and perused the records of the case, we are of the view that the matter can be disposed of, by directing the Respondents to expedite the claim of the applicant either directly verifying the bills vouchers from the hospital itself or for the fact of the matter that his bills have already been processed in furtherance of the communication from the hospital to the VIDAL HEALTH, TPA, Chennai and not the employee.

6. Conclusion: It can be safely assumed that the claim has to be settled either directly by reimbursing to the hospital or through the concerned TPA, for which, only verification of vouchers is required. We make it clear that Respondents can very well verify the claim as the same are processed directly through hospital to the VIDAL HEALTH TPA, and as per the existing policy, there is no embargo that the claims cannot be verified by the Respondents of their own to the extent of admissible amount not paid to the applicant by the Insurance company. Further, in view of judgment rendered by the Hon’ble Apex Court in the matter of Shiva Kant Jha vs Union Of India on 13 April,

MINHAJUL HAQUE

2018 that the claim of medical reimbursement has to be settled and is a statutory right accorded to the applicant, which cannot be denied, and limitation vis a vis technical pleas should not come in way of settlement of claims which are discretionary in nature.

7. The aforesaid exercise may be carried out within a period of two months failing which, the applicant shall also be entitled to interest at GPF rates on the amount so arrived at while settling the bills, for the delayed period after the expiry of the above stipulated period. Accordingly, the O.A. is disposed of, in the above terms. All pending Miscellaneous Applications, if any, shall also stand disposed of. No order as to costs.

(VARUN SINDHU KUL KAUMUDI) (MANISH GARG) ADMINISTRATIVE MEMBER

JUDICIAL MEMBER

/mh/

O.A. is disposed of on

: 16.10.2026 Order dictated on

: 16.10.2026 Submitted for approval on : 22.10.2026

MINHAJUL HAQUE