State bound to bear medical expenses of employees: CAT Srinagar

The Central Administrative Tribunal (CAT) in Srinagar has directed authorities to reconsider a medical reimbursement claim of nearly Rs 30 lakh filed by a government employee for the treatment of his minor son suffering from a brain tumor.

A Bench of M S Latif, Member (Judicial) issued the direction while deciding a district Budgam resident, Muhammad Ashraf Mir’s plea. In his plea, Mir had assailed Deputy Commissioner Budgam’s order dated October 6, 2023, rejecting his claim for reimbursement.

The Tribunal directed the competent authority to reconsider Mir’s claim, noting that reimbursement could not be denied solely on the ground that the patient had undergone treatment in a specialized hospital not approved by the State.

The Tribunal said this while relying on supreme court judgment titled Shiv Kant Jha versus Union of India, 2018 wherein it has been held that the “ court has to be liberal in medical reimbursement cases and that the reimbursement cannot be denied solely on the ground that the patient has undergone treatment in a specialized hospital not approved by the State”.

Mir’s 10-year-old son was diagnosed with a serious neurological condition—Ependymoma (WHO Grade II)—and was initially examined at SKIMS Soura. Due to the critical nature of the illness, the child was later taken to a specialized hospital in Gurugram, where he underwent surgery.

Mir subsequently submitted medical bills amounting to approximately Rs 30 lakh for reimbursement under the J&K Civil Services (Medical Attendance-cum-Allowance) Rules, 1990. However, the claim was rejected by the district administration.

In its decision, The Tribunal observed that the right to medical reimbursement flows from the fundamental right to life under Article 21 of the Constitution.

“It is also a settled position of law that right to health is integral to right to life and the State has a constitutional obligation to provide health facility to its citizens and even if a government servant or any of his dependent has suffered an ailment, which requires treatment at a specialized and approved hospital, it is otherwise the duty of the State to bear the expenditure incurred by a government servant on the treatment, of course, in accordance with the entitlement and the law governing the field,” the Tribunal said.

It also noted that the authorities had failed to file a response despite multiple opportunities, and stressed that preservation of human life is of paramount importance.

While disposing of the petition, the tribunal directed the competent authority to reassess the claim by verifying the genuineness of treatment, medical bills, and procedures undertaken. It also instructed the petitioner to submit all required documents and cooperate with the process. The Tribunal gave the authorities eight weeks to pass a reasoned order in accordance with the law.