Original Application No. 90 of 2009. Case: 1. K. Sarala Devi, Assistant Accounts Officer (Retd.), Thiruvananthapuram, 2. Employees Provident Fund Pensioners' Association, Represented by its Secretary, C. V. Gopinathan Nair, Kesavadasapuram, Thiruvananthapuram Vs 1. Union of India, Represented by its Secretary, Ministry of Labour, New Delhi 2. Central Board of Trustees, Employees Provident Fund Organization, Represented by its Chairman, New Delhi, 3. Central Provident Fund Commissioner, New Delhi, 4. Regional Provident Fund Commissioner, Pattom, Thiruvananthapuram, 5. Secretary, Ministry of Health and Family Welfare, New Delhi. Central Administrative Tribunal
| Case Number | Original Application No. 90 of 2009 |
| Counsel | C. S. G. Nair, N. N. Sugunapalan, S. Sujin, M. V. S. Nampoothiry |
| Judges | George Paracken (Judicial Member) & K. George Joseph (Administrative Member), JJ. |
| Issue | Service Law |
| Judgement Date | July 15, 2010 |
| Court | Central Administrative Tribunal |
Judgment:
K. George Joseph (Administrative Member), (Ernakulam Bench)
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The 1st applicant in this O.A. is a retired Assistant Accounts Officer of the Employees Provident Fund Organization (EPFO). The 2nd applicant is an Association of EPFO Pensioners. For the retired employees of EPFO, a fixed medical allowance of Rs. 600/- per month is granted for outdoor treatment. For indoor treatment they are given medical reimbursement under the Central Services (Medical Attendance) Rules, 1944 since 24.10.2006. The 1st applicant is aggrieved by the denial of the claim of medical expenses of Rs. 19898/- for the treatment of her husband at Aravind Eye Hospital, Madurai from 27.08.2008 to 01.09.2008 on the ground that as a Kerala State pensioner, he is in receipt of Rs. 100/- Fixed Medical Allowance (FMA). The 1st applicant mainly seeks a direction to the respondents to reimburse the medical claim of Rs. 19898/-.
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The 1st applicant submits that she is entitled for reimbursement of medical expenses for in-patient treatment of her husband who is getting Rs. 100/- FMA. She relies on the order of C.A.T., Chandigarh Bench, in O.A. No. 763/CH of 1998. In respect of EPFO pensioners, the husband and wife who are drawing FMA are allowed reimbursement under CS (MA) Rules. There was no discrimination with regard to receipt of FMA when mediclaim policy was in force prior to 24.10.2006. There is no such restriction as in Annexure A-6 in respect of spouses of other Central Government pensioners who are getting CGHS benefits.
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The respondents contested the O.A. They submitted that the rules and guidelines contained in CS (MA) Rules, 1944, have to be followed while processing the claim for medical reimbursement. The O.M. No. S.28013/8/98- MS dated 26.05.2000 issued by the Government of India, Department of health, stipulates that the Central Government employees will not lay claim for medical claims/facilities admissible to their spouses if such spouses are in receipt of some/fixed medical allowance. In the case of an employee whose spouse also an employee of the Government, he/she will be required to give an undertaking that his/her spouse is not availing medical facilities/FMA, if any, granted by the Government. The 1st applicant cannot draw the benefit of her spouse receiving FMA as well as reimbursement under CS (MA) Rules, 1944. There are category-wise ceiling for reimbursement of medical expenses under the mediclaim policy, when it was in force. The...
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