Delhi High Court
Jogeshwar Mahanta vs Union Of India & Ors on 13 January, 2016
Author: Sanjiv Khanna
$~15
*IN THE HIGH COURT OF DELHI AT NEW DELHI
+ W.P.(C) 5981/2014
Date of decision: 13th January, 2016
JOGESHWAR MAHANTA ..... Petitioner
Through Mr. N.S. Dalal and Ms. Ruchika
Sharma, Advocates.
versus
UNION OF INDIA & ORS ..... Respondent
Through Mr. Vikram Jetley, Advocate for UOI.
CORAM:
HON'BLE MR. JUSTICE SANJIV KHANNA
HON'BLE MR. JUSTICE NAJMI WAZIRI
SANJIV KHANNA, J. (ORAL)
Jogeshwar Mahanta, by this writ petition, seeks to challenge the
order dated 30th May, 2014, passed by the Central Administrative
Tribunal, Principal Bench dismissing his Original Application No.563
of 2013. The petitioner had claimed reimbursement of medical
expenditure of Rs.1,38,781/- with interest @ 18% per annum and
damages etc. as he was covered under the Central Government Health
Scheme (CGHS scheme, for short).
2. The impugned order records that the petitioner herein was not
covered under the said scheme on the date when he was hospitalised
and had undergone heart bypass surgery in December, 2009-5th
January, 2010, having become member of the said scheme on 30th
October, 2011.
3. The case of the petitioner before the Tribunal and before us is
that the petitioner was not at fault and could not become member of
the CGHS scheme post retirement as his pension control order was
finalised and issued on 21st June, 2011, though the petitioner had
retired on 30th June, 2007.
4. We may have found merit in the said contention, if it was
correct and true, but are unable to accept the said argument for we
perceive and believe that the said contention is an afterthought and
make believe. The accepted position is that the petitioner had retired
on 30th June, 2007. Thereafter, he did not exercise the option and
subscribe to the CGHS scheme. As per the case of the petitioner, he
suffered heart attack in December, 2009 and was admitted to a private
hospital and, thereafter had undergone bypass surgery in January,
2010 incurring an expenditure of Rs.2,00,000/-. Rs.75,000/- was
reimbursed under a mediclaim policy, leaving a balance of
Rs.1,38,781/-.
5. The petitioner applied for membership under the CGHS scheme
after about 20 months in August, 2011. We have repeatedly asked the
learned counsel for the petitioner to show us any rule under which the
petitioner was required to produce pension order to exercise the option
to be covered under the CGHS scheme after retirement. Learned
counsel is unable to show and point out any such stipulation and
requirement in any rule, circular or notification. He, however, relies
upon a file noting in the petitioner's case dated 25th April, 2012, which
was obtained by the petitioner under the Right to Information Act,
2005. We are afraid file notings do not create a rule. The noting does
not record that there was a statutory or other stipulation to the said
effect. Learned counsel for the respondent, on the other hand, has
drawn our attention to the Swamy's Handbook relating to CGHS
scheme wherein it is mentioned that upon retirement, an employee has
an option to get covered under the said scheme and has to make
payment of registration fee and pay annual contribution or life time
contribution.
6. Looking at the facts of the present case, we are satisfied that in
the present case the petitioner by way of choice did not opt for the
CGHS scheme after his retirement on 30th June, 2007 and was not a
member of the scheme when he was hospitalised and operated in
December, 2009-January, 2010. He became a member only on 30th
October, 2011. From 30th June, 2007 till August, 2011, he did not
write even a single letter seeking enrolment or membership of the
CGHS Scheme.
7. The legal conclusion recorded by us is in consonance and as
per the mandate of a Division Bench of this Court in Dal Chand
Vashisht Vs. Government of NCT of Delhi and Others, 2008 VI AD
(DELHI) 44, wherein after referring to several earlier judgments, the
ratio elucidated and expounded was that a person should be a
subscriber of the scheme when medical procedure was performed.
Where a person has not exercised the option to become a member and
there was no automatic coverage under a scheme, the said person
would not be entitled to benefit and reimbursement. Legal ratio in
MCD; Union of India and Ors. Vs. Chander Prakash Gupta; Nand
Ram, W.P.(C) 3368 & 4806/2010 decided on 30th July, 2010, is
identical.
8. In view of the aforesaid, we do not see any reason to interfere
with the impugned order. The writ petition is dismissed.
SANJIV KHANNA, J.
NAJMI WAZIRI, J.
JANUARY 13, 2016
NA
