Jharkhand High Court
Mukhtar Alam vs Coal India Limited on 4 September, 2025
Author: Ananda Sen
Bench: Ananda Sen
2025:JHHC:27849
IN THE HIGH COURT OF JHARKHAND AT RANCHI
W.P.(S) No. 418 of 2025
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Mukhtar Alam, S/o Mohiuddin, R/o Ghutiatand Colony, P.O. Bermo, P.S.
Bermo & District Bokaro, Jharkhand.
... Petitioner
-versus-
1. Coal India Limited, a Public Sector Undertaking under Control of Ministry of
Coal, Govt. of India through its Chairman, Officiating at Coal Bhawan, 10,
Netaji Subhash Road, P.O. Kolkata G.P.O., P.S. & District Kolkata, West
Bengal-700001;
2. Central Coal Fields Limited through its Managing Director, Officiating at
Darbhanga House, P.O. GPO, P.S.- Gonda, District- Ranchi.
3. The Director (Personnel), Central Coalfields Limited, Darbhanga House,
P.O.-GPO, P.S.- Gonda, District-Ranchi.
4. The Director (Finance), Central Coalfields Limited, Darbhanga House, P.O.
GPO, P.S. Gonda, District-Ranchi.
5. The Accounts Officer, Central Coalfields Limited, Darbhanga House, P.O.
GPO, P.S. Gonda, District-Ranchi.
6. The Chief Medical Officer in the Office of the Chief Medical Services, Head
Quarter, Central Coalfields Limited, Darbhanga House, P.O. GPO, P.S.
Gonda, District- Ranchi.
7. The General Manager (B & K), Kargali Area, C.C.L, P.O. Bermo, P.S. Bermo,
District Bokaro 829104.
8. The Project Officer (B & K), Kargali Project, C.C.L, P.Ο. Bermo, P.S. Bermo,
District Bokaro 829104..
.... Respondents
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CORAM : SRI ANANDA SEN, J.
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For the Petitioner(s) : Mr. Sanjay Kumar, Advocate
For the Respondent(s) : Mr. Anoop Kr. Mehta, Avocate
: Mr. Amit Kumar Sinha, Advocate
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04/ 04.09.2025 Heard learned counsel for the petitioner and learned counsel for
the respondents.
2. Petitioner, in this writ petition, has prayed for the following reliefs:-
(i) For quashing the Letter dated 07/10/2024
(Annexure- 9) issued under the pen and signature of
the Respondent No. 6 whereby the medical claim of the
Petitioner for reimbursement of his medical bill has
been rejected assigning reason that the treatment has
been taken in a non-empanelled hospital hence as per
guidelines of CPRMSE, medical bill is not reimbursable
and such finding is against the terms, conditions and
spirit of the CPRMSE (Contributory Post Retirement
Medicare Scheme for Non Executive, 2014 and its
modified scheme of 2020);
(ii) To hold and declare that as per the aim and object
of the CPRMSE of 2014 as well as its Modified
Medicare Scheme of 2020, the Petitioner is eligible and
entitled for the reimbursement of his medical expenses
occurred under the compelling circumstances;
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(iii) For direction upon the Respondents especially the
Respondent No. 2 and Respondent No. 6 and its
officials to consider the medical claim of the Petitioner
under "the Contributory Post Retirement Medicare
Scheme for Non-executives, 2014 and/or Modified
Scheme, 2020 and make payment of his medical claim
with all consequential benefits for which he is entitled
under the said scheme;
3. The case of the petitioner is that he joined Central Coalfields
Limited in the year 1988 at Kargali Project (B&K) as Category-I employee and
retired from the post of Senior D.E.O Grade-I (B&K) Kargali on 31.01.2023
with basic pay of Rs. 81,022.65/- per month. On 12.09.2023, the petitioner fell
ill during his visit to Chennai. The petitioner was unable to sit or walk properly.
Due to the sudden emergency and was in need for urgent medical attention.
The petitioner was rushed to Apollo Hospital, Chennai. After the doctors
examined the petitioner, it was found that there was a 15 cm long infection in
the petitioner's right thigh muscle and needed to be operated immediately as if
the infection is left untreated it would further spread and there could have
been a possibility of losing the right leg of the petitioner. The petitioner was
operated and admitted in the same hospital for a total of 5 days. The
treatment at the hospital costed Rs.2,69.260/-. The petitioner applied for
reimbursement of the said amount under the Medicare Scheme, 2014 of Coal
India Limited for Non-Executives of Coal India Ltd. and its Subsidiary
companies but the same was rejected stating that the hospital was not
empanelled with the company. On rejection of claim for reimbursement, the
petitioner filed a writ petition being W.P.S. No. 4255 of 2024 which was
allowed with a direction upon the respondent authorities to look into the
representation if made by the petitioner and consider if he is entitled for any
medical reimbursement within a period of 16 weeks. The petitioner
immediately prepared a fresh representation praying consideration of his
case, but the respondents rejected the same with the reason that the hospital
was non empanelled.
4. Learned counsel for the petitioner submits that the rejection order
of the respondents is against the spirit of order of this Hon'ble Court in W.P.S.
No. 4255 of 2024 and the same frustrates the aim and object behind the
Medicare Scheme of CCL. Learned counsel has placed reliance on the
Supreme Court judgment in Shiva Kant Jha vs Union of India (W.P.(C) No.
694 of 2015) reported in AIR 2018 SC 1975 wherein it has been held that
every government employee during his lifetime or after his retirement is
entitled to get the benefit of the medical facilities and no fetters can be placed
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on his right. The counsel further submits that the action of the respondent
authorities is arbitrary and violative of principles of Articles 14, 21 & 300 A of
the Constitution.
5. Learned counsel representing the respondents submits that the
petitioner avoided nearby Government Hospital, Semi Government Hospitals,
Empanelled Hospitals notified by Coal India Limited and its subsidiaries. The
counsel submits that to claim reimbursement under clause 3.1.1 (B) of the
Modified Medicare Scheme 2020, the treatment has to be taken during
emergencies like Heart Attack, Accident, etc. and on non availability of
empanelled hospitals in a particular town or city.
6. After hearing the counsel for the parties and going through the
records, it transpires that the Medicare Scheme 2014 was modified vide letter
dated 08/04/2020 and referred as Modified Medicare Scheme 2020 w.e.f.
01/07/2016. The Modified Medicare Scheme, effective from 01.07.2016,
provides under Clause 2.1(k) that employees who were on the rolls of
CIL/Subsidiaries as on 01.07.2016, or who joined thereafter, shall be deemed
members of CPRMS-NE (Modified) from the date of their separation upon
deduction of full contribution, with medical cards to be issued at the time of
separation subject to other conditions of the scheme. The Modified Medicare
Scheme, 2020 under Clause 4 provides a contribution of Rs.40,000/- (one-
time or in installments) for Non-Executives. Since the Petitioner has already
paid this amount, a conjoint reading of Clauses 2.1(k) and 4 makes the
Petitioner a member of the Scheme. Clause 3 of the said scheme provides the
benefits of reimbursement of medical expenses. The petitioner here was in
utmost need for treatment when he was examined at Apollo Hospital Chennai.
It is well understood that a Doctor alone makes the ultimate decision as to
how to treat the patient, leaving very little scope for the patient and his family.
Medical reimbursement claim arising from treatment taken in an emergency
situation cannot be denied solely on the ground that the hospital was not
empanelled. The essential consideration is whether the treatment was indeed
undertaken under emergent circumstances on medical advice of the doctors
and duly supported by records. The preservation of human life is of paramount
significance, and the State bears an obligation to provide timely medical care
to a person in need. Any denial of such treatment or reimbursement would
amount to a violation of Article 21 of the Constitution of India. No
reimbursement policy can capriciously reject the claim on grounds that the
hospital was non empanelled. Coal India Limited and its subsidiary companies
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are State within the meaning of Article 12 of the Constitution of India. Their
action or any resolution, which they adopt cannot be contrary to the provisions
of any Statute promulgated by the legislatures. It is also not a case where any
one is doubting the treatment or the quantum of expenditure. Further, the
petitioner had undergone treatment in a reputed hospital of the country in
Appollo Hospital, Chennai. A patient always prefers the best of the hospital
and the petitioner has chosen the same.
7. In view of the observations made above and the facts of the case,
I am inclined to allow this writ petition with a cost of Rs.1,00,000/- (Rupees
One Lakh) to be paid by the respondent authorities to the petitioner. The letter
dated 07/10/2024 rejecting the medical claim of the Petitioner for
reimbursement of his medical bill, is hereby, quashed and set aside. The
payments are to be made within 6 (six) weeks from today.
8. This writ petition is, accordingly, allowed. Pending interlocutory
applications, if any, stand disposed of.
(Ananda Sen, J.)
Kumar/Cp-03
