Delhi High Court refuses to order reimbursement of medical expenses abroad for former BSF DG

Diagnosed with herpes simplex encephalitis, he incurred approximately $20,449 (approximately Rs 10.03 lakh) in expenses. He then submitted a claim for reimbursement to the Director General of Medical and Health Services.

However, the claim was denied on the ground that the facility of treatment abroad is available under the provisions of the Central Services (Medical Attendance) Rules for serving Central government employees, and that pensioners are neither eligible to receive treatment abroad under the Central Government Health Scheme (CGHS) nor under the CS (MA) Rules.

Singh then moved the Delhi HC, challenging the decision and pointing out that such a distinction between retired and serving officers cannot be carved out. The authorities, on the other hand, contended that their policy clearly states that pensioners holding valid CGHS cards are not allowed to seek medical treatment outside India.

It was also their case that the rules allow government employees to avail of medical treatment abroad only under specific conditions, such as for treatments not available in India or high-risk medical procedures.

Justice Amit Sharma, in an order on October 16, observed that a division bench of the Madras High Court had earlier recommended that the CS(MA) Rules be made applicable to pensioners; however, to date, they have not been made applicable to them.

“…various OMs (office memorandum) have been placed on record by the respondent (authorities), including CGHS Rules wherein it is clearly stated that such reimbursements are neither covered under the CGHS nor the CS(MA) Rules….There is no doubt with respect to legal principle that the State has a Constitutional obligation to bear the medical expenses of the Government employees while in service and also after retirement.”

“However, certain policy decisions have been taken by the Government creating a distinction between serving Government employees and retired Government employees with respect to aspect of reimbursing medical expenses incurred abroad…this Court is of the considered opinion that the relief sought for in the present petition cannot be granted,” the court held.

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