ARMED FORCES TRIBUNAL, REGIONAL BENCH, KOCHI O.A.No. 101 of 2011 TUESDAY, THE 27TH DAY OF OCTOBER, 2015/05TH KARTHIKA, 1937 CORAM: HON'BLE MR. JUSTICE S.S.SATHEESACHANDRAN, MEMBER (J) HON'BLE VICE ADMIRAL M.P.MURALIDHARAN, AVSM & BAR, NM, MEMBER (A) MAJ. MANJU RAJAPPAN, NR -20296L, AGED 35 YEARS, D/O K.M.RAJAPPAN, NURSING OFFICERS MESS, MILITARY HOSPITAL, RANIKHAT, ALMORA DISTRICT, UTTARAKHAND. APPLICANT: BY ADV.SRI.M.R.NANDAKUMAR versus RESPONDENTS: 1. UNION OF INDIA, MINISTRY OF DEFENCE, REP. BY SECRETARY, GOVERNMENT OF INDIA, SENA BHAVAN, SOUTH BLOCK, NEW DELHI 110 011. 2. THE CHIEF OF THE ARMY STAFF, INTEGRATED HEADQUARTERS OF MOD, (ARMY), DIRECTOR GENERAL OF MEDICAL SERVICE (ARMY) 'L' BLOCK, NEW DELHI 110 011. 3. THE FLAG OFFICER, COMMANDING-IN-CHIEF, (FOR COMMANDED MEDICAL OFFICER), HEAD QUARTERS, SOUTHERN NAVAL COMMAND, KOCHI- 682 004. 4. THE COMMANDING OFFICER, I.N.H.S. SANJIVANI, NAVAL BASE, KOCHI 682 004. BY ADV.SRI. S.KRISHNAMOORTHY, SENIOR PANEL COUNSEL
O.A. No.101 of 2011 : 2 : O R D E R VAdm. M.P. Muralidharan, Member (A): 1. This Original Application has been filed by Maj Manju Rajappan, No.20296L of Military Nursing Service seeking reimbursement of medical expenses incurred by her for the treatment of her father. The Original Application, which was originally admitted in this Tribunal in November 2011, was dismissed in January 2013 for want of prosecution. However, based on M.A.Nos.175 and 176/2015 having regard to the claim canvassed by the applicant and taking note of the facts and circumstances involved, the application was restored to file in June 2015. 2. The applicant's father, who was dependent on her, was admitted to Naval Hospital INHS Sanjivani in December 2008. Since full treatment was not available at the service hospital, he was referred to a civil hospital, namely, Medical Trust Hospital, Kochi on 20 th December 2008 as he was medically unfit to be transferred to the nearest service hospital where such facilities were available. He was discharged on 02 January
O.A. No.101 of 2011 : 3 : 2009. The total expenses incurred for his treatment as per applicant is Rs.1,15,096 (Rupees One Lakh Fifteen thousand and Ninety Six only). 3. Shri M.R. Nandakumar, learned counsel for the applicant submitted that on completion of treatment of her father at the civil hospital, the applicant had submitted requisite bills for reimbursement to the respondents in February 2009 (Annexure A1). At that time the applicant was working in Military Hospital, Nazirabad and as the treatment was undertaken at the Naval Hospital at Kochi, the contingent bills were submitted through Commanding Officer of Sanjivani to Headquarters, Southern Naval Command (Respondent no.3). The said contingent bills along with necessary documents were forwarded by Respondent no.3 to Respondent no.2 (DGMS (Army)) for requisite sanction, counter signature and forwarding of it to the concerned Defence Accounts Department for clearance of bills (Annexure A2). However, the same was returned by Respondent no.2 to Respondent no.3 with some observations and requirements of additional
O.A. No.101 of 2011 : 4 : document (Annexure A2/2). When the same was forwarded to Commanding Officer of the hospital where the applicant was then working (Annexures A3/2 and 3/3), the applicant submitted an appeal to respondent no.4 stating that all the original copies of the medical bills and requisite documents had been submitted by her and they were forwarded in June 2009 to Respondent no. 2. Since no other copies were kept with her she could not initiate any further action till the original bills were received back by her. The learned counsel submitted that despite protracted correspondence since then, the medical expenses have not yet been reimbursed to the applicant. He further submitted that while the applicant had submitted all necessary documents, some of them were lost in transit between the offices of the respondents. He therefore prayed that respondents be directed to waive the production of original bills at this stage and amount due be reimbursed to the applicant at an early date. 4. Shri S.Krishnamoorthy, learned Senior Panel Counsel
O.A. No.101 of 2011 : 5 : for the respondents submitted that the reimbursement claim for medical expenses incurred by the applicant had been forwarded by Commanding Officer INHS Sanjivani (Respondent no.4) to Respondent no.3 in May 2009 (Annexure R3(a)). The claim was duly recommended by Respondent no.3 and forwarded to Respondent no.2 for necessary approval and onward desptach to CDA for payment (Annexure R3(b)). However, the claim was returned by Respondent no.2 with some observations, such as, getting the bills pre-audited by CDA, statement of case, copy of dependent card and other documents in accordance with Army Order 32/81. Respondent no.3 had observed that when the claim was returned the original bills, case summary and certificates issued by civil hospital were missing. The available documents were forwarded to the applicant's place of duty and Respondent no.2 was also intimated about the missing enclosures (Annexure 3(c)). However, the reconciled claim had not been received back from the applicant.
O.A. No.101 of 2011 : 6 : 5. The learned counsel further submitted that Respondents 1 and 2 had submitted that in accordance with Para 295 of RMSAF 1983, only the officer of the Military Nursing service is authorised for reimbursement of treatment in civil hospitals and families of MNS were not covered by rules (Annexure R1(a)). He further submitted that the medical bills submitted by the applicant through the Headquarters of the Southern Naval Command (Respondent no.3) were returned back with observations in August 2009 and had not been received back by respondent no.2. Therefore, in view of lack of receipt of the same and based on the rule position, reimbursement of medical expenses to the applicant was not feasible. 6. Heard rival submissions and perused records. 7. It is not disputed that the father of the applicant was treated at service hospital, namely, INHS Sanjivani and was referred to the civil hospital in view of the critical state of the patient and lack of facilities at the service hospital. It
O.A. No.101 of 2011 : 7 : is also not disputed that the requisite contingent bills were submitted by the applicant through Respondent nos. 4 and 3 to Respondent no.2 and when claim was returned by Respondent no.2 to Respondent no.3 seeking further clarifications/details, some documents were missing. 8. It is evident from Annexure R3(b) that in June 2009 the contingent bill submitted by the applicant along with all connected documents had been forwarded by Respondent no.3 to Respondent no.2. It also included ex post facto sanction of Flag Officer Commanding in Chief, Southern Naval Command (Administrative Authority) for treatment of the applicant's father at a civil hospital in Kochi. The sanction order clearly mentions that it was necessary to admit the patient as requisite specialist facilities were not available in the service hospital and the patient was not in a fit state to be transferred to the nearest service hospital where such facility was available (Annexure R3(b)(2)). A total amount of Rs.1,15,096/- has been indicated as the amount for reimbursement subject to pre-audit by the
O.A. No.101 of 2011 : 8 : concerned audit/accounts authority. We also observe that when it was returned to Respondent no.3 by Respondent no.2 the contingent bills were received back without connected documents (Annexures R3(c) and R3(d)). The documents were apparently lost in the office of Respondent no.2 or during transit to Respondent no.3. In our view, therefore, the applicant is not responsible for it and in the absence of originals, it has not been feasible for the applicant to pursue the claim. 9. It is also seen that the only observations made by Respondent no.2 while returning the claim in August 2009 was to get the bill pre-audited by CDA, copy of the dependent card and statement of case (Annexure A2/2). No mention was indicated at that stage that the applicant's father was not entitled for reimbursement of medical facilities. Therefore, we do not appreciate Respondent no.2 raising such a claim at this belated stage. While Respondent no.2 has submitted that as per RMSAF 1983 (relevant extract at Annexure R1), only an officer of MNS is
O.A. No.101 of 2011 : 9 : entitled for treatment in private hospital and not her father, it is observed that in the amended RMSAF, treatment at private hospital is authorized to families of MNS Officers also. Relevant Regulation is quoted below: PRIVATE HOSPITALS OR NURSING HOMES 295.(a) When hospital treatment is considered necessary by the authorised medical attendant, the Area/Div Commander or the Administrative Authority in the Navy or in the case of Air Force personnel, the AOC-in-C Command (for personnel posted to Command HQ)/AOP (for personnel posted to Air HQ/Unit or Station Commander not below the rank of a Wg Cdr personnel posted to units/stations other than Air HQ (Command HQ), may authorise the admission of treatment at public expense of :- (i) An officer of the Armed Forces on active list in Defence Service employ a member of his/her family. (ii) An Officer of the Military Nursing Service and their families; 10. We observe that the new RMSAF was issued in 2010 and supersedes the earlier 1983 edition quoted by Respondent no.2. It however appears from the sanction issued by Respondent no.3 that orders for reimbursement of
O.A. No.101 of 2011 : 10 : medical claims of dependents of MNS officers were in force when applicant's father was admitted, more so, as the sanction has been accorded by Headquarters of Southern Naval Command as ex post facto, ie, after the treatment was over. It would thus have been a deliberate action after looking into all rules and regulations. Hence we find no merit in the submission of Respondent no. 2 that the applicant's father was not entitled for treatment. 11. In our view, therefore, the applicant is entitled for reimbursement of payment made to the private hospital for treatment of her father as he was duly referred by a service hospital and ex post facto sanction was also granted by competent authority. The original documents were duly submitted by the applicant, but were lost in transit between the respondents and the applicant cannot be held in any way responsible for the same. It is also well known that competent authorities have been vested with powers to waive production of original bills where the same were lost and the genuineness of the claim is not in doubt.
O.A. No.101 of 2011 : 11 : 12. In view of the foregoing, the Original Application is partly allowed and the applicant is held entitled for reimbursement of medical expenses incurred on account of treatment of her father. The applicant is to submit a fresh representation to Respondent No.2 seeking reimbursement as per Annexures R3(b)(2)/A7, with available documents and also seek waiver of production of documents lost in transit in accordance with the Regulations within a period of two months from the date of receipt of a copy of this order. On receipt of such a representation, respondents are to process and sanction all admissible claims in accordance with law within a further period of four months. 13. There will be no order as to costs. 14. Issue free copy to the parties. Sd/- Sd/- VICE ADMIRAL M.P. MURALIDHARAN, JUSTICE S.S.SATHEESACHANDRAN, MEMBER (A) MEMBER (J) krs/an. (true copy) Prl.Pvt.Secretary