#CGHS

The Punjab & Haryana HC ordered Rs 72,500 plus interest for a pensioner’s emergency surgery at a non-empaneled hospital, holding it is reimbursable under the Central Government Health Scheme. The ruling confirms that an emergency certificate alone triggers CGHS liability, speeding up claim disposal for government staff and retirees.

The Central Administrative Tribunal ruled that retired employees undergoing emergency medical treatment are entitled to full CGHS reimbursement, even if intimation is delayed, provided the treatment and expenses are verified. The ruling underscores that administrative technicalities cannot override the right to medical reimbursement in emergencies, protecting pensioners from arbitrary denial of benefits.

CAT Kolkata rules that pensioners receiving Fixed Medical Allowance remain entitled to reimbursement for specialized or life-threatening treatments under the CS(MA) Rules. The judgment clarifies that the allowance is supplementary, not substitutive, ensuring pensioners' right to health is protected without opting for CGHS or PMJAY.

CAT reaffirms that government pensioners are entitled to full reimbursement for emergency medical treatment in non-empanelled hospitals, extending the principle from Shiva Kant Jha v. UoI. The ruling mandates CGHS authorities to honor claims without arbitrary deductions, ensuring welfare state obligations are met for retirees.

Madras High Court rules that CGHS beneficiaries are entitled to full reimbursement for emergency medical treatment, even if costs exceed approved rates. The court mandated referral of such claims to the Technical Standing Committee, rejecting mechanical denial and affirming the primacy of the right to health under Article 21 over procedural compliance.