No reimbursement to staff for going to pvt hospital without nod

A retired railway employee who went to a private hospital for treatment without informing the authorities and submitted a hefty bill was rapped by the Delhi State Consumer Commission for not complying with its rules.

Last Updated: Jul 28, 2010, 18:49 PM IST

New Delhi: A retired railway employee who
went to a private hospital for treatment without informing the
authorities and submitted a hefty bill was rapped by the Delhi
State Consumer Commission for not complying with its rules and
said he was not entitled to any reimbursement.

"The action of the patient, ignoring them (Railway
Board policy rules) and going to Sir Ganga Ram Hospital
straightaway was not in accordance with rules and he was not
entitled to any reimbursement," the Commission bench headed by
its President Justice B A Zaidi said.

The Commission passed the order on a petition of the
Railways seeking dismissal of the District Forum`s direction
to pay medical reimbursement of over Rs two lakh to
complainant Puran Chand Agarwal besides compensation.

"The disease of the patient at the time of admission was
chest pain and uneasiness. It was not mentioned by doctors in
discharge history that it was a case of emergency and no such
circumstance was also mentioned from which any such inference
could be drawn," it said.

The discharge slip showed that angiography was done and
thallium test was advised and other health parameters, pulse,
blood pressure, respiratory system, bilateral vascular, breath
sounds, bowel, higher mental function, motor and sensory
system CVS etc were normal, the Commission said.

"In a situation like this, the rules and emergency
conditions do not permit an employee to rush to a private
hospital without taking prior permission from an authorised
medical officer," it said.

According to the rules, there is no scope available for
any railway beneficiary to go to any private hospital himself
or their dependents on their own volition, except in a case of
real emergency situation.

Agarwal had approached the District Forum after his
medical reimbursement was rejected by the Railways for not
complying with its rules.

PTI

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