Panel tells ECHS Director to reimburse claim for treatment of ex-serviceman

Ramkrishan Upadhyay

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Chandigarh, June 20

The benefits, which have been provided through various schemes to Army personnel while in service and after their retirement, have to be construed in a manner, which would translate promises into reality. By observing this, District Consumer Disputes Redressal Commission Chandigarh has directed the Director and OIC, Ex-servicemen Contributory Health Scheme (ECHS), to pay the entire amount incurred on the treatment of the retired Army man.

What order says

Benefits, which have been provided through various schemes to the Army personnel while in service and after their retirement, have to be construed in a manner, which will translate promises into reality.

The commission has passed the judgment while deciding the complaint moved by a Subedar Major (retd) Jaswant Singh of Sector 47, Chandigarh. In the complaint Jaswant Singh alleged that the OIC, Ex-servicemen Contributory Health Scheme, Polyclinic, Sector 47-A, Chandigarh, refused to pay the entire amount he incurred on the treatment under the scheme.

Jaswant Singh (73) in a complainant stated that he met with an accident on March 16, 2020, and was admitted to Fortis Hospital, Mohali, the nearby empanelled hospital of the Ex-servicemen Contributory Health Scheme, for the treatment of multiple injuries of left ankle and on otherr parts of the body causing heavy bleeding and complications.

Jaswant Singh said he was discharged from the hospital on March 20, 2020. The complainant said that he submitted Rs 23,750 medical claim for the purchased medicines/consumable/equipment for the period from March 21 to June 10, 2020. The complainant said he received Rs 9,309 on August 28, 2020.

The opposition party (Ex-servicemen Contributory Health Scheme) stated that an amount of Rs 14,441 was deducted and not payable, which according to the complainant was unjustified, unacceptable and deficiency in service.

On the other hand the Ops, Ex-servicemen Contributory Health Scheme, justified the deduction. They said that out of total bill of Rs 23,750 an amount of Rs 14,441 spent on buying consumable items was deducted, whereas the rest of the bill charges of Rs 9,309 pertaining to the purchase of only medicines was reimbursed.

After hearing arguments the commission allowed the appeal and directed the OPs to pay Rs 14,441 to the complainant along with interest at the rate of nine per cent per annum from the date of repudiation of claim till realisation.

The commission has also directed the OPs, Ex-servicemen Contributory Health Scheme, to pay Rs 3,000 to the complainant as compensation for causing mental agony and harassment and Rs 2,000 as costs of litigation.

“We are of the view that it is well settled that the right to health is an integral part of life. The government has a constitutional obligation to provide health facilities to its serving personnel or ex-servicemen in case they require a specialised treatment in an approved hospital. Also it is duty of the government to bear or reimburse their expenses,” the commission stated in the order.

“Declining/rejection of reimbursement of balance amount of Rs 14,441 of medical claim is deficiency in service, not according to law, is arbitrary, unjust, and unconscionable without any justification,” the commission further stated.