Word reimbursement used very loosely: HC pulls MCD over affidavit on cashless medical services to retired staff

The petition was filed by Akhil Dilli Prathnim Shikshak Sangh submitted that the prevalent arrangement on basis of which a retired employee is made to pay for the medical treatment first, which is later reimbursed by the MCD Health Department, should be changed. It sought that administration should directly make the payment at the hospital instead of reimbursing it.

Also Read: Doctor Shortage: HC asks Delhi to expeditiously recruit doctors, paramedics in Govt hospitals

The petitioner through Advocate Ranjit Sharma stated that the Municipal Corporation was bifurcated into three corporations - South, North and East - with a common Health Department and the corporations had taken subscription premium from the retired teachers and employees for extending cashless medical facility.

Advocate Ranjit Sharma submitted that the above directions are necessary since it takes a long time for the officials to reimburse the money that the retired employees made at the hospital.

The petitioner further told the court that the MCD's present conduct is contrary to its own amended scheme, which mentioned that the payment would be made by the authority without charging the pensioners.

The petition stated,

"Despite the retired employees having deposited the premium, the Corporations are yet to extend to them the cashless medical facility. The employees are required to first report to the Health Department and after obtaining the referral from the Department, can they seek medical treatment from the approved Hospital."

It further said,

"Not only this. If the approved Hospital advises surgery the retired employee is required to revert back to the Health Department for approval and only then, the actual treatment will start. In emergency cases, such a procedure is not only cumbersome but also likely to prove fatal."

The petition also alleged that hospitals do not provide cashless treatment and employees have to first deposit money and then seek reimbursement from the Health Department of MCD which takes a lot of time.

"This act of the MCD is absolutely unfair and illegal. During this COVID-19 pandemic, a large number of retired employees who did not receive pension on time had to face extreme hardships in arranging money for their treatment as the hospitals did not provide cashless treatment," the plea read.

According to a media report in the Live Law, the plea was filed in December last year which stated that a lot of retired employees did not receive their pension on time, due to which they had to face a lot of difficulties while arranging money for their treatment as the hospitals refused to provide cashless treatment to the patients during the Covid 19 pandemic.

The case was heard by a bench of Chief Justice DN Patel and Justice Jyoti Singh, who pointed out some contradictory statements in the affidavits of the municipal corporations in the matter. It noted that in its affidavit the MCD loosely used the word, 'reimbursement' instead of cashless service.

The court noted,

"Your statements are contradictory. The complaint is that under the amended scheme, bills will directly come to you and you will make the payment without charging the pensioners. But you are using reimbursement word very loosely. There is contradiction in para 11 and 14. This is a very poorest position over here. The complaint is you're not following your own policy."

The bench also said that the court could not interfere in the manner in which the medical bills should be paid since it is a policy decision.

Earlier, the Delhi High Court had criticized the three municipal corporations in Delhi for not providing cashless medical services to their retired employees including teachers despite charging subscription fees from them.

The Bench had expressed disappointment with the three MCDs - South, North and East - and noted that retired employees of the corporations had pending medical bills. The court asked how a fee can be charged if the corporations do not have a tie-up with the hospitals for cashless treatment. It also asked about the employees not getting their pensions for a long time.

Respondent corporations had informed the court that they are reimbursing the medical bills in the best way. The respondents have been ordered to file a fresh affidavit in the issue. Advocate Namrata Mukim had appeared for the respondents.

The next hearing is scheduled on April 27, 2022. The bench on Friday said that in April next year the final arguments will be heard in the matter, reports ANI.

Also Read: Candidate seeks CW certificate for Medical Admission, HC dismisses plea