Recovery on medial expenses by a psu management
DKTAZILANOM9909
(Querist) 23 May 2015
This query is : Resolved
Dear Sir,
We are working in a Public Sector Undertaking (PSU) in India. Our PSU management has fixed different bed entitlement in many hospitals depending upon the post (salary grade) of employees for medical treatment of employees. Many hospitals fixed different treatment cost (including surgery and others) for different bed costs. When employees get admitted in a hospital in higher bed rent (as bed is not available according to his entitlement in that hospital at that time) our PSU management has been deducting money from the employees depending on the difference on cost of medical treatment in higher bed and his normal bed entitlement.
My query is that as the employee is bound to be admitted in higher bed (as bed is not available according to his entitlement in that hospital at that time) can our PSU management deduct the additional cost of medical treatment due admission in higher bed? If yes/no, then why?
regards,
TAPAN
malipeddi jaggarao
(Expert) 24 May 2015
There is no legal point involved in the matter. It is the internal administration of the PSU. Only way out is, you can appeal for reimbursement of deducted amount representing the circumstances. No legal action can be taken on the administrative policy decisions.
P. Venu
(Expert) 24 May 2015
Has these hospitals entered into any MoU or similar arrangement with these hospitals.
Kumar Doab
(Expert) 24 May 2015
The query is: Can employee claim more than he/she is entitled to, as per mediclaim policy/medial benefits available as per service conditions etc?
The counter logic is : If bed is not available then what should be done?
Has the hospital stated in writing that on that day at that time bed as entitled in the policy and even lower was not available, hence higher one was offered?
Was the condition an emergency?
The designated authority has to decide as per provisions of the policy that is applicable.
The chances are authority shall decline.....to pay more than eligibility.
Dr J C Vashista
(Expert) 25 May 2015
I agree with the experts advise.
In case of emergency and non-availability of bed in the hospital as entitled but available of higher grade, the position has to be intimated and approved by competent authority (ex-post-facto)if it is permissible under the rules.
T. Kalaiselvan, Advocate
(Expert) 28 May 2015
The simple logic is that your entitlement is restricted to certain limit therefore anything beyond entitlement if availed has to be borne by you. The employer's attitude is actually appreciable that it accepted the liability to the hospital by first paying the bills and then recovering it from you, suppose there was no bed of your entitlement, and the employer denies to make payment for higher facility, then your life itself would have been in risk, you may make a representation on the lines of expert Mr. Kumar Doab but the results are not guaranteed in your favor.
DKTAZILANOM9909
(Querist) 28 May 2015
Dear Sir,
We heard that in various judgment of High Court & Supreme court Government was held to be under a constitutional obligation to reimburse the expenses since the right to health is an integral to the right to life.
So as the PSU nominated these hospitals for the treatment of its employees then is it legal to recover the extra charges for medical treatment?
regards,
TAPAN
Ref: IN THE HIGH COURT OF DELHI AT NEW DELHI
SUBJECT : REIMBURSEMENT MATTER
WP(C) No.16651/2006
DATE OF DECISION : January 10, 2013
DALJIT SINGH ...... Petitioner
versus
GOVT. OF N.C.T. OF DELHI & ORS. ..... Respondents
CORAM:
HON’BLE MR. JUSTICE VALMIKI J.MEHTA
VALMIKI J. MEHTA, J (ORAL
