High Court order on employee medical claims reimbursement

Delay in submission of the claim cannot be attributed to the claimant, he observed.
Orissa High Court building. (Courtesy to orissahighcourt.com)
Orissa High Court building. (Courtesy to orissahighcourt.com)
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CUTTACK: The Orissa High Court has directed Chief Secretary to form a Secretary-level High Power Committee to monitor medical reimbursement claims of employees and ensure quick disposal of such cases on monthly basis.

High Court issued the direction while imposing cost of Rs 20,000 on Managing Director of Odisha Forest Development Corporation (OFDC) Ltd for defaulting on reimbursement of money spent by an employee for 16 years. “This amounts to inhumane attitude by an employer to an employee”, the Single Judge Bench of Justice Biswanath Rath observed.

He directed the MD to pay within six weeks the entitlements of Satya Ranjan Pattanaik who had moved the court after his medical claim was rejected in December 2008. The petition challenging the rejection order was filed in 2009 while High Court allowed it on November 27, 2019.

While quashing the rejection order, Justice Rath further directed the MD of OFDC “to calculate the entitlements of the petitioner through the claim bill after adjusting a sum of Rs 3,000 paid by way of advance and pay the balance entitlements along with interest at 7 per cent per annum all through”.

As per prescribed rules for medical reimbursement, claims have to be submitted within three months of expiry of duration of treatment with ‘Essentiality Certificate’ issued by a medical officer. The petitioner’s mother had undergone treatment from January 1, 2001 to February 13, 2001, but Essentiality Certificate was granted on October 30, 2003.

His case for reimbursement was rejected on December 23, 2008 on the ground that the claim for Rs 51,605 was barred by time with a direction to refund the advance of Rs 3,000 he had received immediately or face recovery of the amount from his salary.

Justice Rath ruled “such claims should not have been denied merely on technicality of being submitted after long delay when there was no fault of the petitioner”. Delay in submission of the claim cannot be attributed to the claimant, he observed.

What the HC order states
Direction issued for defaulting reimbursement of money spent by an employee for
16 years
OFDC MD directed to pay entitlements of the petitioner within six weeks
Petitioner mother had undergone treatment from Jan 1, 2001 to Feb 13, 2001
Essentiality Certificate was granted on October 30, 2003
 His case for reimbursement was rejected on December 23, 2008 on the ground that the claim for Rs 51,605 was barred by time

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