Right to Health Under Article 21 Cannot Be Overridden by FMA
In a significant ruling, the Calcutta High Court has upheld the reimbursement of over ₹29 lakh to the legal heirs of a retired government employee who underwent life-saving cancer treatment. The court made it clear that opting for Fixed Medical Allowance (FMA) cannot override the fundamental right to health guaranteed under Article 21 of the Constitution.
State’s Appeal Against CAT Order Rejected
A bench comprising Justices Debangsu Basak and Ajay Kumar Gupta was hearing the state’s challenge to a 2019 order of the Central Administrative Tribunal (CAT). The tribunal had ruled in favour of the legal heirs of K.R. Samson, a retired government employee who passed away during the pendency of the proceedings.
FMA Meant for Minor Expenses, Not Critical Care
In its February 27 order, the High Court observed that Fixed Medical Allowance is intended to cover routine and minor medical expenses. It cannot be construed as a waiver of reimbursement rights in cases involving life-threatening diseases. The bench noted that denying reimbursement in such cases would amount to placing an unreasonable restriction on the right to health of retired employees and pensioners.
Treatment and Expenditure Details
The retired employee, a graduate-trained teacher who superannuated on July 31, 2018, developed severe head pain in October 2019. Initially admitted to G.B. Pant Hospital, he was later referred to Apollo Hospital, Chennai, and subsequently to Apollo Proton Cancer Centre for specialised care. On January 10, 2020, he underwent surgery for left temporoparietal glioblastoma and was discharged on March 11, 2020. The total medical expenditure amounted to ₹29.06 lakh.
Reimbursement Claim and Rejection
In June 2020, his wife submitted two applications seeking reimbursement. However, through a memo dated October 12, 2020, the claim was rejected on the ground that it was not admissible under the Central Service (Medical Attendance) Rules, 1944, and a Ministry of Health and Family Welfare letter dated September 29, 2020. The rejection was repeated, prompting the family to approach the CAT, which ruled in their favour.
Court Criticises Arbitrary Decision-Making
Examining the 2016 office memorandum stating that authorities “may take their own decision,” the High Court clarified that this does not allow arbitrary or whimsical actions. The discretion must be exercised reasonably and in accordance with constitutional principles. The court emphasised that the right to life includes living with dignity and meaningful access to healthcare.
No Dispute Over Genuineness of Treatment
The bench noted that the tribunal had clearly recorded that the treatment was genuine, necessary, and supported by documentary evidence. There was no allegation of fabricated or exaggerated bills. The rejection was based solely on the applicability of the 2016 memorandum and the fact that the retired employee had opted for FMA.
Failure to Inform Employee About Options
The court further observed that while the 2016 memorandum required departments to inform employees at the time of retirement about available medical options, no such information was provided in this case. The responsibility to inform lies with the authority, not the retiring employee. Holding the rejection legally unsustainable under Article 21, the High Court dismissed the state’s challenge and upheld the CAT’s direction for reimbursement.
