None appears for the appellant and the respondent. However, on the materials produced before us including written submission by appellant, we are inclined to dispose of the case as it is appeal of 2009.

2.      This appeal is filed u/s 15 of the Consumer Protection Act (hereinafter called the ‘Act’ in short). Parties hereinafter were arrayed as the complainants and OPs as per their nomenclature before the learned District Forum.

3.      The case of the complainant in nutshell is that the complainant being Central Government employee is the beneficiary under the Central Government Health Scheme and as such has got the CGHS Card No. 142. As per the scheme, the medical care facility was provided to Central Government employees. The scheme is applicable to All India Service Pensioners including the Central Government and State Government employees. The complainant alleged that he was paying Rs.150/- per month having retired on the basic pay of Rs.25,100/-. It is alleged that complainant suffered from heart ailment on 23.3.2006 and was under treatment at Kalinga Hospital from 21.3.2006 to 30.3.2006 for which incurred expenditure of Rs.45,326/-. He claimed before the OP for the amount but the OP reimbursed only Rs.25,752/- and rest of the amount was not reimbursed. Showing deficiency in service on the part of the OP, the complaint was filed by the complainant.

4.      OP filed written version but remained ex parte  by not participating the hearing. OP has averred in the written version that the complainant is a retired employee but as per the rules and recommendation of the committee, he is entitled to Rs.25,752/-and accordingly, was sanctioned that amount. So, there is no deficiency in service on the part of the OP.

5.      After hearing both the parties, the learned District Forum passed the following order:-

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In the result, the complaint is hereby allowed ex parte against the OP. The OP is hereby directed to reimburse Rs.19,574/- to the complainant, further the OP is directed to pay compensation of  Rs.5,000/- and litigation cost of Rs.1000/-. In aggregate the OP is directed to pay Rs.25,574/- to the complainant. The entire sum be paid within one month from the date of communication of this order, failing which the sum would carry interest at the rate of 9% per annum till the date of payment.”

6.      Learned Central Government Counsel filed written argument stating that the expert committee applied the procedure and approved for making payment but the learned District Forum committed error in law by not considering the said scheme. According to him, the complainant having been treated in private hospital has violated the procedure. However, CGHS committee considered the case and awarded Rs.25,752/- out of bill amount of Rs.45,326/-. Learned District Forum ought to have accepted the written version of the OP. Moreover, the complaint is not maintainable. So, it is submitted to set aside the impugned order by allowing the appeal.

7.      Perused the appeal memo and the impugned order including the DFR.

8.      It is admitted fact that the complainant being a Central Government employee was paying the monitarycontribution  to receive the service under the CGHS Scheme. Annexure – 1 and 2 show that the complainant has provided the necessary reimbursement form claiming reimbursement of Rs.45,326/-. Annexure – 3 shows that entire money receipt has been submitted but the complainant was awarded only Rs.25,752/- by cheque. The report of the committee restricting the amount Rs.25,752/-  has not been filed by the OP although relied on the document. Also Central Government Counsel failed to convince us how the amount reduced to Rs.25,752/-. Apart from this, the plea of the OP that the complainant is not entitled to the medical facility at Kalinga Hospital could to be substantiated. If he is not entitled to be treated at Kalinga Hospital, then how far the committee approved the reimbursement cost of Rs.25,752/- out of claimed amount.

9.      In view of aforesaid discussion, we are of the view that the appellant has no any basis to challenge the appeal and accordingly, the impugned order is confirmed and the appeal sands dismissed. No cost.

         DFR be sent back forthwith.

       Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.