Certified emergency treatment entitles beneficiaries to full reimbursement of actual medical expenses.

The respondent, a retired Railway employee, sought reimbursement of ₹3,85,578 incurred for his wife’s bilateral total knee replacement at Sarvodaya Hospital.

The Railways rejected the claim by order dated 30 January 2024. The Central Administrative Tribunal set aside that order and directed reimbursement of the full amount, treating the surgery as emergency treatment.

The Union of India challenged the Tribunal’s decision, arguing that knee replacement is not ordinarily an emergency and that the respondent’s prior consultations for knee pain and difficulty walking showed the surgery was elective.

The treating doctor had issued an Essentiality-cum-Emergency Certificate stating that the treatment could not have been delayed and was essentially required.

Whether the knee replacement was emergency treatment warranting full reimbursement, notwithstanding the respondent’s prior consultations for knee pain and difficulty walking

Whether the Tribunal erred in directing reimbursement of the full expenses incurred for the emergency treatment

Under Shiva Kant Jha v. Union of India, a genuine medical claim supported by records certified by the treating doctors cannot be denied on technical grounds; in an emergency, prior permission is not required where timely treatment is necessary.

The Court relied on Hira Lal Bhat v. Chairman and Managing Director, BSNL, Union of India v. Joginder Singh, Union of India v. Surender Kumar Kaur, Jasbir Singh v. Union of India and Jagir Kaur v. Union of India for the principle that, where emergency treatment is established, the claimant is entitled to reimbursement of the actual expenses incurred, and the authorities cannot reject the claim merely on technical grounds.

The Court also referred to the constitutional importance of the right to health as an aspect of the right to life under Article 21.

The Court found that the Essentiality-cum-Emergency Certificate was issued by the competent medical officer and expressly stated that the treatment could not have been delayed.

There was no contrary medical certificate, and the Court would not sit in appeal over the treating doctor’s assessment.

The respondent’s prior consultations for pain and difficulty walking did not, by themselves, establish that the surgery was elective; the Court rejected the proposition that every knee replacement is necessarily non-emergency.

Applying the authorities on emergency medical reimbursement, the Court found no error in the Tribunal’s direction to reimburse the full claim.

It dismissed the writ petition in limine, made no order as to costs, and directed compliance with the Tribunal’s order within four weeks from 23 September 2026.