Medical reimbursement claims cannot be withheld based on alleged excess payments previously made directly to hospitals.

The applicant, a retired employee of the respondent department, underwent medical treatment involving stent implantation on a cashless basis. Initially, the respondents paid the hospital directly but later began recovering the amount from the applicant's salary, claiming four stents were unnecessary

The applicant successfully challenged this recovery in OA No. 740/2012, where the Tribunal quashed the recovery order on April 11, 2016, and directed the respondents to recover any "excess" payments from the hospital rather than the employee

Despite this, the respondents withheld a subsequent reimbursement claim of Rs. 54,607/- filed by the applicant for related post-operative treatment expenses, citing pending recoveries from the hospital related to the original dispute

The applicant filed the present OA seeking disbursement of the balance amount with interest

1. Whether the respondents are justified in withholding the applicant’s personal medical reimbursement claim on the grounds of pending recoveries from a third-party hospital stemming from a previous dispute

2. Whether the respondents’ action contradicts the directions issued by the Tribunal in the earlier judgment of OA No. 740/2012

Section 19 of the Administrative Tribunal Act, 1985, regarding the adjudication of grievances of government servants

The primary legal principle applied was the doctrine of res judicata and the finality of judicial orders, specifically the judgment in OA No. 740/2012, which established that financial liability for medical "excesses" attributed to hospital decisions cannot be shifted to the patient/employee

The court emphasized the right to medical reimbursement as a substantive right that cannot be stalled by administrative disputes between the department and the service provider

The court reasoned that the current claim for Rs. 54,607/- is distinct from the previous litigation, as it pertains to expenditures incurred personally by the applicant for his treatment

The respondents' defense—that the claim could not be finalized because the "excess" payment made to the hospital in the 2012 matter remained unrecovered—was found legally untenable

The 2016 judgment explicitly prohibited the respondents from recovering those amounts from the applicant and granted them liberty only to pursue the hospital

By stalling the new, valid reimbursement claim based on an unrelated recovery issue, the respondents acted in a manner "contrary to the decision passed in OA No. 740/2012"

Consequently, the department was obligated to verify the personal expenditure of the applicant independently of the hospital's billing dispute

The Tribunal (Member (J) Justice Om Prakash-Vlll) disposed of the OA by directing the respondents to take a clear decision on the applicant's claim within three months