'.
.'. Appeal to 1st A.A .•••• Place: Kurduvadi. Date: 14.02.2017.
, TO~ Vihe A. S. & FAA, August Kranti Bhavan, Bhikaji Cama Place, New Delhi: 66.~ Sub: Information under RTI Act: 2005. . . Ref: CHD & PIO (Med) CMD's Office, Mumbai CSTM's No. G.402.RTl/information/CIC/ RNW dated 06.02.2017 (copy enclosed). ------)( ------Respected Sir,
The information furnished by CHD & PIO under reference vide his letter under reference is incomplete, misleading & far from facts of ground reality as stated against Sr. NO.6 to 9 below :-. ".
1.( Name & Address of Appellant. : R. N. Walujkar, 05/454, Sanegurujinagar : Kurduvadi (413208), Dist: Solapur (Maharashtra) 2.) Name & address of CPIO who : Shri: S. C. Sharmaji, D.O. &0. R. CIC's Office, New Delhi • 3.) Name & address of CPIO who : Dr. M.B. Gangurde, CHD & PIO(Med), CMD's Officer, C.R Gave the reply to application : Mumbai CSTvide letter under reference.(Annexure-lI) 4.) Name & address of 1st A.A. : A.S. & FAA, August Kranti Bhavan & Bhikaji Cama place : New Delhi: 110066. 5.) The particulars of application. : The information given by CHD & PIO(Med) vide his reply • Against which appeal is made : under reference is incomplete, misleading & without : facts finding report as sought for by me. (Annexure-II) 6.)The Brief facts leading to the : As per item No. 21') of Bd's letter 2008/H/6.4/Policy dt. appeal : 11.7.2008 referred to in his reply clearly says that the ;: : reason for not recommending the proposal for sanction : of competent Authority needs to be intimated to employee ) : based on fact finding report brought from treating Doctor, : to which CHD& PIO(Med) fails to furnish to me. " 7.) Prayer or relief sought for. : The CMS/SUR has got no powers t ) accept or reject or : sanction the claim at his whims & fancies4(ttrhave to •• : submit proof of his letter dt. 10.3.16 for authenticity. , " 8.) Grounds for prayer or relief. : CMS/SUR fails to depute Doctor to verify my health at : my residence as per my letter dt. 3.10.2012 (Enclosed as : Annexure-III) as per Para: 5 of Bd's No. F(E)1/20091AL-711 dt. : 24.7.2009 itself proves how he attends to Noble profession. 9.) Any other information relevant : CMS/SUR fails to prove that Emergency certificate To appeal : issued by treating Doctors at Akluj are false by deputing . , : his doctor at concerned Hospital at Akluj (Copy enclosed • : as Annexure-IV /1 & 2). 100(" 10) Verification/Authentication : Done. -. D By the appellant. \ \1- ~tS'( • 2 .. " •, ' 1 .. . . 1 1)1-\ D.A,f As per index given below: .Yours faithfully ? \ , /V'1; 1) Original Application as Annexure: i/O I ' '_ ;', 2) Respondent's reply as Annexure-II!"I tool (~~mwC : : 3) Intimation To CMS/SUR & M.S./KWV Kurduvadi. ,'~ f As Annexure-iii) 0 , ;~.". 4) Treating Doctors Emergency Certificate '.''"; .~ as Annexure-Iv! Total: \ \ pages !12o-v- / To, Place: Kurduvadi. The Chief Public Information Officer, Date: l!;08~lIl16. Shri: Subhash Chander Sharmaji, I6 ..c; t ---'U'1 Designated Officer & Deputy Registrar, Cle's Office, New Delhi: 110066.
Sub: The Information under RTI Act: 2005. Ref: 1) Your F. No. 3/3/2008/Admn/CIC dt. 04.10.16. 2) Cle's decision Order issued vide letter No. CIC/VS/A/2014 /001846 dated 25.01.2016 (Copy enclosed) ------X ------_
Respected Sir,
I the undersigned desires to have a following information from the C.H.D. (Med) CMD's Office & CPIO, Central Railway, Mumbai CST.
Q1,1 Full Name of Applicant : Ramling Narayan Walujkar. 02.) Full Address. : 05/454, Sanegurujinagar, Kurduvadi (413208). : Dist: Solapur (Maharashtra State). 03.) Contact No. Mob. No. :09420781659/ E-Mail: [email protected]. 04.) Subject matter of : The information of base on which my claim of information. : re-imbursement of Medical expenses has been : brought under planned investigation be furnished OS.) The period to which info Reqd.: From 03.10.2012 to 04.10.2012 06.) Description of Information. : The fact finding report related to my Medical : claim with base on which it has been rejected. 07.) Reason for application : Your decision orders conveyed to the CPIO & : C.H.D. (Med) vide your Office letter No. CIC/VS/ : A/2014/001846 are not complied with by him : even after lapse of nearly' year. Even he has : not taken care to attend V.C. on 25.01.2016. : He may be forced to furnish the information as : per your lilecision order with penalty clause under : provision of RTf-Act: 2005. 08.) Whether in person or by post: By RLAD post on said address. 09.) Particulars fees paid. : P.O. NO.1 OF 748799 issued by Post Ofice Miraj : attached Any additional Amt. required for : furnishing said information will be paid on : demand please. 10.) Applicant coming under BPL.: No.
In case you do not hold the requested information, the request may be forwarded to competent Authority under section 6(3) of the RTI Act : 2005.
D.A,f As above: 1 + 1 = 2. YOUrsFait~ ,..).1 ,&-bt \ CA (~/l ~\7 (R. N. Walujkar) Kurduvadi. RTI / URGENT J Central Railway CMD's Office, CSTMumbai. Dt. 06/02120 I 7. Dy, Registrar Central Information Commission, Club Building, Opp. Ber Sarai Market, Old JNU Campus, New Delhi-ll 0067
Sub: - Notice for hearing for non compliance of commissioner's order CIC/VS/ A/ 2014,t.Q.01846
Ref:- Your Order No. CIC/VS/ A!2014/001846 dtd. 30/01/2017 ...... ,.,- ..
******** . With reference to the above it is to inform yoU tliat copy of rules / guidelines reldted to reimbursement of medical claim has already been sent to Mr.' R. N. Valunjkar on 10/03/2016 by Regd. A/D.and same has been received / acknoledged by him. (Copy enclosed).
Thisisfor your information please.
DA/AS above .
. : .
C/- Shri.'R.N. Valunjkar, . /R/O.' 05/4~4,Sane Guguji Nagar, V .Kurouwadl, Tal. Madah, . Dist.Solapur. (Maharashtra) -413208.
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. ".;.',. RTI / URGENT ~ . !~ l . centtal~dnway CMD's Office, !".1 ': CSTMumbai. No. G. 402, RTIinformation/ RNW/~ A PPEA L Dt. 08/0212017. " . \ ~. , !.' .'Dy, Secr~tary . ~APIO', , ,. GM' sot!fi~e/CRly /CSTM
, Sup,:- Information under Right to information Acl.2005. -
Re;f:- Your letter No. G.197 /RTI/Appeal-Med/2014 dtd- 03/02/2017. -_. ******** With reference to the above it is to inform you that as per decision of C1C , a copy of rules/;guidelines related to reimbursement of medical claim has already been sent to Mr. R. N,.walunjkar on 10/03/2016 by Regd. A/D.and same has been received / ackrioledged by him. However a copy of the same is again sent herewith to the applicqrit ,
- V (Dr.M. B. G ngurde) CHD & PI , (Med)
i .:r: R./-N. walunjkar, R/O. 05/454, Sane Guguji Nagar, . Kurduwadi, Tal. Madha, /1Qist.Solapur. (Maharashtra) -413208 . .l r' A copy of the rules / guidelines related i, t6 reimbursement of medical claim is enclosed. , PI.Acknoledge the recipt. ",. .
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" .J -~."- ~ . ,.~ ,"I;' .... ,1 'l'lR(,! 'iR",Ti't GOVERNMENT OF INDIA .... .~~~ ~I~o( tR ~?ffC;'l.1MINISTRY OF RAiLWAYS (t('fil -rr-i RAILWAY .BOII.RD) 5.1"0" 8 /!1ealth/200B No. 2008/H!6-4 Policy New DeIhl, do'ted II .7.2008
C!I{C! UL/l-TF IV ALL The General M•.••nagel, A~llndion Ralf\vays I'. Produ,~Hon Units, J5lV1~ ~<'iT .(-(4,,- Direc:lor G,,'ncroi. RDSOituc know. eND/6\.
Sub.: Reimbursemen: of medic(ll expenses - procedureaf DIsposal. •..•'.Ref.: Board's letter No. 2005/Hj6-4jPollcy-1i daled 31.01.2007.
The metter re0CJrdi,"q procedure/guidelines tot)'.") followed by rTledical fc:ncfionories oj peripheral. Divisional .ond Lonol levels for reirr,bursernent of c::::im,' ,'for"'{he treatment taken in pr'vote nQn. recognized hospitO',;':[J5 beer; exornine.j in Somd's office and it has be,en .~3s'::.:".:!ed as un:jer:.
1. Proced,;re: The procedlJl"" '0 be "')i1ow,s,d for comicJerolion and rejeclion of the
rl?:inibursernent cioi!i~. it !t I'; treot'-r)c-:n1 is :(;ken by roilv,foy employee In a nor-recogniz.ed priv(Jte j-;;,',spiioi v ...ilho~J~ (':efe:r.:)i OV ouihoril.ed Medico: • Offi,:er silcll be os l,tl,d,c;r:-- A. A Ul1.~.Q-'yLs.!(~C'(Z9.'.!9.Lt!..t to CHD of the concerned
B. At t.p,~.1.Q,'l~ILtt~9_dg~Jrtw--=, (i) il,e, C:,/.D of i~le concerned zone scrutinizEis the !"(;:in"ltJtJrS8(ne~d' cloirn Grid ,",vill send the SOmE?for FA 6. //
(ii) :f 11~e reimburs'emeni aonount is within ihe powers , del'c'gatcd to 0:;eneral MGnoger, the claim will be seni / t for his approval otherNise the proposo: will be sent to " , :?,.:Jard for consideration. 2. The competent authority to reject the claim shall be the authorlty which scrulinlzes the claIm In cases where emergency Is not established.
A. ,rhe competeni authority to reject tr\f'.•c:laim.in case ..where . emergency is nol esfoblish~d as~per,.guidE)lin~s).fl!,cj",~own,ih' .y Boord's leiter NO.200S/H/6-4/Policy.11 doled :3(i.07 ,'sh"QiI;be, l,. CMS of the Div;~.ion/PcoductionUnit or "Jledlcal Dired6r of the '. lona: Hos[ii~a!,CIS th~ case nlCiy be. ' I B.' In cme. the' prapo.sal has' been dlJly' forwarded to the concerne.d CMD and CMD concerned after scrutiny. comes to ihs conclusion tho' emeroencv is not established .. the cornpeter:1 ouillarity to reje;~t tr~e .c1dm shall' be CMP -0:.. (.:onc~rne'.i ", 'AI->Q\. II" case. tr'e re:eetion ison any ground other than emergency ) R:l ec.t-i 01) c. n01 being estcblished. the cornpe1ent'authority to reject the cloir.; sholl be ORM ot lhe Divisional,ieve!. and General / rvlnnac.lerat the Zonal leVel/Producticn Unit level. • t D. , rho reasNls1or'n0t\~~<::orhmendillg tne-.pr6pcsbl{for'sancfiOI} ''Of. ccmp~teQf;':i%tnorih(~-needsto,. be'intimote.d:-ta"tl,~ en7J~!oietJ"at,~!5~~crufinv'level ~t~eit.•
3. lhis dispose, of [.CJ2oiivo/(J'/sletler 1'1<:.>. E<':I
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CENTRAL INFORMATION COMMISSION Clu,bbuilding, Opposite Ber Sarai Market, Old JNU Campus, New Delhi-110067, Tel: 011 - 26182594 .Website: cic.gov.in
No. CIC/CPIO/AB/2017/06 Dated:31.01.2017 To ~ Ramling Narayan Walujkar 05/454, Sanegur:ujinagar, Kurduvadi (413208), Distt-Solapur (Maharashtra State)
Subject-Information under the RTI Act 2005
Sir, Please refer to your RTI application dated 16.8'1.2017 received by us on 24.11.2017. Parawise reply is as under: '''''..;;:)',' (1) The Registry has started functioning since March 2016. Hearing started from 25.04.2016. Your case related to 25.01.2016. (2) We have sent a letter to the respondent to explain the reason for non compliance of CIC decision (copy enclosed). I hope this will serve your purpose. In case you are not satisfied with the reply you can appeal to the FAA within 30 days from the date you have received this letter. Address of the FAA is as under AS & FAA 2nd floor:, B-wing, August Kranti Bhawan . Bhikaji Cama Place, New Delhi-11 0066
Copy to: RTI Cell, CIC for information regarding Registration No. CICOM/R/2017l00100. CENTRAL INFORMATION COMMISSION Club building, Opposite Ber Sarai Market, Old JNU Campus, New Delhi-II0067 .. / Tel: 011 - 26182593/26182594 Email: [email protected] File No:- C1CIVS/A/2014/001846 Dated 30-01-2017 Central Public Information Officer(Med) CHD, Central Railway CMD's Office Mumbai CST
Sub: Notice for hearin for Non- Com liance of Commission's order. CICIVS/A/2014/001846
- WHEREAS pursuant to the Commission's order dated 25/01/2016 (copy enclosed) itr"respect of Second Appeal filed by Sh. R.NWalujkar of Kurduvadi against CHD Central Railway, CMD's Office Mumbai-CST Corresponding to his RTI application dated 25/02/2014
And WHEREAS the CPIO is directed to provide rules/guidelines to the RTJ application within 30 days of receipt of this order.
The Appellant Mr. R.N.Walujkar has now intimated vide his RTI application dated 16/01/2017 (copy enclosed) that the concerned Pia has not provided any rules/guidelines related to re-imbursement of Medical Claim.
Therefore, you are directed to offer your comment and provide full information to the complainant as per said CIC Order under infor.mation to the Registry.
"
\ .:
(A.. ala atra) Deputy Registrar Copy to- 1. Sh. Saket Kr. Mishra (Dy. GM & Pia) GM Office, Central Rly, CSTMumbai- 400001 (For necessary direction to implement the CIC Order). ~R.NWalujkar, R/o 05/454, Saneguruji Nagar, Kurduvadi, Tal-Madha, Distt- Solapur, Maharashtra-413208 ...... ~'v\ "'-~ ~;rr}j {}7 /QENTRAL INFORMATION COMIVHSSION_VWi 'Wft 5t • 2nd Floor, August Kranti Bhavan, Bhikaji Cama Place, NEWDELHI-l1O 066 TEL:011-26717355 Appeal No.CIC/VS/ A/2014/001846 Appellant . Shri R.N. Walujkar, Rj 0.05 j 454, Saneguruji Nagar, Kurduvadi, Tal-Madha, Distt. Solapur - 413208, Maharashtra. Respondent Central Public Information Officerj (Med) C.H.D;, Central Railway, CMD's Office, Mumbai CST.
Date of Hearing : •. 25.1.2016
Date of Decision : 25.1.2016
ORDER
RTI Application:
1. The appellant filed an RTI application dated 25.2.2014 seeking information on 4 points regarding the base on which his re-imbursement claim of medical expenses has been brought under planned investigation. The PIO responded on 5.3.2014. The appeilant filed first appeal dated 12.5.2014 with the first appellate authority alleging ambiguous information provided to him. The FAA responded on 1&.5.2014.' The appellant filed second appeal dated 19.6.2014 with the Commission.
Hearing:
2. The appellant participated m the hearing through video
.-'. -, From: R. N. Walujkar Akluj Critical Care & Trauma Centre, At & Post: Akluj, Tal: malsirus, Dist: Solapur. Datc:- 03.10-2012. To, The Chief Medical Superintendent, Central Railway, Dr. Kotnis Memorial Hospital, Solapur (413 001)
Sub: Admission of my father in Said Hospital in Emergency Since His was in Danger Due to Serious Cardiac Problem ------)( ------~ Respected,
J the undersigned Son of Shri: H..N. Walu,jkar, who Retired as ADFM/SUR forced to got admitted to my father in the Akluj Critical Care & lJ;;iuma Centre Hospital at Akluj due to serious all of sudden cardiac problems.
This is for your kind information please.
Yours faithfully ~~/l () ) f' (S. R. Walujkar) \...... IUO: Laul at Aklu,j. C/- The Medical Superintendent, Centl'al Railway, Kurduvadi: For information please.
;"".- I,
CERTIFICATE 'G'
(To be completed in the CRse of patients who are admitted to hOl;pital for treatmcilt) I PnnA i I. Dr.:\I.:..V.~~t:.~.<:;.y hereby certify:. I I (8) that the patient WDoS admitted to hospital on my a.dvicelo~~oe .et." :::::=, (n Name of medicines Pric.e I t..~~: ..:...:....~~t~~.--.~;~::...::..:~~'!;~ \ 4.::::::::::::::::::::::::::::::iQ):~:::::.<' :::5.2.\';j"-;:~:~ I' (c;) that the injections :ujmll!..1~.!cred wcre not for immunising or prophylnclic Pltrposcs. ! (~) l!!"l! fJ:~ r,,!i(~!l~ wns.suffr:rioS fjom Co::'.<:.~.~..~ ~~\g~r:r1 Willi uad:r my treatmcnt !~om o..3 ..:v?..~.\.2.-t() I .oA-..\.Q .•..\ '1- . (c) that the"X.rny" I:born~ tests, etc. for whic~n expc~diture of I!-s .... 9;Q.Q../r.7:".: ..... \liDS incurred werc necessary and were I undertakcn on my advlcc al.:\.nl\.~ ...":-A(Q.~.'::....:~ ..M....1>..:'\~}.':-/l...\.. (narqc of hospItal or laboratory). I ~ , . (I) that I called In Dr .. ~:zs:W)..O:\O... \?_ ..5\r.a!-.k. for specialist cohsultation and that thc neccssary: approval of the I ,i M,'.",m." •.~"'," foe,",.:~:' i "':40':.~,\:' .,,",''"'.' :::~qn.;~;~RU* Plnce..~¥-~~... ' MedJenl1:.T~fg~D:r-JfKLUJl I Pa'rt B . J certify that the patients has been under Ircatmeryt at the ~C.c:...~...Cci.).,~~..f:\-~.~~hospital ~nd that the sClViccs of the special ntl(SCS, f~r which an e':pe;lditure of Rs 7.Q.OG-/ " was incurred vide bills and receipts attached, were essentil'll i for thc recovery/prevention of serious deteJiarotion in the condItion of the patien't. I ./ I Dnle ...O..A.c..\.Q>..-J-O \")... i PI." ..;(I..¥-,~. \ C "'Ii' 'I' 'j ~ At , A' 'p:i;~'i~;i~~~~~RUmA • I. ~;.[~~~:A~~'!"~'~~~;'~:'~j;{;,;:}~l~:;;::::~.~; , . "~ntmcn;....lor~(.\c,. ..%il.\.~""'.<', ... d"cnsc from ..O..':l".•.\.t). .•.J.•.O.\.?,. '0 OA.....\ ..Q ..~":kO.Y2_ nt the ,,[. {\.c..e...Pr.:\ c;z..\A: ~~"':::>.hospitlll and thaI Ihe fncililies provided wer~ the minimum w:lich were essential for the patient's . ~ trei.ltmCll!. J ! I J , I ..\ . . 1 •• •..' ANNEXURE V (See P.r. 659) ~~ ..... RAILWAY - MEDICAL DEPARTMENT ESSENTIALITY CERTIFICATE I. certify' that ShriiShrimatilKumar~"",~.~ .. ~ ...\!::i..0:t...0.~ ....Y.':I.~\~~..-:Y wlfe/son/d.ughter lM«.t:<;,j~"""'~r,.; ...WA.:~~a.::l of R.hI.....~:i::>.f'.-.\'Q..I...s.u.... emplo,red in the ~._.~ o.~c..R.....~..~."~.~has been under m:i treatmepl.. fo 'r6t. t\-\C..h .•r Cau~c:\w<~.I Name of medicines Price ~'?1~ - ...... 3 ..1.c.•.!;!>-O ...... !:)".\.r-.ei) ;z- ;3:iQ;::S Date Q.L:l:'C\P.::.~ ..\ "- Signature and designation of the PI.ee ....\\¥"),,.~... Authorised Medical Officer ~ ""'~ 0-\-\ C--a-\--'l) .•. -.