IREC Rule No.617: Treatment In An Emergency
617. Reimbursement Of The Expenses Incurred For Treatment In An Emergency:-
In an emergency if a railway employee has to go for treatment including confinement to a government hospital / recognized hospital or a dispensary run by a philantherapic organization without prior consultation with the authorized medical officer, reimbursement of the expenses incurred to the extent otherwise admissible, will be permitted if after a careful examination of the circumstances of the case, the competent medical authority accords ex-post facto approval. In such case, before reimbursement is admitted, it will be necessary to obtain in addition to other documents prescribed, a certificate in the prescribed form from the medical superintendent of the hospital to the effect that the facilities provided were the minimum and essential for the patient’s treatment.
Note :
(1) In such cases, GMs are delegated powers to allow reimbursement of medical expenses up to a limit of Rs.3000 in each case in private institution and up to Rs.10000 in recognized / Government hospitals.
[Authority: No.91/H/6-4/26, 20.11.1995]
(2) CMDs are authorized to reimburse claims up to Rs.1000 of railway employees in the event of special investigations (laboratory tests etc) got done from non-recognized institutions on the advice of the authorized medical officer in the absence of such facilities in the railway hospital. These cases should be decided in consultation with FA&CAO provided these were done at the instance of the authorized medical officer. These powers will not be re-delegated.
It has also been decided that claims above those permitted in Note (1) and (2) above, be referred to the Railway Board for consideration along with FA&CAO’s comments and the circumstances which necessitated such investigations being done at non-recognized institutions.
[Authority: No.91/H/6-4/26, 05.01.1994 & 04.05.1994]
(3) Sterility – per se: Cases of treatment of sterility may also be treated at par with other cases for reimbursement under the existing rules.
[Authority: No.86/H/6-4/58, 21.12.1988, ACS No.8]
(4) Recognition of CATSCAN test for reimbursement:-
(i) General Managers are fully empowered to sanction charges levied at a Government hospital for CATSCAN.
(ii) In case CATSCAN in a government hospital is not possible in time, CMD will arrange for CATSCAN at a reasonably priced private institution. In such case, General Manager is empowered to sanction CATSCAN facility charges up to Rs.2000 in each case. MRI, CMDs can within their power sanction Rs.3000. For fees beyond this amount, concurrence of associate finance be obtained and proposals submitted to Railway Board for consideration and sanction. Chief Medical Director should ensure that prior permission is accorded to get this CATSCAN done only in very deserving and definitely needed cases.
[Authority: No.86/H/3/3, 22.01.1987]
(5) General Managers have been delegated powers for granting post-facto sanction even in cases where prior permission of Chief Medical Director could not be obtained for reimbursement of expenses incurred on CATSCAN up to Rs.2000 only in each case done in Government hospitals.
[Authority: No.88/H/6-4/80, 12.05.1989]
(6) Chief Medical Directors are empowered to sanction CATSCAN fee charges up to Rs.2000 in each case. Powers are also delegated for granting post-facto sanction.
[Authority: No.88/H/6-4/57, 21.12.1988 & No.88/H/6-4/80, 09.09.1989]
(7) Chief Medical Directors can sanction reimbursement of the cost of hearing aid for employees and dependent family members up to Rs.1500. The cost shall be paid to the firm directly. Cases where cost of hearing aid exceeds the limit of Rs.1500 they should be referred to the Railway Board duly concurred by the FA&CAO.
[Authority: No.85/H/6-4/28, 26.09.1988]
(8) Reimbursement of expenses on purchase / replacement repair / adjustment of artificial electronic larynx:-
Reimbursement of the cost of the artificial electronic larynx should be made to the railway employees and their family members governed by the Railway medical attendance rules on the recommendations of the Director General Health Services. The payment would, however, be made by the administrative authority direct to the supplying agency and not to the railway employee concerned.
[Authority: No.82/H/6-1/21, 11.10.1984]
(9) Provision of specialized medical services to construction staff:- General Managers on merits in such areas can decide provided provision of such consultants is within the norms laid down by Railway Board for appointment of consultants. Cases not falling within the framework of these norms shall be referred to the Board for approval.
[Authority: No.89/H/2/3/5, 24.07.1989]
(10) Utilizing the service of an Anaesthetist from outside during emergencies: When Railway Anaesthetist is not available because the post / posts is / are vacant or the anaesthetist had / have gone on leave / sick or is not on duty elsewhere / out of station, the services of an anaesthetist from outside may be utilized on payment of Rs.150 per case towards professional charges.
[Authority: No.88/H/6-1/29, 06.01.1989]