T.R. NO. 141 dated 27th April, 1976 

MUMBAI PORT TRUST EMPLOYEES

(Medical Attendance and Treatment) REGULATIONS, 1976

 1. Short title, application and commencement - 

              (1) These regulations may be called the BOMBAY PORT TRUST EMPLOYEES (Medical Attendance and Treatment) REGULALTIONS, 1976. 

              (2)   They shall apply to all employees while they are on duty or on leave or under suspension within the city of Bombay and its contiguous areas. 

              (3)  They shall come into force on and from the date of publication of Government sanction in the official gazette.

 

2. Definitions - In these regulations, unless the context otherwise requires -- 

              (1)  "Board", "Chairman" and "Deputy Chairman" shall have the meanings respectively assigned to them in the Major Port Trusts Act, 1963; 

              (2) "Chief Medical Officer" and "Assistant Chief Medical Officer" mean respectively the Chief Medical Officer and Assistant Chief Medical Officer of the Board; 

              (2A) "contiguous areas" means such areas upto Bassein on the Western Railway and Kasara and Karjat on the Central Railway as are contiguous to Bombay City. 

              (3) "dispensary" means a dispensary specified in Appendix 'A' to these regulations;    

                Explanation : 

              (i)  The list of dispensaries given in Appendix 'A' may be altered or added to from time to time with the approval of the Board. 

              (ii) The days of the week on which, and the hours during which, each dispensary shall be open for providing medical attendance and treatment shall be fixed by the Chief Medical Officer from time to time.  Necessary arrangements shall, however, be made for attending to emergency cases outside the hours so fixed at such dispensaries as may be decided by the Chief Medical Officer. 

              (4) "Port Trust Hospital" means the hospital established and maintained by the Bombay Port Trust at Wadala, Bombay, for the treatment of its employees and their families; 

                  Explanation :      

The hours during which the various departments and services in the Port Trust Hospital shall be open for medical attendance and treatment shall be as fixed by the Chief Medical Officer from time to time; 

              (5) "employee" means an employee of the Board whether permanent or temporary and includes any employee on foreign service or any permanent or temporary employee of the Central or a State Government or a local or other authority on deputation with the Board; 

              (6)  "family", in relation to an employee, means -

                        (i)  his wife, if the employee is a male; 

(ii)  her husband, residing with and wholly dependent on the employee, if the employee is a female; and

(iii) the children and step-children, residing with and wholly dependent on the employee;  

(iv) the parents residing for the time being with the employee and wholly dependent on the employee;  

                  Explanation : 

(1)  The parents shall be regarded as 'wholly dependent' on the employee, if they are residing for the time being with the employee and their total recurring monthly income from all sources including sources such as, houses, landholding, etc., does not exceed Rs.250.  (Lump sum non-recurring income, e.g., Contributory Provident Fund benefits, Gratuity/Commuted Gratuity, Insurance benefits, etc., shall not be regarded as 'income' for the purposes of this clause.  The declaration regarding the income of parents shall be furnished by the employee concerned once in the beginning of each financial year.  In cases where an employee does not furnish a declaration about the dependency on him of his parents at the beginning of the year, submission of a declaration at the time of seeking medical attendance and treatment of parents may be accepted provided that the date from which the parents are residing with him is indicated and the Chief Medical Officer is satisfied about the genuineness of the statement thus made.  It shall be open to the Chief Medical Officer, if he so desires in any particular case, notwithstanding the fact that a declaration regarding the income has already been made in the beginning of the financial year, to require an employee to make a further declaration at the time of seeking medical attendance and treatment of parents). 

(2) Married, widowed and divorced daughters shall not be regarded as 'wholly dependent' on the employee under any circumstances. 

(3) Sons and unmarried daughters who are employed otherwise than on a casual basis shall be regarded as gainfully employed and shall not be regarded as wholly dependent on an employee.  The Chief Medical Officer may require an employee to make declaration regarding the occupational status and residence of sons and unmarried daughters at the time of seeking medical attendance and treatment of sons and unmarried daughters. 

(4) The term 'children' includes legally adopted children. 

(5) A dependent son or daughter, who is prosecuting studies outside Bombay and its contiguous areas, shall be regarded as residing with an employee in Bombay and its contiguous areas, if the son or the daughter is in Bombay or its contiguous areas at the time of seeking medical attendance and treatment. 

(6) An employee's wife, if she is herself employed in a Department either of the Central or a State Government, or in a Corporation/Undertaking, financed partly or wholly by the Central or a State Government or in a local body or a private organisation, which provides medical services to its employees, and eligible children of such an employee, would be entitled to choose either the facilities admissible under these regulations or the medical facilities provided by the organisation in which she is employed.  In case she and/or the eligible children avails/avail herself/themselves of the facilities provided for in these regulations, the employee who claims reimbursement should furnish a declaration that no claim is being made for the reimbursement of the same medical expenses from any other source.  In a case where both husband and wife are Port Trust employees, the wife as well as eligible dependants may be allowed to avail themselves of the medical concessions provided for in these regulations according to his/her status.  

(7)  "Medical attendance" means attendance -- 

(i)  at a dispensary, by the Medical Officer in charge of, or attached to, that dispensary, or 

(ii)  if, due to the severity of illness, the patient is unable to come personally to a dispensary, at the residence of the patient by the Medical Officer in charge of, or attached to, a dispensary nearest to his residence or in the case of an employee on a scale of pay rising to over Rs.650, the Medical Officer in charge of, or attached to, a dispensary nearest to his residence, or the Assistant Chief Medical Officer, or 

(iii) at the consulting room in the Administrative Offices Building by the Assistant Chief Medical Officer, or the Chief Medical Officer, as the case may be, if previously agreed to by him, or 

            (iv) at the Port Trust hospital (outpatient department) with prior arrangements with the hospital, and includes - 

(a) such pathological, bacteriological, radiological or other methods of examination for the purpose of diagnosis, as are available in any dispensary and considered necessary by the Medical Officer in charge of, or attached to, a dispensary, or by the Assistant Chief Medical Officer, or the Chief Medical Officer, as the case may be; and 

                        (b)  such consultation with a Specialist in the Port Trust hospital as the Medical Officer, Assistant Chief Medical Officer, as the case may be, may consider necessary to such extent and in such manner as the Specialist in the Port Trust hospital, may, in consultation with the Medical Officer, Assistant Chief Medical Officer, Chief Medical Officer, as the case may be, may determine or in the absence of the required Specialist in the Port Trust hospital, such consultation with a private Specialist, as the Chief Medical Officer may certify to be necessary, to such extent and in such manner as the private Specialist may, in consultation with the Chief Medical Officer, determine; 

(8) "patient" means an employee or a member of his family to whom these regulations apply and who has fallen ill; 

(9)  "treatment" means the use of all medical and surgical facilities available at a dispensary, or the consulting room maintained in the Administrative Offices Building, or the hospital, as the case may be, in which the patient is treated and (a) includes -- 

(i)  the employment of such pathological, bacteriological, radiological or any other methods as are considered necessary by the Medical Officer attached to the dispensary, the Assistant Chief Medical Officer, the Chief Medical Officer or the doctors attached to the Port Trust hospital, as the case may be; 

            (ii)  the supply of such medicines, vaccines, sera or other therapeutic substances as are ordinarily available at a dispensary or the Port Trust hospital but excluding -- 

                        (a) such preparations which are not medicines but are primarily used as food, tonic, toilet or disinfectant, and 

                        (b)  such expensive drugs, tonics, laxatives and other elegant and proprietary preparations (for which drugs of equal therapeutic value are available), as may be laid down from time to time by the Chief Medical Officer. 

            (iii)  the supply of such medicines, vaccines, sera or other therapeutic substances not ordinarily so available as the Medical Officer attached to a dispensary, the Assistant Chief Medical Officer, Chief Medical Officer, or the doctors attached to the hospital, as the case may be, may certify in writing to be essential for the recovery, or for the prevention of serious deterioration in the condition of the patient; 

            (iv)  such prosthetic aids as the Chief Medical Officer may certify in writing to be essential for the making up of a serious bodily defect or deficiency in a patient; 

            (v)  such accommodation as is ordinarily provided in the hospital and is suited to his status.  If accommodation suited to his status is not available, accommodation of a higher class may be allotted provided it can be certified by the Chief Medical Officer if the patient is treated in the Port Trust Hospital, or by the Medical Superintendent of the hospital concerned, if the patients is treated in any other hospital -- 

                        (1) that accommodation of the appropriate class was not available at the time of admission of the patient, and 

                        (2) that the admission of the patient into the hospital could not be delayed without danger to his health until accommodation of the appropriate class became available; 

            (vi) such nursing as is ordinarily provided to an in-patient by the Port Trust Hospital or if the patient is treated at any other hospital, such nursing as is ordinarily provided to an in-patient by such hospital; 

            (vii) such special nursing as the Chief Medical Officer may certify in writing to be essential for the recovery or for the prevention of serious deterioration in the condition of the patient, having regard to the nature of the disease; 

(viii) such diet as is ordinarily provided in the hospital subject in respect of employees in receipt of a monthly pay exceeding Rs.220, to the recovery of diet charges at such rates as may be fixed by the Board from time to time; 

            (ix) the specialist consultation described in sub-clause (b) of clause (7); 

            (x) confinement of a female patient in the Port Trust hospital; 

            (xi)  the pre-natal and post-natal treatment received by a female patient before and after child birth for physiological or other disability attributable to child bearing or child birth; 

            (xii) dental treatment, subject, when the treatment is obtained on the advice of a Medical Officer attached to a dispensary, the Assistant Chief Medical Officer, Senior Dental Surgeon or Chief Medical Officer, as the case may be, from the Government Dental College, Bombay, to the regulations made in that behalf by the Board; 

            (xiii)  anti-rabic treatment; 

            (xiv)  blood transfusion service; and 

            (xv) provision of ambulance service, whenever necessary, for the transport of a patient to the hospital; 

                        (b) but does not include -- 

                                    (i)  cost of eye glasses, if any, purchased by a patient, as part of the treatment; 

                                    (ii) taxi, hack victoria or other conveyance charges incurred to convey a patient from his residence to a hospital or vice versa,  except as provided in sub-clause (xv) of clause (a); and 

                                    (iii) special articles of diet not ordinarily provided by a hospital to its in-patients. 

3. Medical attendance and treatment on employees -- 

(1) An employee shall be entitled free of charge to medical attendance and treatment at a dispensary by the Medical Officer in charge of, or attached to, that dispensary and, if so recommended by the Medical Officer, to medical attendance and treatment at the consulting room in the Administrative Offices Building, by the Assistant Chief Medical Officer or the Chief Medical Officer, as the case may be. 

Provided that if an employee on a pay-scale rising to over Rs.650, so desires, he may directly seek medical attendance by the Assistant Chief Medical Officer or the Chief Medical Officer, as the case may be, at his consulting room in the Administrative Offices Building. 

(2) Where an employee is entitled under sub-regulation (1) to receive medical attendance free of charge, any amount paid by him on account of such medical attendance shall, on production of a certificate in this behalf, in the form prescribed in Appendix 'B', by the Assistant Chief Medical Officer or the Chief Medical Officer, be reimbursed to him.

 

4. Medical attendance and treatment of families of employees -- The members of the family of an employee shall be entitled at Port Trust cost to medical attendance and treatment at a dispensary or the consulting room maintained in the Administrative Offices Building on the scale and conditions allowed to the employee himself under these regulations. 

5. Medical attendance by person other than Medical Officer in charge of, or attached to, a dispensary or the Assistant Chief Medical Officer --   

(1) If the Medical Officer in charge of, or attached to, a dispensary, or the Assistant Chief Medical Officer, is of the opinion that the case of the patient is of such a serious or special nature as to require medical attendance by some person other than himself. 

                        (a) he may send the patient to the Specialist, full time or part-time, as the case may be, in the Port Trust hospital, as provided for in clause (b) of sub-regulation (7) of regulation 2, by whom in his opinion, medical attendance is required for the patient; or 

                        (b) if there is no such Specialist in the Port Trust hospital, he may refer the patient to the Chief Medical Officer who, after examination of the case, may refer the patient to a private Specialist, as provided for in clause (b) of sub-regulation (7) of regulation 2, by whom, in his opinion medical attendance is required for the patient; or 

                        (c)  in cases covered by (a) or (b) if the patient is too ill to travel he may arrange with the appropriate Specialist in the Port Trust hospital, or with the private Specialist, to whom the patient has been referred by the Chief Medical Officer, as the case may be, to attend the patient at the patient's residence. 

(2) Where a patient receives medical attendance from a private Specialist under clause (b) or clause (c) of sub-regulation (1), the fees of such Specialist shall, on production of a certificate in the form prescribed in Appendix 'C' from the Chief Medical Officer, be reimbursed in full. 

(3) (a) Where an employee is entitled, free of charge, to medical attendance and treatment from a Specialist in the Port Trust Hospital under sub-regulation (1), any amount paid by him on account of such medical attendance shall, on production of a certificate, in the form prescribed in Appendix 'B' by the Chief Medical Officer or the Assistant Chief Medical Officer, be reimbursed to him. 

(b) Where a member of an employee's family is entitled to medical attendance and treatment from a Specialist in the Port Trust hospital under sub-regulation (1), any amount paid by the employee on account of such medical attendance shall, on production of a certificate, in the form prescribed in Appendix 'B', be reimbursed to him. 

6.  Medical treatment at hospital  -- 

(1) An employee shall be entitled to medical attendance and treatment free of charge 

(a) at the Port Trust hospital; or 

(b) If in the opinion of the Chief Medical Officer, the Port Trust hospital cannot provide the necessary and suitable facilities, at such Government or Municipal hospital in Bombay or its contiguous areas, at or near the place where the employee falls ill as can in the opinion of the Chief Medical Officer, provide the necessary and suitable facilities, or 

(c) where in any exceptional case, the Chief Medical Officer is of the opinion that the necessary, and suitable treatment is available only in a private hospital or nursing home in Bombay at such private hospital or nursing home. 

Note :-- 

                        (1)  The facilities in a Government or Municipal hospital in Bombay do not include admission to a nursing home attached to that hospital.  If in the opinion of the Chief Medical Officer it is necessary for a patient to be admitted to a nursing home attached to a Government or Municipal hospital in Bombay, he may send the patient to such nursing home, but in such a case, the expenditure on the cost of the treatment shall be borne by the Board and the employee in the ratio of two to one. 

                        (2) In according his approval to an employee undergoing treatment at a Government, Municipal or private hospital in which different classes of accommodation are provided the Chief Medical Officer shall indicate the particular class to which the employee should seek admission. 

(2) Where an employee is entitled under sub-regulation (1) to medical attendance and treatment in the Port Trust hospital or in a Government or a Municipal hospital or in a private hospital or nursing home any amount paid by him on account of such treatment shall, on a claim being preferred in the form prescribed in Appendix 'D' and the Chief Medical Officer furnishing a certificate as to its admissibility, be reimbursed to him. 

            Provided that in the case of an employee in receipt of monthly pay exceeding Rs.220 undergoing treatment in the Port Trust Hospital, diet charges are recovered at such rates as may be fixed by the Board from time to time under clause (viii) of sub-regulation (9) of regulation 2. 

            Provided further that the liability of the Port Trust to reimburse an employee undergoing treatment in a Government or Municipal hospital under sub-cause (b) of sub-regulation (1) or in a private hospital or nursing home under sub-clause (c) of sub-regulation (1) will not include special nursing, tonics, restoratives and unless he is an employee who would have been eligible for free diet, had he undergone the treatment at the Port Trust hospital, also diet. 

            Provided also that in the case of an employee undergoing treatment in a private hospital or nursing home, the cost of treatment including the fees of Specialist, if any, who is consulted, and if any operation has been performed on the employee, the fees of the Surgeon and Anaesthetist, who performed the operation, together with the incidental expenses and charges levied for the use of the operation theatre shall be borne by the Port Trust and in the case of an employee undergoing treatment in a nursing home attached to a Government or Municipal hospital in Bombay, such cost shall be borne by the Board and the employee in the ratio of two to one. 

Note : 

            (1)  The maximum charges which should be taken into account as the basis for reimbursement in respect of each class of surgical operation performed in a private hospital or nursing home or a nursing home attached to a Government or Municipal hospital shall be as set out in Appendix 'E'.  The Chairman may on the recommendation of the Chief Medical Officer revise from time to time the maximum charges to be taken into account as the basis of reimbursement, but any reduction in such charges shall not be made without the approval of the Board. 

            (2)  In the case of reimbursement of medical expenses incurred by an employee on hospitalisation for himself in a private hospital or nursing home or a nursing home attached to a Government or Municipal hospital, the tariff of which indicates a flat inclusive charge per diem the diet charges will be reckoned as follows :- 

(a) where the flat charge made by the hospital includes  (i) diet, (ii) accommodation, (iii) ordinary nursing and (iv) medical and surgical services, 20% of the flat charge will be reckoned as diet charges; 

                        (b) where the flat charge made by the hospital includes  (i) diet, (ii) accommodation, (iii) ordinary nursing only but not (iv) viz. charges for medical and surgical services, 50% of the flat charge will be reckoned as diet charges. 

            (3)  The members of the family of an employee shall be entitled at Port Trust cost to medical attendance and treatment in the Port Trust hospital or in a Government or Municipal hospital in Bombay its contiguous areas or a private hospital or nursing home in Bombay and its contiguous areas on the scale and conditions allowed to the employee himself under these regulations. 

7.  Treatment at residence : 

            (1)  If an ailing employee or an ailing member of his family requests the Medical Officer in charge of, or attached to a dispensary nearest to his residence or if the employee is on a scale of pay rising to over Rs.650, the Assistant Chief Medical Officer, to attend on him at his residence and the Medical Officer, or the Assistant Chief Medical Officer, as the case may be, is satisfied that owing to the severity of the illness or other causes considered adequate by him the employee or the member of his family is unable to come personally for treatment at a dispensary, as provided in regulation 3, the employee or the member of his family may receive treatment at his residence at the hands of the Medical Officer or the Assistant Chief Medical Officer, as the case may be on the same scale and conditions as he would have been entitled to had he been treated at a dispensary. 

                        Provided that the right of calling to his residence a Medical Officer or the Assistant Chief Medical Officer, as the case may be shall not be available to an employee, or a member of the family of an employee, living beyond Jogeshwari or Bhandup.

 

8. Employees residing beyond Bhandup or Jogeshwari  

            (1) An employee, residing at a place beyond Bhandup or Jogeshwari, or a member of such an employee's family may, with the prior approval of the Chief Medical Officer or the Assistant Chief Medical Officer, receive treatment at the employee's residence from a local medical practitioner if the patient is too ill to come personally to a dispensary for the necessary medical attendance and treatment. 

            (2)  Where an employee or a member of his family is receiving treatment at his residence under sub-regulation (1), he shall be entitled to receive towards the cost incurred by him on such treatment a sum equivalent to the full cost of such treatment. 

                        Provided that the Assistant Chief Medical Officer, or the Chief Medical Officer, considers the cost of the treatment to be reasonable.

 

9. Treatment in emergency --  Where an employee or a member of his family suddenly takes seriously ill or receives a serious injury as a result of a serious accident and his condition does not permit of his being shifted to the Port Trust hospital without the risk of danger to his life and he is admitted into a Government, Municipal or private hospital nearest to the place at which he falls ill, with the prior approval of the Chief Medical Officer, as required under clause (b) or clause (c) of sub-regulation (1) of regulation 6, medical expenses to the extent otherwise admissible upto the time he is fit to be shifted to the Port Trust hospital for the purpose of treatment may be reimbursed, if the fact of admission and the attendance circumstances had been brought to the Chief Medical Officer's notice as soon after the admission into the Government, Municipal or private hospital as possible, and if after a careful examination of the circumstances of the case, the Chief Medical Officer recommends such reimbursement.  

10.Special provisions for certain diseases, viz.,   Tuberculosis, Cancer, Poliomyelitis and Mental Diseases. 

            (1)  Tuberculosis -- 

            (i) Employees and their families shall be entitled to receive, free of charge, treatment for tuberculosis to the extent facilities are available at the Prince's Dock T.B. Centre and other dispensaries. 

            (ii) Employees and their families shall also be entitled to receive , free of charge, treatment for tuberculosis in any sanatorium outside Bombay where beds have been reserved by the Port Trust for the purpose, subject to the conditions that the number admitted at any one time does not exceed the number of beds reserved in the sanatorium at the Port Trust cost and in the case of the employees on scales of pay rising to over Rs.650 and the members of families of such employees, diet charges are recovered. 

                        Provided that the Chief Medical Officer certifies that treatment in a T.B. Sanatorium is absolutely necessary. 

(iii) Employees and their families may also be allowed reimbursement, as admissible under these regulations, when on the advice of the Chief Medical Officer, they, as a result of their own efforts, are admitted to a tuberculosis institution in Bombay, recognised for the purpose of treatment of Central Government servants and their families suffering from tuberculosis, or a tuberculosis institution in Bombay designated by the Chief Medical Officer, subject to the Chief Medical Officer certifying that immediate sanatorium or hospital treatment is absolutely necessary and no reserved bed in the sanatorium where the Port Trust has reserved beds for its employees and their families is available. 

            (2)  Cancer (including Hodgkin's disease and Leukaemia) 

(i) Subject to the provisions of clauses (ii) and (iii), an employee or a member of his family shall be eligible for consultation and, with the prior approval of the Chief Medical Officer, receive treatment for cancer at the Tata Memorial Hospital, Bombay. 

            (ii) (a)  Where an employee or a member of his family receives consultation at the Tata Memorial Hospital under clause (i), any amount paid by the employee as the charges for such consultation with any of the surgeons or physicians of that Hospital shall on production of a certificate in form prescribed in Appendix 'C', be reimbursed to him in full. 

(b) Where a surgeon or physician of the Tata Memorial Hospital who attends on an employee or a member of his family is of the opinion that hospitalisation is absolutely necessary and the employee or the member of his family, as the case may be, undergoes treatment at the Hospital, the amount paid by the employee, for the treatment of himself, or a member of his family, as the case may be, at the hospital in the class of accommodation which the Chief Medical Officer considers to be appropriate shall, on a claim being preferred in the form prescribed in Appendix 'D' and the Chief Medical Officer furnishing a certificate as to its admissibility, be reimbursed to him in full. 

            Provided that the liability of the Port Trust will not include charges levied by the hospital for diet, unless the patient is an employee on a scale of pay not rising to over Rs. 650/- or  a member of such an employee's family. 

           (3) Mental Diseases -- An employee or a member of his family suffering from mental diseases may on the advice of the Chief Medical Officer receive consultation and/or treatment at the N.M. Mental Hospital, Thana, subject to the condition that the treatment for which reimbursement of medical expenses will be admissible shall not exceed six months, unless the Medical Superintendent of the Hospital certifies that treatment for a reasonable period, upto one year, beyond the initial six months' limit, is likely to lead to complete recovery of the patient.  Further notwithstanding the provisions of clause (viii) of sub-regulations (9) of regulation 2, the reimbursement of diet charges in the case of patients suffering from mental diseases and undergoing treatment in the N.M. Mental Hospital as in-patients will be allowed in full, if the employee is on a scale of pay not rising to over Rs.650 per month.  In the case of employees on scales of pay rising to over Rs.650 per month, 20% of the hospitalisation charges will be reckoned as diet charges and will not be reimbursed. 

            (4) Poliomyelitis -- An employee, or a member of his family, suffering from poliomyelitis may, receive treatment at any of the hospitals in Bombay providing such treatment and recognised by the Central Government for the purposes of treatment of their employees, or member of the families of such employees, subject to the condition that such treatment is recommended by the Chief Medical Officer.  Any amount paid by an employee for the treatment at such a hospital either of himself, or of a member of his family, shall, on a claim being preferred in the form prescribed in Appendix 'D' and the Chief Medical Officer furnishing a certificate as to its admissibility be reimbursed to him, provided that the liability of the Port Trust will not include charges levied by the hospital for diet, unless the patient is an employee on a scale of pay not rising to over Rs.650 or a member of such an employee's family who would have been eligible for free diet, had he undergone treatment at the Port Trust Hospital. 

11. Treatment of infectious diseases -- 

 An employee or a member of his family suffering from an infectious disease may receive treatment at a Government or Municipal infectious diseases hospital, or in isolation wards of such a hospital, in Bombay or its contiguous areas.  Any charges which may ordinarily be levied by such hospital for such treatment and paid by the employee, in respect of himself or a member of his family, may, on production of the necessary certificate from the Medical Superintendent of the Hospital, be reimbursed to him in full. 

            Explanation :  For the purpose of this regulation, infectious disease means chicken-pox, small-pox, cholera, diptheria, leprosy, measles, mumps, plague, scarlet fever, typhus fever, typhoid fever, whooping cough, cerebrospinal meningitis or such diseases as may be declared to be infectious diseases by the State Government from time to time.

 

12. Special concession to family members in case of death of employee while in service  --  In the event of the death of an employee while in service, a member of his family undergoing treatment at any of the dispensaries or the Port Trust hospital or at any other hospital at the time of the death of the employee may continue to receive such treatment for a period not exceeding three months from the date of the death of the employee on the same scale and conditions as applicable to him immediately before the death of the employee. 

13. Charges for services not included in medical attendance and treatment --  

            (1)  Charges for services rendered in connection with, but not included in, medical attendance on, or treatment of, a patient entitled, free of charge, to medical attendance or treatment under these regulations shall be determined by the Chief Medical Officer and paid by the patient. 

            (2)  If any question arises as to whether any service is included in medical attendance or treatment, it shall be referred to the Chairman whose decision shall be final. 

14.  Mode of supplying medicines, etc. --  

            (1)  All medicines, injectiles, vaccines, sera or other therapeutic substances prescribed by a Medical Officer, Assistant Chief Medical Officer, Chief Medical Officer or a Specialist shall, if available at the dispensary at which the employee is registered for purposes of medical attendance and treatment or the Port Trust hospital, as the case may be, be supplied from such dispensary or the hospital. 

                        Provided that when any medicines, injectiles, vaccines, sera or other therapeutic substances are not ordinarily available at the dispensary at which the employee is registered for purposes of medical attendance and treatment or the hospital, as the case may be, the same shall be purchased by the employee at his own cost and he shall subsequently be reimbursed by the Port Trust the cost involved, subject to the Chief Medical Officer, or the Assistant Chief Medical Officer furnishing a certificate in the form prescribed in Appendix 'B' and the employee producing the relative cash mema. 

15.  Reimbursement of hospital, etc. charges --  

(1)  Payment on account of fees of specialists or charges levied by a hospital shall, in the first instance be made by the employee to the specialist, or the hospital, as the case may be, and reimbursement thereof to the extent admissible under these regulations claimed from the Port Trust in the forms prescribed for the purpose, in Appendix 'C', or Appendix 'D' as the case may be.

 

16. Time-limit for preferring claims for reimbursement -- 

Every claim for reimbursement of medical expenses incurred by an employee in respect of a particular spell of illness shall be presented within six months from the date of completion of treatment. 

            Provided that any claim may be admitted after the said period of six months, where the employee satisfies the Chief Medical Officer that he had sufficient cause for not presenting the claim within the said period. 

 

17. Transfer to foreign service --  No employee shall be transferred to foreign service unless, the foreign employer undertakes to afford to him, so far as may be, privileges not inferior to those which he would have enjoyed under these regulations, if he had been employed in the service of the Board.

 

18.  Interpretation -- If any question arises as to the interpretation of these regulations, it shall be referred to the Chairman whose decision thereon shall be final.

 

19. Power to relax -- Where the Chairman is satisfied that the operation of any of those regulations causes undue hardship in any particular case, he may by order, for reasons to be recorded in writing, dispense with or relax the requirements of that regulation to such extent and subject to such exceptions and conditions as he may consider necessary for dealing with the case in a just and equitable manner. 

20.  Repeal and savings --  

(1) On the commencement of these regulations, every rule, regulation, resolution or order in force immediately before such commencement shall, in so far as it provides for any of the matters contained in these regulations, cease to operate. 

(2) Notwithstanding such ceasation of operation, anything done or any action taken under the old rule, regulation, resolution or order shall be deemed to have been done or taken under the corresponding provisions of these regulations.  


APPENDIX 'A'

 

List of dispensaries

 

(see clause (3) of regulation 2)

 

1.         Ballard Estate Dispensary, 2nd floor, Thackersay House, Graham Road, Ballard Estate, Bombay 400 038. 

2.         Prince's Dock Dispensary, Prince's Dock Dispensary Building, P.D'Mello Road, Bombay 400 009.  

3.         Dockyard Dispensary, Dholkar Street, Bombay 400 010.  

4.         Cotton Green Dispensary, 4/2, Zakeria Bunder Road, Bombay 400 015.  

5.         Wadala Dispensary, Wadala Dispensary Building, Reynolds Road, Bombay 400 037. 

6.         Antop Village Dispensary, Nadkarni Park, Antop Village, Bombay 400 037.

 

Sub-Dispensaries

 

1.         Pir Pau Dispensary, Combined Building, Pir Pau Manifold, Chembur, Bombay 400 054. 

2.         Butcher Island Dispensary, Butcher Island. 

3.         Colaba Dispensary, B.P.T. Recreation Club Building, Dumayne Road, Colaba, Bombay 400 005.


APPENDIX 'B'

 

            (See

 

 

Certificate granted to Shri/Smt/Kum._____________________________________________

wife/son/daughter/father/mother of Shri/Smt/Kum. ___________________________________ employed as

 ______________________ in _____________ Section of ________________________ Department.

 

__________ 

 

            I certify that the patient was under my treatment/the treatment of the Medical Officer, _______________ Dispensary/the Asstt. Chief Medical Officer, and that the medicines detailed below was prescribed by me/him/the Specialist, Dr. ________________________ as the same were essential for the recovery/prevention of serious deterioration in the condition of the patient.  I further certify that these medicines are not stocked at the dispensary at which the patient is registered for the purpose of medical attendance and treatment or the Port Trust Hospital for supply to patients and do not include proprietary preparations for which cheaper substitutes of equal therapeutic value are available nor preparations which are primarily foods, tonics, toilet preparations or disinfectants. 

Names of medicines

1.

2.

3.

4. 

Date :                                                                                   Signature of the Asstt.Chief Medical Officer

                                                                                                                          Chief Medical Officer.


APPENDIX 'C' 

(See sub-regulation (2) of regulation 5) 

_________________________________________________________ 

 

Certificate granted to Shri/Smt/Kum. ____________________ wife/son/daughter/father/mother of Shri/Smt/Kum. ___________________________________ employed as ______________________ in _____________ Section of ________________________ Department.

 __________ 

  

            I certify that the patient was referred to Dr. ________________ for specialist consultation by Dr. __________________________, Medical Officer, ________________ Dispensary/Port Trust Hospital, with my approval and that the services of the specialist Dr. _____________________ for which an expenditure of Rs.__________ was incurred were essential for the recovery/prevention of serious deterioration in the condition of the patient. 

Date :                                                                                              Signature of the Chief Medical Officer


APPENDIX 'D' 

(See sub-regulation (2) of Regulation 6) 

_________________________________________________________ 

            Form of application for claiming re-imbursement of medical expenses incurred in connection with medical attendance and/or treatment of employees and eligible members of their families in a Government, Municipal or private hospital. 

__________ 

 

N.B. :  Separate form should be used for each patient.

 

__________

 

 

1.   (i) Name and designation of employee             :

            (in block letters)

 

      (ii) Whether married or unmarried                    :

 

      (iii) If married, whether wife/husband is            :

            employed and the place where wife/

            husband is employed.

_________________________________________________________ 

2.  Section and Department in which                    :

      employed.

_________________________________________________________ 

3.  Pay of employee                                             :

_________________________________________________________ 

4.  Actual residential address                               :

_________________________________________________________ 

5.  Name of patient and his/her relationship            :

     to the employee 

     N.B. :  In the case of children state age also.

_________________________________________________________ 

6.  Place at which patient fell ill               :

_________________________________________________________ 

7.  Nature of illness and duration                       :

_________________________________________________________ 

8.  Details of amount spent                           :

 

     I.  Medical Attendance -

 

            (i) Fees for consultation indicating

 

                 (a)  The name and designation of            :

                       the medical officer consulted

                       and the hospital to which

                        attached; 

                 (b)  the number and dates of                  :

                       consultation and the fee paid

                       for each consultation; 

                 (c)  the number and dates of                 :

                       injections and the fee paid

                       for each injection;

 

            (ii) Charges for pathological,                :

                  bacteriological, radiological or

                  other similar tests undertaken

                  during diagnosis indicating -

 

                  (a) Name of the hospital or             :

                       laboratory where the tests

                       were undertaken; and 

                  (b) Whether tests were undertaken            :

                       on the advice of the Medical

                       Officer consulted.  If so, a

                       Certificate to that effect should

                       be attached.

 

            (iii) Cost of medicines purchased            :

                  from the market.

                  (List of medicines and cash

                    mema should be attached).

_________________________________________________________

 II.  Hospital treatment -

 

      Name of the hospital                              :

 

      Charges for hospital treatment indicating

      Separately the charges for -

       (i) Accommodation --

 

            (State whether it was according to             :

              the pay of the employee and in

              cases where the accommodation is

              higher than that admissible according

              to pay, a certificate should be attached

              to the effect that the entitled the

              type of accommodation was not

              available).

 

     (ii) Diet                                                       :

      (iii) Surgical operation or                             :

            medical treatment

      (iv) Pathological, bacteriological radio-   :

            logical or other similar tests

            indicating -

                   (a) the name of the hospital or            :

                        laboratory at which undertaken;

                   (b) whether tests were undertaken             :

                        on the advice of the Medical

                        Officer in charge of the case

                        and if so, a certificate should

                        be attached;

      (v) Medicines                                            :                                  

      (vi) Special medicines                                :

            (List of medicines and cash memo

              should be attached).

     (vii) Ordinary nursing                         :

    (viii) Special nursing, i.e. nurses specially            :

            employed for the patient.  State

            whether employed on the advice of

            the Medical Officer in charge of the

            case and if so, a certificate to that

            effect should be attached.

       (ix) Ambulance charges                                    :

            (State the journey to and from

              undertaken).

        (x) Any other charges, e.g. charges for            :

            electric light, fan, air conditioning etc.

_________________________________________________________

 III.  Consultation with specialist -

 

       Fees paid to a specialist other than the

       Medical Officer in charge of the case,

       indicating -

 

       (a) the name and designation of the       :

            specialist and the hospital to which

            attached;

 

      (b) number and dates of consultations            :

            and the fees charged for each

            consultation.

_________________________________________________________

9.  Total amount spent                                       :

_________________________________________________________

10.  List of enclosures                                            :

_________________________________________________________

Declaration

             I hereby declare that the statements in the application are true to the best of my knowledge and belief.

  

Date :                                                                                                                         Signature of employee


APPENDIX 'E' 

(See Note (1) below sub-regulation (2) of Regulation 6) 

_________________________________________________________ 

 

1.  For the purpose of the reimbursement, under the third proviso to sub-regulation (2) of Regulation 6, to employees of the expenses incurred on surgical operations undergone either by themselves or members of their families, operations will be divided into three classes depending on the nature of the operation, as shown below :- 

(A) Minor

 

1. Tonsillectomy                                          7.  Setting of fractures

2.  Correction of the septum of                      8.  Plaster putting

     the nose                                                9.  Vasectomy

3.  Simple operations on the ear                  10.  Phrenic Evulsion

4.  Sinus puncture                                      11.  Dilation and Currettage

5.  Aspiration of the chest                              (Gynaecological)

6.  Bronchoscopy/Oesophagoscopy            12.  Minor amputations.

                                                                13.  Operations on eye-lids

 

(B)  Intermediate

 

14. Piles                                                  19.  Appendicectomy

15. Female Sterilization                            20.  Ventri-suspension

16. Removal of cataract                            21.  Fistula-in-ano

17. Hydrocele operations                         22.  Removal of fibroids

18. Hernia operations                               23.  Major amputations.

  

( C)   Major  

Operations on the  

24. Gall bladder                                      31.  Thoracoplasty

25. Stomach                                          32.  Resection of the chest

26. Kidneys, and                                    33.  Laminectomy

27. Spinal Column                                   34. Hysterectomy

28. Mastoid operations                            35.  Splemectomy

29. Resections of the intestines               36.  Bone-grafting

30. Lobectomy                                        37.  Orthopaedic operations for

                                                                   major repairs for locomotion

  

(1) The above classified list is merely illustrative and not exhaustive.

(2) If the complexity of a case or its other attendant circumstances so warrant, it shall be open to the Chief Medical Officer to transfer a particular operation from one class to another. 

2.  As a general rule, the maximum charges, which will be taken into account as the basis for reimbursement in respect of each class of operations, will be as under : 

Class of operation       MAXIMUM  
Operation  Theatre charges 
( Rs. )
Surgeon's  Fees  
( Rs. )
Anaesthetist's Fees  
( Rs. )
(A)  Minor          30  150    30
(B)  Intermediate    50   300      60  
(C) Major  75     600         120  

       

(1) If the complexity of a case or its other attendant circumstances so warrant, it shall be open to the Chief Medical Officer to vary the above rates. 

(2)  The Surgeon's fees noted above will include the necessary post-operative treatment and his routine visits to the patient in the hospital or nursing home. 

(3)  Medicines, drugs, injectiles and blood transfusions will be allowed extra in accordance with rules. 

_______________                  

1