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 ( 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.
_______________