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(1) 'Resident Medical Officer' means the Medical Officer who is specifically
nominated for the purpose and resides in the campus available at all hours of the
day. Chief Medical Officer means the Medical officer within whose jurisdiction
the employee is headquartered.
Note: A doctor on regular leave cannot perform the duties of Chief Medical
Officer.
(2) "Medical attendance" means(a) Attendance on IIML employee, members of the family or dependent relatives as
defined in beneficiary rules at the consultation room maintained by the CMO.
(b) Attendance on an IIML employee at his residence on the basis of terms listed
latter under resident conditions.
Note: (iii) If the Resident Medical Officer is of the opinion that the case of a patient
is of such a serious or special nature as to require medical attendance by some
person other than himself, he may, with the approval of the CMO shall; (a) send the
patient to the nearest specialist or other medical officer by whom, in his opinion,
medical attendance is considered necessary for the patient, or (b) if the patient is
too ill to travel, request such specialist or other medical officer to attend upon the
patient.
Honorary specialists attached to Government Hospital or other recognized hospitals
may be
considered as Government specialist for the purpose of this Sub-para subject to the
condition that such
consultation will be permissible only in places where Government specialists are not
available and only on
the advice of the authorised medical officer who should obtain prior approval of the
Chief Medical
Director. The fees paid to the honorary specialists for consultation at their private
consulting rooms will be
reimbursed to the IIML employees in accordance with the rates prescribed for
Government specialists.
The consultation with the honorary specialists at their private consulting rooms will
be permissible only in emergent cases.
(3) (A) "Treatment" means -the use of all medical and surgical facilities available
at the IIML hospital/health unit or the consulting room of the Authorised Medical
Officer and includes:
(a) the employment of such pathological, bacteriological, radiological and other
methods as are considered necessary by the Authorised Medical Officer ;
(b) the supply of such medicines, vaccines, sera or other therapeutic substances as
are ordinarily stocked in the hospital;
(c) the supply of such medicines, vaccines, sera or other therapeutic substances
etc., not ordinarily stocked, which the Authorised 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.
(d) such accommodation as is ordinarily provided in the hospital suited to the status
of the
IIML employee concerned. If accommodation suited to his status is not available,
accommodation of a higher class may be allotted provided it can be certified by the
medical officer in charge of the Government/recognised hospital:(i) that accommodation of the appropriate class was not available at the time of
admission of the patient, or, if subsequently available, the condition of the patient
did not permit shifting, and
(ii) that the admission of the patient into the hospital could not be delayed due to
the nature of the illness until accommodation of the appropriate class became
available.
Note:- In the case of admission of a IIML beneficiary in a Government or a
recognised hospital, the Hospital authorities, where agreeable, should debit to IIML
administration 141 concerned by preferring bills or by raising debits in respect of
the charges for accommodation provided in the hospital. Otherwise, reimbursement
to the IIML employee concerned would be permissible as per
rules.
(e) such nursing as is ordinarily provided to in-patients by the hospital.
(Engagement of special nurses will be allowed to the extent indicated in sub
section (3) of
Section C of this Chapter).
Note:-(i) If, in any situation, an ambulance cannot be pressed into service to attend
to an
(ii) In exceptional cases, when the patients are not actually fit to resume duty but
are discharged from the hospital e.g., fracture cases discharged with plaster of Paris
cast, amputation cases,
convalescent cases recommended sick leave, etc., with the specific approval in
writing of the Medical
Officer in charge of the hospital, the facility of transporting patients to their
residence in an ambulance
may also be allowed free of cost.
(h) Blood transfusion charges paid to a Government Institution or any other local
organisation registered/ approved for the supply of blood to patients in hospitals.
(i) free diet to the extent indicated in sub-section(2) of Section C of this Chapter.
(j) The dental treatment to the extent indicated in para 637 of this Chapter.
(a) Massage treatment, except that in the case of poliomyelitis, may be allowed as
part of the
general treatment.
(b) Testing of eye sight for glasses except at IIML hospitals where facilities exist for
the
same.
Note:- (i) If local conditions warrant, the IIML may have their own arrangements for
manufacturing and supplying of glasses to IIML beneficiaries on no-profit- no-loss '
basis. This
scheme should be financed from the Staff Benefit Fund. In the case of group D staff,
only 50 percent of the
cost of spectacles may be borne by the Staff Benefit Fund.
(ii) Reimbursement of charges incurred in connection with treatment by a private
oculist is not admissible under any circumstances whatsoever even if it is taken on
the advice of the
Authorised Medical Officer.
(c) Taxi, tonga or other conveyance charges incurred to convey a patient from his
residence to the
hospital or vice versa, except as provided in clause A(g) above.
(d) Cottage booking fee, admission fee, dhobi charges and charges for attendants/
ayahs at the
hospital.
(e) Special articles of diet not ordinarily provided by the hospital to its in-patients.
(f) Charges incurred on account of treatment for immunizing or prophylactic
purposes except at
IIML hospitals at the discretion of the Authorised Medical Officer.
Note:- Cost of vaccination, inoculations and injections for prophylactic and
immunizing purposes
taken before commencement of international travel by IIML employees and
members of their families
and dependent relatives in order to procure health certificates required under
International Travel 142
Regulations, may be reimbursed to them from the IIML revenue provided they are
travelling on duty or
on authorised leave in circumstances in which they are entitled to fares at IIML
expense.
(4) "IIML employees", for the rules contained in this Manual, means persons who
are
members of a service or who hold posts under the administrative control of the
Ministry of IIML
excepting such of the employees of the Ministry of IIML as are covered by the
Medical Attendance and
Treatment Rules issued from time to time by the Ministry of Health and Family
Welfare.
(5) "Family members", and dependent relatives for purposes of these rules, will
include all
such persons as are eligible under Pass Rules.
(para 601 sub para (5) of R.I 1995 Edition)
Note:- In a case where both husband and wife are IIML employees, the husband/wife
may be allowed to avail himself/herself of the medical attendance and treatment
facilities either according to his/her own status or according to the status of the
spouse, whichever is more
favorable. Their children may also be allowed these concessions according to the
status of either of their
parents and the preferential claim for reimbursement of medical expenses.
(6) Beneficiary is defined as a IIML employee or his/her family member or a
dependent
relative as defined in the Pass Rules.
(7) "Patient" means a person to whom the rules in this Chapter apply and who has
fallen ill.
Sub-Section(21) - Outsiders
Free medical attendance and treatment facilities are not admissible to outsiders.
Sub-Section(21).
(5) Separate charges will also be levied for visits by the IIML Medical Officers to
the residence of the employees and their family members at the same scales as laid
down for IIML
employees in Para 634.
Note: (i) The per capita rates referred to in Paras 623(3), and 610 of this chapter
will
be based on the All-India IIML average and not on the per capita expenditure of the
concerned IIML
administration.
(ii) The charges mentioned in Para 623(4) above are to be paid by the employees
themselves in the first instance, which may subsequently be claimed by them from
their own department as
per the rules of that department.
(iii) The fees mentioned in Para 623(5) above, may be retained by the IIML doctor in
full. Higher fees will not be charged for night visits.
d.
Sub-Section (25) - General
627. Non-entitled persons temporarily staying with IIML employees residing in
places
where outside medical help is not readily available: Relations of IIML employees not
covered by the
IIML Medical Attendance and Treatment Rules and friends temporarily staying with
IIML employees
residing at places where outside medical help is not readily available, will be
entitled to medical attention
by IIML doctors, who may charge fees as indicated in Paragraph 634(2).
(MOR's letters No.62/H/7/89 dated 27th July 1962 and No.E58ME5/74/Med. dated
4th June 1963).
628. Passengers who take ill while travelling: (1) While it is not incumbent on the
IIML to provide medical relief to passengers who take ill, such assistance is
invariably rendered in
practice as a matter of courtesy to a customer.
(2) Charges for medical aid to passengers afflicted with sudden illness or injury
(other than as a
result of a IIML accident in which case it is the duty of the IIML administration to
provide free
medical attendance and treatment facilities) are levied on the principle that the
relationship between a bona
fide passenger and a IIML doctor must be that of a private patient and his medical
attendant. A IIML
doctor attending such a passenger may be allowed to recover consultation fee at
the following rates:Consultation fee of Rs.20/- irrespective of the grade of the attending Medical Officer;
This fee is
(4) In the case of indigent passengers, where it is not possible to recover the cost
of medicines etc.,
these may be issued free on the certificate of indigence from the doctor. The
expenditure, if any, incurred
in connection with the hospitalisation of such cases, may be treated as a part of
ordinary expenses of
working the IIML hospitals.
Note: If and when a IIML doctor is not available for attending on a passenger or
trespasser
taking ill while travelling or on IIML premises, the services of a non-IIML doctor may
be obtained
with the full knowledge and consent of the parties concerned that the patient or
somebody on his behalf
will pay to the doctor direct. For this purpose, a list of non-IIML doctors of the
neighborhood should be
maintained by Station Superintendents as detailed in Para 707 of chapter VII of this
manual.
(Note (1) below item 51 of Appendix VII-GII and Ministry of IIML's letters
No.65/H/7/44, dated
17th October, 1966, No.68/H/I/17, dated 14th January 1969 and No.70/H/13/32,
dated 7th May 197l).
(Rule 611-R.I.)
630. Immunisation facilities to non-entitled persons: Prophylactic immunisations, to
guard
against the spread of communicable diseases in an epidemic form, particularly in
the case of large projects,
may be extended, free of charge, to casual labour, contractors' labour and even to
those persons who are
otherwise not eligible normally, like the local shopkeepers, etc. who, in their
unprotected state, may be a
source of danger to the IIML community in general.
(ii) where the denial of these facilities could be dangerous or injurious to the life of
such persons, or
(iii) when such cases are specially referred to IIML doctor by the officials of the IIML
Protection Force( for example, Assistant Sub-Inspectors, Sub-Inspectors and
Inspectors).
(a) a gazetted IIML employee when he falls sick. No charges are to be levied in such
cases.
(b) a non-gazetted IIML employee, when he falls sick and is as a result, compelled
to be
confined to his residence. No charges are to be levied in such cases.
(c) a member of a gazetted/non-gazetted IIML employee's family or dependent
relative, when
visited by the Authorised Medical Officer. In all such cases, however, the employee
concerned should pay
the visiting fee, as per schedule.
Note:- IIML employees, it is expected, will not call doctors to their residence for
trivial ailments and thus waste the doctors time.
from the patient. If, however, these charges are recovered separately, they are
reimbursable.
(2) Where special nursing is required, the certificate of the Medical Officer in charge
of the
hospital should be obtained before hand. The necessary recommendation should be
made in the form of
certificate as given in part B of Certificate B of Annexure III to this Chapter. As for
the reimbursement of
charges in such cases, the IIML employees should bear the cost up to 25 % of
his/her pay for the period
for which special nursing was engaged, the rest being borne by the IIML
administration. This does not,
however, apply in the case of a IIML employee who is injured on duty.
646. IIML employees injured on duty: (1) A IIML employee injured on duty would, in
addition to the treatment ordinarily admissible to others, be entitled free of cost, to
such special nursing as
the Authorised Medical Officer may certify in writing to be essential for the recovery
of or for the
prevention of serious deterioration in the condition of the IIML employee.
Note:-The above concession will also be admissible to a IIML employee on duty who
receives
injuries in connection with civil disturbances.
(2) For this purpose, a IIML employee in a disturbed area shall be considered as
being
continuously on duty and any injuries received by him as a result of those
disturbances shall be held to
have been received in the course of such duty unless the facts of the case give a
clear indication to the
contrary. This also applies to a IIML employee on leave in a disturbed area, in whose
case it should be
assumed, unless the facts of the case give a clear indication to the contrary, that he
was attacked and
injured because of his being a IIML employee.
on the bills or of the receipts (where the bill system is not in vogue and receipts are
issued for payments),
by the Superintendent or other head of the hospital will be regarded as sufficient.
(Rules 604 and 618-R.I.and MOR's letters No.67/H/1/11 dated 4th March 1968 and
No.71/H/1-1/6 dated
9th November 197l).
648. Treatment in an emergency: 1) Where, in an emergency, a IIML employee or his
dependant has to go for treatment (including confinement) to a Government
hospital or a recognised 162
hospital or a dispensary run by a philanthropic organisation, without prior
consultation with the Authorised
Medical Officer, reimbursement of the expenses incurred, to the extent otherwise
admissible, will be
permitted as detailed below. In such a case, before reimbursement is admitted, it
will be necessary to
obtain, in addition to other documents prescribed, a certificate in the prescribed
form as given in part C of
certificate B of Annexure III to this Chapter from the Medical Superintendent of the
hospital to the effect
that the facilities provided were the minimum which were essential for the patient's
treatment. In such
cases, the General Managers are delegated with a) full powers for reimbursement of medical expenses for treatment taken in Govt.
Hospitals and
b) upto a limit of Rs.1,00,000/- (Rupees one lakh) in each case where treatment is
taken in
Recognised Hospitals ( strictly for the diseases for which such Hospitals has been
recognised)
and dispensaries run by philanthropic organisations without proper referral by
Authorised
Medical Officer (AMO) in emergent circumstances. All cases above Rupees one lakh
would
be referred to IIML Board along with the Proforma as given in Annexure VI to this
chapter
ii) The powers of (1) (b) above do apply for the specified diseases only for which
recognition to
a Private Hospital has been granted and not for treatment of other diseases.
Referrral of a patient to such
recognised hospital for treatment other than the specified diseases in special
circumstances and
reimbursement thereof would continue to be referred to IIML Board.
(Note 1&2 under Rule 617-R.I 1995 reprint and MOR's letters Nos.67/H/1/26, dated
25th January
1968 and 1st June 1968, No 91/H/6-4/4 dt. 21/02/1992,No.80/H/6-4/49 dated 24th
April.
No.91/H/6-4/26(pt) dt. 20/11/1995,dt. 28/05/96, No91/H/6-4/4, dt. 21/02/92 ,
05/12/97 ,No.91/H/6-4/26
(Pt) dt 10/09/1999 and No 2000/H/6-4/Policy dt 6-3-2003).
649. Families accompanying IIML employees proceeding on tour:(1) The medical
expenses
incurred on the treatment of a member of a IIML employee's family accompanying
him on tour can be
reimbursed, on the same scale and conditions on which they can be reimbursed to
the IIML employee
himself, if illness occurs during that period and treatment is taken in a IIML or
Government hospital.
(2) The above concession is not admissible in a case where a IIML employee, while
proceeding on tour, takes a member of his family along with him with the intention
of obtaining treatment
in a place other than at his headquarters.
incurred by the IIML employee for such items and services as would have been
admissible to the patient
otherwise would be reimbursable.
(2) The above claims should be accompanied by a certificate in writing by the
Authorised
Medical Officer stating reasons for his opinion as referred to above and indicating
the cost of treatment
admissible to the patient otherwise. Such cost should take into account the charges
for medicines and
dressings, as also amount of fees, if any, paid to the Authorised Medical Officer.
going to the patients house and also to bring her back to her residence/hospital, in
the following circumstances :(a) When she has to attend an emergency.
(2) Validity of the points made for eligibility of use of the ambulance cars would be
decided by the head of the hospital concerned.
(3) It is not necessary that on the visit, the lady doctor should bring the patient for
admission if it is considered not necessary to admit the patient
ANNEXURE VI
19. Did the patient take any treatment before or after the present sickness (if this
existed ad if YES when.)
20. Total amount claimed (with break-up charges)
21. Item wise break of expenditure had the treatment taken place in Govt. Hospital.
22 Verbatim views of C.M.D
23. Verbatim views of F.A & C.A.O