Contributory Medical Attendance Rules - BEL

OO.NO.
HO/821/009 (As amended) DTD 14/11/85
Subject: CONTRIBUTORY MEDICAL ATTENDANCE--REVISED RULES.

*****
1.0 Management hereby introduces the Revised Rules for Contributory

Medical Attendance, as given in the Annexure.
2.0 Subject to the following provisions, these Rules apply to all the Units and
Offices of the Company and come into force from 1.11.85.
2.1 Wherever the Units / Offices have already notified:
(a) PMPs/GMPs/AMAs for outpatient treatment and / or for

referring cases for hospitalisation/ specialist treatment, and
(b) Specialists and Panel Hospitals,
such PMPs/GMPs/AMAs and Specialists and Hospitals will continue to be

valid as if they have been approved by Head Office under these Revised
Rules for the relevant purposes. This validity will, however, be for the
period upto 31/3/1986 only. The Units / Offices should review the lists /
panels well before that date and get fresh lists / panels approved by the
Head Office in time, to announce the fresh lists / panels which are to be
effective from 1/4/1986.
2.2 The scheme for outpatient treatment specified in these Rules shall be
deemed to have come into force effective from 1/4/1985.
2.3 In the case of the Head Office and Bangalore Complex only, the existing
system of outpatient treatment (through AMAs / Company Hospital) will
continue in operation until specific orders are issued bringing them on to
the scheme for outpatient treatment specified in these Rules. Till then,
the AMAs will be deemed to be the PMPs under these Rules. In regard to
all matters other than outpatient treatment, the Revised Rules will apply
to Bangalore Complex and Head Office as well.
2.4 In the case of Regional Offices / Sales Depots / New Units, where under
the extant orders any unutilised amount allocated for outpatient
treatment for the last financial year 1984-85 remains to be carried
forward to the financial year 1985-86, the same will be deemed as so
carried forward to 1985-86 and merged with the allocation for 1985-86
under these Rules. The combined amounts shall be available for
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utilization during 1985-86, and any amount remaining unutilised as on
31/3/86 shall lapse.
3.0 This Office Order supersedes all previous Office Orders / Circulars issued
from HO and from all Units on the subject (except to the extent specified
above). File decisions not in consonance with these orders will
automatically cease to apply.
CHAIRMAN & MANAGING DIRECTOR.
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ANNEXURE
BEL CONTRIBUTORY MEDICAL ATTENDANCE SCHEME
1.0 APPLICABILITY
1.1 This scheme applies to employees (both executives and non-executives)

who are not covered under the ESI Scheme by reason of having been
exited / exempted therefrom or otherwise.
1.2 Deputationists will be governed by this scheme only if they have opted to
be governed by BEL’s Medical Rules in lieu of parent department’s /
organisation’s rules.
1.3 These rules apply only in respect of medical treatment within India.
2.0 OPTION:
2.1 For availing the benefits of the scheme employees shall pay to the
Company the monthly contributions specified in para 4.0 below.
Coverage under the Scheme is, however, compulsory and no employee
can opt out of it, except where the employee’s spouse is employed in any
other organisation (Govt/PSU/Private) and by virtue of which the spouse
is entitled to Medical benefits from his / her employer, for the entire
family including the BEL Employee. In such cases, the employee
concerned should send a written communication specifying the details
about the spouse’s employment and the medical benefits derived
therefrom, to the Accounts / Pay Rolls Department so as to reach them
atleast a month in advance of the commencement of the quarter from
which the employee wishes cessation of the contribution and consequent
withdrawal from the scheme. Once an employee has so withdrawn from
the scheme, he shall not ordinarily be permitted to rejoin the scheme,
except for valid reasons to the satisfaction of the Head of the Unit such
as the spouse’s cessation of employment with the particular
Organisation.
2.2 Where both the husband and wife are employed in BEL, both of them
should make the monthly contribution separately under this scheme to
become eligible for the benefits thereunder, and one of them cannot opt
out of the scheme in terms of 2.1 above.
$2.3 Woman employee has a choice to include either her parents or her
parents in law. Option exercised can be changed only once during her
service."
"Explanation: In the case of Pensioners, for determining pension amount

for the purpose of dependency, the original pension (before
communication) excluding the Dearness Relief sanctioned after
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December 1995 will be taken into account to determine the gross income
for the purpose of income limit of Rs.9000/- per month".
$(Inserted vide Office Order No.HO/821/036 Dated 29th June, 2005 with
immediate effect)
3.0 DEFINITIONS:
3.1 Family: For the purpose of the Scheme, “Family”, means and includes:
3.1.1 Employee himself;
3.1.2 Employee’s spouse;
3.1.3 #Legitimate / adopted/step children wholly dependent upon the

employee; and
(# Amended Vide OO No.HO/821/31 Date 20.11.2002)
3.1.4 Parents of the employee wholly dependant upon and normally residing
with the employee.
NOTE (i) Where both the husband and wife are employed in BEL they
as well as their eligible dependants may be allowed to avail the facilities
under the Scheme according to the status of one of them. For this
purpose, they should furnish a joint declaration to the Accounts / Pay
Rolls Departments, with a copy to the Personnel Department, giving the
details of dependants and also committing as to who will prefer the
claims under the scheme (including the quarterly reimbursement
towards outpatient treatment vide para 5.1.3 below) in respect of the
other spouse and the dependants. This declaration shall remain in force
until it is revised in writing by both the husband and his wife e.g., in the
event of Promotion, resignation etc., of either of the two. In the absence
of the joint declaration, claims for reimbursement shall be accepted only
from the husband and regulated according to his status.
(ii) Where the spouse is employed in any other organisation (Private

/ Govt. / PSU) the employee while claiming any reimbursement from BEL
under this scheme, should furnish a declaration to the effect that his
spouse has not availed / claimed or will not avail / claim any
reimbursement or other benefit from his / her organisation in respect of
the same period / treatment.
(iii) A son will be deemed to be wholly dependant upon the employee

if he is unmarried and unemployed and has no other source of income.
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(iv) A daughter will be deemed to be wholly dependant upon the
employee if she is unmarried / widowed and unemployed and has no
other source of income.
* “(V) Parents whose income from all sources put together exceed Rs. 9000/-
per month plus the amount of Dearness relief, on Basic pension of Rs. 9000/-
per month as on date of consideration shall not be considered to be wholly
dependant on the employee.
Explanation: The amount of Dearness relief, as indicated in the income limit

stands for the amount of dearness relief, drawn by the pensioner/family
pensioner on the date of consideration and not the amount Dearness Relief due
on the date of consideration.”
(*Substituted vide OO No. HO/821/055 dtd 23.06.2017 with immediate effect)
3.2 “Panel Medical Practitioner” (PMP) is one who is a registered Medical

Practitioner in allopathic with the minimum qualification of MBBS, and
who has been included in the Panel of Medical Practitioners maintained
by the Unit with the approval of HO. The main criteria for inclusion of a
Medical Practitioner in the Panel will be his / her integrity and
professional standing. Employees and their family members may consult
any Panel Medical Practitioner on payment by them of the consultation
fees and claim reimbursement thereof within the limit allowed for
outpatient treatment, as detailed in para 5.0 below. Panel Medical
Practitioners will alone be the competent authorities to refer cases for
Specialist treatment or Hospitalisation. (For purposes of such reference,
CMO/SMO and other Medical Officers of the Company will also be
deemed to be PMP).
4.0 CONTRIBUTION:
4.1 Contribution shall be recovered from the employee through pay roll
deduction at the following rates:
4.1.1 ~~ In respect of Non-Executive employees: Rs 25/- per month.
(~~ Para 4.1.1 & 4.1.2 deleted and new 4.1.1 para added vide OO No.
HO/821/039 dt 14-08-2009. Effective from 01-07-2009)
4.1.2 ^^ In respect of Executives :-
i) TC-I to TC-V and E-I to E-III grade : Rs. 100/- per month.
ii) E-IV grade & above : Rs. 150/- per month.
(^^ Substituted vide O.O. No. HO/821/049 dated 21.05.2013)

4.2 The recovery towards the monthly contribution shall take priority above
all other recoveries, except statutory recoveries. Where in relation to a
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particular month, the salary accrued to the employee is not sufficient to
permit the recovery wholly or partly, the recovery due for that month or
balance thereof as the case may be, shall be carried forward and
recovered from the salary of the employee for the succeeding month / s.
5.0 OUTPATIENT TREATMENT:
5.1 Employees and their family members may obtain outpatient treatment
from any PMP or from any Registered Medical Practitioner (RMP) of
their choice.
5.2 The cost of out-patient treatment including consultation fees, house visit
charges, charges towards pathological, radiological, bacteriological and
other tests based on PMP / RMPs prescription, charges for
administration of injection, cost of drugs, medicines, mixtures, dressing
materials etc., will be reimbursable to the employees subject to the
following limits and conditions:
5.3 The maximum reimbursement per employee (including on account of the

family members) per financial year, shall not exceed Rs. 500/-. The
allocation of funds for the purpose will, however, be regulated on a
quarterly basis as below:
NAME OF THE QUARTER MAX. ALLOCATION FOR THE

QUARTER
I Quarter (April to June) Rs. 125/-
II Quarter (July to Sept) Rs. 250/- (inclusive of the

allocation for the
previous quarter)
III Quarter (Oct to Dec) Rs. 375/- (inclusive of the

allocation for the previous
2 quarters)
IV Quarter (Jan to March) Rs. 500/- (inclusive of the

allocation for the previous
3 quarters)
In regulating the disbursements during each quarter, the following will apply:
5.3.1 Where the actual expenditure incurred during a quarter is more than the
total allocation available for the quarter, the claim should be restricted to
the maximum allowed for the quarter. The excess expenditure may,
however, be carried forward by the employee and reimbursement
therefore claimed by him / her during the succeeding quarter/s. The
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allocation remaining unutilised at the close of the year will, however,
lapse.
5.3.2 Where the employee’s date of joining the Company or exit / exemption
from ESI is other than from the first day of a quarter, the allocation for
that quarter as well as the contribution recoverable from him for that
quarter shall be regulated as follows:
5.3.2.1 In respect of whole calendar month/s of service, if any, falling within that
quarter, the allocation shall be at Rs. 40/- P.M (subject to the total for the
quarter not exceeding Rs. 125/-) and recovery of contribution will be at
the rate specified in Para 4.1. Fraction of a calendar month of service, if
any, falling within the quarter will be treated as a whole-month both for
purposes of the allocation and contribution, provided the number of
calendar days of service (including holidays / leave) occurring in that
fraction of the month comes to 15 or more, and if the number of such days
is below 15, no allocation nor recovery of contribution will be made for
that fraction of the month.
5.4 No employee/ family member shall be supplied with any medicine or
other items from any of the Company’ s hospital / dispensary / Medical
Unit, except to the employee himself / herself for any emergency while on
duty.
5.5 Claims for reimbursement arising from out-patient treatment falling

within the annual quarterly limit specified in 5.3 should be submitted in
the form at Appendix-I. (White-coloured form to be used). Prescriptions,
vouchers, bills, etc., need not be enclosed thereto, but these will have to
be preserved by the employee for at least 3 months from the date of
preferring the claim, for being produced to the Company, if called upon to
do so, for verification. A single consolidated claim should be preferred for
each quarter.
5.6 Where an employee / family member requires prolonged outpatient

treatment for heart disease, asthma, diabetes, hypertension, or any of the
chronic or long term diseases listed in Regulation No. 98 of the ESI
(General) Regulations, 1950, (the list as on date is reproduced at
Appendix VI), the employee / family member may consult any PMP and
based on his reference obtain a certificate from a Panel Specialist of the
appropriate specialization, certifying the requirement for prolonged
treatment and also specifying the period of treatment involved. Based on
such certification, the employee / family member may obtain continuous
treatment from the PMP for the specified period. In such cases, the cost
of medicines only will be reimbursable to the employee, outside the
annual limit of Rs. 500/- (subject to such ceilings as may be separately
prescribed) ; the consultation fees to the PMP/Panel Specialist and the
charges, if any, towards tests / investigations on PMP's / Panel
Specialist’s prescription, charges for administration of injections,
dressings, etc., shall be borne by the employee within the annual limit of
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Rs. 500/-. Claims for reimbursement of the cost of medicines falling
outside the annual limit of Rs. 500/- should be submitted in the form at
Appendix-II (Red-coloured forms to be used). These claims should be
accompanied by the necessary certification by the Specialist,
prescriptions, vouchers, bills, etc., countersigned by the PMP. Before
these claims are admitted, they will be got examined by the
CMO/SMO/MO.
**5.7 The value of domiciliary treatment of #Rs 1,213/- per month for general
aliments ( Authorized Medical Attendance retainer fees, Rs 500/- paid
per annum towards Out-patient treatment and cost of medicines) will be
considered as part of perks (compulsory) in respect of all employees
(executives including TC Personnel and non-executive employees) for
#2017-2018. Every Financial Year the actual cost of domiciliary medical
treatment will be calculated and 25% will be reduced from the said
amount. The amount so arrived after reduction will be the recovery rate
for the next year.”
(**substituted vide OO No. HO/821/042 dated 21.09.2010 with effect from

01.04.2010 in case of Executives ( including TC Personnel) from 01.05.2010 for
non executive employees )
(#Amended vide Memo No. 17556/821/HOA dtd. 12.10.2017)
6.0 HOSPITALISATION:
6.1 With the approval of the Corporate Office, each Unit will notify from time
to time a Panel of Allopathic Hospitals and Nursing Homes in the area
for inpatient treatment of employees and their family members. The
Hospitals and Nursing Homes will be chosen with reference to their
location, reasonableness of charges, standard of medical attendance etc.,
The reference to the Hospital / Nursing Home has to be made by the
Company’s CMO/SMO/MO, or by the PMP or Panel Specialist. However,
in cases of emergency, the hospitalisation in one of the Panel Hospitals /
Nursing Homes can be undertaken but ex-post-facto approval will have
to be obtained from the Head of the Unit on the recommendations of
CMO/SMO/MO or PMP/PS.
6.2 With the approval of the Corporate Office, the Head of the Unit will
notify different classes of wards/ rooms in the hospitals appropriate to
different grades of employees, for inpatient treatment taking into account
the local conditions as also the different rates of contributions under 4.0
6.3 Expenditure towards the ward charges, professional / specialist

consultation, investigation, surgical operation, treatment, admissible
medicines, injections, dressing materials and other medical charges paid
to the Panel Hospitals will be reimbursed by the Company (subject to
such ceilings or ‘Maximum Allowable Tariff’ as may be prescribed for the
Unit from time to time) on production of vouchers indicating the name of
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the Employee, name of the patient and duly certified by the Hospital.
The hospital’s bills / vouchers should contain each item of cost separately
by name such as the names of medicines, injections, etc., administered, to
enable the Accounts Dept to check their admissibility and it will not be
sufficient for the hospital to mention the consolidated amount under each
head of expenditure. This requirement will be insisted upon the
hospitals at the time of negotiation for their inclusion in the Panel.
Incidental expenses such as diet charges, washing expenses, collie hire,
tips, transport etc will not, however, be reimbursed. Cost of any special
facilities provided at the request of the patient will not qualify for
reimbursement.
6.3.1 Where after discharge from the hospital, the patient is required by
attending Doctor / Surgeon of the hospital to come for a post-
hospitalisation check up, and on check up, the attending Doctor /
Surgeon, prescribes further treatment / medicines, the cost of the same
will be treated, as part of hospitalisation and is not to be included in the
annual amount of Rs. 500/- given for outpatient treatment, provided such
treatment does not extend beyond one month from the date of discharge
from the hospital and subject to the recommendation of the
CMO/SMO/MO or PMP/PS that the reimbursement be admitted as part
of the hospitalisation.
6.4 No reimbursement will be admissible for in-patient treatment other than

in the Panel Hospital / Nursing Home, except for hospitalisation on
account of maternity in which case the reimbursement will be limited to
the “Maximum Allowable Tariff” (MAT) prescribed for the Unit and
where such MAT has not been prescribed, the reimbursement will be
limited to the current schedule of charges of a hospital, which has been
designated to be the “Standard” for the respective Unit / Office.
6.5 The Units may enter into arrangements with any or all the panel
Hospitals / Nursing Homes for payment of their bills directly by the
Company in respect of eligible employees / family members, subject to
recovery from the employee of any inadmissible charges or charges which
are in excess of his entitlement, provided the Hospital / Nursing Home
concerned agrees to limit its charges to the MAT prescribed for the Unit,
from time to time.
6.6 The foregoing provisions shall not be deemed to authorise hospitalisation

of employees / family members in the panel hospitals in respect of the
types of cases specified in Appendix-V. In respect of such cases, only
treatment at the hospitals noted against the relevant type in Appendix-V
will qualify, subject to the provisions contained in para 8.2 below.
6.7 Claims for reimbursement arising from hospitalisation will be submitted

to the Accounts / Pay Rolls Department in the form at Appendix-III
(Blue-coloured forms to be used). Admission of the claim will also be
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subject to counter signature of the bills, vouchers, etc., by the
CMO/SMO/MO and he will also affix his signature at the appropriate
column in Appendix-III.
++6.8 In cases where hospitalization of employee / spouse is prior to retirement

and employee / spouse gets discharged post-retirement, then Company
will reimburse the medical expenditure incurred up to a maximum of 15
days from the date of retirement in case of retiree/ spouse only provided
that they are covered as BERECHS members. Further, the employee has
to adhere to the procedure / seek prior permission wherever necessary,
for undergoing such treatment in order to claim reimbursement in such
cases.
(++ Added vide O.O. No. HO/821/053 dtd. 22.08.2016)
++6.9 Employees / Dependents who are required to undergo Robotic assisted

surgery as part of Cancer treatment should seek prior approval from
Corporate Office and such treatment should have been planned in a
panel hospital. Management after careful examination will accord
approval on case to case basis. In any other cases, Robotic surgery will
not qualify for reimbursement.
++6.10 The following is to be adhered to in cases of inpatient treatment of an

employee / dependent of an employee in a panel hospital:
i) Medical Officer i.e. CMO / VMO of concerned Unit should instruct all
panel hospitals to report the condition of patient who has been
admitted for a period of more than 15 days or the expenditure exceeds
Rs. 10 Lakhs, whichever is earlier. The concerned CMO / VMO has to
visit such patients to assess the treatment given and also suggest the
future course of action.
ii) The CMO/VMO of the concerned Unit has to put up a proposal
(through Unit HR head & Unit head) to Director (HR) for information
and necessary approval, including the future course of action /
treatment, in case the stay at panel hospital exceeds 15 days or the
expenditure exceeds Rs. 10 Lakhs, whichever is earlier.
iii) Further, treatment at home is not allowed.
(++ Replaced vide O.O. No. HO/821/059 dtd. 25.07.2018)
7.0 SPECIALIST TREATMENT:
7.1 Specialist consultation and treatment in various specializations such as

Dental, Paediatrics, Ophthalmology, ENT, Psychiatry, etc will qualify for
reimbursement only if availed from the Panel Specialists nominated by
the Unit with the approval of HO. (Unless specifically nominated, the
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Specialists attached to Panel Hospitals are not to be deemed as
automatically included in the Panel of Specialists). Notification of such
nomination shall also prescribe the rates for consultation allowed for such
specialist consultations. Reimbursement will be limited to such
prescribed rates or the actuals, whichever is less. Where a Panel
Specialist is one who is attached to a Hospital, and if his consultation fee
vary-one rate for consultation at the Hospital and another for
consultation at his private chambers--the lower of the two rates shall only
be allowed.
7.2 The reference to the Specialist shall be by the Company’s CMO/SMO/MO

or by a PMP.
7.3 The number of consultations with a specialist for a specific ailment

/condition shall not exceed four without a further reference form
CMO/SMO/MO/PMP.
7.4 Specialist consultation should be had only at the Specialist’s Clinic /

Residence. No Visiting fees to the employee’s residence shall be
reimbursed, except in emergencies, to be certified by the Specialist.
7.5 The expenditure towards Specialist Consultation / treatment will be

reimbursed based on vouchers from the Specialist indicating his name,
qualifications, Specialization, names of the employee and the patient,
nature of the condition / ailment treated, prescription given etc. For
reimbursement of charges towards Pathological, Radiological,
Bacteriological or other tests, prescribed by the Specialist, (subject to
such ceilings as may be prescribed), vouchers should be produced from
the concerned Laboratory / Institution, indicating the names of the
Patient and the Specialist. Reimbursement of charges towards
administering injections, dressings, etc., will, however, not be admissible.
However, in exceptional and extraordinary cases where the dressing,
administering injection, etc., forms vital part of the treatment, the Head
of the Unit may, on the recommendation of the CMO/SMO/MO or
PMP/PS, authorise such expenditure as part of the specialist treatment.
7.6 No reimbursement will be admissible towards charges for any medicines,

mixtures, drugs, injections, etc dispensed by the Specialist himself.
These will have to be purchased from outside registered Dispensaries,
Pharmacists or Chemists / Druggist shops over Cash Memos indicating
the names of the patient / and the specialist and reimbursement claimed.
7.7 Reimbursement for specialist treatment for eyes and teeth will be limited
as follows:
7.7.1 **Treatment for Eyes: Reimbursement will include only treatment of eye
diseases and testing of eyes for vision or other defects, but not the
provision of spectacles, contact lens, soft lens etc. However, the Company
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will extend financial assistance to the employee to certain extent, to
procure the Spectacles (including glass / contact lens / soft lens). The
assistance will be limited to ^ Rs. 1,000/- or actual, whichever is less,
based on voucher, per occasion, once in *two years and limited to *four
occasions during the employee’s career in the Company. The assistance
shall be confined to procurement of the Spectacles / contact lens / soft lens
for the employee himself and it does not extend to family members.
Testing of the eyes will, however, be permissible both for the employee and
family members, but limited to once in three years, relaxable on merits of
each case by the Head of the Unit.
**NOTE: The employee shall certify in the claim form (i) that he /
she has not availed reimbursement towards the cost of spectacles
during the preceding *two years nor has he / she already availed the
reimbursement for more than *4 occasions ; (ii) that he / she has
not availed reimbursement towards testing of the eyes for him / her
for the particular member of the family during the preceding three
years.
**In the case of conventional operation for cataract, the Company will
extend the financial assistance to the employees to procure spectacles for
correction of distant / near vision. Such assistance will be restricted to
Rs. 1,000/- or actual cost, whichever is less, for each occasion. Cost of
such spectacles will be admissible for reimbursement, based on voucher /
cash bill, provided the same is purchased on the advice / prescription of
the Company’s Medical Officer and / or Company’s authorised Specialist
in the field. The financial assistance towards replacement of such
spectacles will be once in every two years and limited to four occasions
(including the initial procurement), during the employees’ career in the
Company.
Company’s financial assistance, as above, shall not, however, be

extended to the dependent family members (including the spouse of
the employee).
(**Substituted vide OO NO. HO/821/040 DTD 08.12.2009 w.e.f. 01.11.2009)

(^Substituted vide OO NO. HO/821/060 DTD 01.01.20179w.e.f. 01.01.2019)
7.7.2 Dental Treatment: Reimbursement will be restricted to extraction, filling

and such other simple procedures and is admissible only in cases where
the employee or any of his family members is suffering from a disease for
which the teeth are the source of trouble, but does not* include the
provision of dentures, crowns or other specialised services.
(* Substituted vide Corrigendum No. 17556/821/HOA dt 29/3/90. Effective from

14.11.1985)
***7.8 Orthopaedic Appliances:
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7.8.1 In the case of diseases like Polio and in certain types of accidents, an
appliance may have to be fitted to the hands, feet, etc., and the same
may have to be re-adjusted or re-placed periodically as the person (if a
child) grows up or the affected part improves. In all such cases, where
the fitting / adjustment of the appliance becomes essential for the patient
(employee / family member), as certified by the Panel Specialist and
counter-signed by the Company’s CMO/DCMO/MO, the expenses
incurred on the procurement / repair of the appliance may be
reimbursed, subject to the following conditions:
7.8.1.1 The reimbursement shall be limited to once per person during a period of
3 years, subject to a maximum of *3 occasions per person, during the
employee’s service in the Company (covering both the employee and all
his family members); and
*The number of occasions in so far it relates to CALIPERS alone

(i.e. Sl. No. 57 of Appendix-VII to CMA Scheme) has been liberalised to
5(five). The decision of H.O. circulated to all Units vide AGM (P&A)/CO
Letter No. 17556/821/HOA dt. 28.9.1999.
7.8.1.2 The purchase / repair of the appliance should have been from the
Rehabilitation Department of Medical Colleges and Hospitals, Artificial
Limb Centre, Pune or from such other Centre or Organization recognised
for the purpose by the Central or the State Government or by the
Company;
7.8.1.3 The appliance referred to above shall be one covered in the list at
Appendix-VII (enclosed);
7.8.2 Notwithstanding any thing contained in the foregoing sub-paras, where

the fitting of the appliance is only a one time requirement or if provided
by the Company, no reimbursement shall be allowed for any subsequent
occasion with reference to the same case. For enforcing this, the Panel
Specialist, at the time of recommending the case, shall clearly certify
whether the case is one, which requires one time fitting or repeat
fittings.
(***Inserted Vide OO No. HO/821/014 Dt. 15.10.88. Effective From 15/10/88)
*7.9 Claims for reimbursement arising out of Specialist treatment shall be

submitted to Accounts / Pay Rolls Department in the form at Appendix-
IV (Yellow coloured form to be used). Admission of the claim will also be
subject to counter signature of the bills, vouchers, etc., by the
CMO/SMO/MO and he will also affix his signature at the appropriate
column in Appendix-IV.
(* Renumbered As Sub - Para 7.9 Vide OO NO. HO/821/014 DT. 15.10.88)
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*7.10 Reimbursement of the expenses on purchase of hearing aid.
Reimbursement of cost of hearing aid to the employees will be made

subject to the following conditions:
a) That procurement of hearing aid is recommended by the empanelled /

authorised ENT Specialist and / or Audiologist on the basis of the
audiogram test, identifying the degree and nature of the deafness,
and certified / approved by the Company’s Medical Officer;
**b) The cost of the hearing aids shall not exceed Rs. 10,000/-.
c) That payment would be made directly to the supplying agency and

not to the employee;
d) That the expenses incurred on account of replacement / repair /

adjustment / procurement of the accessories for the hearing aid shall
not, however, qualify for reimbursement;
**e) The reimbursement will be restricted to twice during the employees’

career in the company subject to a minimum gap of 8 years
between two occasions.
f) That this facility shall be extendable to the dependent family
members also; but subject to the overall ceiling indicated vide sub-
rule (e) above.
(*Inserted vide OO No. HO/821/026 dtd 16/6/95. Effective from 16th June 1995)
(** Substituted vide O.O. No. HO/821/058 dtd. 19.02.2018)
8.0 TREATMENT AT OUTSTATIONS:
8.1 ** Employees or their family members may avail out-patient treatment at

out-stations, while the employee is on official tour or on private visit and
claim reimbursement thereof within the annual limit of Rs. 500/-.
Hospitalization or Specialist treatment at Company’s cost would, however,
be admissible only to the employee himself on tour, only in cases where
the sickness of the employee is of a serious nature, requiring immediate
hospitalization or specialist treatment, as the case may be. In these cases,
approval of the Unit Head will have to be obtained for reimbursement of
the expenses incurred subject to the reasonableness of the claim being
gone into based on the circumstances in each case.
Further, out-station medical reimbursement under emergency conditions

will be allowed for employee only, when the employee is on leave /
personal tour. Details of emergency cases & procedure to be followed is
enclosed at APPENDIX – VIII.
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However, hospitalization on account of maternity of a female employee or
of the wife of a male employee will continue and the reimbursement will
be regulated in terms of 6.4 above.
(** Substituted vide O.O. No. HO/821/050 dtd. 18.03.2015)
@8.2 In exceptional cases involving treatment of the employee / family member

for (a) By-Pass coronary surgery, (b) Kidney Transplant, (c) Cancer, (d)
complicated Heart Surgery or (e) Eye treatment, the Unit Management,
on a case by case basis, may permit hospitalization and treatment in any
of the hospitals specified in Appendix-V, even though such hospital may be
located at an outstation, provided facilities/specialist treatment are not
available in the hospitals empanelled by the unit subject to the panel
specialist or the CMO/SMO/MO certifying that the treatment /
hospitalization is essential to save life and the same is not available in the
empanelled hospitals of the unit. In such cases, reimbursement will be
subject to the reasonableness of the claims being certified by the
CMO/SMO/MO and approval of appropriate authority. As regards the
travel cost in such cases, company’s assistance will be limited to
reimbursement of railway fare by the shortest route between the
employees place of posting and the city / town in which the hospital
concerned is situated. However, in exceptional and deserving cases only
where patient is not in a position to travel alone an escort will be allowed
if the necessity for the same is certified by the CMO/SMO/MO and
approval of appropriate authority is taken. The class of travel by train for
the patient and the escort (if permitted) will be allowed on the basis of the
employee’s entitlement as per TA/DA Rules.
@(Amended vide Office Order No.HO/821/033 Dated 19.08.2003)
8.3 Where the employee’s dependant son / daughter is residing at an

outstation for prosecuting any regular / full time study / course conducted
or recognised by the State Secondary / Higher Secondary Education
Board / University or such other Authority, the Unit Management may,
on a case by case basis, allow reimbursement for hospitalisation of the
son / daughter at such outstation, provided the hospitalisation is
undertaken at:
i) Govt. Hospital; or
ii) BEL panel hospital at that station or any hospital recognised
by a Public Sector Undertaking.
In such cases, reimbursement will be subject to the reasonableness of the

claims being certified by CMO/SMO/MO. No reimbursement would be
admissible for travel and other expenses.
NOTE: The employee should produce a certificate from the

Principal / Head of the Institution furnishing the necessary
15
particulars including the facts as to the full-time nature of the
course, its recognition by the State Board / University, etc.
8.4 In the case of employees on tour abroad or on postings overseas, separate

rules will be promulgated.
9.0 GENERAL:
9.1 On the back of every voucher, receipt, Cash Memo, etc., required to be
produced by the Employee for reimbursement under this scheme, the
employee shall affix his signature in token of the genuineness of the
claim.
9.2 Units where CMO/SMO/MO is in position, all vouchers, receipts, Cash

Memos etc., produced under this Scheme will be subject to his counter
signature and reimbursement will be limited as per his
recommendations.
9.3 In all cases involving payment / reimbursement by the Company,

especially in regard to reimbursement for outpatient treatment for
prolonged period, falling outside the annual limit of Rs. 500/- in terms of
5.6, the CMO/SMO/MO may visit the patient or in the alternative require
the patient to call on him for examination to determine the genuineness
of the case. Where the CMO/SMO/MO is not satisfied, the claim may be
rejected in toto and past payments recovered, besides any action that
may be taken against the employee.
9.4 For the purpose of counter-signature, etc. under these rules the
respective jurisdiction of the CMO/BG and SMO/GAD will be as follows,
until further arrangements:
SMO/GAD - for all Northern Units

CMO/BG - for all Other Units
In the case of Regional Offices / Sales Depots coming under the direct
administrative control of HO, while SMO/GAD will have the jurisdiction
over Delhi Regional Office / Sales Depot, CMO/BG will have jurisdiction
over the rest of the Regional Offices / Sales Depots.
9.5 No reimbursement will be admissible for preparations classified as foods,

tonics, toilet preparations, disinfectants and such other preparations. In
this behalf, the list of inadmissible items as enumerated from time to
time in Schedule I & II of Appendix XXI to Central Services (Medical
Attendance) Rules, 1944, shall be adopted for guidance. Each Unit shall
from time to time prepare a list of inadmissible items in a booklet form
and keep copies thereof at the Medical Unit etc., for general reference.
16
9.6 No reimbursement will be admissible towards cost of contraceptives.
However, sterilization operation will qualify for reimbursement.
9.7 All claims for reimbursement relating to hospitalisation, specialist

treatment, and out-patient treatment falling outside the annual limit of
Rs. 500/- should be submitted immediately after completion of the
treatment, in any case not later than 3 months therefrom.
10.0 REIMBURSEMENT TO EMPLOYEES ON PROLONGED LWP & AWL:
10.1 The benefits under this scheme shall also be extended to employees on
LWP to the extent indicated below:
10.1.1 Employees on LWP for a continuous period exceeding 30 days on account

of self-sickness, duly supported by Medical Certificates will be allowed
the benefits under the scheme (including for the family members) during
the LWP period upto one year from the month following that in which
period the of LWP commenced.
10.1.2 In all other cases of employees on LWP for a continuous period exceeding
30 days, the benefits under the scheme will be allowed to the employees
and their families only upto a period of 3 months from the month
following that in which the period of LWP commenced.
10.1.3 For availing the benefits specified in 10.1.1 and 10.1.2 the employee
concerned should keep his coverage under the scheme alive, by remitting
to the Company his monthly contribution at the rates laid down in 4.1
upto the benefit period specified above.
10.1.4 Cases of employees on Study Leave without pay will also be regulated in
accordance with 10.1.2 and 10.1.3 (Employees on Study Leave with full
pay / half pay will be treated on par with regular employees on duty).
10.2 Employees on AWL for a continuous period exceeding 30 days shall not
be entitled to any benefit under this Scheme including hospitalisation or
specialist treatment, from the month following that in which the period
of such AWL has commenced. Where such disentitlement period
commences during the course of a quarter, and if the employee has
already availed the quarterly reimbursement for that quarter in excess of
the entitled portion of the quarter (such computation being made in
terms of 5.3.2) the excess will be recovered from the employee. Likewise,
no contribution to the scheme shall be recoverable / receivable from the
employee from the month following that in which such AWL has
commenced. Where subsequent to the period of AWL, the employee is
allowed to rejoin duty, he shall be admitted afresh into the scheme from
the date of such rejoining, treating such re-joining as fresh appointment
for purposes of regulating the commencement of monthly contributions
17
and making allocation towards quarterly reimbursement for out-patient
treatment in terms of 5.3.2.
11.0 APPROVAL FROM CORPORATE OFFICE:

11.1 Approval for rates, ceilings, MAT as well as nomination of Panel Medical
Practitioners and Panel Specialists, Panel Hospitals / Nursing Homes
and “Standard” Hospital, mentioned in the foregoing Rules will have to
be obtained from the Corporate Office before implementation by the
Units / Offices.
11.2 Cases not coming within the purview of these Rules or where relaxation
is considered justified, should be sent to the Corporate Office with due
recommendations for obtaining the orders of the **D (P) based on merits
of each case.
11.3 Unit Managements may issue detailed Circulars keeping strictly within
the provisions of this Office Order. Any amendment to these provisions
shall be issued from the Corporate Office.
12.0 Management reserves the right to amend, modify, repeal, abrogate or

withdraw any or all the provisions of this OO at their discretion at any
time without any notice whatsoever.
(** "Full Powers" sub-delegated to D (P) by CMD vide OO No. HO/134/013 dtd
13/2/91)
18
APPENDIX-I
SL. NO.
BHARAT ELECTRONICS LIMITED
MEDICAL REIMBURSEMENT CLAIM FORM
(To be used for Out-Patient Treatment falling within the

Annual limit of Rs. 500/-)
Reimbursement claim for the

Qr
.*I / II / III / IV of 20....
In accordance with para 5.5 of the Annexure to OO No. HO/821/009 dtd

14th November, 1985, I hereby submit my claim for reimbursement of
the expenditure incurred by me towards out-patient treatment (falling
within the annual limit of Rs. 500/-) for the Quarter No. ...... of 20 ..........
The details are furnished below:
1. Name of the Claimant : _______ 2. St. No. _________________
3. Designation: _________________ 4. Div/Dept / Sec: ___________
5. Cost Centre No: ____________ 6. Date of Joining /

Gradation: ______________
7. Date of Exit / Exemption

from ESI:
8. Name/ s of the Patient / s Relationship Period of Treatment
i)
ii)
iii)
9. Total cost of outpatient treatment for Rs. P.

which reimbursement is claimed ...........
10. Certificates / Declaration
i) Certified that the above expenses were actually

incurred by me towards the outpatient treatment
during the above said quarter.
ii) Certified that I have not submitted any other claim

in respect of the above expenditure / quarter.
19
% iii) Certified that my parent/s in respect of whom the
claim is made is / are wholly dependant on me. He /
She / They have / has been normally residing with
me and his / her / their income from all sources put
together does not exceed Rs. 1,500/- P.M.
@ iv) Certified that my spouse is not employed (including

in BEL) / certified that my spouse is employed in
................ but he / she has not availed / claimed or
will not avail / claim any reimbursement or other
benefit from the said employer in respect of the
same period / treatment.
v) Certified that I am aware that should any of the

above particulars / certificates be found to be
incorrect / false in any respect at any time, I shall be
liable for disciplinary action being taken against
me, besides recovery of the amount wrongfully
drawn by me.
Date: Phone: SIGNATURE OF THE

EMPLOYEE
ACCOUNTS OFFICER
THRO’ HEAD OF DEPT / SEC.

_____________________________________________________________
* Tick the Quarter No. applicable and strike out the rest.
% Strike out if inapplicable.
@ Strike out, whichever is inapplicable.
FOR USE IN ACCOUNTS DEPT.
Amount Claimed Rs. ...................
Amount Admitted Rs. .....................
Asst. Acctt. Accounts Officer A.O IA)

==========================================================
NOTE: i) Do not attach prescriptions, vouchers, bills, etc. But, they

are to be kept with you for atleast three months as
specified in the Rules.
ii) Incomplete form is liable to be rejected without notice.
iii) A consolidated claim is to be preferred for the quarter.
20
APPENDIX-II
SL. NO.
(To be used for Out-Patient Treatment falling outside the

Annual limit of Rs. 500/-)
(Separate form to be used for each patient)
In accordance with para 5.6 of the Annexure to OO No. HO/821/009 dtd

14th November, 1985, I hereby submit my claim for reimbursement of
the expenditure incurred by me towards out-patient treatment (falling
outside the annual limit of Rs. 500/-) for self / family member. The
details are furnished below:
1. Name of the Claimant : __________ 2. St. No. __________
3. Designation: ________________ 4. Div / Dept / Sec: _____________

5. Cost Centre No: _____________ 6. Date of Joining /
Gradation: ________________
7. Date of Exit/Exemption ________ 8. Name of the PMP / AMA _____

from ESI:
9. Name of the Specialist: __________________
10. Name/ s of the Patient / s Relationship Period of Treatment
i)
ii)
iii)
Rs. P.
11. Cost of medicines, drugs, injections, etc., for which
reimbursement is claimed under Rule 5.6
12. Certificates / Declaration
i) Certified that the above expenses were actually

incurred by me towards the outpatient treatment
referred to above.
ii) Certified that I have not submitted any other claim in

respect of the above expenditure / treatment.
21
% iii) Certified that my parent/s in respect of whom the claim is
made is / are wholly dependant on me. He / She / They have /
has been normally residing with me and his / her / their
income from all sources put together does not exceed
Rs.1,500/- P.M.
@ iv) Certified that my spouse is not employed (including in BEL) /

certified that my spouse is employed in ................ but he / she
has not availed / claimed or will not avail / claim any
reimbursement or other benefit from the said employer in
respect of the same period / treatment / expenditure.
v) Certified that I am aware that should any of the above

particulars / certificates be found to be incorrect / false in
any respect at any time, I shall be liable for disciplinary
action being taken against me, besides recovery of the
amount wrongfully drawn by me.
Date: Phone: SIGNATURE OF THE

EMPLOYEE
ACCOUNTS OFFICER

_____________________________________________________________________
@ Strike out, whichever is inapplicable.
Recommended as recorded on the enclosures.
CMO / SMO / MO
===========================================================
Asst. Acctt. Accounts Officer A.O (IA)

===========================================================
NOTE: i) Attach prescriptions, vouchers, bills, etc. in support of the

claim.
ii) Incomplete form is liable to be rejected without notice.
22
APPENDIX-III
SL. NO.
“HOSPITALISATION”
1. Name of the Claimant : _________ 2. Staff No. ____________________
3. Designation: ___________________ 4. Div / Dept / Sec: ______________
5. Cost Centre No: _______________ 6. Date of Joining /

Gradation: __________________
7. Date of Exit / Exemption 8. Name of the PMP / AMA /

from ESI: ________ Specialist who referred: _______
9. Name of the Patient: ____________ 10. Relationship: _________________
11. Whether patient working in BEL : YES / NO (If ‘YES”, furnish details)
12. Name of Hospital _________________
13. Period & Nature of treatment undergone in the Hospital ...........................
14. Charges Incurred:
a) SUMMARY Amount Claimed Enclosure (s)

Rs. P.
i) Ward Charges
ii) Clinical / Laboratory Charges
iii) Operation charges
iv) Professional / Specialist charges
v) Injection charges
vi) Miscellaneous charges
(specify details)
vii) Cost of Medicines
=========
TOTAL
=========
23
b) DETAILS OF COST OF MEDICINES
Date of Name of Medicine Quantity Amount Enclosure (s)

purchase (In Block Letters) Rs. Ps.
TOTAL
Certificates / Declaration
i) Certified that the above expenses were actually incurred by me.
ii) Certified that I have not submitted any other claim in respect of the
above expenditure / treatment.
% iii) Certified that my parent/s in respect of whom the claim is made is /

are wholly dependant on me. He / She / They have / has been
normally residing with me and his / her / their income from all
sources put together does not exceed Rs. 1,500/- P.M.
@ iv) Certified that my spouse is not employed (including in BEL/certified

that my spouse is employed in ................ but he / she has not availed /
claimed or will not avail / claim any reimbursement or other benefit
from the said employer in respect of the same period / treatment.
v) Certified that I am aware that should any of the above particulars /

certificates be found to be incorrect / false in any respect at any time,
I shall be liable for disciplinary action being taken against me,
besides recovery of the amount wrongfully drawn by me.
Date: Phone: SIGNATURE OF THE EMPLOYEE
ACCOUNTS OFFICER

===========================================================
@ Strike out whichever is inapplicable.
==========================================================
CMO / SMO / MO
==========================================================
24
Asst. Acctt. Accounts Officer A.O (IA)

===========================================================
NOTE: 1) Attach prescriptions, vouchers, bills, etc. in support of the claim.

2) If the space is insufficient, attach additional sheet.
3) Incomplete form is liable to be rejected without notice.
25
APPENDIX-IV
SL. NO.
“SPECIALIST TREATMENT”
(Separate form to be used for each patient and for each spell of illness)
1. Name of the Claimant: ________ 2. Staff No. ________________
3. Designation: ____________ 4. Div / Dept / Sec: ____________
5. Cost Centre No: ____________ 6. Date of Joining /

Gradation: _______________
7. Date of Exit / Exemption _____ 8. Name of the Specialist ________

from ESI:
9. Name of the PMP/AMA

who referred _______________ 10. Name of the patient __________
11. Relationship _____________ 12. Age _______________________
13. Whether patient working in BEL: YES / NO (If ‘YES”, furnish

details)
14. Nature of illness & duration of

treatment with the Specialist.
CHARGES:
15. Consultation Fee:

==============================================================
No. Date Consultation Fee Encl.
==============================================================
==============================================================
16. Injection Fee: (Indicating the number and date of injection and the fee paid
for each injection)
==============================================================
No. Date Type of injection Injection fee
Encl
Muscular / Intravenous
==============================================================
26
==============================================================
17. Pathological Test Etc.,(Indicating charges for Pathological, Bacteriological
(excluding Radiological tests) and other similar tests undertaken during
diagnosis on the advice of the specialist).
==============================================================
No. Date. Nature of the Name of the Hospital Fees
examination or Laboratory paid Encl
Rs.
==============================================================
==============================================================
18. Radiological Test: (Indicating number and size of X-Rays taken on the
advice of the RMP / AMA)
==============================================================
No. Date Nature of No. of X-Rays Size Name of Hospital Fees
X-Ray or Laboratory paid Encl
Rs.
==============================================================
==============================================================
19. Cost of Medicines (Indicating particulars of medicines purchased on the
advice of Specialist)
==============================================================
Date of purchase Name of medicines
(Block Letters) Quantity Amount Encl
Rs.
==============================================================
==============================================================
20. Testing of Eyes / procurement of Spectacles

==============================================================
Consultation Cost of
fees for testing Spectacles Encl
==============================================================
Rs. Rs.
==============================================================
27
21. SUMMARY OF THE CLAIM
==============================================================
Consultation Injection Pathological Radiological Cost of Testing Cost of
fee fee tests etc tests Medicines of eyes/ Spectacles
==============================================================
Rs. Rs. Rs. Rs. Rs. Rs. Rs.
==============================================================
22. CERTIFICATES / DECLARATION
i) Certified that the above expenses were actually incurred by me.
ii) Certified that I have not submitted any other claim in respect of
the above expenditure / treatment.
% iii) Certified that my parent/s in respect of whom the claim is made is/
are wholly dependant on me. He / She / They have / has been
normally residing with me and both their income from all sources
put together does not exceed Rs. 1,500/- P.M.
@ iv) Certified that my spouse is not employed(including in BEL)/certified

that my spouse is employed in ................ but he / she has not availed
/ claimed or will not avail / claim any reimbursement or other benefit
from the said employer in respect of the same period / treatment/
expenditure.
% v) Certified that I have not availed reimbursement towards the cost of

Spectacles during the preceding three years nor have I already
availed the reimbursement towards the same on more than 4
occasions during my service.
% vi) Certified that I / family member referred to above have / has not
availed reimbursement towards testing of the eyes during the
preceding three years.
vii) Certified that I am aware that should any of the above particulars /
certificates be found to be incorrect / false in any respect at any time I
shall be liable for disciplinary action being taken against me, besides
recovery of the amount wrongfully drawn by me.
DATE: PHONE: SIGNATURE OF THE EMPLOYEE
ACCOUNTS OFFICER
THRO’ HEAD OF DEPT / SEC
28
@ Strike out whichever is inapplicable.
==========================================================
CMO / SMO / MO
==========================================================
FOR USE IN THE FINANCE AND ACCOUNTS DEPT.
Consultation Injection Pathological Radiological Medi- Misc.Total

Fee Charges & other tests Tests cines
_______________________________________________________________________
1. Amount
claimed:
Rs.
______________________________________________________________________
2. Amount
admitted:
Rs.
_____________________________________________________________________
Asst. Accountant Accounts Officer Accounts Officer (IA)

==========================================================
NOTE: 1) Attach prescriptions, vouchers, bills, etc. in support of the claim.

2) If the space is insufficient, attach additional sheets.
3) Incomplete form is liable to be rejected without notice.
29
$$Appendix-V
LIST OF HOSPITALS RECOGINISED UNDER 6.6 AND 8.2
A.BY-PASS CORONARY SURGERY/COMPLICATED HEART SURGERY CASES
1. Jayadeva Institute of Cardiology, Bangalore

2. M.S. Ramaiah Institute of Cardiology, Bangalore
3. St. John’s Medical College Hospital, Bangalore
4. Wockhardt Heart Hospital, Bangalore
5. Manipal Hospital, Bangalore
6. Mallya Hospital, Bangalore
7. Mahaveer Jain Hospital, Bangalore
8. Narayana Hrudayalaya, Bangalore
9. Appolo Sagar, Bangalore
10. All India Institute of Medical Sciences, New Delhi
11. Batra Hospital & Medical Research Centre, New Delhi
12. St. Stephen Hospital, New Delhi]
13. G.B.Pant Hospital, New Delhi
14. National Heart Institute, New Delhi
15. Escort Heart Institute, New Delhi
16. Narinder Mohan Hospital, Ghaziabad
17. Yashoda Hospital, Ghaziabad
18. Post Graduate Institute of Medical Sciences, Chandigarh
19. Christian Medical College & Hospital, Vellore
20. Appolo Hospital, Chennai
21. Institute of Cardiovascular Disease, Chennai
22. Southern Railway HQ Hospital, Chennai
23. Nanavath Hospital, Mumbai
24. Jaslok Hospital, Mumbai
25. Bombay Hospital, Mumbai
26. KEM Hospital, Mumbai
27. NH Wadia Institute of Cardiology, Pune
28. Nizam’s Institute of Medical Sciences, Hyderabad
29. MEDICITI Hospital, Hyderabad
30. Care Hospital, Hyderabad
31. Citi Cardiac Research Centre, Vijayawada
32. Sri Chitra Tirunal Institute of Medical Sciences & Technology Hospital,
Thiruvananthapuram
33. Samaritan Hospital, Kolkata
34. B.M. Birla Heart Foundation, Kolkata
35. S.S.K.Hospital, Kolkata
36. Kasturba Hospital, Bhopal
37. Vijaya Hospital, Chennai (added vide OO No. HO/821/034 dated 14th May 2004)
38. Sri Ramachandra Hospital, Chennai (added vide OO No. HO/821/034 dated 14th
May 2004)
39. Himalayan Institute Hospital Trust, Dehradun (added vide OO No. HO/821/047
dated 07.06.2012)
30
B. FOR CANCER CASES
1. Kidwai Memorial Institute of Oncology, Bangalore

2. Bangalore Institute Of Oncology, Bangalore
4. M.S.Ramaiah Hospital, Bangalore
6. All India Institute of Medical Sciences, New Delhi
7. Batra Hospital & Medical Sciences, New Delhi
8. St.Stephen Hospital, Delhi
9. Rajiv Gandhi Cancer Institute of Medical Sciences, Chandigarh
10. Post Graduate Institute of Medical Sciences, Chandigarh
11. TATA Memorial Hospital, Mumbai
12. Cancer Institute, Adyar, Chennai
13. Christian Medical College Hospital, Vellore
14. Thakurpukur Hospital, Kolkata
15. Chittaranjan National Cancer Reasearch Centre, Kolkata
16. Nizam’s Institute of Medical Sciences, Hyderabad
17. Sibar Cancer Hospital, Vijayawada
18 Vijaya Hospital , Chennai (added vide OO No. HO/821/034 dated 14th May 2004)
19.Sri Ramachandra Hospital, Chennai (added vide OO No. HO/821/034 dated 14th
May 2004)
20 Himalayan Institute Hospital Trust, Dehradun (added vide OO No. HO/821/047
dated 07.06.2012)
C FOR KIDNEY TRANSPLANTAION

2. M.S. Ramaih Institute of Nephro Urology, Bangalore
3. St.John’s Medical College Hospital, Bangalore
5. Mahaveer Jain Hospital, Bangalore
6. All India Institute Of Medical Sciences, New Delhi
7. Batra Hospital & Medical Research centre, New Delhi
8. St Stephen Hospital, New Delhi]
9. Narinder Mohan Hospital, Ghaziabad
10. Yashoda Hospital, Ghaziabad
11. Post graduate institute of medical sciences
12. Christian Medical College Hospital, Vellore
13. Apollo Hospital Chennai
14. Nanavathi Hospital, Mumbai
15. Jaslok Hospital, Mumbai
16. Nizam’s Institute Of Medical Sciences, Hyderabad
31
17. Mediciti Hospital, Hyderabad
18. Mahaveer Hospital, Hyderabad
19. Arun Kidney Centre, Vijayawada
20. Nagarjuna Hospital, Vijayawada
21. kothari Medical Research Institute, Kolkata
22.Vijaya Hospital, Chennai (added vide OO No. HO/821/034 dated 14th May 2004)
23.Sri Ramachandra Hospital, Chennai (added vide OO No. HO/821/034 dated 14th
May 2004)
dated 07.06.2012)
D. FOR EYE TREATMENT
1. Lion’s Eye Hospital, Bangalore

2. Shankara Netralaya, Chennai
dated 07.06.2012)
$$(Replaced vide Office Order No.HO/821/033 Dated 19.08.2003)
32
APPENDIX - VI
LIST OF DISEASES
1. Tuberculosis.
2. Leprosy.
3. Mental Diseases (Psychosis).
4. Malignant diseases.
5. Paraplegia.
6. Hemiplegia.
7. Chronic Congestive heart failure.
8. Immature cataract with vision 6/ 60 or less in the affected eye.
9. Bronchiectasis.
10. Lung Abscess.
11. Myocardial infraction.
12. Dislocation and prolepses of intervertebral disc.
13. Parkinson’s disease.
14. Aplastic Anameia.
15. Cirrhosis of liver with ascites.
16. Detachment of Retina.
17. Non-union or delayed union of fracture.
18. Emphysema.
19. Intra-cranial space occupying lesion.
20. Spinal cord compression.
21. Chronic (Simple) primary glaucoma.
22. Monoplegia.
33
Appendix-VII
(Ref: OO NO. HO/821/014 dt 15 Oct 88)
LIST OF ARTIFICIAL APPLIANCES
1 Unilateral long leg brace without hip 37 Universal raising 1"

joint
2 Hip joint with pelvic band 38 Foot drop splint
3 Spinal Brace 39 Below Knee Prosthetics
(P.T.B type Prosthetics)
4 Unilateral short leg brace 40 A.K. Prosthetics
5 Shoe or Boot-Protective or aiding to 41 Aluminium adjustable
paralysed or weak legs above knee right splint
6 Bilateral hip joint with pelvic band / 42 Plastic shoulder abduction
weak leg splint
7 Bilateral long leg brace without hip 43 Plaster of Paris or
joint Gypsona cast
8 Bilateral short leg brace 44 Modified shoes
9 Lumbe-sacral or spinal support or 45 Below Elbow Prosthetics
Back support
10 Taylor's brace 46 Hooks
11 Milwankee brace 47 Cosmetic hand
12 Mermaid splint 48 Splint for C.D.H
13 Posterior slab 49 Splint for Elbow
14 Cervical brace four post 50 Above Elbow and below
elbow Prosthetics
15 Rigid Cervical Collar with head 51 Above Elbow and below
extension elbow Orthotics
16 Cervical Collar 52 Corset
17 Dynamic splint (Aluminium) 53 Wheel Chair
18 Cock-up splint plain (Aluminium) 54 Protective shoes with
micro-cellular rubber
without nails often with
additional gadgets like
adjustable springs and
rockets
19 Cock-up splint (Plastic) or long 55 Crutches
Opponens
20 Turn Buckle splint 56 Walking iron with Plaster
Casts
21 Nuckle bender splint 57 Callipers
22 Anterior Knee Guard splint 58 Braces
23 Densis Brown Splint 59 Artificial limbs
24 Congenial Talipus Equino Varus / 60 Illestomy Kit (G.I., M.H.,
Valgus splint O.M. No.S 14025/31/79-
MS, dated the 11th June
1981 addressed to the
34
Chief Controller of
Imports & Exports, New
Delhi.
25 Short Opponens P.V.C (Plastic) 61 Aluminium Walker (on
permission)
26 Knee Cage 62 Arm Pack
27 Long Opponens with M.P lobar and 63 Cock up Splint with finger
finger ext.
28 Extension (Plastic) Dynamic 64 Folding Wheel Chair (on
permission)
29 Boot with C and E heel and arch 65 Frog Splint
support
30 C and E heel 66 Knee Braces for Post-op.
cases only
31 Arch Support 67 L-S Belt from size 16
(max.)
32 M.T. Pad 68 Mallet splint
33 M.T.E.Raising 1" 69 Shoulder Immobilizer
34 T. Strap 70 Soft Collar (Cervical)
35 Sponge heel 71 Unilateral Arch
36 Wedge 1/8" 72 Van Rossam Splint, Berlin
Splint.
(Sl. No. 61 to 72 – Added vide O.O. No. HO/821/057 dated 04.09.2017)
35
++ APPENDIX – VIII
A) Medical emergencies which will be considered for reimbursement for
Employees only while on leave / personal tour at out-station are as under:
1) Road traffic Accidents causing grievous injuries like Fractures and causing
disability. Simple wound treatment will not be considered.
2) Cardiac emergencies such as Acute Myocardial infraction (Heart Attacks),

Heart failure and Cardiac arrhythmias.
3) Acute abdominal emergencies like Acute Appendicitis, Organ perforations
and complicated Hernias.
4) Cerebro-vascular accidents causing paralysis.
5) Vascular emergencies like pulmonary embolism.
6) Status Epilepticus.
7) Threatened or incomplete abortion.
8) Any other acute life threatening emergencies requiring immediate

hospitalization and treatment.
B) Procedure to be followed in the process of reimbursement of out-station

treatment in case of emergencies for employees only:
1) Employee to inform the HR Head of Unit /SBU/ Office the date and time of
admission at an out-station Hospital within 24 hours either telephonically or by
e-mail.
2) Employee should produce a certificate from the treating doctor stating the
type of emergency which required immediate treatment.
3) Employees have to support their medical claim with detailed discharge

summary.
4) Employees have to submit medical claim through their concerned HR

department with in one month of discharge from the hospital. The concerned
HR Officer will forward the same to CMS/ACMS/CMO/VMO of respective Unit
for further scrutiny and certification.
5) CMS/ACMS/CMO/VMO has to certify the genuineness of the claim and certify

the same for reimbursement.
6) The reimbursement of the claim is restricted to the extent of 75% of MAT

rates of the company which is in par with emergency treatment in Non-panel
Hospitals.
7) The claims are not applicable for dependent members of the employee.
36
No. 17556/821/HOA Date: 24.02 1986
Sub: Contributory Medical Attendance—Revised Rules—

Finalization of proposals for Nomination of PMPs and
empanelment of Specialists / Hospitals.
--------
The following Committees have been constituted for finalizing proposals

for nomination of PMPs and empanelment of Specialists/Hospitals for various
Units, except for Bangalore Complex and Head Office:
For HYD, CHN, MC, TJ & PN:
(1) A representative from P & A / HO;

(2) A representative from the Finance Department of the Unit concerned; &
(3) Chief Medical Officer/BG or his nominee
For Northern Units (GAD/PK/KOT):
(1) A representative from the P &A / HO;

(2) A representative from the Finance Department of the Unit concerned; &
(3) DCMO / GAD or his nominee.
The Committee/s may also co-opt suitable additional members, wherever

required.
The Committee/s may make spot visits and finalize the proposals.
GM (PER & ADMIN.)
37
No. 17556/821/HOA Date: 13.05.1987
MEMO
Sub: Contributory Medical Attendance Rules -

Reimbursement of cost of `Pacemaker'.
Ref: OO No. HO/821/009 dated 14-11-1985.

--------
1.0 Of late, implantation of PACEMAKER in heart-block condition is being

resorted to often. The question has been raised whether the cost of
Pacemaker implanted to an eligible patient would be reimbursable by the
Company under the provisions of the Medical Attendance Rules referred
to above.
2.0 Management have decided that the Unit Head may authorise
reimbursement of the cost of Pacemaker implanted to an eligible patient,
under the provisions of the Rules referred to above, subject to the
following additional conditions:
2.1 that the Company's CMO/DCMO/MO is satisfied about the fact of

the implantation and also certifies that the same was necessary to
save life;
2.2 that the implantation has taken place at an empanelled hospital;
2.3 that the amount is paid directly to the empanelled hospital/

supplier, and NOT to the employee.
*2.4 that the model of Pacemaker is a "Standard Type" which would

serve the purpose; and
*2.5 that the cost of the Pacemaker is certified as "fair and reasonable" by
CMO/DCMO/MO, having regard to the prevailing market rates
ADVISER (INDL. RELATIONS)
(*Added vide Memo No. 17556/821/HOA dtd 30/5/90)
38
No. 17556/821/HOA Date:26.09.1988
MEMO
Sub: Delegation of Powers to Unit Heads to dispose of cases

of hospitalisation at NON-PANEL Hospitals due to
emergency.
--------
1.0 According to para 6.0 of OO No. HO/821/009 dated 14 Nov 85,

hospitalisation charges will qualify for reimbursement only if the
hospitalisation undertaken has been at an empanelled hospital, on a
reference from the AMA/PMP. There have been references from the Units
for relaxing this rule and allowing reimbursement even though the
hospitalisation undertaken has been at a NON-PANEL hospital.
Management have decided that the Unit Heads may, in future, dispose of
such cases by allowing partial relaxation of the rule and grant
reimbursements limited to the extent indicated below, if the case fulfils all
the following conditions:
1.1 Each case should be considered on its merits specifically at the Unit
Head's level without further sub-delegation of the power.
1.2 The hospitalisation at the NON-PANEL hospital should have been due to
"emergency", as certified by the Company's CMO/ DCMO/ MO. The
certification should be not only with regard to the patient's condition
which required his/her immediate hospitalisation at a nearby hospital
(NON-PANEL) leaving no scope at all for admission at an empanelled
hospital, but also with regard to continuance of the patient's condition
which prevented his/her being shifted to an empanelled hospital
subsequently. The Certifying Authority should also satisfy himself about
the genuineness of the case and about the bonafides of the non-panel
hospital chosen.
1.3 Once relaxation is permitted in accordance with the above,

reimbursements may be allowed, but limited to 75% of MAT or 75% of the
admissible bills, whichever is lower. (For the above purpose, where MAT
has not yet been finalized the tariff of the hospital identified as the
"Standard" hospital for the Unit/Station in terms of para 6.4 of the OO
referred to above, shall be deemed to be the MAT, and where the
"Standard" hospital has also not been identified, the tariff of Govt.
Hospitals at the place shall be deemed to be the MAT).
39
1.4 This provision for relaxation at the Unit level will apply only if the total
reimbursement involved in terms of the above does not exceed Rs.5,000/-
(Rupees five thousand only) in a single case and the case is considered
deserving of relaxation. Cases exceeding this limit should be referred to
Corporate Office for approval, if the Unit Head considers them as fit cases
for decisions by CMD. All other cases may be rejected at the Unit level.
2.0 The relaxation contemplated herein is restricted to hospitalisation at a

NON-PANEL hospital, at the same station, with or without reference by
the AMA/PMP. It does not extend to cases of other types of deviations
from the Rules, including out-station cases, which should continue to be
dealt with as at present, viz., rejected outright or referred to Corporate
Office for orders if exceptional circumstances exist.
3.0 These provisions may be applied also to all pending cases. Past cases
already decided will, however, not be re-opened.
ADDL. GENERAL MANAGER (PERSONNEL/CO)
40
No. 17556/821/HOA Date: 19.05.1989
MEMO
Sub: Out-station Specialist Treatment / Hospitalisation

for Family Members.
--------
1.0 Company's Medical Scheme (vide Rule 8.1) specifically disallows out-
station Specialist Treatment/ Hospitalisation for family members (except
those specifically permitted under the scheme).
2.0 The question of relaxing the above rule and allowing such benefit in
individual cases on merit, in terms of Rule 11.2, which provides for
relaxation of rules at the discretion of CMD, has been examined at
Corporate Office, in the light of frequent references of such cases to
Corporate Office from the Units.
3.0 Having regard to all aspects including the historical background, which
led to the incorporation of the rule cited in 1.0 above, it has been decided
NOT to consider relaxation of the said rule, in any case.
4.0 Consequently, requests for such relaxation be rejected at the Unit level
itself, and such cases need not be referred to Corporate Office.
ADDL. GENERAL MANAGER (P&IR)
41
No. 17556/821/HOA 20 July 89
MEMO
Sub: Empanelment of Hospitals/Nursing Homes

and designation of Standard Hospital.
--------
1.0 According to existing rules (vide para 11.1 of OO No. HO/821/009 dated
14.11.85), the Units have to obtain the approval of Corporate Office for
empanelment of Hospitals/Nursing Homes and also for designation of
Standard Hospital for the Unit.
2.0 It has been decided that the henceforth such approval may be accorded by
*EDs (in respect of the Units under their control), subject to compliance
with the guidelines specified in the ANNEXURE.
3.0 Units which do not come under the control of any *ED, have to continue to
obtain the approval of the Corporate Office.
( * Now read as Director)

DIRECTOR (PERSONNEL)
42
ANNEXURE
(Memo No. 17556/821/HOA Dt. 20 July 1989)
GUIDELINES TO THE UNITS ON EMPANELMENT OF HOSPITALS/

NURSING HOMES AND DESIGNATION OF STANDARD HOSPITAL
1.0 All Government Hospitals at the station will be automatically treated as

empanelled hospitals.
2.0 Hospitals/Nursing Homes at the station `recognised' by other PSUs under

similar Medical Rules may be considered for empanelment by the Unit.
3.0 Missionary hospitals and hospitals which are genuinely charitable in

nature, without any profit motive whatsoever, may be considered for
empanelment, subject to the conditions specified in para 7 below.
4.0 One of the leading missionary/ charitable hospitals at the station whose
tariff is generally low compared to the Unit's MAT if any, and also to the
charges of other missionary/ charitable hospitals at the station, may be
empanelled and also designated as the "Standard Hospital" for the
Unit/Station.
5.0 The Unit's MAT for each Station and any change thereof should be got
approved by the Corporate Office.
6.0 The Unit may also empanel a few Private Nursing Homes which agree to
limit their charges to the Unit's MAT/ Standard Hospital's Rates, subject
to the conditions specified in para 7 below.
7.0 Any Hospital/ Nursing Home proposed for empanelment by the Unit,
including those specified in 1.0 & 2.0 above, should conform to the
following:
7.1 The hospital/ Nursing Home in question should be located within

the same station and its actual location should be easily accessible,
and should have pleasant surroundings. It would be advantageous
if a sizeable section of employees are also residents of the same
locality.
7.2 The Hospital/ Nursing Home should have adequate number of beds,
of which a reasonable proportion should be of single-bed and twin-
bed rooms. The average occupancy rate should not exceed 80%.
The single-bed and twin bed rooms should have attached toilets.
Maintenance of beds, linens and other accessories should be
hygenic, aesthetically pleasant and comfortable. The wards should
be reasonably spacious, pleasantly got up, and reasonably free from
43
noise or other disturbances, with reasonable measure of privacy,
particularly in relation to single-bed and twin bed rooms.
7.3 The Nursing Home/ Hospital should be self-contained with its own
facilities, in regard to Laboratory & X-Ray, and preferably also in
regard to Pharmacy, Canteen/ Kitchen, Washing, and other such
commonly required ancillaries.
7.4 The Hospital/ Nursing Home should normally have "Intensive Care"
Unit/s.
7.5 There should be adequate arrangements for medical and nursing

attendance and for para-medical services.
7.6 There should be enough facilities for attending at least to `normal'

cases in the important fields of Medicine, Surgery and
Obst/Gynaec., including cases of "emergencies". These Departments
should be headed by experts in the respective fields, functioning as
resident Doctors or at least there should exist permanent
arrangement to ensure their instantaneous availability in cases of
emergency.
7.7 There should be good and adequate arrangements for visits to the
Hospital/ Nursing Home by eminent specialists, in different
specialities.
7.8 In a few rare and exceptional cases, a Hospital/ Nursing Home may
be recognised or empanelled only for a particular facility, such as
for ENT, Orthopaedics, Cardiology, Eye Treatment etc., having
regard to its special position with availability of special facilities for
the particular type of treatment.
7.9 The integrity of the Hospital/ Nursing Home in terms of financial

and professional ethics should be above question and where any
malpractice comes to notice, the hospital/ nursing home concerned
should forthwith be black-listed and removed from the panel, and
disqualified for future empanelment.
7.10 Where direct payment system has been entered into with a
particular empanelled Hospital/ Nursing Home, in terms of para 6.5
of the Medical Rules, it should be ensured that such hospital/
nursing home does not have any direct financial dealings with the
employee/ patient, except in regard to diet charges etc., or towards
levy of excess charges where the patient chooses a ward/ room of
higher entitlement or has obtained extra facilities such as special
Nurse / attendant etc. Charges towards such extra facilities should
in no way be so manipulated as to bring them within the purview of
Company's reimbursement.
44
8.0 The total number of Hospitals/ Nursing Homes empanelled for a
Unit/Station should be limited, consistent with the relevant factors such
as the Unit's staff strength (non-ESI employees), the size of the city/ town
etc.
9.0 The empanelment arrangement shall be terminable by one month's notice

on either side.
**10.0 Proposals for empanelment shall be processed by an Advisory Committee

of the Unit, consisting of;
a) Head of the HR & A reporting to Unit Head - Chairman

b) Representative of Finance, not below the rank of DGM - Member
c) Representative of Management Services, not below
the rank of DGM - Member
d) Head of the Medical Services of the Unit - Convener
Note: The senior person among Head of HR & A and Head of Medical
Organization will be the Chairman of the Advisory committee.
Before recommending empanelment, the committee shall visit the hospital

/ nursing home concerned and ensure that the guidelines specified above
are fulfilled. After empanelment, the Advisory Committee shall undertake
periodical visits to the Hospitals/ Nursing Homes to ensure that the
conditions for empanelment are continued to be followed. Proposals for
removal from empanelment will also be processed by the Advisory
Committee.
A committee comprising of CMS/BC, representative of HR/CO and

Finance/CO will review the proposal submitted by the Unit level
committee before putting up for Management approval.
(** Substituted vide Memo No. 17556/821/HOA dtd. 22.08.2013)
-o0o-
45
No. 17556/821/HOA 29 Jan 90
MEMO
Sub: BEL Contributory Medical Attendance Scheme.
Ref: (1) OO No. HO/821/009 dt 14.11.85

(2) Memo No. 17556/821/HOA dt 26.9.88.
------------
1.0 An exhaustive set of rules have been laid down in the OO referred to above
for dealing with medical claims of employees seeking reimbursement of
the expenses incurred.
2.0 In the Memo under reference, powers have been delegated to Unit Heads
to dispose of cases of hospitalisation at non-panel hospitals due to
emergency, subject to certain conditions.
3.0 In the very scheme of things, references to Corporate Office for relaxation
of rules should be few and far between. But, in practice, cases are being
referred to Corporate Office quite frequently by the Unit Managements,
which involve deviations from the rules. Furthermore, such approvals are
sought in a routine manner and more often that not, on ex-post-facto
basis.
4.0 Seeking ex-post-facto approval from Corporate Office should be in

exceedingly "rare and emergent cases” alone. In other words, seeking ex-
post-facto approval should be an exception rather than a rule.
5.0 It is, therefore, considered necessary to impress upon all concerned that
references of cases to Corporate Office requiring relaxation of relevant
rules should be done sparingly and only in deserving cases.
6.0 These instructions may please be adhered to strictly, in future.
46
No. 17556/821/HOA Date: 21.05.1991
MEMO
Sub: "Radial Keratotomy" operation--When qualifies for

reimbursement under CMAS--Clarifications on the .
Ref: CMD's OO No. HO/821/009 dtd 14.11.85.

---------
1.0 A question whether "Radial Keratotomy" operation undergone by the

employees' qualifies for reimbursement under the Contributory Medical
Attendance Scheme announced vide OO referred to above has been raised
by one of the Units for orders. Hence, the following clarifications are
issued.
2.0 Radial Keratotomy operation is undertaken not only for correction of short
sight (myopia) but also for dispensing with wearing of spectacles or
contact lenses.
3.0 It is hereby clarified that the cost of operation is not admissible for
reimbursement if it is undertaken merely for cosmetic purposes, that is, to
avoid wearing of spectacles or contact lenses.
4.0 It is further clarified that only in those cases where myopia (short sight)
cannot be corrected by lenses, the operation undertaken could be
categorised as a therapeutic one qualifying for reimbursement. The
reimbursement in such cases is subject to the following conditions:
(i) the operation is undertaken on specific advice of the treating Eye

Surgeon on reference from AMA;
(ii) the operation is under the category of "Keratoplasty"; and
(iii) the reimbursement is restricted to MAT rates (if already existing) or

as per the "Standard Hospital rates", as the case may be.
5.0 The reimbursement in such cases shall be only for the employees and does
not extend to family members.
6.0 Pending claims, if any, may be regulated in accordance with the above
clarifications. Claims already settled shall not, however, be reopened.
47
No. 17556/821/HOA 5th March 93
MEMO
Sub: Invitro Fertilization--Whether qualifies for reimbursement

Under CMA Scheme---Clarifications on the.
Ref: CMD's OO No. HO/821/009 dated 14.11.85

(as amended from time to time)
---------
1.0 For treatment of primary infertility, the modern medical science offers
high-tech procedures, e.g., Invitro Fertilization (IVF). A few employees or
their family members have taken treatment for infertility under these
sophisticated procedures and sought reimbursement of the expenses
incurred in connection therewith.
2.0 The admissibility of reimbursement of such expenses has been examined

at the corporate level. In the light of the decisions taken, the following
clarifications are issued.
3.0 Expenses incurred for the treatment of primary infertility / sterility, by

taking recourse to high-tech procedures, like IVF, shall not qualify for
reimbursement under the Company's Contributory Medical Attendance
Scheme.
4.0 However, routine consultations/ investigations, like, Dilatation and

Curettage (D&C), Tube testing, Hysterogram, Laboratory Investigations
and the cost of medicines purchased based on specialist's prescriptions,
come under the purview of CMA Scheme. The expenses incurred in
connection with these routine consultations / investigations / tests,
therefore, qualify for reimbursement to the extent admissible under the
normal rules of the CMA Scheme and subject to a maximum allowable
tariff (MAT) or "Standard Hospital rates", as the case may be.
5.0 These instructions may be given wide publicity amongst the employees,
for their information.
6.0 Pending claims, if any, may be regulated in accordance with the above
clarifications. Claims already settled shall not, however, be reopened.
7.0 The above guidelines shall strictly be followed by all concerned, in future.
GENERAL MANAGER (PERSONNEL)
48
No. 17556/795:821/HOA Date: 11.02.1994
MEMO
Sub: Certification with regard to 'Parents' dependency vis-a-vis

medical claims etc., of employees--Standing Instructions--
Issuing of.
--------------
1.0 Under the Contributory Medical Attendance Rules, in order to get

coverage under the same, parents of an employee should be wholly
dependent on and normally reside with him/her. Besides, income of the
parent from all sources, put together, ought not to exceed Rs. 750/- p.m.
(Now changed to Rs. 1,500/-)
2.0 Of late, a number of cases are being referred to Corporate Office in respect
of dependants of the employees seeking reimbursement of the expenditure
incurred in connection with their medical treatment. While examining
such cases, the question whether they are, in fact, dependent upon and
normally residing with the claimant-employee, within the meaning of the
relevant rule, assumes significance. In the absence of crucial inputs about
this aspect of the matter, it becomes extremely difficult for the Corporate
Office to process such cases to their logical end.
3.0 In order to save delay and also for correct appreciation of the facts of the
case, the Unit Personnel Heads are requested to, invariably, mention the
following facts, after due verification, in their correspondence with the
Corporate Office.
(a) Whether the parent i.r.o whom the claim is made is wholly / solely
dependent upon the employee concerned;
(b) Whether the parent normally resides with the employee concerned,
as a member of his / her family;
(c) Whether the income of the parent, from all sources, put together,
does or does not exceed the ceiling prescribed under the rules;
(d) Any other information germane to the subject matter.
4.0 It may please be noted that if the aforesaid particulars are not furnished,
in future, the Corporate Office will be left with no option, but to remit the
49
cases back to the Units / Offices, without processing the same for
appropriate orders.
5.0 Similar action is required in respect of cases emanating under LTC and
TA/DA rules also, if the reference pertains to dependants of the employees.
6.0 All Unit Personnel Heads are requested to note the above instructions,
carefully, for strict compliance, here-in-after.
50
No. 17556/821/HOA Date: 28.06.1995
MEMO
Sub: Contributory Medical Attendance Scheme--Exercising

of options by employees--Guidelines--Issuing of.
Ref: CMD's OO No. HO/821/009 dtd 14.11.85 (as amended).

-------------
1.0 Note (ii) appended to rule 3.1.4 vide definition of the term "family" under
the Contributory Medical Attendance Scheme (CMAS) reads thus:
"Where the spouse is employed in any other organisation (Private /

Government / PSU) the employee while claiming any reimbursement from
BEL under this scheme, should furnish a declaration to the effect that his
spouse has not availed / claimed or will not avail / claim any
reimbursement or other benefit from his / her organisation in respect of
the same period / treatment."
2.0 The intention behind seeking such a declaration / certification from the
employee is to avoid simultaneous availing of the facilities by the spouses
from the respective organisations.
3.0 Of late, a number of cases are being referred to Corporate Office in respect
of spouses of employees seeking reimbursement of the expenditure
incurred in connection with the medical treatment.
3.1 While examining such cases, it has come to light that the employees
concerned have included their spouses in the family composition;
either just prior to a major surgery or even after the requisite
treatment was taken.
3.2 Apparently, such belated inclusions are sought with a view to

claiming reimbursements of substantial amounts from the
Company. It is neither proper nor can it be allowed to continue.
4.0 It is, therefore, considered necessary to issue a set of guidelines for the
information of and implementation by the Unit Personnel Heads.
5.0 Guidelines:
(a) Whenever a person joins BEL and if he / she is already married and
his / her spouse also employed in a Private / Government / PSU
51
organisation, then, option should be taken from such an employee
at the time of joining itself. He / she may choose either the facilities
under CMAS of BEL or facilities provided by the organisation in
which the spouse is employed;
(b) On the other hand, when an employee acquires a family after

joining BEL and if his / her spouse is employed in any of the
aforesaid organisation, then, such an employee should be directed to
exercise an option, immediately, as in (a) above; and
(c) In any case, the Unit Personnel Heads cannot glibly accept requests
from such employees for inclusion of the spouse in the family
composition, at any time during their service, as is being done at
present.
6.0 It is hereby impressed upon the Unit Personnel Heads that, as and when
such requests are made, it is incumbent upon them to carry out effective
verification and then only accept and incorporate such 'inclusions' in the
medical identity cards, sparingly and judiciously, of course.
7.0 The Corporate Office will, in future, be left with no option but to
summarily reject such cases and remit the cases back to the Units,
without processing the same, if the above guidelines are not followed, both
in letter and spirit, by the Unit Personnel Heads.
52
NO. 17556/821/HOA 5 September 1995
MEMO
Sub: Sub-delegation of powers to Director (Personnel).
Ref: 1) OO No. HO/134/013 dt. 13 Feb 91.

* 2) OO No. HO/144/005 dt. 29 Mar 95.
-----------
1.0 The Chairman and Managing Director had, vide his OO No. HO/134/013
dt. 13 Feb 91 sub-delegated "full powers" to the Director (Personnel) to
exercise on his behalf and pass appropriate orders in all cases coming up
for decision, in terms of para 11.2 of the Contributory Medical Attendance
Scheme.
2.0 The aforesaid sub-delegation being "specific" and "special" in nature, the
same continues to be valid and effectively operational, even after issuance
of "general" sub-delegation of powers to the various officers, including the
Functional Directors, vide OO No. HO/144/005 dt. 29 March 95. (now read
as OO. No. HO/144/011 dt. 15.3.2001).
3.0 Consequently, cases not coming within the purview of the Contributory
Medical Attendance (Revised) Rules, OR where relaxation is considered
justified, are required to be sent to the Corporate Office, with due
recommendations by the Unit Heads, for obtaining the orders of the
Director (Personnel), based on merits of each case.
4.0 The above clarification may please be noted by all concerned for action,
accordingly.
*( now replaced by OO NO.HO/144/011 dt.15.03.2001.)
53
Sub: Sub-delegation of Powers
Ref: OO No. HO/144/011 dtd 15.3.2001.
CHAPTE SL. NATURE OF POWERS SUB- EXTENT

R REF NO POWERS DELEGATED OF REMARK
NUMBER TO POWERS S
REIMBURSE- D (P) Full Powers As per
II 18 MENT OF Guideline
MEDICAL FD Full Powers s
EXPENSES IN upto Rs.
RELAXATION 10,000 in
OF RULES each case
GMs/
UHs/ Full Powers
SBUHs upto Rs.
3,000 in
each case.
(*** Vide OO No. HO/144/011 dt. 15.3.2001. Effective from 1st April 2001)
54
No.17556/821/HOA Date: 07.05.1999
CIRCULAR
Sub: Reimbursement against Hepatitis-A&B immunisation
***
The General Secretary, BEL-TEX Employees’ Union, Chennai, requested

the Management for reimbursement against Hepatitis-A & B immunisation. The
same has been examined at Corporate Office and it has been decided to continue
the present the present practice of not reimbursing the expenditure against this
immunisation.
ADDL.GEN.MANAGER (P&A)
55
No. 17556/821/HOA Date: 02.08 1999
CIRCULAR
Sub: Reimbursement against Hepatitis ‘A’ & ‘B’ immunisation
Ref: Circular No. 17556/821/HOA dt. 7.5.1999.

------------
1.0 Management has decided to reimburse the expenditure incurred towards

Hepatitis ‘B’ vaccination, as exceptional cases to the following categories:
(a) those who undergo dialysis:
(b) medical Officers, Medical Student, Dental Surgeon, Dental Student:
(c) para-medical staff/ Veterinary student;
(d) the children of parents where mother or father is suffering from

Hepatitis Infection.
2.0 The above decision may be noted by the Personnel Heads / Finance Heads,
for uniform application in their respective Units/Offices. Pending cases, if
any, may also be disposed off on these lines.
ADDL GENERAL MANAGER (P&A)
56
No.17556/821/HOA Date: 13.01.2000
CIRCULAR
Sub: Medical facilities under Company’s CMA Scheme

to divorced daughter/s who are solely dependent
on the employee.
----------
1.0 Clarifications were sought by some of the Units as to whether the divorced
daughter/s who are solely dependent on the employee could be allowed to
avail medical facilities under Company’s CMA Scheme.
2.0 The above issue has been examined at Corporate Office in detail and in
the light of the provisions of the extant Rules; it has been decided not to
allow divorced daughter/s who are solely dependent on the employee to
avail medical facilities under Company’s Scheme.
3.0 The above decision may be noted by Personnel Heads of all the Units for
its uniform implementation across the Company.
ADDL. GENERAL MANGER (P&A)
57
No.17556/821/HOA Date: 03.08.2000
MEMO
Sub: Contributory Medical Attendance Scheme - Revised Rules-

Reimbursement of expenditure incurred by the blind employees
On the purchase of N.I.V.H make Folding Stick made up of
Aluminium (Walking Stick) - Notifying of.
Ref: Office Order No.HO/821/009 dated 14.11.1985.

--------
1.0 In our Contributory Medical Attendance Scheme, at present, there is no

provision to allow reimbursement of the expenditure incurred by the blind
employees on purchase of National Institute for the Visually Handicapped
(N.I.V.H.) make Folding Stick made up of aluminium (Walking Stick).
2.0 Management has now decided to allow reimbursement of the expenditure

incurred by them on purchase of N.I.V.H. make Folding Stick made up of
aluminium (Walking Stick); subject to the following conditions:-
(i) The reimbursement shall be allowed once in a period of 5 (five)

years;
(ii) The reimbursement shall be on production of proof of expenditure

incurred on purchase of the aforesaid Stick; and
(iii) The reimbursement shall not exceed Rs.30/-(Rupees Thirty Only).
3.0 This Memo shall come into force with immediate effect.
58
No. 17556/821/HOA Date: 12.05.2004
MEMO
Sub: Implantation of Intra-Ocular Lens (IOL) – Reimbursement

under CMA Scheme.
Ref: i) Office Order No. HO/821/009 dated 14.11.1985(as amended)

ii) Memo No. 17556/821/HOA dated 20.06.1994.
------------
1.0 According to rule 3.0 of the above referred Memo, a clarification was
issued to all Units that cost of implantation of IOL will be reimbursed
only in respect of serving employees who are covered under CMA scheme
and will not be reimbursed for family members/dependants of the
employees covered under CMA Scheme.
2.0 The issue has now been reviewed by Management. In the light of the
decision taken the following clarifications are issued:
i) Cost of implantation of IOL will be reimbursed hereafter for both

employees and their dependants who are covered under CMA
Scheme:
ii) Reimbursement towards cost of implantation of IOL will be

limited to applicable MAT Rates or Standard Hospital Rates of
respective Units or actuals, whichever is lower.
3.0 This will come into force with immediate effect.
4.0 This Memo supersedes the earlier Memo No. 17556/821/HOA dated
20.06.1994 on the subject.
EXECUTIVE DIRECTOR (P&A)
59
No: 17556/821/HOA Date: 28.10.2005
MEMO
Sub: Contributory Medical Attendance Scheme – Revised Rules.
Ref: Office Order No.HO/821/036 dated 29/06/2005
1.0 In the course of implementation of Office Order referred to above, certain

doubts have been raised by the Units for clarification.
2.0 The points raised have been examined and in the light of the decision
taken, the following clarifications are issued:
Sl. Point/doubt for clarification Clarification

No.
1 What qualifies as original pension Pension granted as per Pension
before commutation, which is to be Payment Order (PPO) before
taken into consideration for commutation for determining the
determination of income limit? income limit.
2 The Dearness Relief sanctioned The DA component of pension is
after December 1995 is to be merged as on 31/12/1995. Hence,
excluded for determination of the the revised PPO after the merger
income limit. There is a DA has to be obtained to arrive at the
component of pension as on ceiling limit of Rs.1500/- p.m. for
December 1995. Whether this also coverage in the scheme
is to be excluded?
3 Whether the family pension Yes, the family pension indicated
granted to the surviving spouse in the original PPO will be the
consequent on the death of the determining factor to arrive at the
pensioner, is to be taken as eligibility. However, as the DA
original pension for purpose of component of pension if any, is
determination of income limit? merged as on 31/12/1995, the
revised PPO after the merger has
to be obtained to arrive at the
ceiling limit of Rs.1500/- p.m. for
coverage in the scheme.
4 Employees are submitting banks No. A copy of revised PPO
statements issued by some indicting the original pension
nationalized banks as the granted before commutation &
document to be relied on to after merger of DA as on December
determine the pension. Whether 1995 shall be insisted.
this is acceptable?
60
3.0 The above clarifications may please be noted for uniform application by all
the Units/ Offices.
ADDL.GENERAL MANAGER (P & IR)
61
NO. 17556/821/HOA Date: 31.05.2007
Sub: Contributory Medical Attendance Scheme - Revised Rules

Reimbursement of cost of 'Cataract Surgery by Phaco
emulsification Method
Ref: Office Order No. Ho/821/009 dated 14.11.1985 (as amended).

----------
1.0. The rules and regulations governing the Contributory Medical

Attendance - - Revised Rules are notified in the Office Order referred to
above.
2.0. At present, Management is reimbursing cost of conventional cataract

surgery under the Contributory Medical Attendance Scheme. Cataract
surgery by "Phaco-emulsification method" is the latest technology in
cataract surgery.
3.0. Management has decided to allow the employees / dependants to undergo

cataract surgery by phaco-emulsification method. The reimbursement for
both the surgery as well as the cost of foldable lens will be limited to
applicable MAT rates or Standard Hospital rates of respective Units for
Cataract surgery by "Phaco-emulsification method" or actuals, whichever
is lower.
4.0. This will come into force with immediate effect.
GENERAL MANAGER (P)
62
BHARAT ELECTRONIC LIMITED
CORTORETE OFFICE
OUTER RING ROAD, NAGAVARA, BANGALORE
NO.17556/821/HOA 11th August, 2009

MEMO
Sub: Contributory Medical Attendance Scheme -Revised Rules Reimbursement of

cost of ‘Laparoscopic Surgeries and removal of stones from Kidney & Ureter
by Liththotripsy (ESWL).
Ref: Office Order No. HO/821/009 dated 14.11.1985 (as amended).
***
1.0 The rules for reimbursement of cost of Laparoscopic surgery and removal of stones
from Kidney & Ureter by Lithotripsy (ESWL) has been notified in the Memo referred
above.
2.0 At present as per CMS Scheme, Management allows the employees / eligible family
members to undergo the below mentioned laparoscopic surgeries and removal of
stones from kidney & Ureter by Lithotripsy OR Extra Corporal Short Wave
Lithotripsy (ESWL);
1. Cholecystectomy;
2. Appendicectomy;
3. Hernia;
4. Hystrerstomy;
5. Entopic Pregnancy;
6. Ovarian Cystectomy; and
7. Removal of stones from Kidney Ureter by Lithotripsy or ESWL
The reimbursement is limited to the conventional surgery rates if the cost of the
Laparoscopic / lithotripsy surgery is higher than the conventional procedure,
Company reimburses 75% of the difference in addition to the cost of conventional
surgery.
3.0 Management has now decided to reimburse the above Laparoscopic surgeries &
Lithotripsy at actual limited to the MAT Rates of the cost of conventional limited to
the MAT Rates of the Units.
4.0 This amendment comes into force with effect from 1 st July 2009.
5.0 This Memo supersedes earlier Memo No 17556/821/HOA dated 14.01.2003 on the
above subject.
6.0 All other terms and conditions governing the rules and regulations of contributory
Medical Attendance - - Revised Rules will remain unaltered
GENERAL MANAGER (HR)
63
CORPORATE OFFICE
OUTER RING ROAD, NAGAVARA, BANGALORE
NO. 17556/821/ HOA 27th April, 2010

MEMO
Sub: Contributory Medical Attendance Scheme - Revised Rules
Ref: Office Order No. HO/821/036 dated 29.06.2005
1.0 In the Course of implementation of the aforesaid Office Order, Certain doubts
have been raised for clarifications. The points raised has been examined and in
the light of the decisions taken the following clarifications are issued.
Sl Point / doubt for clarification Clarification

No
1 Whether woman employees who has opted for her No, since the employee has
parents initially as dependents under the scheme already exercised her
and has subsequently changed her option to parents option to change once
-in-law will be given option to change her option to during her service.
parents again?
2 Whether a woman employee who has continued with Yes, Once during her
her option for parents even after introduction of the service, the employees can
Office Order will be given a one-time option to change her Option.
include her parents -in -law
3 Whether a woman employee who has continued with No, since the option to
her option for parents / opted for parents -in-law change should have been
after introduction of the Office Order will be allowed made at the time when
to change her option once, consequent to the death of parent/s were alive.
her parents/ parents-in-law? However, with regard to
parents -in-law , one time
option is already exercised
in this case. Hence,
question of changing the
option does not arise.
4 In the case of a woman employees wherein her No, the option should be
parents who were dependents under the CMA exercised when one of the
Scheme were not alive at the time of introduction of Parents is alive.
the Office Order, whether a one-time option can be
exercised to include her parents-in -law who is solely
dependant on her?
2.0 The above clarifications may please be noted for uniform application by all the
Units /Offices.
GENERAL MNAGER (HR)
ALL UNIT/SBU HEADS

ALL EDs/GMs
ALL ROs / MARKETING CENTRES
64

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OO.NO.

HO/821/009 (As amended) DTD 14/11/85

Subject: CONTRIBUTORY MEDICAL ATTENDANCE--REVISED RULES.

1.0 Management hereby introduces the Revised Rules for Contributory

2.1 Wherever the Units / Offices have already notified:

(a) PMPs/GMPs/AMAs for outpatient treatment and / or for

(b) Specialists and Panel Hospitals,

such PMPs/GMPs/AMAs and Specialists and Hospitals will continue to be

CHAIRMAN & MANAGING DIRECTOR.

BEL CONTRIBUTORY MEDICAL ATTENDANCE SCHEME

1.1 This scheme applies to employees (both executives and non-executives)

"Explanation: In the case of Pensioners, for determining pension amount

3.1.1 Employee himself;

3.1.2 Employee’s spouse;

3.1.3 #Legitimate / adopted/step children wholly dependent upon the

(# Amended Vide OO No.HO/821/31 Date 20.11.2002)

(ii) Where the spouse is employed in any other organisation (Private

(iii) A son will be deemed to be wholly dependant upon the employee

Explanation: The amount of Dearness relief, as indicated in the income limit

(*Substituted vide OO No. HO/821/055 dtd 23.06.2017 with immediate effect)

3.2 “Panel Medical Practitioner” (PMP) is one who is a registered Medical

4.1.1 ~~ In respect of Non-Executive employees: Rs 25/- per month.

4.1.2 ^^ In respect of Executives :-

(^^ Substituted vide O.O. No. HO/821/049 dated 21.05.2013)

5.0 OUTPATIENT TREATMENT:

5.3 The maximum reimbursement per employee (including on account of the

NAME OF THE QUARTER MAX. ALLOCATION FOR THE

I Quarter (April to June) Rs. 125/-

II Quarter (July to Sept) Rs. 250/- (inclusive of the

III Quarter (Oct to Dec) Rs. 375/- (inclusive of the

IV Quarter (Jan to March) Rs. 500/- (inclusive of the

5.5 Claims for reimbursement arising from out-patient treatment falling

5.6 Where an employee / family member requires prolonged outpatient

(**substituted vide OO No. HO/821/042 dated 21.09.2010 with effect from

6.3 Expenditure towards the ward charges, professional / specialist

6.4 No reimbursement will be admissible for in-patient treatment other than

6.6 The foregoing provisions shall not be deemed to authorise hospitalisation

6.7 Claims for reimbursement arising from hospitalisation will be submitted

++6.8 In cases where hospitalization of employee / spouse is prior to retirement

++6.9 Employees / Dependents who are required to undergo Robotic assisted

(++ Added vide O.O. No. HO/821/054 dtd. 23.12.2016)

++6.10 The following is to be adhered to in cases of inpatient treatment of an

(++ Replaced vide O.O. No. HO/821/059 dtd. 25.07.2018)

7.0 SPECIALIST TREATMENT:

7.1 Specialist consultation and treatment in various specializations such as

7.2 The reference to the Specialist shall be by the Company’s CMO/SMO/MO

7.3 The number of consultations with a specialist for a specific ailment

7.4 Specialist consultation should be had only at the Specialist’s Clinic /

7.5 The expenditure towards Specialist Consultation / treatment will be

7.6 No reimbursement will be admissible towards charges for any medicines,

Company’s financial assistance, as above, shall not, however, be

(**Substituted vide OO NO. HO/821/040 DTD 08.12.2009 w.e.f. 01.11.2009)

7.7.2 Dental Treatment: Reimbursement will be restricted to extraction, filling

(* Substituted vide Corrigendum No. 17556/821/HOA dt 29/3/90. Effective from

***7.8 Orthopaedic Appliances:

*The number of occasions in so far it relates to CALIPERS alone

7.8.2 Notwithstanding any thing contained in the foregoing sub-paras, where

1. Name of the Claimant : _ 2. St. No. ___________

3. Designation: _______ 4. Div/Dept / Sec: _

1. Name of the Claimant : 2. St. No.

3. Designation: ____ 4. Div / Dept / Sec: _

7. Date of Exit/Exemption ____ 8. Name of the PMP / AMA _