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Government of J ammu and Kashmir
Finance Department, Civil Secretariat
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Subject:- Checklist for Medical Reimbursement Claims.
Circular
While examining the Medical Reimbursement claims submitted to Finance
Department by the various Administrative Departments for consideration in
relaxation of the J&K Civil Services (Medical Attendance-cum-Allowance)
Rules, 1990, it has been observed that most of the cases are incomplete in
various aspects as per rules in vogue and are submitted without the prior
approval of Competent Authority in the departments.
In order to ensure speedy disposal of Medical Reimbursement claims and
with the aim to avoid any hardship to the claimants, a checklist has been
devised forming Annexure to this circular. The check list, duly filled, shall be
furnished by the Administrative Departments along with the medical
reimbursement proposals to the Finance Department for seeking concurrence
in relaxation of rules.
Accordingly, all the Administrative Secretaries are requested to ensure
that the Medical Reimbursement claims are submitted to the Finance
Department along with the checklist. Incomplete cases shall not be
entertained by the Finance Department.
Sd/-
(Dr Arun Kumar Mehta), IAS,
Financial Commissioner,
Finance Department
No.:- A/16(2008)-I-502 Dated:-15-07-2019
Copy to:-
1. Advocate General, J&K High Court Srinagar/Jammu.
2. All Financial Commissioners.
3. Financial Commissioner with the Hon'ble Governor.
4. Principal Accountant General J&K Srinagar/Jammu.
5. All Principal Secretaries to Government.
6. Principal Resident Commissioner, 5-Prithvi Raj Road New, Delhi.
7. Chief Electoral Officer, J&K.
8. All Commissioner/ Secretaries to Government.
9. Divisional Commissioner Kashmir/ Jammu/Ladakh.
10. Chief Vigilance Commissioner, J&K.
11. Principal Secretary to Chief Justice J&K High Court Srinagar/Jammu.
12. Registrar General, J&K High Court Srinagar/Jammu.
13. Director Anti Corruption Bureau, J&K.
14. Director General, J&K Funds Organization.
15. Director General Accounts and Treasuries.
16. Director General, Budget Division J &K.
17. Director General, Audit and Inspections.
18. Director Local Fund Audit & Pensions, J&K.
19. Director Information J&K.
20. All Head of Departments/ Managing Directors/ Chief Executives of State PSU's/
Autonomous Bodies/ Societies.
21. Secretary J&K Public Service Commission.
22. All District Development Commissioners.
23. Secretary, J&K Legislative Assembly/ Legislative Council.
24. Director/Principal, Northern Zonal Accountancy Training Institute Jammu.
25. Director Accounts & Treasuries Kashmir/ Jammu.
26. All Directors of Finance/Financial Advisors & CAOs.
27. Principal Accountancy Training School Srinagar.
28. Joint Director, J&K Funds\ Organization Srinagar/Jammu.
29. General Manager, Government Press, Srinagar/ Jammu for publication in
Government Gazette.
30-33. Private Secretary to Hon'ble Advisors (K)/ (G)/ (S)/ (KS).
34. Private Secretary to Chief Secretary.
35. All Treasury Officers.
36. I/ C website, FD (www.jakfinance.nic.in).
37. I/C website, GAD (www.jkgad.nic.in).
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38. Government Order File (W2scs).
..... .
(S. Pandita),
Directo (Codes),
~nance Department
-
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Annexure
Checklist for submission of Medical Reimbursement Claims to Finance Department in
terms of the J&K Civil Services (Medical Attendance-cum-Allowance) Rules, 1990.
S.No.
01.
Particulars
Name of the Officer/Official with Designation
Remarks .
02. Treatment of Self or Dependent
03. Name of Dependent with relationship
04. Whether the patient/ individual is dependent cm the employee
( certificate to be enclosed)
05. Whether the patient is suffering from a Life Consuming Disease
06. Whether Life Consuming Disease certificate has been issued by
the Competent Medical Authority i.e. OHS/Principal
GMC/Director SKIMS, (certificate to be enclosed, if applicable)
07. Whether treatment has been taken with proper referral from
Competent Medical Authority (Certificate to be enclosed, if
applicable).
08. Name of the Hospital/Institute wherefrom treatment has been
taken.
09. Whether the Hospital/Institute is in the list of empanelled
Hospitals/Institutions.
Period of Hospitalization Date of Date of
10. (Discharge Certificate to be enclosed) Admission Discharge
11. Essentiality Certificate on Form 2 issued by the Hospital
Authorities to be enclosed.
12. Whether the vouchers submitted have been verified from
relevant Medical Authority of the hospital wherefrom treatment
has been taken.
13. Form of application for claiming refund of medical expenses
incurred, Annexure "E" of Medical Attendance Rules complete
in all respect to be enclosed.
14. Whether Medical claim has been preferred by the beneficiary
within .specified time limits (if not, justifiable reasons with the
recommendations of the department be enclosed)
15. Relaxation required, If any (if yes, Rule to be mentioned).
16. Whether the case has been forwarded to Finance department
with the approval of Competent Authority in the department.
Certified that the particulars from S.No. 1 to 16 have been verified and found correct, as such
merits for consideration.
Signature of Director Finance/CAO/ AO
G.P.S. 51/16-5000 Nos.
JAMMU AND KASHMIR CIVIL SERVICE MEDICAL ATTENDANCE
Form No. 2
ESSENTIALITY CERTIFICATE
(To be filled in by the Specialist/Medical Officer/Government Doctor) •
I, Dr.···········································································································
certify that the following medicines were prescribed by me to .
(indicate the name of the beneficiary lies ; if treated of : ..
. . .. . . . . . .. . . .- Department.
The patient(s) was/were suffering from ..
and the employee is registered under Registration No ..
Name of the Medicines :
I also certify that the medicines were essential for the recovery of the patient/s
and these drugs or their substitutes do exist in the Master List. The patient was
referred to the Specialist/Hospital/P.H.C for treatment.
Rs have been received by me as consultation fee.
Dated: .
Signature and designation of
the Specialist/Medical Officer/
Government Doctor.
