INDEX

Rule Contents
No.

SECTION - I

1. Title

SECTION - II

2. Applicability

SECTION - III

3. Definitions
Corporation
Employee
Family
Authorised Medical Attendant
Authorised Medical Attendant
(Homoeopathic System)
Specialist

Medical Attendance
Hospital / Nursing Home Treatment
Medicines
Inadmissible Medicines
Admissible Medicines under Homoeopathy System Treatment of Drug
4. Abuse/Alcoholism (Self inflicted disease)
Controlling Officer
Competent Authority

SECTION - IV

Medical Attendance
Consultation Fee - Allopathic
Consultation Fee - Homoeopathic
Injection Administration Charges
Room / Bed Entitlement
Special Nursing Charges
Consultation with Specialist
5. SECTION - V

Hospital / Nursing Home Treatment

Charges for Bed / Room
Dressing Charges
Reference for Indoor Treatment

SECTION - VI
6.
Dental Treatment

SECTION - VII
7.
Other Medical Facilities
Anti - rabic treatment
Treatment for immunising and Prophylactic purpose
Treatment through Lithotripsy(technology for Gall Bladder / Kidney stone Therapy)
Cost of Spectacles/ Contact lenses
Cost of artificial appliances (Orthopaedic Appliances)
Cost of Intra-ocular lens.
Cost of Hearing aid
Laser Treatment

8. SECTION - VIII

Special Diseases
Cancer
Mental diseases
Poliomyelitis
Tubercular diseases
Diabetes
Cardiac arrests / Strokes etc.
Post-operation treatment of Kidney donor
Post-operation treatment of Liver donor
Reimbursement of medical expenses on prospective donor of bone marrow for Bone Marrow
Transplant (BMT)

9. SECTION - IX

Travelling Allowance for Medical Attendance and / or Treatment & Transit

Accommodation
Entitlement
Reimbursement of ambulance charges
Rail fare for an attendant / escort
Local conveyance in referred outstation Cases
Transit accommodation
Death in service
Death of Dependent

10.
 SECTION - X

Rules Governing the Employees Staying in the

11. Refinery Townships
Maternity cases
Medical facilities for Freedom Fighters

12. SECTION - XI

Medical Expenses Incurred in foreign

country while on Tour Abroad

SECTION - XII

Miscellaneous
Time limit for Medical claims
Discretionary Powers
Hospitalisation of an employee for an injury arising out of and in the course of
employment
Advance against Medical expenses
Medico Legal Cases

13. SECTION - XIII

Admissible Physiotherapy Treatment

14. SECTION - XIV

Medical Check-up for Officers

15. SECTION - XV

Diet Charges at Refinery Hospitals

16. SECTION - XVI

Prevention of abuse of Facilities

Control measures in Medical Facilities

17. SECTION - XVII

Provision of Medical Facilities to Employees 'Relations' not covered by the

term 'Family' as defined in Medical Rules and special groups amongst
employees

Medical facilities to special groups amongst employees and others

 Annex - ANNEXURES
I
Recognised medical qualifications in Homoeopathy
Annex -
II Admissible Homoeopathic medicines

Annex-
IIIA List of 'Nominated' and 'Model Hospitals' - Metropolitan Cities

Annex-
IIIB
List of Nominated Hospitals - other than Metropolitan Cities
Annex-
IV Reference letter for indoor treatment

Annex - Scheme for initial medical check-up for Officers

V
Scheme for periodical medical check-up for Officers
Annex-
VI

SECTION - I

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1. TITLE:

These Rules may be called the Indian Oil Corporation Medical Rules.

Note:

a. These Rules supersede all previous Rules / Orders on the subject including Orders
issued from time to time; and
b. any interpretation or clarification of the Rules will be issued only by the Headquarters.

SECTION - II

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2. APPLICABILITY:

2.1 These Rules shall apply to all the employees of the Indian Oil Corporation Limited and their families
except those:

i. On deputation to Indian Oil Corporation and governed by parent organisation's Rules.

ii. On deputation from IOC to other organisations in or outside India unless the terms of
deputation specifically provide for an option to the employees to elect the IOC Medical
Rules. In such cases the entire liability for medical reimbursement will be that of the
borrowing department; and
iii. On leave outside India. The family of the employee staying in India while the employee is
on tour or leave outside India will, however, be governed by these Rules.
2.2 In respect of those who are employed in Refinery, Pipeline and Marketing Units/ Locations where
facility for treatment from the Refinery Hospital exists and who stay in Township / IOC Colonies, the
provisions of Section X of these Rules will only apply.

2.3 Reimbursement of Medical expenses incurred by an employee while on tour outside India will only
be as indicated in Section XI of these Rules.

2.4 Employees on Study Leave and female employees on Special Leave without pay to join their
husbands posted at out stations / abroad will not be entitled to any benefit under these Rules during the
period of such leave.

SECTION - III

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3. DEFINITIONS:

3.1 Corporation:

The Indian Oil Corporation Limited.

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3.2 Employee:

Regular employees of the Indian Oil Corporation Limited who are in regular employment but does not
include apprentices, daily rated or casual employees on daily wages. The word 'employees' referred to in
the Rules also includes employees' family members subject to notes under Rules 3.3.

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3.3 Family:

For the purpose of these Rules, family includes employee's wife, wholly dependent parents, children, step
children and legally adopted children, wholly dependent upon the employee and does not include earning
or married sons and daughters.

However, in the case of employees joining the corporation on the basis of letters of appointment issued
on or after 1.7.88, the family would include employee's wife and only two wholly dependent children. Step
children and adopted children, if adoption is permissible under the personal law are also covered. Where
there are more than two wholly dependent children, medical benefit would be confined to the two oldest
children and not to any two. It may be further clarified that the expenses incurred on the birth of a third
child either for prenatal, delivery or post-natal treatment will not be reimbursed. Resultantly, if the mother
suffers from any ailment which is a consequence of the birth of the third child, the expenses incurred on
treatment of such a disease / emergency would also not be reimbursed. This covers the spouse of male
employees as well as female employees themselves.

In the event of birth of triplets as a first issue, or if triplets are born as a second issue, when the child from
first issue is also alive, the stipulation of family related benefits limited to two children in such a case will
not apply. However, where triplets are born as first issue, the child born subsequently as second issue will
not be eligible for family related benefits/facilities [P/P/3(Rules) (CR No.13/2012 dated 11th June 2012].
However, please see Notes 1 to 12 below:

Note 1: Husband/Wife employed in organisation other than IOC

If the spouse of an employee is employed in another organisation (Private or Govt.) whether at the same
station or elsewhere, which provides medical facilities in cash or kind or both, the spouse shall be entitled
to the medical facilities under the medical rules only if he/she does not avail of the medical facilities in the
organisation, in which he/she is employed. The employee shall give his/her option in writing whether
his/her spouse who is employed in another organisation, shall avail of the medical facilities of IOC or of
the organisation, in which he/she is employed and furnish a certificate to the effect that he/she is not
availing medical facilities in cash or kind or both, from any other sources.

Note 2: Dependent parents

The term 'family' includes parents, provided they are wholly and exclusively dependent on the employee
and are permanently residing with the employee under the same roof. A married female employee may
also declare her parents as dependent on her provided they are wholly and exclusively dependent on the
employee and are permanently residing with her under the same roof.

An exception is however made if the dependent parents have to be away for temporary periods, the limit
for which has been fixed at 3 months in a year with prior information to the office. However, any
exceptional cases should be decided on the merits of each case. It is clarified that reimbursement for
regular treatment at a place other than the place of posting of the employee in respect of dependent
parents shall not be admissible, if prior intimation of their absence is not available in the office and
reimbursement shall be restricted only for hospitalization obtained in emergency. Further treatment in
such cases should be obtained from the regular place of stay only. Such parents whose combined
monthly income exceeds Rs.9000/- shall not be viewed as dependent. The Corporation reserves to itself
the sole right of deciding whether or not parents are wholly dependent.
(Ref. CR 33/09 dt.08.10.09)

Note 3: Unmarried sons and daughters

Unmarried sons and daughters who are employed only on a part-time basis shall be treated as wholly
dependent on the Corporation's employee for the purpose of these Rules provided the concerned
employer does not provide medical assistance. Such unmarried sons and daughters, whose total monthly
income exceeds Rs.3000/- p.m., shall not be viewed as dependent.

Note 4: Proof of income & dependency

The Corporation shall have the right to satisfy itself with regard to the dependency of employee's parents
or children and the employee is bound to provide such reasonable proof in this regard as Corporation
may in its absolute right demand. Certificates from Local Authorities regarding income and dependency
may also be asked for.

Note 5: Income for purpose of dependency

For assessing the income of parents / children for the purpose of dependency the regular income
received from all sources like interest on Bank deposits, security, dividend, pension under any scheme
(excluding interim relief received by Govt. pensioners) rentals from house / land holdings, employment
(full time / part-time), returns from investment would be taken into reckoning.

Note 6: Husband & Wife employed with IOC

In a case where both husband and wife are employees of IOC and posted at the same or different
stations, each one of them may claim medical benefits in individual capacity like any other employee at
their option. They may divide the eligible dependents among themselves as per their convenience,
subject to following:-

a) Only one of them would be permitted to declare his/ her parents as

dependent on meeting the eligibility conditions.

b) Only one of them would be permitted to claim reimbursement of expenses

on Spectacle / Contact lenses up to the prescribed ceiling.

c) The option to claim reimbursement in individual capacity once exercised

will not be changed during the Financial Year.

The Income-Tax provisions on the medical reimbursement claims will also apply in individual capacity.

Employees whose spouse is employed in IOC would have to give additional information every year in
the Dependency Proforma pertaining to the name, Employee No, Grade, station of posting of his/her
spouse. They will also declare that who among them will claim medical benefits in respect of his/ her
dependent parents along with the particulars of the parents and similarly who will claim
reimbursement of expenses on spectacles/contact lenses.

Note 7: Dependent members (other than parents) staying away from employees

Reimbursement of medical expenses in respect of dependent members of family (other than parents)
staying away from the employee may be allowed under the Medical Rules subject to the employee
obtaining prior permission of the Management, for availing himself of the facility of reimbursement of
expenses on medical treatment of such members of family at the place of their stay. Such reimbursement
will be in accordance with and subject to medical rules as modified / clarified from time to time.

Note 8: Children employed as trainees

Children of employees who are employed as Trainees in some Industrial Undertaking and such training is
a part of the employment or is likely to lead to automatic employment at the conclusion of the training,
cannot be considered as dependent children of our employees.

Note 9: Employed wife of deceased employee

Where alternative employment has been given to the wife in case of death of an employee, the original
dependents of the deceased employee will continue to avail of the medical facilities. The facility will even
continue after the remarriage of the widow in respect of self and dependent family members, as available
to regular employees as per rules.

Note 10: Legally separated married daughter

Medical benefits will be admissible to a married daughter of an employee, who perforce reverts to the
status of dependent of her parent after legal separation from her husband subject to the fulfilment of the
following other conditions:

i. The daughter should have a valid legal separation.

ii. She should not be getting any maintenance allowance from her ex-
husband or from any other source.
 iii. She should not be having any regular source of income.
iv. She should be residing under the same roof with the employee.
v. The medical benefits will be allowed only for daughter and not for her
children.
vi. The facility shall cease to be available when she re-marries or re-joins
her ex-husband.

Note 11: Children born as twins/triplets

In the event of birth of twins as a second issue, when the child from the first issue is also alive, the
stipulation of family related benefits limited to two children in such a case would not be applied and all the
three children would be eligible for the family related benefits. However, where the twins are born as a
first issue, the child born subsequently as a second issue will not be covered for the family related
benefits.

In the event of birth of triplets as a first issue or if triplets are born as a second issue, when the child from
the first issue is also alive, the stipulation of family related benefits limited to two children in such a case
may not be applied and all such children should be eligible for the family related benefits. However, where
triplets are born as first issue, the child born subsequently as second issue will not be eligible for family
related benefits/facilities.

Note 12: Updation of list of dependents

A system of updating the list of dependents every year should be introduced and the details should be
supplied by the Personnel Dept. to Finance, Admn. & Welfare Department to enable them to regulate the
bills accordingly. For details please refer CR No.01/2014 dt.08.01.2014.

In case an employee, who has declared his parent(s) as dependent at the current location, has taken his
family (spouse/children) along with him upon transfer to hardship location/ difficult locations/ remote
COCOs (as defined under the Transfer Policy 2013) but is unable to take his parent(s) to such location,
the same-roof condition for parents dependency in such case may be relaxed; however, other criterion of
income ceiling shall continue to be applicable without any change. However, if the concerned employee
has retained his family at a location other than the place of posting, the same-roof condition for
dependency of parents shall continue to apply without any relaxation. In case of a new recruit, who has
been posted at hardship location/ difficult locations/ remote COCOs (as defined under the Transfer Policy
2013), the same-roof condition for parents dependency may be relaxed in such case if he is unable to
take his parent(s) to such location; however the parent(s) should be otherwise dependant on him by
meeting the criterion of income ceiling. This special relaxation for new recruits shall be applicable only in
respect of dependant parents and not for other family members (spouse/ children). The above relaxations
shall apply only for the tenure the concerned employee is posted at such hardship location/ difficult
locations/ remote COCOs. [Ref. P/P/3(Rules)(CR 18/2014 dated 30.06.2014)].

Note13: Medical benefits to adopted children

The child can be legally placed for adoption of the prospective adoptive parents only with the order of the
Competent Court . However, the procedure for legal adoption has provision for pre-adoption foster care to
place the child in temporary custody of the prospective adoptive parents on submission of
undertaking/affidavit in this regard to the adoption agency even before the legal adoption order has been
passed by the Court. In a situation where, the child has been placed in temporary custody of an eligible
employee (i.e. prospective adoptive parents) by the licensed/authorized adoption agency for pre-adoptive
foster care prior to legal adoption order by the Court; the medical expenses incurred on such child by the
employee during the period of temporary custody may be considered for reimbursement under Medical
Rules. Such claims shall however be settled after the eligible parent(s)/employee is granted legal
adoption of the child by Court of law and the employee submits a copy of affidavit/undertaking
acknowledged by the adoption agency in this regard (Ref. CR No. 30/2012 dt, 03.12.12)

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3.4 Authorised Medical Attendant (A.M.A.):

A private or Government registered medical practitioner by which expression is meant a registered

medical practitioner qualified in modern system of medicines (Allopathic) with a minimum qualification of
M.B.B.S. In small towns / villages where medical practitioners with M.B.B.S. or higher qualifications are
not available, the term authorised medical attendant will include registered medical practitioner in
Allopathic System of Medicine with a qualification less than M.B.B.S. but not lower than a Licentiate in
Medicine.

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3.5 Authorised Medical Attendant (Homoeopathic System) (A.M.A.H.S.):

A private or government medical practitioner by which expression is meant a registered medical

practitioner qualified in Homoeopathic System of Medicine. The term qualified would include the
recognised medical qualification as notified in the Second & Third Schedules of the Homoeopathy Central
Council Act, 1973 (Vide Annexure - I of these Rules).

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3.6 Specialist:

A registered medical practitioner in Allopathic System possessing a post-graduate qualification or a

medical graduate holding a diploma in a particular branch of medical science entitling him to be called a
Specialist such as 'Child Specialist' , 'Skin Specialist' , 'E.N.T. Specialist', 'Heart Specialist',
'Gynaecologist and Obstetrician' etc. and practising as a Specialist.

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3.7 Dental Surgeon:

A registered medical practitioner qualified in dentistry having a minimum qualification of B.D.S. or its
equivalent and should be a practicing dental surgeon.

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3.8 Medical Attendance:

Attendance by an A.M.A. of the employee's own choice, either at the consulting room or residence of the
authorised medical attendant or at the residence of the patient or in a hospital nursing home and includes
:

i. Employment of such pathological, bacteriological, radiological, surgical

or such other methods as are considered necessary by the A.M.A.;
ii. Consultation with Specialist if such consultation is prescribed by the
A.M.A. under the allopathic system ; and
 iii. Purchase and use of such medicines, vaccines, sera or other therapeutic
substance prescribed by the A.M.A. / Specialist.

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3.9 Hospital / Nursing Home Treatment:

Medical treatment in a hospital / nursing home which, inter alia, includes employment of pathological,
bacteriological, radiological, surgical, etc. methods and supply of medicines etc. and consultation with
specialist as prescribed by the A.M.A.

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3.10 Medicines:

Such therapeutic substances as are prescribed by the authorised medical attendant / specialist under a
clear prescription signed by him but excludes inadmissible medicines.

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3.11 Inadmissible Medicines:

Preparations that are not medicines as such but are primarily food or toilet preparations or
disinfectants.Kindly refer IOM No. P/P/3(Rules) (CR No. 22/2014) dated 08.08.2014.

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3.12 Admissible Medicines under the Homoeopathy System:

The medicines listed in Annexure (II) of these Rules as modified from time to time.

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3.13 Treatment of Drug Abuse/Alcoholism (Self inflicted disease):

Expenses incurred by an employee on treatment of Drug Abuse/Alcoholism for self and/or eligible
dependent family member(s) shall not be admissible for reimbursement.

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3.14 Controlling Officer:

An Officer to whom powers have been delegated by the Corporation for administration of these Rules.

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3.15 Competent Authority:

Wherever in the rules, Competent Authority has not been specified, Functional Directors may be
construed as Competent Authority.
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SECTION - IV

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4. MEDICAL ATTENDANCE:

4.1 An employee may receive medical attendance from an A.M.A. either under the Allopathic or
Homoeopathic System.

4.2 Expenditure incurred by an employee in obtaining medical attendance under these rules in India will
be reimbursed by the Corporation subject to provisions hereinunder:

4.3 i. An employee may consult an A.M.A. under the Allopathic or Homoeopathic system of Medicines
and the medicines prescribed by him may be obtained by the employee from a chemist.

ii. a) In case of Homoeopathic treatment the ceiling per ailment where the medicine is either dispensed by
A.M.A. (Homoeopathy)/Specialist (MD Hom. or equivalent) or purchased from outside, is Rs.750/- per
ailment subject to one day's medicine costing not more than Rs.25/-. List of admissible
Homoeopathy medicines is mentioned in Annexure II.[Ref.P/P/3(Rules)(CR No.28/12 dt. 07.11.12]

b) In case of dispensation by A.M.A. in Allopathy the total expense towards consultation, medicines,
injection etc. will also be restricted to Rs.350/- per ailment. But the medicines purchased from outside
Chemist prescribed by the A.M.A. (Allopathy) will not be included in this limit. Further, the dispensation in
the case of Allopathy, will not be for more than five days at a time in normal as well as emergency cases.
[Ref. CR No.11/2013 dt. 15.5.13]

iii. The A.M.A. may repeat medicines if the situation demands it. The number of consultation will,
however, be restricted to four.

iv. Whenever the A.M.A. dispenses medicines such dispensation should indicate the name and quantity
of medicines together with cost thereof, disease treated, consultation fee etc.

v. a) The A.M.A. should prescribe medicines normally for a period not exceeding 7 (seven) days at a time
for each sickness which can be repeated, if required.

b) In case of chronic ailments the medical attendant may prescribe medicines for a longer period but not
more than one month at a time. However, for such longer treatment an essentiality certificate from the
A.M.A. has to be attached with the claim.

vi. The cash voucher of the druggist should invariably indicate name and address of the patient, name of
the doctor, batch of medicines purchased, etc.

vii. Homoeopathic treatment will continue to be availed as prescribed in the Rules.

viii. All claims exceeding Rs.2500/- shall be sent to Finance only after being counter-signed by the
Controlling Officer, who must satisfy that there are no inconsistencies in the prescription or bills and, if
required, may call the employee concerned to explain the same before the bills are sent to concerned
deptt. for processing. Heads of Departments in grade 'E' and above may be treated as Controlling Officer
in respect of their own medical reimbursement claims exceeding Rs.2500/-. [Ref. P/P/3(Rules)(CR
No.06/2014 dt.26.02.2014]
ix. The provisions under paras (ii) to (viii) above are not intended in case of treatment availed in the
Refinery Hospitals / Government Hospitals and the company approved / nominated Hospitals. However,
for chronic ailments AMA in a nominated Hospital may prescribe medicines upto a maximum period of 90
days and the reimbursement of cost of medicines shall be limited upto 30 days at a time i.e. employee
would not purchase prescribed medicines for a period exceeding 30 days at a time except that the
patients who are referred outstation for treatment in a Nominated Hospital or to a specific specialist
doctor/non-nominated hospital, may purchase medicines upto a maximum of 90 days at a time i.e., the
restriction of 30 days shall not apply in their cases.

x In case medicines are supplied only in packs and it is not possible to purchase the exact prescribed
quantity, reimbursement of medicines purchased in company’s lowest retail market pack, even though its
quantity may be more than prescribed may be allowed. Employee would, however, be required to submit
a certificate from the AMA that the prescribed medicine (s) is/are available only in this lowest pack/bottle,
specifically mentioning the quantity contained therein. In the absence of such certification, payment shall
be restricted to the prescribed quantity.

xi. If the A.M.A. has prescribed X-Ray, pathological tests, etc. the same can be availed from him if he has
such facilities or from any other authorised establishment and the cost thereof within the prescribed limits
shall be borne by the Corporation against receipted bills / original prescription.

4.4 The limits upto which the Corporation shall reimburse expenditure incurred by the employee on
consultation fee, fee for X-Ray, various pathological tests, etc., room charges for hospitalisation,
operating charges, special nursing etc. shall be as under:

4.4.1 Consultation Fee:

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a) Under Allopathic System:

X class cities Other than X class cities

Fee per Consultation Rs.200/- Rs.150/-
[Ref.P/P/3(Rules)(CR No.28/12 dt. 07.11.12]

Note: Number of consultations per ailment will be restricted to four.

b) In case of reference to a Specialist by Company's Medical Officer or by an A.M.A. where there is no

Medical Officer of the Company, the actual fee charged by the Specialist will be reimbursed without any
limit on the number of consultations.

c) Employees who consult a specialist, for any discipline, directly will be reimbursed maximum
consultation fee as under:

Fee per Consultation Rs.500/- for X class cities

Rs.300/- per consultation for other than X class cities

d) Under Homoeopathic System:

 X class cities Other than X class cities
Fee per Consultation Rs.150/- Rs.100/-

Note: Number of consultations per ailment will be restricted to four.

Consultation from Specialist under Homeopathy System (from MD (Homeopathy) or its equivalent)

- Rs.450/- per consultation for X class cities

- Rs.250 per consultatation for other than X class cities.

[Ref.P/P/3(Rules)(CR No.28/12 dt. 07.11.12]

4.4.2 Injection Administration Charges:

Injection Charges per Injection

Intravenous - Rs.50/-
Others - Rs.40/-

Actual cost of disposable syringes and needles will be reimbursed on production of cash receipts.

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4.4.3 Room / bed entitlement for Hospitalisation / Nursing Home treatment-ceiling limits ( Rs.):

i. Category I : [Ref.P/P/3 Rules (CR No.1/2010) dt.04.01.2010]

a. In Model Hospitals:

Sir Ganga Ram Hospital at Delhi, Nanavati Hospital at Mumbai, Calcutta Medical
Research Institute at Kolkata and Vijaya Hospital at Chennai are the Model
Hospitals for Northern, Western, Eastern and Southern Region respectively. The
room / bed entitlement of employees in Model Hospitals are linked to classification /
category of accommodation of the Hospital as under:

Sir Ganga Nanavati CMRI, Vijaya Hospital,

Ram Hospital, Hospital, Kolkata Chennai
Delhi Mumbai

WORKMEN

Gd. I & II Semi paying II class Non A/C Non A/C -

(4/6 (3 bedded) Spl. Ward (More than 2 beds).
bedded A/C)

Gd. III to Semi paying II class -do- Non A/C -

VII (4/6 (DB-AB) (2 bedded)
bedded A/C)

Gd. VIII -do- -do- -do- -do-

 OFFICERS

Gd. A A/C Semi Non A/C A/C Spl. Non A/C

Nursing (Class II) Ward (2 Single Room
Home (SB - AB) bedded)

Gd. B & A/C Semi A/C Cabin -do-

C Nursing (Class II)
Home (DB - AB)

Gd. Nursing A/C Single A/C Single A/C Single Room

D,E&F Home (Single Room (DX- Room
A/C Room) Ward V or class
I - Ward 14)

Gd. G & Nursing A/C class - I A/C Single DX Room

above Home (DX (Spl.Wing 'A') Room
Room)

b. In Nominated Hospitals(w.e.f. 01.04.2014): (Ref. CR No.15/2014 dated 29.04.2014)

WORKMEN

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. I to 1770 1770 1685 1060

VII

Gd. VIII 2205 2205 2090 1590

Gr. IX 2645 2645 2510 1910

Bed entitlements shall be limited to monetary ceiling or actual charges on twin

sharing room/ward, whichever is lower.

OFFICERS

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. A* 2950 2950 2950 2950

*Bed entitlements shall be limited to monetary ceiling or actual

 charges on twin sharing room/ward, whichever is lower.

Gd. B & C# 3975 3975 3975 3170

# Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd. D, E & F** 6200 6200 6200 4765

** Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd.G & H Actual (A.C. Single Room)

Gd. I Actual (AC Single room/Deluxe room)

Functional Actuals (Super/Luxury Deluxe room)

Dirs./
Chairman

c. In Non-Nominated Hospitals (w.e.f. 01.04.2014): (Ref. CR No.15/2014 dated 29.04.2014)

WORKMEN

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. I to 1330 1330 1260 790

VII

Gd. VIII 1685 1685 1590 1195

Gr. IX 2020 2020 1910 1430

Bed entitlements shall be limited to monetary ceiling or actual charges on twin sharing
room/ward, whichever is lower.

OFFICERS

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. A* 2220 2220 2220 2220

*Bed entitlements shall be limited to monetary ceiling or actual

charges on twin sharing room/ward, whichever is lower.

Gd. B & C# 3015 3015 3015 2400

 # Limited to monetary ceiling or A.C. single room charges, whichever is
lower

Gd. D, E & F** 4720 4720 4720 3570

** Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd.G & H Actual (A.C. Single Room)

Gd. I Actual (AC Single room)

Functional Actuals(Super/Luxury Deluxe room)

Dirs./
Chairman

Category I (comprising of Delhi, Greater Mumbai, Chennai, Kolkata, Bengaluru, Hyderabad, Ahmedabad,
Surat, Nagpur, Pune, Jaipur, Lucknow and Kanpur cities). Other cities where HRA is being paid at X class
city rates would also be placed in this category.

ii. Category II cities (all other cities not included in Category I):
[Ref.P/P/3 Rules (CR No.1/2010) dt.04.01.2010]

a. In Nominated Hospitals (w.e.f. 01.04.2014): (Ref. CR No.15/2014 dated 29.04.2014)

WORKMEN PANIPAT CITY

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. I to 1060 1010 1010 790

VII

Gd. VIII 1330 1330 1260 1060

Gr. IX 1595 1595 1515 1275

Bed entitlements shall be limited to monetary ceiling or actual charges on twin

sharing room/ward, whichever is lower.

OFFICERS

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. A* 1770 1770 1770 1770

*Bed entitlements shall be limited to monetary ceiling or actual

 charges on twin sharing room/ward, whichever is lower.

Gd. B & C# 2400 2400 2400 1910

# Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd. D, E & F** 3705 3705 3705 2870

** Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd.G & H Actual (A.C. Single Room)

Gd. I Actual (AC Single room/Deluxe room)

Functional Actuals (Super/Luxury Deluxe room)

Dirs./
Chairman

b. In Non-Nominated Hospitals (w.e.f. 01.04.2014): (Ref. CR No.15/2014 dated 29.04.2014):

WORKMEN PANIPAT CITY

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. I to 790 790 760 605

VII

Gd. VIII 1010 1010 985 790

Gr. IX 1215 1215 1185 950

Bed entitlements shall be limited to monetary ceiling or actual charges on twin sharing
room/ward, whichever is lower.

OFFICERS

Category NR (Rs.) WR (Rs.) ER (Rs.) SR (Rs.)

Gd. A* 1330 1330 1330 1330

*Bed entitlements shall be limited to monetary ceiling or actual

charges on twin sharing room/ward, whichever is lower.

Gd. B & C# 1800 1800 1800 1435

 # Limited to monetary ceiling or A.C. single room charges, whichever is
lower

Gd. D, E & F** 2800 2800 2800 2140

** Limited to monetary ceiling or A.C. single room charges, whichever is

lower

Gd.G & H Actual ( A.C. Single Room)

Gd. I Actual (AC Single room)

Functional Actuals(Super/Luxury Deluxe room)

Dirs./
Chairman

4.4.4 Treatment charges as an in-patient or out-patient in Government Hospitals or in anyone of

the recognised/ nominated Hospitals or a non-nominated Hospital/ Nursing Home:

a. All Government Hospitals and Hospitals mentioned in Annexure III A & III B, are recognised as
Nominated Hospitals for treatment of our employees. Management will have the sole right to add
or drop any Hospital / Nursing Home at any time.

i. Treatment in Govt. / Nominated Hospitals/ Nursing Homes - Category I and II cities:

a. In patient:
In respect of treatment taken as an in-patient in Government or in any of the Hospitals / Nursing Homes
nominated at these places, the actual charges as applicable to the room entitlement as indicated in
4.4.3(i)a, 4.4.3(i)b and 4.4.3(ii)a of the employee concerned (except diet and Special Nursing Charges)
shall be reimbursed in full. Where the employee has been allowed to avail accommodation beyond
entitlement, the employee would be entitled to reimbursement as per the charges relating to one-step
above his / her ward entitlement with the approval of Competent Authority.

b. Out-patient:
As an 'Out-patient' in any of the Government or nominated Hospitals / Nursing Homes, the actual charges
for tests for pathological, radiological and other investigations shall be reimbursed in full.

ii. Treatment in Non-Nominated Hospitals/ Nursing Homes:

If an employee chooses to receive medical treatment as an in-patient in any Hospital / Nursing Home
other than the nominated Hospitals / Nursing Homes at Metropolitan and Category I Cities, the ceiling
limits for Room / Bed Charges will be as indicated in 4.4.3(i)(c) above. If an employee chooses to receive
medical treatment as an inpatient in any Hospital / Nursing Home other than the Nominated Hospitals /
Nursing Homes at other than Category I Cities, the ceiling limits for Room / Bed charges will be as
indicated in 4.4.3 ii(b). However, the reimbursement towards treatment whether as in-patient or out-
patient, shall be subject to the ceiling limits relevant to the room entitlement of the employee in Sir Ganga
Ram Hospital at Delhi, Vijaya Hospital at Chennai, Calcutta Medical Research Institute at Kolkata and
Nanavati Hospital at Mumbai as the case may be. In respect of various radiological / pathological and
other tests carried out as an outpatient in any private hospital, or from a private clinic / radiologist /
pathologist, the highest rates prescribed for the various tests in the 'Model Hospital' shall be the ceiling
limits for reimbursement.
4.4.5 Special Nursing Charges: (Ref. CR No.28/12 dt. 07.11.12)

Reimbursement for Special Nursing shall be allowed under approval of Unit Head and HR Head of Hqrs.
only during hospitalisation in serious and critical cases in respect of Cardiac, Neurology, Nephrology
(Kidney transplantation), Hepatic(Liver transplant) and serious accident cases when Special Nursing is
absolutely essential as evidenced by a certificate to that effect from Hospital Authorities (Operating
Surgeon / Attending Physician or their Superior). The issuing authority should certify that the Nursing
Staff engaged is qualified and absolutely essential for the recovery of the patient. The daily charges
admissible shall not exceed Rs.1000/- per day (24 hours) subject to the employees bearing first 20% of
the charges.

In case of serious Psychiatric / Mental cases, for engagement of a wardboy on the recommendation of
the Operating Surgeon / Attending Physician, reimbursement will be allowed to a maximum of Rs.300/-
per day (24 hours) subject to the employees bearing first 20% of the charges.

4.5 Consultation with Specialist:

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During the course of treatment of any sickness under the allopathy whenever consultation with a
'Specialist' is considered necessary by A.M.A. (Allopathic), Specialist may be consulted, in which case the
actual fee charged by the Specialist, shall be reimbursed.

Employees who consult a Specialist directly will be reimbursed Consultation fee subject to ceilings laid
down (Rule 4.4.1(c).

4.6 The cost of medicines prescribed by the A.M.A. and purchased by the employee shall be reimbursed
to the employee on the basis of cash vouchers obtained from the Chemist supported by the A.M.A.'s
prescription. If the A.M.A. himself has supplied the medicines, the reimbursement shall be on the basis of
the receipt for payment received as furnished by him in this regard. (See Rule 4.3 also). The same
principle will apply for reimbursement of 'X' Ray, Pathological tests, etc. except that limits upto which such
costs are borne by the Corporation will be as prescribed from time to time under Rule 4.4 above.

Medical expenses without production of cash memo when patients’ life is at risk and prescribed drugs are
not manufactured indigenously, subject to certification by the attending doctor, as life saving drug not
manufactured indigenously may be reimbursed subject to the approval of Competent Authority.

4.7 The Cost of inadmissible medicines even if prescribed by an Authorised Medical Attendant /
Specialist will not be reimbursable.

4.8 The cost of medicines prescribed by the A.M.A. (H.S.) subject to the ceiling limits prescribed from
time to time shall be reimbursed to the employee on the basis of cash vouchers obtained from the
Chemist supported by the A.M.A' s prescription and if the A.M.A. himself has issued the medicines, on the
basis of his receipt for payment received. The list of admissible medicines are given in Annexure II (Rule
4.3 may also be seen).

4.9 Allopathic medicines prescribed by a Homoeopathic doctor or Homoeopathic medicines prescribed

by an Allopathic doctor will not be admissible for reimbursement. Treatment obtained for same ailment
simultaneously under different systems of medicines shall not be permissible and the reimbursement
would be made under one system only.Allopathic medicines prescribed by a Homoeopathic doctor or
Homoeopathic medicines prescribed by an Allopathic doctor will not be admissible for reimbursement.
Treatment obtained for same ailment simultaneously under different systems of medicines shall not be
permissible and the reimbursement would be made under one system only. However, basic
investigations/tests as prescribed by the AMA-Homeopathy (the qualification of whom is mentioned in
our Medical Rules, as per the prescribed schedule of the Homeopathy Central Council Act, 1973) shall be
admissible under the Medical Rules. The expenses of such test(s)/investigation(s) shall be exclusive of
the ceiling per ailment laid down under Homeopathic system (Ref. CR No.20/2013 dt.24.07.2013)

4.10 Consultation with Spouse ( AMA) - On the prescription /advice by the spouse ( AMA) for self,
medical benefits shall not be admissible. On the prescription/advice by the spouse ( AMA) for other family
members and employee, medical benefits shall be admissible only during emergency.

SECTION - V

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5. HOSPITAL / NURSING HOME TREATMENT:

5.1 In case where hospitalisation / nursing home treatment has been considered necessary by the
A.M.A. / specialist, the employee will be entitled to obtain such treatment as under :

a. In Government Hospitals or similar Hospitals of other local authorities, Maternity and Child
Welfare Centers recognised by the State Government and having arrangements for in-patients at
or near the place where he / she falls ill ;
b. In nominated Hospitals / Nursing Homes of that place, and
c. In private Hospitals / Nursing Homes subject to limits prescribed by the Corporation (See Rule
4.4.4).

5.2 All hospitalisation charges (excluding special nursing charges subject to Rule 4.4.5 and diet charges
which will not be reimbursable subject to Rule 5.4 & 12.3) actually incurred will be reimbursable restricted
to ceiling of rates prescribed from time to time as per Rule 4.4. The hospitalisation charges, inter alia,
include room rent, cost of blood and blood transfusion, injection, 'X' Ray, delivery, pre-natal & postnatal
treatment, operation, operation theatre charges, ICU/HDU charges, anaesthesia, pathological,
bacteriological and radiological examination, E.C.G., serology, parasitology, viralogy, mycology,
immunology, cytology, cytogenetics, testing fluids and excertions, haemotology, ordinary nursing etc.
Wherever the ceiling limits have not been prescribed, actuals incurred shall be reimbursable.

5.3 The Hospital / Nursing Home charges will be paid by the Corporation directly to the Hospital /
Nursing Home authorities wherever such an arrangement exists and in such cases only charges incurred
in excess of the limits prescribed from time to time shall be recovered from the employee. If arrangement
for payment of the charges directly to the Hospital / Nursing Home cannot be made, then the employee
will pay such charges and claim reimbursement of the same subject to the limits prescribed. For this
purpose, employees shall be entitled to an advance equal to the estimated expenditure as certified by
A.M.A. limited to the amount prescribed from time to time (Refer Rule 12.4 in this regard).

5.4 Diet charges at the Hospital / Nursing Home shall be borne by the employee and no reimbursement
is due from the Corporation.

If the diet charges are not indicated separately in the bills of the Hospital / Nursing Home and if the diet
has been provided to the patient by the Hospital / Nursing Home or if room charges normally include an
element for diet charges, whether or not diet is availed of, but not shown separately, will be taken as diet
charges to be recovered from the employee as per the following :(See Rule 12.3).

- 20% of the room / bed charges or Rs.75/- per day whichever is less in respect of non-officers and
- 20% of bed charges or Rs.100/- per day, whichever is less in respect of officers,
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5.5 Charges for Bed / Room:

i. The entitlement of employees for reimbursement of bed/room charges shall be within the limits
prescribed under Rule 4.4.3
ii. The bed/room charges to be reimbursed shall not ordinarily exceed the prescribed limits for
various categories but in emergency cases when a bed/room within the entitled ceiling is not
available in the hospital / nursing home at the outstation where the patient has been referred for
treatment, the employee may avail of a bed/room the charges of which may be one step above
the prescribed limits for the employee's category, and the same shall be borne by the Corporation
subject to the approval of Competent Authority. The employee should shift to the room as per his
entitlement as soon as the same is available.
iii. In emergency cases for hospitalisation in respect of local referred cases when a bed/ room within
the entitled ceiling is not available, the employee may be allowed to avail a bed / room above his /
her entitlement and only 50% of the excess bed charges or 50% of the differential between the
entitlement of the employee and next one higher step entitlement of the employee, whichever is
lower, may be reimbursed subject to the approval of Competent Authority. However, this facility of
additional reimbursement will be restricted to hospitalisation in nominated hospitals only. And the
employee should shift to the bed / room as per his entitlement as soon as the same is available.
iv. When an employee has been referred from outside to receive hospitalisation in the Model
Hospital in a Metro City, and the bed / room as per his entitlement is not available, the next higher
category of entitlement would be determined on the basis of classification / category of
accommodation available instead of monetary ceiling, subject to the approval of the Competent
Authority, consequent upon the employee producing a certificate from the Hospital regarding non-
availability of entitled accommodation during the entire period of hospitalisation. The employee
should shift to the bed / room as per his entitlement as soon as the same is available.
v. Day Care Procedures: Expenses incurred on day care procedures involving same day discharge
from the hospital like cataract, chemotherapy, angiography, dialysis, radiation procedures or any
such minor OT procedures etc. shall be treated as hospitalisation expenses, even if no bed
charges have been levied.

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5.6 Dressing Charges:

The ceiling limits for reimbursement of dressing charges by AMA are as under:-

a) Single wound dressing Rs.100/- per dressing

b) Multiple wound dressing Rs.250/- per dressing
c) Dressing in burn cases Charges will be reimbursable
depending upon the percentage &
degree of burns in consultation with
CMO.

e) Reimbursement upto above ceiling limits would be admissible for various types of dressing mentioned
in the Rules, for any bodily injury, necessitating dressing by an A.M.A, irrespective of the fact whether any
operation / surgery is involved or not.

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5.7 Reference for Indoor Treatment:

 a. In case an employee needs a Reference Letter for admitting the patient in a nominated hospital
for indoor treatment, he would be required to make a written request in this regard mentioning in
brief the ailment for which the patient has to be admitted. In case the patient has been advised to
be admitted in the hospital by an AMA, a copy of same should also be enclosed with the request.
b. Reference Letter, as per Annexure-IV, is to be addressed to the Hospital. All such Reference
Letters should be serially numbered and entered in the control register for effective check.
c. The Reference Letter to the Hospital would be valid initially for 15 days from the date of
issue. In case the patient is required continued admission beyond the validity period, the
Hospital may continue the treatment but arrange to send an intimation facilitating
further extension of the indoor treatment.

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SECTION - VI

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6. DENTAL TREATMENT:

6.1 An employee is entitled to have 'major dental treatment' from a dental surgeon. 'Major treatment'
inter-alia includes treatment of jaw bone disease, wholesale removal of teeth, surgical operations needed
for removal of odontoes and impacted wisdom teeth, treatment of pyorrhea of teeth and gingivitis.

6.2 In addition to major dental treatment, charges on minor dental treatment taken from a dental
surgeon are also reimbursable subject to the prescribed limits.

6.3 The various types of dental treatment for which reimbursement is admissible and the applicable
ceiling rates are as follows:

Admissible Dental Treatment and Maximum Charges Payable:

Sl. No. Treatment Maximum charges (Rs.)

I a. Consultation * 150.00

b.Consultation from MDS* 250.00

II Fillings:

a) One Surface 450.00

b) Two Surfaces 600.00

c) Glass lonomer Filling 450.00

d) Composite Filling 600.00

e) Composite Veneer 1100.00

III Minor – I

1. Extraction per tooth 450.00

2. Periocoronotomy 600.00

3. Frenectomy 600.00

4. Biopsy 600.00

5. Abscess Incision 450.00

IV Minor - II

1. Gingivectomy per segment- Gum 900.00

Treatment

2. Alveolectomy 900.00

3. Growth Removal 900.00

4. Pulpotomy 900.00

5. Flap Surgery - per segment 1600.00

6. Flap Surgery - full mouth 14000.00

V Major - I

1. Removal of impaction/apecectomy 1400.00

2. Cystectomy 1400.00

3. Root Canal Treatment 1600.00

4. Multiple Root canal treatment 2500.00

5. Crown (Capping) following RCT per 1500.00

tooth

VI Major - II

1. Fixation of fracture of jaw 4500.00

2. All extractions in one jaw 3750.00

3. Gingivectomy - full mouth 3750.00

4. Tumour excision 3750.00

5. Peripheral neurectomy 3750.00

 VII Major – III

1. Total extractions 4500.00

2. Segmental resection of jaw 4500.00

3. Ostectomy 4500.00

4. Condylectomy 4500.00

VIII Special procedures Resection of 15000.00

Jaw

IX Dentures

1. X-Ray (single plate) 200.00

2. Denta CT 1200.00
Scan/Orthopantomorgram/ X-Ray
(full mouth)

X Dentures

1. Full Denture 7500.00

2. Partial Denture (1st Tooth) 1200.00

3. Partial Denture (Addl. Tooth) 600.00

4. Bridge per unit if required while 2000.00

providing denture

* Restricted to one consultation per ailment

N.B. : This includes, charges for L.A.(Local Anaesthesia) and not for G.A.(General
Anaesthesia). Where G.A. is given, charges for G.A. will be 20% of the procedure
charges.
Note: For dental treatment obtained for the above specified items in a nominated
hospital, irrespective of the above maximum ceilings, actual charges levied by the
nominated hospital shall be reimbursed in full.

6.4 Expenditure incurred for scaling, polishing of teeth is not reimbursable and any consultation fee paid
in this regard is not allowed. The cost of artificial dentures and dental surgery / treatment is reimbursable
in case of 'accidents'. The cost of dentures in other than 'accident cases' will be reimbursible in a limited
way as per ceilings prescribed above.

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SECTION - VII

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7. OTHER MEDICAL FACILITIES:

7.1 Anti-rabic Treatment:

Full charges incurred for anti-rabic treatment are reimbursable.

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7.2 Treatment for immunising and prophylactic purpose:

Full charges incurred on this account are reimbursable only in case of communicable diseases such as
Cholera, Typhoid group of fevers, Plague, Diptheria, Whooping Cough, Tetanus, Poliomyelitis, Small Pox,
etc.

In case of immunisation/vaccination obtained from the AMA, reimbusement shall be limited to Maximum
Retail Price (MRP) of the vaccine and also the admissible injecting charges. The Doctor’s Bill should,
therefore, indicate the name and brand and other details of the vaccine administered by him. For effecting
reimbursement, MRP of the vaccine should be checked from journals like, MIMS/Idea/Drug Today, which
are easily available in the market and can be subscribed for use in office.

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7.3 Treatment through Lithotripsy in Nominated Hospitals (technology for Gall Bladder / Kidney
Stone therapy):

Expenditure incurred on Lithotripsy treatment is fully reimbursed, irrespective of the number of occasions
for which the treatment has been taken by our employees / dependents.

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7.4 Cost of Spectacles / Contact Lenses:

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The cost of spectacles or contact lenses in lieu of spectacles will be reimbursed in respect of serving
employees and their dependent family members, limited to Rs.8000/- in every financial year, which
includes charges for eye-testing forming part of the prescription for spectacles. The employees may claim
reimbursement of expenses on Spectacles/Contact Lenses for self & family members on self-certification
basis. Signature of controlling officer will not be required for these claims. Where both husband and wife
are employees of IOC they are to be treated as one family.

7.5 Cost of Artificial Appliances (i.e. Orthopaedic appliances):

In case where artificial appliances i.e. Orthopaedic appliances, have to be purchased on the advice of the
A.M.A. / Specialist, hospital or nursing home, the reasonable initial cost of such artificial appliances will be
borne by the Corporation. Any cost incurred subsequent to the initial

, for replacement, repair, maintenance etc. will be reimbursed to the extent of 75% of the cost.

Reimbursement of cost of a Wheel Chair on the basis of prescription / advice of the attending specialist (
as defined under Medical Rules) from a Nominated / Govt. Hospital on submission of essentiality
certificate within a one-time maximum ceiling of Rs. 10,000/ for movement of a physically handicapped
employee/eligible dependent family member is also allowed.
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7.6 Cost of Intra - Ocular lens:

The cost of Intra - ocular lens shall be reimbursable subject to a maximum of Rs.8000/- per lens.

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7.7 Cost of Hearing Aid:

7.7.1 The cost of hearing aid would be reimbursable upto a ceiling of Rs.12,500/-(inclusive of taxes)
(per hearing aid) on the basis of prescription/recommendation of one ENT Surgeon.

In keeping with the objective of the Persons with Disabilities(Equal Opportunities, Protection of Rights and
Full Participation) Act 1995, an employee with hearing impairment on the prescription/recommendation
from two ENT Surgeons of Government/Nominated/Corporation's own Hospitals based on the hearing
loss and its attendant disability supported by audiometric evidence will be allowed reimbursement of the
cost of per Digital Hearing Aid upto a ceiling of Rs.30,000/-(inclusive of local taxes).

7.7.2 Repair and Maintenance of the hearing aid may be allowed once in a year limited to 10% of the
maximum cost prescribed, upon production of receipts.

7.7.3 Employee may replace the hearing aid after every four years.

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7.8 Laser Treatment:

7.8.1 Medical treatment of preventive or remedial in nature for curing the ailment and not for cosmetic
purposes (e.g. doing away spectacle/lenses or removal of scars, etc.) through the use of Laser
Technology will be admissible and the reimbursement for such treatment will be in accordance with the
Rules.

7.9 Treatment of Infertility:

Reimbursement of expenses incurred on infertility treatment in respect of married women (female

employees/dependant spouse living with husband) shall be admissible subject to regulatory provisions
provided hereunder:

i. The IVF treatment procedure will be allowed only in cases of infertility where the couple
has no living issue, if taken in a nominated hospital.

ii. Reimbursement of expenditure incurred on IVF treatment upto a maximum of three

cycles shall be admissible if carried out in a nominated hospital.

iii. The treatment for infertility would be allowed after minimum 5 years from marriage. The
age of the woman undergoing IVF treatment should be between 23 and 39 years.

iv. An amount not exceeding Rs.65,000/- per cycle or the actual cost, whichever is lower ,
will be allowed for reimbursement. This amount will be inclusive of the consultations,
investigations, surgical evaluations, procedural charges cost of drugs and disposables and
monitoring cost during IVF procedures.
 v. Employee would be required to obtain a one-time written permission for availing IVF treatment
(upto a maximum of three cycles). The request of the employee would be processed by Unit HR-Deptt for
approval by Unit Head of the level of GM and above. At Ref. Hqrs, such proposals would be approved by
HR Head.

vi. Since, the permission of IVF treatment shall be allowed only once, an undertaking shall be
obtained from the employee that reimbursement on IVF treatment has not been availed by the employee
earlier from the Corporation and will not claim it in future. The one-time permission granted to the
employee shall also be recorded in the concerned Service / P-file.

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SECTION - VIII

8. SPECIAL DISEASES:

8.1 Cancer:

An employee may receive treatment for cancer at the nearest hospital providing such treatment subject to
the condition that commencement of such treatment is recommended by the A.M.A. Once the treatment
has begun, then the A.M.A need not necessarily come into picture and the case may be dealt with by the
Specialist. Expenditure incurred on the treatment of Cancer will be reimbursed in full if certified by the
Cancer Specialist as reasonable and necessary.

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8.2 Mental Diseases:

An employee suffering from mental disease may receive treatment at the nearest hospital on the advice
of A.M.A (Allopathic) subject to the condition that the patient shall be allowed to receive indoor treatment
at the hands of a Specialist at Corporation's cost for initial period of upto six months. This period of six
months may be extended by a further period of six months with the approval of the ED/GM and
extensions beyond shall be approved only by Functional Directors.

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8.3 Poliomyelitis:

An employee or a member of his family suffering from poliomyelitis may receive treatment from the
Government / Semi-Government Hospitals providing such treatment either as an indoor or outdoor
patient.

In case where the employee chooses to secure treatment from a Private A.M.A. or Specialist or nursing
home, the cost reimbursable by the Corporation shall not exceed that, that would have been admissible
had he / she been treated in Hospital or Rs.5000/- in all, for the employee or any member of his family
affected by the disease, whichever is favourable.

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8.4 Tubercular Disease:

If a Specialist in Tubercular disease certifies treatment in a T.B. Sanatorium is necessary, the employee
or a member of his family will be entitled to receive treatment in any sanatorium / T.B. Institution which
can, in the opinion of the T.B. Specialist provides the necessary and suitable treatment and where
accommodation for him / her is available. An employee or the member of his family from Tuberculosis for
whom treatment as an in-patient in a Hospital / Sanatorium etc. is not considered necessary by the
authorised medical attendant or who fails to get accommodation for treatment as an in-patient in the T.B.
Institution may receive domiciliary treatment as an out-patient of the T.B. Hospital or T.B. Institution or at
the consulting room of the authorised medical attendant or consulting room of a T.B. Specialist.

The maximum period of treatment which may be allowed from the date of detection of the disease for the
purpose of reimbursement shall be restricted to

24 months as certified by the T.B. Specialist / Medical attendant etc. The said period of treatment for 24
months may however, be computed for each occurrence of relapse in a patient, to be certified as such by
the treating physician, medical attendant, etc. which may occur in certain percentage of T B cases
irrespective of the fact that the patient had received treatment on a number of occasions earlier. A patient
who had received treatment as an in-patient in a hospital / sanatorium and is discharged after a certain
period of treatment should be allowed to take domiciliary / out-patient treatment from any of the sources
in accordance with the advice of the sanatorium / hospital authorities at the time of their discharge. But in
no case the total period of treatment both in-patient and out-patient, put together should exceed a
continuous period of 24 months.

The case of relapse of the disease shall be referred to Corporate Office for review as to the admissibility
or otherwise of the reimbursement of the expenses beyond a reasonable period.

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8.5 Diabetes:

In the case of Diabetes, reimbursement in respect of cost of periodical consultation and tests, anti-
diabetes drugs viz. Insulin, Nadisan, Talbutamide or a recognised equivalent, regularly administered will
be permissible but the expenditure on administration of injections like Insulin etc. will not be allowed
except in the initial stages or / and when the patient develops complications and has to be hospitalised.

A case of diabetes within a period of six months after detection shall be deemed to be in the initial stage
of the disease and claims relating to the treatment for the first six months after the first detection of
Diabetes will be reimbursable, subject to any limits that may be prescribed from time to time.

Cases of treatment (other than hospitalisation) of the Diabetes after the initial stage of 6(six) months shall
be referred to Competent Authority for, decision in regard to the admissibility or otherwise of
reimbursement of the expenses other than on normal periodical consultation and tests and anti-diabetes
drugs.

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8.6 Cardiac arrests/strokes etc.:

All expenditure in obtaining medical attendance during emergencies caused by Cardiac arrests, strokes,
etc. including intensive care at Hospital or nursing home or residence, visits by specialists, special
nursing, routine and special pathological, radiological and other tests / exams etc. shall be reimbursed in
full except diet charges and the limits set out elsewhere in these rules shall not apply.

The cost of post-emergency treatment will however be governed by the normal rules.
The cost of replacement of valves and installation of pace makers if considered essential by the
Cardiologist shall also be reimbursable.

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8.7 Post-operation treatment of Kidney donor:

8.7.1 In case of kidney transplant, apart from the reimbursement of expenses incurred towards the
treatment of the patient as per rules, the expenses incurred on a prospective kidney donor, who is legally
allowed to donate his kidney, will be reimbursable as follows:

i. The immediate one time post-operative expenses incurred.

ii. The bonafied expenses incurred for conducting prescribed tests for checking on the suitability of
the prospective kidney donor subject to fulfilment of the following conditions:

a. the tests are prescribed by the A.M.A. in respect of the recipient employee, at the hospital
where the kidney-transplant operation is to be carried out, and
b. the payments are made to the said hospital.

Under no circumstances, will the 'donation' of the kidney be reimbursed. The reimbursement on item
No.(i) and (ii) above will be approved by the Headquarters.

Permissible expenses incurred for conducting prescribed tests for checking the suitability of kidney
donor/one time hospitalisation of donor etc. shall cover all legally permissible donors, i.e., living donor,
donation from 'deceased person' or 'brain stem death' cases under the Transplantation of Human Organs
Act 1994 as per the legal procedure followed under the Act.

8.7.2 Reimbursement of TA expenses in respect of a donor in case he/she has to go outstation

alongwith the patient to donate his kidney will also be permissible as per the TA entitlement of the patient.
The TA to the donor shall however, be admissible only in the eventuality of the donor donating the
Kidney. If the donor and the donee can not travel together after surgery with a common escort, the
Competent Authority on satisfying himself on compulsions of a separate travel, may allow an
attendant/escort to the kidney donor provided the need is certified on medical grounds by the AMA.

The reimbursement on account of travel expenses of donor as well as attendant (wherever necessary)
shall be approved by Headquarters.

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8.8 Post-operation treatment of Liver donor:

In case of liver transplant, apart from the reimbursement of expenses incurred towards the treatment of
the patient as per rules, the expenses incurred on a prospective liver donor, who is legally allowed to
donate his liver, will be reimbursable as follows:

i. The immediate one time hospitalisation expenses incurred on donation of liver.

ii. The bonafied expenses incurred for conducting prescribed tests for checking on the suitability of
the prospective liver donor subject to fulfilment of the following conditions.

a. the tests are prescribed by the A.M.A. in respect of the recipient employee, at the hospital
where the liver-transplant operation is to be carried out, and
b. the payments are made to the said hospital.
Under no circumstances, will the 'donation' of the liver be reimbursed. The reimbursement on item No.(i)
and (ii) above will be approved by the Headquarters.

Permissible expenses incurred for conducting prescribed tests for checking the suitability of liver
donor/one time hospitalisation of donor etc. shall cover all legally permissible donors, i.e., living donor,
donation from 'deceased person' or 'brain stem death' cases under the Transplantation of Human Organs
Act 1994 as per the legal procedure followed under the Act.

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8.9 Reimbursement of medical expenses on prospective donor o f bone marrow for

Bone Marrow Transplant (BMT)

Apart from medical expenses incurred towards Bone Marrow Transplant (BMT) of eligible patient, the
expenses incurred on the prospective donor of Bone Marrow will be reimbursable as under:-

i. If the donor is self/blood relation covered under the definition of family under medical rules -
reimbursement for the donor would be allowed under normal rules, and

ii. If donor is other than blood relation(s) and not covered under the definition of family under
medical rules - the medical expenses incurred on prospective donor will be
admissible as follows : -

a. The immediate one-time hospitalisation expenses involved, if any, on

bone marrow donation.

b. The bona fide expenses incurred for conducting prescribed test(s) for
checking the suitability of the prospective bone marrow donor provided
the tests are prescribed by the AMA, at the hospital where BMT is to
be carried out.

Permissible expenses incurred for conducting prescribed tests for checking

the suitability of bone-marrow donor/one time hospitalisation of donor etc.
shall cover all legally permissible donors, i.e., living donor, donation from
'deceased person' or 'brain stem death' cases under the Transplantation of
Human Organs Act 1994 as per the legal procedure followed under the Act.

SECTION - IX

9. TRAVELLING ALLOWANCE FOR MEDICAL ATTENDANCE AND/OR TREATMENT AND

TRANSIT ACCOMMODATION:

9.1 Entitlement:

a. Employees or any member of their families requiring medical attendance / treatment shall
be entitled to travelling expenses only but not daily allowance at the rates and under the
conditions specified below for outstation journeys authorised by the Corporation and
 undertaken by them to obtain appropriate medical attendance from the nearest hospital /
nursing home etc. Reference to a outstation specialised Hospital/Institution would be
permitted only if the patient is suffering from serious ailments like, Heart disease, Brain
Tumor, Kidney problem, Cancer, TB, etc. For other ailments, the reference would be
restricted to the nearest place where adequate facilities for proper treatment are
available. Travel by air is not permissible to any employee and the T.A. rules in regard to
air travel shall not be applicable in these cases. However, please see Rule 9.1 a) (iii)
below:

i. For journey by rail:

Fare of the entitled class by rail as for the journey as on tour or the lower
class by which they actually travel. Actual bedding charges, Reservation
charges including Reservation charges under Tatkal Scheme shall also
be reimbursable.

ii. For journey by road:

For the road portion of the journey and / or his journey between stations
connected by road only, actual charges incurred limited to the
entitlement for journey on tour.

iii. For journey by air:

Travel by air to receive medical attendance under these Rules is not

admissible to any employee. However, the Competent Authority may
permit air travel in individual cases on the basis of medical advice,
provided he is satisfied that travel by any other means i.e. by rail or road
etc. would have definitely endangered the life of the patient or involved a
risk of serious aggravation of his / her condition.

iv. For journey by other means of conveyance:

If the patient travels by means of conveyance, other than those specified in these rules or by his / her
private conveyance, travelling allowance would be admissible to the extent otherwise admissible under
these Rules and the mileage will be regulated as per T.A. Rules.

b. In case the patient desires to have treatment at a place other than the one where he is
referred to by the AMA/CMO, he or she may be permitted to do so but no TA for to & fro
journey would be admissible for the patient as well as for the attendant, if any.

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9.2 Reimbursement of Ambulance Charges:

Employees will be entitled to reimbursement of charges paid for an ambulance used for their conveyance
or the conveyance of members of their families if it is certified as essential by the authorised medical
attendant.

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9.3 Rail Fare for an Attendant / Escort:

If certified by the A.M.A. that the patient requires an attendant / escort to accompany him / her to the
place of treatment, that escort will be permitted to accompany the patient in the same class or mode of
transport used by the patient and the actual fare incurred shall be reimbursable. It may be clarified that
the provision of the attendant / escort is admissible only where it is not safe / possible on medical grounds
for the patient to travel without the help of an attendant / escort on the specific certification by the CMO /
AMA. TA for an attendant shall not be admissible when a patient, who was earlier permitted to obtain
medical treatment at an outstation with or without an attendant, has to visit outstation for review of his/her
case, provided the patient is an adult and can move on its own. However, the Competent Authority in exceptional cases
on merits of each case may approve TA to the attendant of an adult female patient for review of her treatment at an outstation. (For
regulation of the T.A. for journeys in this connection, please see chapter on TA Rules in the Personnel Manual).

In the following cases two attendants may be permitted on merit duly supported by a certificate of
AMA/Specialist/Hospital who makes the reference, certifying the reason warranting the need of two
escorts to accompany the patient during the journey :

i. When the patient is an infant or baby (upto age of 2 years)

ii. When the patient is totally paralysed
iii. When the patient is in coma
iv. Acute Violent Schizo Phrenia(Mental Disorder with violent behaviour)

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9.4 Local Conveyance in Referred Outstation Cases:

If any employee or any of his / her member of the family is referred for outstation treatment by the
CMO/AMA, actual local conveyance charges for only, one trip from rail head / bus terminal / Airport to
Doctor's Clinic / Hospital / Nursing Home and back to rail head / bus terminal/Airport, irrespective of the
number of trips made at outstation or number of days of stay, shall be reimbursable.

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9.5 Transit accommodation at 4 Metropolitan Cities:

Transit accommodation will be available for use by the patients / escorts when referred for outstation
treatment to Mumbai, Kolkata, Delhi and Chennai, in addition to the accommodation lined up at Vellore.

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9.6 Death in Service:

The cost of transportation of the body and also fare for journey of the permitted escort will be borne by the
Corporation, in case of death of an employee on tour, undergoing treatment at other location on being
referred, or at the place of existing posting when the family is kept at the old place of posting.

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9.7 Death of Dependent:

The cost of transportation of dead body of the dependent patient referred to for medical treatment at out
station, is reimbursed limited to air / rail / road cost as the case may be subject to maximum cost incurred
by transportation by air between places connected by air and by rail in respect of places connected by rail
and by road in respect of places connected only by road subject to approval of Competent Authority.
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SECTION - X

10. RULES GOVERNING THE EMPLOYEES STAYING IN REFINERY TOWNSHIPS:

10.1 i) The Corporation runs its own hospital at the various townships attached to each Refinery. All the
employees residing in such Townships shall get medical attendance or treatment only from the
Corporation Hospital.

ii) This is to clarify that reimbursement of medical expenses in respect of dependent members of family
(other than parents) staying away from the employee may be allowed under the medical rules subject to
the employees obtaining prior permission of the Management for availing himself of the facility of
reimbursement of expenses on medical treatment of such members of the family at the place of their stay.
Such reimbursement will be in accordance with and subject to the Medical Rules as modified / clarified
from time to time.

iii) It is also clarified that some times employee and / or their families required to avail themselves of
medical facilities at the refinery hospital have to be away from their place of posting for short duration to
places where there are no hospital owned/approved by the Corporation. They should normally avoid
taking specialist treatment during such stay at outstation. In case specialist treatment on a reference
made by the local authorised medical attendant has to be obtained by them it should be for emergency
cases only like, myocardinal infraction, intestinal obstruction (operated), Intestinal perforation (operated).
The reimbursement in such cases may be permitted by the CMO where he is satisfied that such a
specialist treatment was absolutely necessary and could not have been avoided.

iv) However, where an employee avails himself of treatment in other than emergency cases as explained
above the reimbursement will have to be regulated as in a non referred case.

v) The authorised medical attendant in respect of employees staying in the township will be the Chief
Medical Officer attached to the Refinery Hospital.

vi) If any medicine or alternative medicine is not available in the Refinery Hospital, the employee can
purchase the same on the advice of the Medical Officer if authorised by CMO, to issue prescriptions for
purchase of medicines from outside and CMO need not counter sign each and every prescription for such
purpose where treatment is administered at our own hospital / dispensaries. Where a medicine is not
available in India and has essentially to be procured from outside the country because the prescribed
medicine or another indigenous medicine of equal efficacy is not available, normal approved channel for
procuring it should be followed.

vii) Since facilities for indoor treatment and surgical operations also exist in all the Refinery Hospitals,
the patient can be referred to outside Hospital by the Chief Medical Officer only in cases where treatment
cannot be had in the Refinery Hospitals. In cases referred by the Corporation's Chief Medical Officer for
Specialist treatment by a Specialist / Institution / Hospital by name for medical attendance / treatment
outside the Corporation's Hospital, the actual cost of treatment if room within entitled limit was not
available including all medicines prescribed would be reimbursed on production of proof thereof and
certification by the CMO. In such cases while the limits for operation charges etc prescribed under the
rules will not be applicable, the ceiling rates prescribed for room charges, under non-nominated category
will apply. Employees taking treatment outside refinery hospital without being referred by the Chief
Medical Officer, whether for specialist or normal treatment, will not be entitled to reimbursement. {See
Rule 9.1(b) also}
In Govt. hospitals or any other hospitals where operation and other charges are linked to the hospital
room charges, in such cases reimbursement of the various charges for operation / treatment etc. will be
limited to the charges as prescribed in the hospital i.e. linked to the room charges as per entitlement of
the employee.

10.2 Employees in the same station but staying outside the township may as far as possible avail of
the facilities available in the Refinery Hospital. They will, however, be entitled to have medical attendance
as stipulated in Section IV and V of these Rules subject to various conditions stipulated in these Sections.
Stipulations given in Sections I, II,III,VI to IX and XI to XIII, XV and XVI of these Rules will also mutatis
mutandis apply in respect of these cases.

10.3 (i) Rates charged by approved institute / laboratories / hospitals for diagnostic test (pathological /
radiological / bacteriological, etc.) shall be reimbursed in full in case CMO or the specialist to whom the
case has been referred makes a special reference to a particular Institute or Laboratories by name for
diagnostic purposes.

(ii) If an employee has a test done at an Institute or Laboratory other than the one which has been
approved by the respective refinery, reimbursement shall be limited to the rates of one of the approved
institutes / laboratories.

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10.4 Maternity cases:

In case of first delivery the choice of place may be given to the employee (employees staying in Panipat
Refinery Township may be given the choice of place to avail medical facility for second delivery also)
subject to his giving prior intimation to the Management about the same. Reimbursement of charges for
such delivery(ies) at the place of employee's choice should be made limited to the rates provided in the
Medical Rules as for a non referred case. For the subsequent deliveries the employee concerned should
avail the facility at Refinery Hospital.

10.5 The facility of Homoeopathic treatment is also available to employees posted at refineries where
the Corporation has its own hospitals / dispensaries and if they wish to avail of treatment under
Homoeopathic system, it is not necessary to obtain a "No objection" or a reference from the Company's
Medical Officer. However, at such places where the services of a Homoeopathic doctor is available at the
hospital, it would be necessary to obtain the ‘No Objection’ or reference from the Company’s Medical
Officer, for receiving treatment from any other Homoeopathic doctor.

10.6 CISF personnel who have to keep their families away, in case they are not provided housing
accommodation, should lodge their claims with the CISF authorities and claim reimbursement according
to rules applicable to them in their parent deptt. CISF authorities in turn will claim the amount of medical
expenses for reimbursement from IOC.

10.7 The Competent Authority in respect of units is the ED / GM.

10.8 When an employee is out of station on tour, LTC or regular leave, section X will not apply. He will
be entitled to have medical attendance (other than specialist treatment as referred to in 10.1 (iii)) as
stipulated in sections (IV) & (V) of these rules subject to various conditions laid down therein. Further
stipulation given in sections I, II, III, VI to IX, XI to XIII, XV and XVI wherever applicable, will also mutatis
mutandis apply in respect of such cases. Dependent children staying outstation for educational purposes
shall be entitled to medical reimbursement as given above.

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10.9 Medical Facilities for Freedom Fighters:

Freedom Fighters drawing Pension under the Freedom Fighters Pension Scheme, upon establishing as
such, will be entitled to free medical facilities as available in the Refinery Hospitals run by the Corporation
in the Refinery Townships. This facility will be available to those who are residing in the Refinery
Townships and staying as dependents of IOC employees even though they do not come in the category
of "dependent Parents" under the normal rules.

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SECTION - XI

11. MEDICAL EXPENSES INCURRED IN FOREIGN COUNTRY WHILE ON TOUR ABROAD:

11.1 Reimbursement of medical expenses incurred by an employee while on official tour outside India
will be made only under the orders of the Chairman.

An employee (this term for the purpose of these orders does not include any member of the family) on
official tour outside India will be entitled to medical attendance and treatment for illness (i.e. any physical
or mental condition) which actually incapacitates him from the performance of his duty while on tour
abroad. These facilities will be admissible during the actual period of tour outside India including the time
spent in transit from India to the place of tour abroad, and back to India.

11.2 The concession will not be applicable to chronic ailment acquired during service in India and which
are of such a nature as not to have prevented the employee from going on tour and for which he seeks
medical aid or advice while abroad. Acute exacerbations and complications of chronic ailments will,
however, come under the category of incapacitating ailments for which medical benefits will be admissible
while abroad.

11.3 The norms to be followed in reimbursing expenses on medical attendance while on tour abroad will
be more or less the same as adopted by Government of India for its employees posted abroad at the
same or nearby Stations. Such medical attendance and treatment will not exceed in quantum what is
ordinarily admissible to the employees under these Rules in India.

11.4 At places where the Government of India have appointed a 'contract' or 'approved' doctor or a
panel of 'approved doctors' under the Scheme of Medical Attendance for the Government of India's staff
serving in Missions / Posts abroad, the 'contract', 'approved' doctor or one of the 'approved' doctors, will
be the authorised medical attendant for the Corporation employees on tour abroad. In other places where
'contract' or 'approved' doctors or panel of 'approved doctors' have not been appointed, the choice of the
doctor will be left to the leader of the delegation in which the employee of the Corporation on tour is
included or to the employee of the Corporation himself if he himself is the leader. Similarly, in locations
where the Head of Indian Mission / Post has entered into an agreement with a selected Hospital for
hospitalisation of personnel employed in the Mission, the employee of the Corporation on tour will
undergo hospital treatment, if necessary, at the selected hospital.

11.5 In all cases, the employee of the Corporation concerned should first meet all medical expenses
himself, and only then claim reimbursement to the extent admissible. However, having regard to problems
of obtaining Foreign Exchange for payment, the Corporation may arrange remittances as advances to the
employee.

11.6 Claims for reimbursement admissible on this account should be accompanied by:
 a. receipted bills containing full details of the payments made separately for medical advice,
treatment, hospitalisation, cost of medicines etc. ; and
b. a certificate from the medical attendant stating the nature of the ailment and certifying
that the treatment was undertaken and the charges incurred with his advice and
approval.

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SECTION - XII

12. MISCELLANEOUS:

12.1 Time Limit for Medical Claims:

Submission of medical bill(s) by employees for claiming reimbursment may be allowed only if, cumulative
or otherwise, the bill amount exceeds Rs.1000/- and in case the bill amount(s) do not exceed Rs.1000/-
then the same may be allowed to be claimed only after one month of the bill date(Ref. CR No.06/2014
dated 26.02.2014).

Claims for reimbursement of medical expenses incurred by an employee in respect of a particular spell of
illness for treatment from an AMA / Specialist or Hospital / Nursing Home treatment shall be preferred
within three months from the date of incurring the expenditure. Medical claims preferred after prescribed
time limit of 3 months may only be approved upto a further period of 3 months by the Competent
Authority. Medical bills which are more than 6 months old shall not be processed unless in exceptionally
rare circumstance(s) upto a maximum of one year of the bill (Ref. CR No.28/2012 dt.07.11.2012). Medical
bills beyond the period of one year but upto an extended limit of 2 years of the bill can be considered for
reimbusement only on merit of hte case with the approval of the Functional Director(Ref. CR No.06/2014 dated
26.02.2014)

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12.2 Discretionary Powers:

Chairman and Functional Directors shall have discretionary powers to allow in deserving cases
reimbursement of expenses incurred in connection with the medical treatment which is not otherwise
covered under these rules, in respect of an employee, his / her member of family upto the limits specified
below :

Chairman Exceeding Rs.2 Lakhs and upto Rs.5 Lakhs in each case

Functional Directors Upto Rs.2 Lakhs in each case

(Ref. DP/2/8/A/83 dt 23.12.13)

These powers cannot be sub-delegated.

Discretionary powers under this Rule shall not be exercised by the Functional Directors in respect of their
claims and in their own cases the claims would be put up for approval under the discretionary powers of
the Chairman. In respect of the Chairman, approval of the Board is required.

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12.3 Hospitalisation of an Employee for an Injury Arising out of and in the Course of
Employment:

In respect of above cases, the entire cost of treatment including the charges incurred on transportation of
the injured employee from place of work / accident to the hospital and back to residence shall be borne by
the Corporation. Such treatment should as far as possible be arranged by the Corporation. In such cases
even the diet charges as prescribed by the attending doctor during hospitalisation will be reimbursed in
full.

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12.4 Advance against Medical Expenses Applicable to all Stations in India:

Medical advance against medical expenses shall be payable provided the estimated expenditure as
certified by the AMA (Allopathic) for the said treatment is more than Rs.3000/- . Such advance will be
limited to the estimated charges subject to a maximum of Rs.15,000/- for staff and Rs.20,000/- for
Officers.

In case of hospitalisation treatment to be undertaken in a nominated hospital and when the expected
expenditure as certified by the AMA is likely to be beyond Rs.3000/- prior to hospitalisation in the
nominated hospital, the request of an individual for grant of medical advance may be approved on the
merit of each case. The approving authority at the Units shall be the HR Head and in Divisional Hqrs, the
approving authority shall be the HR Head. (Ref.CR No.12/2013 dt. 15.05.13)

In case, however, the advance is not utilised for the treatment for which it has been drawn or the balance
amount, if any, has not been refunded within the permissible period of two months from the date of
incurring the expenditure, the defaulting employee shall be charged interest at the prevailing borrowing
rate of the Corporation plus 1% on the outstanding amount from the date of its withdrawal to the date of
refund in lump sum and the defaulting employee shall be debarred for grant of any advance / loan for any
purpose for a period of 5 years.

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12.5 Medico Legal Cases:

i. In a Medico-Legal case, it would be the responsibility of the attending Doctor / CMO to

inform the police and lodge FIR, if considered necessary, with the assistance of the
Administrative Officer attached to the Hospital.
ii. In so far as infighting between our own employees is concerned, it should be handled
under the CDA / Standing Orders applicable to the employees concerned in consultation
with HR Department of the Unit concerned.
iii. As regards suicide cases, all cases would be informed by the attending Doctor / CMO,
with the assistance of the Administrative Officer, to the police and referred to Civil
Hospital for further necessary action as required under law.

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SECTION - XIII

13. ADMISSIBLE PHYSIO-THERAPY TREATMENT:

Ceiling rates for reimbursement of expenditure on Physio-therapy treatment for single sitting are as
under:
 Sl. No. Treatment Maximum
charges (Rs.)

1. Shortwave diathermy 175

2. Intermittent Cervical or Lumbar traction 175

3. Ultrasonic exposure 175

4. Paraffin wax Bath 175

5. Hydrocoleator packs 175

6. Infra Red Exposure 175

7. Electric Stimulation 175

8. Remedial exercises 175

9. Remedial Massages 175

10. Speech & Language Therapy 175

11. Combinations of any two of the above 225

12. Combination of any three of the above 325

13. Combination of any four of the above 400

NOTE: It is clarified that where Physio-therapy treatment is taken in nominated hospitals, actual charges
for the same as charged by the nominated hospital may be reimbursed in full. However, reimbursement
shall be limited only to items as presently exist under the rules.

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SECTION - XIV

14. MEDICAL CHECK-UP FOR OFFICERS:

14.1 Officers of the age of 40 years or above are medically checked - up at regular intervals in the
manner indicated in Annexure (V) for initial medical check-up and Annexure (VI) for subsequent medical
check-ups.

14.2 The subsequent medical check-ups for Officers in Grade 'C' and above will be carried out annually
and in respect of those in Grade 'A' and 'B' once in three years.
14.3 (a)The Refinery hospitals will be responsible for the required medical check- ups of the Officers
posted at the Refineries.

(b) The Refinery hospitals will besides see to the medical check-ups of the other officers of the Division
posted at places other than the Refineries who may choose to get themselves medically examined under
these Rules at a particular Refinery hospital while on tour to the Refinery area.

14.4 The following Hospitals / Nursing Homes have been selected in each of the Metropolitan cities i.e.
Mumbai, Kolkata, Delhi and Chennai for conducting medical check-ups at the prescribed intervals for
officers posted there. Currently, the arrangement for such check-ups has been lined up with the following
hospitals:

Mumbai

1. Breach Candy Hospital

2. P.D.Hinduja National Hospital

Kolkata

1. Calcutta Medical Research Institute

Delhi

1. Holy Family Hospital

2. Batra Hospital & Research Centre
3. Noida Medicare Centre, Noida
4. Kailash Hospital & Research Centre, Noida

Chennai

1. H.M.Hospital
2. G.G. Hospital

In addition to the above, Escorts Medical Centre, Faridabad, has been nominated for medical check-up of
Officers based at Faridabad.

14.5 Officers going out of station for the purpose of medical check-ups are not to be paid TA/DA.
Officers can however get themselves medically checked-up whenever they visit in connection with some
other official business at a station / unit where the Company has made arrangement for such check-ups.

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SECTION - XV

15. DIET CHARGES AT REFINERY HOSPITALS: (IOM No.P/P/3(Rules) dated 18.4.2011)

i. The diet supplied to employees and their eligible dependents (as per Medical Rules) in
the Refinery hospitals will be charged at the rate of Rs. 50/- per day per patient for all
employees.
ii. Diet charges in respect of Non-entitled patients may be revised at respective Units
keeping in view the actual amount that is being incurred on providing the same.
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SECTION - XVI

16.1 PREVENTION OF ABUSE OF FACILITIES:

To avoid misuse of the reimbursement under liberalised Medical Rules, the following measures are
reiterated:

i. The Controlling Officers are expected to exercise a great vigil in scrutinising the medical
claims for reimbursement without making the staff feel that they are being subjected to
harassment.
ii. The Management at its discretion shall have the right to demand the employee to show
the medicines for physical verification. The Management would also have the right to go
to the residence of the employee to have the physical verification of the medicines
purchased in doubtful cases.
iii. The Management shall have the right to refer medical expenses claims including asking
the patient for examination by Doctor-in-attendance / by any other doctor nominated by
the Management to find out the genuineness of the claim. The Doctor's opinion shall be
binding on the employee.
iv. In case the employee or his eligible family member is hospitalised, the employee should
immediately notify the Management. In doubtful cases, the Management can verify the
genuineness of the hospitalisation.
v. In cases where the medical reimbursement bills are considered to be of not genuine
nature, such bills alongwith prescription shall be referred to CMO / nominated doctor of
the Corporation for a second opinion and if a claim is found to be inflated or not of
genuine nature by the CMO / nominated doctor, the claim shall be rejected in its entirety
apart from initiating such action as the Management may deem fit.
vi. If bills for reimbursement are too frequently received from an employee or if bills are of
large amounts, such bills shall be subject to investigation by the Management followed by
necessary further action as deemed fit by the Management.
vii. At any point of time in any particular case, the Management shall have the right under the
Medical Rules to insist on the employee to obtain medicines either from a chemist
nominated by the Corporation or from the Super Bazar.
viii. In case the Management feels that the reimbursement claimed by a particular employee
for treatment taken from a particular doctor was not of genuine nature, the Management,
at any point of time, shall have the right to insist on the employee concerned to take
medical treatment only from a doctor nominated by the Management.
ix. In case of claims of dependent parents, the Corporation shall have the right to verify the
bonafides even including physical verification / visiting the residence of the employee.
x. Management may also consider appointing a panel of doctors / chemists at different
locations for purpose of medical treatment / purchase of medicines by the employees of
that location.
xi. Where in the course of scrutiny, instances of employees who appear to be availing
themselves of the facility of reimbursement fraudulently come to notice such cases
should be dealt with as under :

a. Petty cases may be dealt with departmentally.

b. Where there are grounds to suspect that false claims are being
submitted habitually or which are otherwise considered of special
significance, such cases should be referred for investigation to the
Vigilance Department.
 xii. In cases where the guilt of an employee is proved, the disciplinary authorities are
expected to impose deterrent punishment upon the erring employee.

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16.2 CONTROL MEASURES IN MEDICAL FACILITIES:

a. The monthly cumulative medical bill of an employee on domiciliary treatment for an

amount of Rs.4500 or more shall be signed by HOD in Gd ‘E’ & above. At field
locations/Units, where Head/In-charge is in Grade ‘D’, such bills may be signed at his
level. In case he is below Grade ‘D’, such bills will be signed by an officer in Grade ‘E’ or
above at the next higher reporting location.
b. As and when, the cumulative medical claim of an employee for domiciliary treatment
exceeds Rs.6000 in a quarter (i.e.Rs.24000 in a financial year), in case of Ref. Units,
such bills are required to be approved by the Head of the Unit. At other places, the same
is to be sent to the next higher location for approval. In case of HQ, such bills would be
approved by Divisional HR Head.
(Ref. P/P/3(Rules) (CR No.06/2010) dt. 04.02.2010]

The expenses on domiciliary treatment obtained in a Nominated Hospital including

Consulting Fee, Investigation Charges, Medicines purchased on the prescription of the
AMA from the Nominated Hospital/Company’s Doctor/Consultant, cost of any
Pathological/Biological/Radiological Investigation obtained outside a Nominated Hospital
exceeding Rs.1000 per Investigation, immunization charges, cost of Spectacles and
Hearing Aids, shall not be included in the overall ceiling of Rs.4500/Rs.24000 for the
purposes mentioned at (a) & (b) above.

c. Reimbursement claims for domiciliary treatment including domiciliary treatment obtained

in Nominated Hospitals exceeding Rs.12500 in a quarter (i.e. Rs.50,000 in a year) would
be placed for scrutiny of a Standing Committee comprising of representatives from HR,
Finance and Medical (wherever feasible). The outcome of the scrutiny will be presented
in the Local Management Committee Meetings regularly.
d. Where the cumulative expenses of an employee for domiciliary and indoor treatment
including treatment obtained in a Nominated Hospital exceeds Rs.25000 in a quarter (i.e.
Rs.1.00 lac in a financial year), his claims shall be placed for scrutiny of the Standing
Committee as at (c) above. The outcome of this scrutiny shall also be presented in the
Local Management Committee Meetings regularly.
e. To verify the actual duration of hospitalisation, the discharge summary/report in all
hospitalisation cases in non-nominated hospitals should be enclosed by the employee
along with the medical claim.
f. The hospital bills (for model/nominated/non-nominated hospitals) at the time of discharge
of the patient should be signed by the employee or the patient or by one of the dependent
family members. Where the patient/dependent family member signs the bill, the name
and the relationship with the employee should be clearly written. In case of difficulties in
getting the signature at the time of discharge, the bill should be signed by the employee
at the time of its submission. The bills received by the office directly from the nominated
hospitals without signature, shall also be got signed from the employee before these are
processed for payment.
g. Where there is a prima-facie evidence of misuse of the medical facility, each such case
may be referred to Vigilance Deptt. after due approval of CVO as per laid down
procedure for reference of cases to Vigilance.

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 SECTION - XVII

17. PROVISION OF MEDICAL FACILITIES TO EMPLOYEES' RELATIONS NOT COVERED BY THE

TERM 'FAMILY' AS DEFINED IN MEDICAL RULES AND SPECIAL GROUPS AMONGST
EMPLOYEES: [Ref. CR No. 08/2011) dated 07.03.2011]

17.1 i. Medical treatment may be allowed from the Refinery dispensaries to even such persons staying
with the employees in the refinery township as may not be covered by the term 'family' under medical
rules.

ii. The term "relation" may be interpreted liberally to include distant relations, occasional
guests and friends of employees who while staying with the employees concerned fall ill.
In case, however, there is clearly a case of abuse of this facility, the matter should be
suitably dealt with by the local management.
iii. Admission of such persons to the Refinery Hospital can also be permitted in
emergencies.
iv. Ambulance services can also be made available whenever it is possible to spare a
vehicle which will be charged at full rates prescribed for private use of a similar type of
vehicle for the employee.
v. The charges for the various types of medical facilities that may be provided to non-
entitled patients are as under :-

Item Revised rates (w.e.f. 15.03.2011)

1. All Surgeries or surgical and diagnostic 25% of applicable charges in Semi Nursing
procedures and treatment (blood Home of Sir Ganga Ram Hospital, New Delhi
transfusion, infusion, physiotherapy etc.) (as per SOR effective 01.04.2010)

Treatment may include Nebuliser, Oxygen

therapies and dressing also.

2. Anaesthesia charges 25% of surgical charges as at Sr. No.1

3. All pathological and radiological 50% of applicable charges in Semi Nursing

diagnostic procedures, investigations Home of Sir Ganga Ram Hospital, New Delhi
(as per SOR effective 01.04.10)

In case of any hospital having outsourced

Pathological, Radiological diagnostic
procedures/ services, the same may be
charged as per actual.

4. Consultation -out patient Amount reimbursed to regular employees

under Allopathic system in non-metro cities
(i.e., Rs. 80/-)

20% extra for consultation in case of specialist.

5. Consultants called from outside for To be borne by the patients as per actuals
surgical, anesthetic, medical or any other
consultation
 6. Daily indoor stay charges (without diet)

Ward Bed entitlement for workmen - Grade I-VII in

non - nominated hospitals in Eastern Region
(other than Metro cities) ( Present rate- Rs.475/
per day)

Cabin Bed entitlement for officer-Grade `A' in non -

nominated hospitals in Eastern Region (other
than Metro cities) ( Present rate – Rs.830/- per
day)

ICU Same as Cabin + nursing charges at actual, if

nurse is deputed exclusively for ICU.

7. Injections and medicines To be purchased directly by the patients.

In case of emergency, the same may be

supplied by hospital, if available, at cost +10%.

Note: For working out the charges for items at Sl. No. 1 to 3, the charges of Sir Ganga Ram Hospital,
New Delhi which are effective from 1.4.2010, are to be taken

 A ‘Request-cum-undertaking’ proforma has been introduced, to be obtained from the concerned

employee seeking treatment for his/her relative from Refinery hospital and undertaking to pay the
charges incurred towards treatment of non-entitled patients (Annexure-A). In the eventuality of
employee, being on duty or not being available at Station, the dependent of the employee may
accompany NEP and provide his details required to be filled in the proforma along with photocopy
of Medical Book cover page consisting the details of the dependent, on the basis of which
treatment may be extended. However, employee would subsequently be required to sign the
Request-cum-Undertaking proforma. A copy of Request-cum-undertaking may be kept at Hospital
for records.
 Recovery of charges towards various types of medical treatment/facilities, i.e., consultation,
investigations, supply of diet, IPD treatment etc. may be made from the salary of respective
employee, whose relative has availed treatment. In case the amount is not recoverable from
employee’s salary, the concerned employee may remit the additional charges through
DD/Cheque drawn in favour of IOCL with the approval of Medical Head of the Unit, in the same
month during which treatment has been availed or in the immediate next month

Record for the treatment facilities provided and charges recovered may be maintained. For the purpose, a
proforma, i.e., NEP case-bill has been introduced which units may like to use/modify as per their
requirement(Annexure-B).

 In case of surgical procedures in respect of NEPs, consent from employee (relative of NEP) for
surgical procedures may continue to be obtained and kept on record.

Annexure-A

(To be filled in duplicate – a copy to be kept in hospital for records in seriatim)

S. No._________ Date:

DGM(Medical)/Chief Medical Officer

IOCL
____ Refinery Hospital

REQUEST-CUM-UNDERTAKING FOR AVAILING TREATMENT BY NE PATIENT

Sir,

I hereby request you to allow Mr./Ms. ___________________ (name of the patient), my

_________ (relation), presently residing with me to avail treatment from Refinery
Hospital.

I undertake to pay the amount incurred for his/her treatment as per rules of the
Corporation. I hereby authorise Medical Department to raise the bill and advise Finance
Department to deduct the amount from my salary towards the treatment and other
charges for my relative’s treatment at Refinery hospital.

Signature of employee

Name______________

Emp.No.___________

Dept. ______________

Contact No.__________

Annexure-B

NON-ENTITLED CASE – BILL

DATE:

NAME OF PATIENT: ___________________________________ AGE: _______ SEX: _____

EMPLOYEE’S NAME: ________________________ EMP.NO.__________ DEPT._____________

DESGN:__________________ RELATION WITH THE PATIENT: ______________

ADDRESS: _____________________________________CONTACT NO._______________

A. CONSULATION CHARGES:
TOTAL NO. OF CONSULTATION/VISIT : ________ CHARGES : Rs.________/-
B. INVESTIGATION CHARGES:
S.No. Test done Date Cost
1 X- Ray
2 Sonography
3 ECG
4 Laboratory examination
(a)
(b)
(c)
(d)
5 Any other test

C. DRESSING CHARGES: _____________

D. INJECTION CHARGES: ______________

E. MEDICINE CHARGES:
S.No. Name of Medicine Quantity Cost

Rs. P.

F. SURGICAL PROCEDURE/TREATMENT CHARGES: ______________________

a. Type of Procedure/Operation
b. Date of Operation
G. ANAESTHESIA CHARGES ___________________________

H. INDOOR STAY CHARGES:

[
____________________________

a. Date of Admission
b. Ward/room
c. Date of discharge
I. DIET CHARGES (IF PROVIDED): _______________________________

J. ANY OTHER CHARGES (PL. SPECIFY) ________________________________

TOTAL CHARGES (A TO J) Rs. ________________________

Prepared by:

Sister-in-charge

Hospital Admn. Officer

CMO

Finance

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17.2 Medical facilities to special groups amongst employees and others:

i. Re-employed pensioner:

The rules applicable to regular employees shall equally be applicable in

the case of re-employed pensioners.

ii. Deputationists:

The medical facilities to the deputationists will be as per the terms of

deputation agreed to by the corporation. However, ordinarily
deputationists will be governed by the rules of the corporation in this
respect.

iii. Apprentices engaged under the Apprentices Act, 1961:

Apprentices are to be provided medical facilities available at our

hospitals / dispensaries free of cost. This facility is not extended to their
families.

iv. Employees of the Marketing Division:

Charges for medical facilities provided to the employees of the Marketing

Division are to be based on total cost per year of the provisions of the
said facilities to be divided by the total number of personnel at respective
units entitled to the said facilities and recoveries proportionate to the
number of personnel of the Marketing Division should be effected
annually from them, provided the total annual liability of the Marketing
Division is not less than Rs.1000/-

v. Domestic servants of employees:

The domestic servants of employees posted at refineries have been granted the facility of availing
ordinary medical treatment on payment of a medical fee of 25 paise per head per day for treatment at the
dispensaries. (They can also get medical aid during emergencies - like accidents).

The ordinary medical facilities will include treatment for casual ailments, but exclude treatment by
specialist, hospitalisation, surgery, laboratory investigation, maternity services, administration of costly
injections and such other medical treatment as may be determined by the Management from time to time.

Outsiders:

a. Central Excise Staff and their "families" have been allowed the
following medical facilities:

i) outtation: Free

ii) Medicines:

A charge of Re.1/- per person per visit if medicines costing 90 paise or less are supplied. If the cost of
medicine at a time clearly exceed 90 paise the actual cost plus 10% thereof to cover overheads.
iii) Injections:

The administration of injection is free. A charge of Rs.1.50 per injection towards cost, if the cost is
Rs.1.37 or less. Otherwise the charges would be the cost raised by 10%.

iv) Expensive Injections / Medicines:

The prescribed injections and medicines are to be purchased directly by the patients. However, in the
case of an emergency, there is no objection to the hospital supplying these, if available, at cost plus 10%.

v) Hospitalisation:

Recoveries at the same rates as for relation of employees not covered by the term "family" under the
medical rules.

b) Railway Staff:

The Railway Board do not want that any medical facilities be extended to the Railway staff and their
families, since they have their own arrangement.

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