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2006 DIGILAW 2626 (RAJ)

Rajesh Kumar v. State of Rajasthan

2006-09-04

GOVIND MATHUR

body2006
Judgment Govind Mathur, J.-The petitioner while on official duty at Delhi on 06.07.2002 suffered with severe heart ailment and was immediately taken to Escort Heart Institute and Research Centre. After Angiography the petitioner was advised to undergo immediate Coronary Artery Bypass Grafting (CABG) with Trans Mycardial Revascularisation (TMR). The advised treatment was taken by the petitioner and for the purpose expenses in a tune of Rs. 2,31,221/-incurred. The petitioner made a claim for reimbursement from the respondents, however, under an order dated 16.05.2003 only a sum of Rs. 55,000/-was sanctioned against the expenses incurred for bypass surgery. 2. By this petition for writ a direction is sought by the petitioner to reimburse the entire amount incurred in bypass surgery. 3. The stand of the respondents in reply to the writ petition is that according to Rule 7 of the Rajasthan Civil Services (Medical Assistance) Rules, 1970 an amount beyond sum of Rs. 55,000/-could not be given to the petitioner as he get himself treated in an institution other than All India Institute of Medical Sciences, New Delhi. 4. The issue involved in present writ petition has already been decided by Division Bench of this Court in the case of Shankerlal vs. The State of Rajasthan & Ors., reported in 2000(3) WLC 585 (Raj.). holding as under:- “27. While considering the contention of the respondent State that the petitioner ought to have availed medical treatment at AIIMS at Delhi or obtained certification required under Rule 7(1) from any medical officer from AIIMS by treating him to be authorised medical attendant in terms of Rule 6(2) who could certify necessary vouchers. It is apt to recall following observations of a Division Bench of Punjab & Haryana High Court in C.W.P. No. 13493/92 titled as Sadhu R. Pall vs. State of Punjab, decided on 010.1993 quoted with approval by the Supreme Court in Surjit Singh’s case (Supra):-“The respondents appear to have patently used excuses in refusing full reimbursement. When the factum of treatment and the urgency for the same has been accepted by the respondents by reimbursing the petitioner the expenses incurred by him, which he would have incurred in the AIIMS New Delhi. We cannot loose sight of factual situation in the AIIMS New Delhi i.e., with respect to the number of patients received there for heart problems. We cannot loose sight of factual situation in the AIIMS New Delhi i.e., with respect to the number of patients received there for heart problems. In such an urgency on cannot sit at home and think in a cool and calm atmosphere for getting medical treatment at a particular hospital or wait for admission in some Government medical institute. In such a situation, decision has to be taken forthwith by the person or his attendants if precious life has to be saved.” This is complete answer to above contention. 28. There are two decisions of the Rajasthan High Court referred by the learned Single Judge in Khuman Singh Mehta vs. State of Rajasthan & Ors, 1996 WLC (UC) 61, and Shyam Singh vs. State of Rajasthan & Ors., 1996 (2) WLC 441, wherein this Court issued a direction to reimburse the medical expenses incurred for securing medical attendance for special deseases outside Rajasthan in like circumstances for the reason that there was no facility of treatment of the disease from which the petitioner was suffering, in the State of Rajasthan are in consonance with above principles and cannot be distinguished. In fact, present case is in better footing inasmuch as the person needing medical treatment has been taken ill and needed such medical attendance while outside Rajasthan and at a place where specialized treatment for her ailment was available at an approved Institution recognised by State of Rajasthan in that behalf . 29. The ratio of these decisions fully applies to the facts of the present case wherein while the petitioner was in Delhi on leave, his wife suffered heart problem and was immediately taken to Escorts Heart and Research Centre, Delhi, which is recognised Hospital for specialised treatment by the State Government, where his open heart surgery was made. Thus, it is clear that Escorts Heart and Research Institute is one of the recognized Hospital for specialized treatment, there is not escape from the conclusion that the State Government is liable to reimburse such expenses without insisting for certification form the authorised Medical Attendant or other Competent Officer, when such a facility was not available in the State of Rajasthan. The claim could not be denied on the ground that because the petitioner instead of waiting in queue and spending time in seeking a clarification from a local hospital has decided to act with promptitude in the interest of self preservation by taking his wife immediately to an institute approved by the State Government 30. Beforeclosing we may notice one ancillary contention raised on behalf of respondent. It was stated that about diagnosis for treatment and certifying expense vouchers, no Doctor of Escorts health Centre could be considered as Authorised Medical Attendant. The argument appears to be fallacious and founded on ignoring the distinction between function of certifying a patient to be taken to an approved hospital or institution outside station for treatment and certifying the disease for which the patient has actually treated and medical attendance and treatment actually made available to such patient. So far as the treatment given at any approved institution or for that matter by any medical attendant is concerned, it follows his own diagnosis and prognosis. Actual treatment does not follow on the certificate issued under Rule 7(1). It depends on patient being examined at the hospital or institution where he is attendant for such treatment. The treatment or medial attendance made available at such institution follows assessments and diagnosis made at or at the instance of such hospital/institution. It is only on such assessment by the treating agency that treatment follows. Therefore, medical attendance at only such institution can certify about the decease with which the treated patient suffered and treatment rendered at such institute as indoor/outdoor patient. The medical attendant of other institution or hospital in such circumstance puts his counter signatures only for the purpose of authenticating it in accordance with rules. However, such counter signing by the authenticated medical attendant cannot be by itself take the place of primary proof of diagnosis and treatment rendered by approved hospital or institution at which patient was attendant to. Cases are not wanting where notwithstanding certification by the prescribed authority under Rule 7(1), the approved institution has on their own assessment has found otherwise. However, such counter signing by the authenticated medical attendant cannot be by itself take the place of primary proof of diagnosis and treatment rendered by approved hospital or institution at which patient was attendant to. Cases are not wanting where notwithstanding certification by the prescribed authority under Rule 7(1), the approved institution has on their own assessment has found otherwise. Therefore, denial of reimbursement of expenses incurred on medical attendance and treatment bona fide and genuinely by the public servant for availing treatment for himself or any member of his family at recognised hospital/institution in the circumstances like the present case on such technical grounds shall be clearly arbitrary, unreasonable and unjust. The required formalities of counter signing the certificate/vouchers issued by such institutions can always be cured by obtaining appropriate counter signatures from the competent officer under the rules and in the absence of doubt genuiness of such certification, such authority will not be justified in refusing to countersign without satisfying his doubt.” 5. In the instant matter also the petitioner suffered severe cardiac ailment while on official duty at Delhi and he was immediately taken to Escort Heart Institute and Research Centre and was treated there. In view of Division Bench Judgment of this Court in the case of Shankerlal (Supra), the petitioner is entitled for reimbursement of the entire medical expenses. 6. Accordingly, this petition for writ is allowed. The respondents are directed to reimburse the entire expenses incurred by the petitioner for his treatment at Escort Heart Institute and Research Centre, New Delhi as certified by the said hospital.